To what degree should your child's restless behavior and wandering attention be “controlled” through the use of medication? That is the question increasingly raised by parents and teachers in response to a growing population of children who are often inattentive, easily distracted, extremely impulsive, or constantly on the move. In any of these cases, such children prove difficult to “control” for the adult powers that be.

Why Medicate?

Unhappily, medication seems to be becoming the first resort, not the last, in many of these cases. Ideally medication would be given only after a host of other helping and self-management strategies have been given a fair try. The medication — usually psychostimulants — can in some cases slow impulsiveness and the tendency to be distracted and increase the child's ability to follow directions and remain focused on a single task.

On the positive side, many medicated children (as well as concerned adults) will report an improved ability to control impulse, to comply with directions, and to concentrate on tasks, which results in fewer cases of getting in trouble (with teachers, parents, or whoever may be in authority). In this sense, life with the ADD/ADHD child becomes easier and less troublesome for adults. For the child, as his disruptive behavior subsides (and more boys than girls are “diagnosed” with these disorders), his treatment by the adults around him improves.

But what you must consider as a parent is whether this increased compliance at home and at school is really what your goal should be with these children. Do you want to just adjust children's behavior with medicine to fit adult needs for conformity and control? There are other options.

To medicate or not to medicate your overactive or inattentive child may be the question you face as a parent. Although the research jury is still out on this, your answer needs to consider the possibility that by establishing some degree of dependency on a stimulant drug to manage her behavior now, you may affect her susceptibility to self-medicating with recreational drugs in the future. In addition, there is the risk of known and unknown side effects on your child's physical and psychological development. Therefore, it is wise to exhaust all other, nonpharmaceutical interventions before putting your child at risk in this way.

Try Training Before Medication

A good starting point for dealing with ADD/ADHD without medication is occupational therapy. Children are taught, through hours of practice, individual self-management skills, and parents are taught effective ways to work with their child.

With this help, your child can learn ways to focus on a task and follow directions and to manage fidgety energy and wandering attention. As parents, you can learn strategies to use at home for reducing distractions; channeling restless energy; and using structure, routine, proximity, and touch to help your child focus better and settle down.

Finally, ask yourself the question, “Are we giving this medication for our child's sake or for our own in order to temporarily make our parenting job, or the job of the school, easier?” Be honest with your answer. If the child's medication is as much for your sake, or for the teacher's sake, as it is to help the child, then medicating your child may not be the best choice.

Reducing discipline problems associated with impulsiveness and inattention at home and at school is not a good reason to medicate your child without trying behavioral training (for both child and parents) first. Using prescription medication as a disciplinary intervention with a child sometimes creates dependent parents who believe they can't effectively manage their child without keeping him or her on psychoactive drugs.

Parents have a substantial amount of influence over their children, but they do not have control over them. Teaching your children to cooperate with you, instead of struggling against you, will help you raise children who abide by your values and follow your rules.