Teacher response to the methylphenidate (ritalin) versus placebo status of hyperactive boys in the classroom

The effects of children's medication status on teacher behaviors were studied in a classroom setting. Teacher behaviors toward hyperactive boys on methylphenidate were compared to those toward hyperactive boys on placebo, as well as those toward normal comparison peers. A medication crossover design was used within the hyperactive group, and the teacher had no knowledge of diagnoses or medication condition. Across 4 different classroom experiments, the teacher was more intense and controlling toward hyperactive boys on placebo than toward the other 2 groups. No differences emerged between the comparison and medicated hyperactive groups, suggesting that methylphenidate served to "normalize" teacher-pupil interactions. Teacher behaviors toward individual boys were also moderately to strongly related to teacher global impressions of these youngsters, as indexed by qualitative rating scales. Discussion focuses on the social ramifications of medication and the need for broader monitoring of treatment outcomes.