I can give you an example of a colleague who works as a social worker in an urban school system in Canada. She sees children who have these kinds of problems. As an experienced teacher and social worker, she is able to work with the families and with the children in terms of modifying behaviour, particularly in supporting the parents, because many parents are under a great deal of stress and the child is a kind of manifestation of this stress.
She works with the family in helping the family develop methods of behaviour control and with the school in terms of arrangements, because some kids do find it much harder to sit still and much harder to concentrate. I think that reintroducing things like physical education back into the schools and keeping the physical activity levels high, especially for young boys, is particularly an issue, and I know families that have looked at things like diet and have worked in terms of family relationships because the child needs very careful boundaries and support.
I think all of these alternatives are possible. The problem is that they're not really systemized or offered in schools because the fallback has been medication. That is one of my points: we need to be looking at and developing these alternatives. I know families who have worked very successfully with this model. There are books and resources and there are even health providers who will work with families and not prescribe drugs.
When you have prescription drugs as the fallback, it means that there's a kind of easy answer, although in my opinion it's very risky. You're exposing children with developing brains to a class of drugs related to cocaine and methamphetamines. I've certainly talked to people in the school system who will say that there is an immediate effect, but it's not long-lasting. When you look at the evidence, you see that there's really not a huge amount of evidence that over the long term these drugs accomplish what parents expect them to do.
I don't think there's an easy answer right now, but I would like the schools in particular to start developing options instead of falling back on the medication as the first line of treatment.