Naturalistic Assessment of Neurological Diagnoses and Pharmacological Intervention

Abstract

There is sufficient reason to believe that drugs are inappropriately prescribed for and used by children who demonstrate learning and behavioral problems. The shortcomings of an exclusively medical or clinical approach to the administration and supervision of drug therapy are discussed. To insure precautions in the prescription and surveillance of drug treatment, certain minimal standards are proposed: (1) translation of the clinical diagnosis into measurable naturalistic behaviors; (2) collection of data by parents and teachers on behaviors to determine severity of the syndrome; (3) situational validation or disconfirmation of the clinical diagnosis; and (4) when indicated, formative assessment of drug treatment. The use of these four standards is illustrated with a preschooler who was scheduled for drug treatment. Resulting data permitted reconsideration of the clinical diagnosis and preempting of drug treatment.