Labels Can Last a Lifetime

by Thomas Armstrong Ph.D.

(Originally published in Learning, May/June, 1996)

© Thomas Armstrong, 1996 

I thought I was still young when it happened to me: One of my former elementary-school students walked into my university class as a student.  For some teachers, this incident would be no more than an unwelcome reminder of how quickly the years pass.  For others, it might be a pleasant postscript to a rewarding career. For me, it was something entirely different.  You see, I'd had this student in a special-education program many years before.  At that time, Ron was on psychoactive medication for his attention and behavior problems.  I could see he'd settled down.  But as we caught up on the years since fourth grade, he talked of further medication, special schools, labeling, and finally breaking free of it all after high school.  "Mr. A., you should tell people what those medications do to people," he said.

Ron had begun to recover from his experience.  But sadly, many students with behavior or attention difficulties are just beginning their struggles.  In the late 1970s when I taught Ron, only a few students were being labeled and medicated for attention and behavior problems.  In the 1990s, things have changed considerably.  Ritalin use has skyrocketed 500 percent in the past five years.  As many as 2 million children have been diagnosed as having attention deficit disorder.  And ADD and Ritalin seem to be on the lips of any adult within arm's reach of a child who shows erratic behavior or wandering attention.

No easy answers 

I'm not opposed to using psychoactive medication for children who are in crisis or for whom other approaches have failed.   In fact, many teachers and parents have told me how their kids have been transformed in a positive way with Ritalin or related drugs.  But I'm concerned that we may be turning too quickly to drugs and labels.    The traits that are associated with ADD--hyperactivity, distractibility, and impulsivity--can result from a number of causes.  For example, a child may be hyperactive or inattentive because of being bored with a lesson, anxious about a bully, upset about a divorce, allergic to milk, temperamental by nature, or a hundred other things.  Research suggests, though, that once adults have labeled and medicated the child--and the medication works--these more complex questions are all too often forgotten.  By rushing to drugs and labels, we may be leaving more difficult problems to fester under the surface.

Before we push the ADD/Ritalin button, we need to take an intermediate step that enables us to look for other ways of seeing the child and to try nonmedical solutions.  Then if these approaches don't work, we can proceed with the appropriate referrals.

Many of the following suggestions came from teachers who are taking that intermediate step.  These strategies may help you capture the child's attention--and keep it--without turning to medication.

Teaching strategies   

  • Give seat work in the morning, when research suggests a child is most focused.   Use the afternoon for open-ended activities.
  • Use strategies that incorporate physical movement in teaching basic skills.   For example, try role-playing, drama, or pantomime.
  • Give instructions in attention-grabbing ways, such as singing, pantomiming, or using pictures instead of speaking.
  • Build art activities into the curriculum.
  • Create learning projects based on the child's special interests. 
  • Teach social and emotional literacy skills such as learning how to make friends, express anger appropriately, and read other people's emotions.
  • Teach organizational skills such as how to keep a notebook, study effectively, and manage homework.
  • Involve the child in creating rules and consequences.
  • Get the child involved in a peer or cross-age tutoring program to increase the feeling of responsibility.
  • Give the child plenty of opportunities to make choices.
  • Encourage the child to visualize movement as a substitute for actual motion.  

Classroom environment

  • Allow the child to have a piece of clay, a squeeze ball, or some other object in hand while you lecture.
  • Give the child special jobs that allow movement, such as watering the plants or working the film projector.
  • Let the student read or do math while moving.  For example, provide a rocking chair for reading.
  • Use background music as a study aid.  Believe it or not, rock music calms some kids like Ritalin--a psychostimulant--settles others.

School environment

  • Work with your physical-education teacher to provide a strong physical-education program so the kids can blow off steam.  Provide breaks during class for physical activity.

Home environment

  • Suggest to parents that the child learn martial arts, which teach discipline, focus, and respect.
  • Help the parents, child, or both get counseling, psychotherapy, or family therapy if emotional difficulties could be causing the attention and behavior problems.
  • Advise parents to make sure the child's breakfast includes both protein and carbohydrates.  This seems to make a difference in a child's behavior and attention span.
  • Encourage parents to spend more positive time with the child.   

 Changing with the times

In a sense, we live in an ADD society.  Everything is moving more quickly these days, and children are asking us to move along with them.  Let's make sure that we don't saddle some kids with labels and drugs just because we're not willing to make the journey.