Conventional treatment

Most experts now agree that the most effective treatment for hyperactivity is medication, such as methylphenidate (Ritalin), dextroamphetamine sulfate (Dexedrine), pemoline (Cylert), or one of several antidepressant medications. These medications may produce nuisance side effects and sometimes problems that are more serious, but the great benefits they provide may be worth the risks. Obviously, the question of benefits versus risks is difficult.

Family counseling can also be helpful for a child with attention deficit disorder; especially in teaching parents which behaviors are attributable to the disorder and which are not. The thrust is to help the family structure the child's activities, learn to identify the child's special skills or gifts, and provide consequences to use for inappropriate behavior.

Much is made of educational treatment. In fact, the American Academy of Pediatrics Committee on Children with Disabilities has stated that behavioral and educational treatment should be tried before medication. However, only one state and Washington, DC provide for academic and behavioral assistance for hyperactive children. Although some teachers are very good with these children, many teachers have little training in dealing with them. Too often, children are incorrectly labeled as emotionally and behaviorally disturbed and are unnecessarily transferred to special settings.

Physical Education (PE) offers an opportunity for therapy, but it is seldom exploited properly. Hyperactive children typically have a rough time in PE because of their poor listening skills, distractibility, and impulsiveness. PE teachers should receive in-service training in the proper management of these children, as should playground monitors and school bus drivers.

For the present, however, most pediatricians cannot count on successful educational modifications and must rely on family therapy and medication. Sports participation can serve as an important adjunct to these modalities.