Ritalin, Adderall, Dexedrine and other medications used to treat Attention Deficit Hyperactivity Disorder all have a potential for some side effects.  Obviously we want to place the child on this medication only if he or she is going to be helped by it.  To do this, we give the medication on a trial basis for two weeks, and compare it with another two week period when the child is taking a placebo (fake medicine).  This is called a blinded cross-over trial, which means that neither the child, nor the teacher will know which, if any, medication the child is taking.  At this point, we prefer that your child and the teacher not know in advance that your child will be on any medication.  Tell your child that you will be trying them out on a new 'vitamin'. We prefer that you tell the teacher nothing at all in advance. Some teachers object to this, insisting that they need to know such issues so that they can observe the child for changes.  In our experience, however, well-meaning teachers will often over-watch the child and thus fail to be impartial in their reports to you. You, the parent, will also need to be as honest and impartial as possible. 

You will be given a prescription for a two-week supply of the active medicine.  Exactly which one will depend on the medicine selected by the doctor based on your child's characteristics. Give this first pill to your child each morning after breakfast for the first two weeks (weeks 1 and 2), both on school days and weekend days. Do not open the container in front of your child -- simply put the pill out for them to take. Be sure to watch them actually swallow the medicine, but try not to make a fuss about it.

Observe for effects of this medicine in your child. You will be the one to take note of differences on the weekend days, and also any remaining effects when your child returns home from school.  You might see the intended effects of increased attention span and less frustration and less hyperactivity.  But some children simply become quiet and observant of their surroundings.  Then again, you might not notice any difference at all. We want you to note not only the effects of the medication, but also how long the effects seem to last in your child.  We want you to note any side effects and any other things that you consider a problem.  Most children have at least some stomach ache and decreased appetite. Of course, call us if you notice any worrisome side effects.  Be sure to ask you child about their day in detail and try to get a sense of how you child felt on the medicine, both the good and bad. After using all of the first bottle of pills, only then ask the teacher how the child did at school during the previous two week period.  Try to ask about changes in concentration, work completion, disruptiveness, etc. 

The next two weeks (weeks 3 and 4) will be the crossover period during which time your child will take an inactive 'fake' medicine known as a placebo. Placebos are, believe it or not, very difficult to obtain from any source.  You'll need to be inventive and find a small tablet of saccharin or other food item in a pill form.  Even a small vitamin tablet will do as the 'fake medicine'.  Give this pill to your child each morning after breakfast for the next two weeks. Again, do not open the container in front of your child, simply put the pill out for them to take. If your child inquires about the different appearance of the pill, simply describe it as a different brand name of the same vitamin.

Once again, you'll need to observe for the effects of the placebo in your child. Some children may do quite well on the fake medicine, simply because they want so much for it to help. We want you to note any side effects and any other things that you consider of interest.  Be sure to ask you child about their day in detail and try to get a sense of how you child felt on the medicine. After using all of the second bottle of pills, only then ask the teacher how the child did at school during this previous two week period.  Try to ask about changes in concentration, work completion, disruptiveness, etc.  And, again, you will be the one to take note of differences on the weekend days.

At the return appointment in 5 or 6 weeks we'll discuss the results and make a decision with you as to whether continuing or adjusting the medicine would be in the best interests of the child.