What happens to the children who take this medication? In the classroom, their actions tend to be more goal-directed and "on task" than before. Things going on around them are often less distracting. They tend to become less aggressive and follow rules better. Psychiatrists, parents, and teachers are often pleased with the changes they see and interpret them as a sign that a child may be "finally settling down."

According to research, however, approximately one-third of the children diagnosed as hyperactive do not become less restless on Ritalin. Some actually become more agitated. At best, the drug can help those who have been accurately diagnosed to focus so they can temporarily absorb information better. Unfortunately, the drug usually does nothing to enhance learning or improve actual academic achievement beyond the short term. Even for those children whose behaviors do respond as intended, the effect is only a temporary suppression of symptoms – not a cure. Not to mention possible meanings attributed by the children (and parents, teachers, caregivers, too), believing they have “something wrong” with their brains that makes it impossible for them to control themselves without a pill! The long-term implications of this type of thinking is concerning, to say the least.

As with any drug, there are inevitably adverse side effects to Ritalin. The Physicians' Desk Reference lists more than 25 symptoms ranging from nausea, insomnia, headaches, weight loss, elevated heart rate, increased blood pressure, repetitive involuntary movements or tics, and seizures.

What about long-term side effects from the drug? This is an important question because children are often placed on Ritalin for many years. It is also a frightening question, because to date no adequate long-term studies have been performed. The children previously and currently prescribed the medication are, unfortunately, the group that will provide the information of long-term effects.

In order to avoid potential side effects of Ritalin, “drug holidays” are often recommended. This abstinence from the drug (often recommended over weekends, holidays, or summer vacations) can also be an opportunity to evaluate a child’s behavior free of medical interventions to possibly determine if the behavior has diminished or is now more manageable.

Alternatives to leading medical treatment are available. This magazine alone is a good source of alternate treatment modalities. Before you begin any treatment plan, however, you should always seek the advice of a trusted, knowledgeable professional. When considering their services, it may help to ask yourself if that person makes himself or herself available to you, and does he or she answer your questions in such a way that you feel you've been heard? What are the available treatments? What is known about the effectiveness of each? Here a couple alternatives to consider:

Children diagnosed with ADHD often have behavior patterns that attract negative responses. When someone is identified as diagnosed with ADHD, the tendency for others to notice ADHD congruent behavior is not only natural but far too easy. One of the most successful techniques to avoid this trap is proactive recognition. Simply put, it is the opposite of finger pointing and criticizing. Catching someone in the act of doing something good and acknowledging it (along with forming a habit of doing both) is the challenge in affecting behavior changes. When parents and teachers point out the positive aspects of children’s behavior and choices, the behavior is more likely to be repeated. Support of positive behavior may also have the unintended effect of reminding the caregiver, too, of the positive aspects to the child’s behavior.

To put proactive recognition into action, concentrate on one or two areas where improvement is needed. After a week of positive feedback in the identified area(s), the child should have made progress towards assimilating the praised behaviors into their daily routine. Move on to different behaviors that need proactive recognition as needed. Ideas that may help:

Consider, too, that for the entire school day, students are expected to sit still for hour upon hour, and to do whatever they are told. While well intentioned, a good number of schools end up teaching obedience and conformity first, then reading, writing, and arithmetic. There are alternative approaches to learning that involve children as active participants not producing boredom and restlessness (such as Montessori schools).

Among the many factors that shape the lives of children, nutrition often plays a critical role. What children eat has a profound influence over the functioning of their brains, the way they process information, and the way they think, learn, and act. Although most human beings have the ability to tolerate a certain amount of exposure to harmful substances, some of us are more sensitive biochemically than others. For children who are especially sensitive, the three most troublesome – chemicals and synthetic food dyes, artificial flavorings, and preservatives – can cause a host of physical, emotional, and mental reactions, and lead to an ADHD diagnosis.

The argument over nutritional contributors to hyperactive behaviors aside, adherence to a healthy diet free of additives and colorings can certainly benefit your child. When children (and the rest of us, too) are put on a healthy diet based on nutrient-dense foods like whole grains, vegetables, and fruits, and avoid sugar and artificial colors, flavors, and preservatives, the results are predictably outstanding.