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Programs & Strategies for Positive Behavior

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Behavior Support for Positive Student Behavior

Alternative Educational Strategies • Comprehensive School-Based Mental Health Services • Coordinated Medical Interventions

Programs and Strategies for Positive Behavior:
Intensive Intervention Programs & Strategies:
Coordinated Medical Interventions

Student Population Served
Students who have received a thorough medical evaluation with input from parents and educators and whom are considered to benefit from the use of medication.

Program Description
Medication is sometimes used to address behaviors that interfere with student learning. However the use of medication with school-age children remains highly controversial. Opponents argue that quality educational programming for children and adolescents with behavior and emotional problems is being replaced by attempts to find a quick cure, and note that many medications now prescribed for children were approved only for adults. Notwithstanding, research has indicated the positive impact of a number of medications on student behavior and academic performance when compared to other treatments. It should be noted, however, that schools must follow local procedures when administering psychiatric medications to students. This ordinarily means trying a number of different behavioral interventions before prescribing medication. If these other interventions do not evidence any or much effectiveness within a period of a month or more, then school personnel may consider recommending medication to treat the student's problem. It should also be noted that even when medication works properly, other interventions, including sound educational instruction and positive behavioral supports, are still needed to ensure student success.

Properly used, medications can increase the success of non-medical interventions, enhance quality educational programming and allow a student to be educated in a less restrictive, home-school environment. Central nervous system stimulants (i.e., Ritalin, Dexedrine, & Cylert) for example, are sometimes used to treat children with Attention Deficit Hyperactivity Disorder (ADHD). When working properly, these stimulants can reduce the symptoms of hyperactivity and impulsiveness, and increase concentration level. In addition, psychopharmacotherapy research has suggested that a number of medications including antidepressants, stimulants, nonstimulants, and others may be effective in treating various internalizing and externalizing symptoms.

It is important to keep in mind several points when students in your school are receiving medication. First, acquire a working knowledge of medication as a treatment intervention. Second, make certain that students receive medication on schedule. Generally, this means reminding students to go to the nurse's office to take their medicine. Third, observe student's behavior and note instances that support or do not support the use or dosage level of medication, or that suggest the presence of side effects. If side effects occur, a teacher or other school staff member should notify the school nurse or other appropriate school personnel (e.g., a psychologist and/or nurse), and/or the student's family. Fourth, closely monitor the effects of psychopharmacological intervention by systematically observing and assessing student behavior and academic performance. Such information is useful in determining the appropriateness of a particular medication as well as dosage.

Evidence of Effectiveness
A study carried out by the MTA Cooperative Group (1999) on treatments for ADHD in children showed that the most effective interventions included medication - either on its own or in conjunction with behavioral interventions. -Comprehensive behavioral intervention without use of medication , however, did not yield significant behavioral change. Outcome measures used in this study included teacher-rated social skills and reading achievement.

References & Additional Resources
Hutchens, T.A., Canter, A.S., & Carroll, S.A. (1998). Medications for children with behavior and emotional problems: A primer for parents. Washington, DC: National Association of School Psychologists. Available: http://mentalhealth.miningco.com/cs/psychopharmacology/

Carroll, S.A. (1998). Medical management of behavior and emotional problems in children and adolescents: A primer for educators. Washington, DC: National Association of School Psychologists.

MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56, 1073-1086.

Quinn, M.M., Osher, D., Warger, C., Hanley, T.V., Bader, B.D., & Hoffman, C. (2000). Teaching and working with children who have emotional and behavioral challenges. Longmont, CO: Sopris West. Available: http://www.apa.org/pubinfo/kidsmed.html

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