Children are often referred for a medical opinion because they behave badly. Typically the child, more often a boy, is disobedient and quarrelsome, does badly at school, disrupts others and is inattentive during lessons. He has few, if any, friends, and is in trouble for stealing or truancy. His mother may complain that the child never settles to play for long and is generally restless. Such children, often from disturbed or rejecting homes, respond poorly to psychotherapy or behaviour therapy. In the U. S. A. many such children would be labelled ‘hyperkinetic’ and treated with stimulants. In the U. K. this diagnosis is much less common and drugs are used much less frequently. Thus what is known about the effectiveness, limitations and dangers of stimulants is mainly in a American context.1 2
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