The Art of Medicating Hyperkinetic Children: A Number of Practical Suggestions

Abstract

The psychologic aspects of the prescribing, giving, and taking of medicines are especially important when trying to modify the emotion-laden behavior of hyperkinetic children. The physician should start by cultivating positive expectations in child, parents, and teacher. This is necessary in order to break up existing complex vicious cycles of negative expectations, low self-esteem, discouragement, resentment, misbehavior, and poor achievement. One promotes the child's cooperation by building rapport from the first contact and by negotiating a medication contract directly with him. The child needs to know not only that his past misbehavior of failures are not being held against him but also that better is expected of him now that he has medical help. Parents deserve unhurried clarification of questions and should be warned about side effects. The time taken to talk directly with the teacher is most valuable. Direct communication can help set up positive expectations in school and elicit objective information about the child's day-to-day performance.