There has been a lot of response to my article Part 1, “Medication – is it the real cure?” regarding medicating children. Many readers identified with the concept that, whilst medication can provide help in some cases to students struggling academically, medication is very often overly prescribed and being used as a quick fix, in the Limmudei Kodesh division, without a Hebrew educational evaluation being done prior to promoting medication.
A comprehensive evaluation would identify any hidden under-developed skills which could be hampering the student in his learning which could be leading to low academic performance, behavioural problems, poor retention of information and concentration issues. As some readers questioned my medical background, I would like to reiterate that the article was not discussing diagnosing medical and neurological issues, but rather referring to potential learning difficulties which simulate neurological deficiencies. I am also referring specifically to Limmudei Kodesh deficiencies which is the background of my work for the past 30 years.
It has unfortunately been well documented that medication can create many side effects which appear to exacerbate the problem, with many of them actually hampering the child during his day. Known side effects include lack of appetite, stunted growth, irritability, spaced out from reality, insomnia, dry mouth, and blurred vision. Unfortunately, suicidal thoughts are also high up on the list too.
Below, I have enclosed suggestions which can be used to evaluate a student before promoting medication. (please note that some of these suggestions are comprised here from previous articles to create a more comprehensive check list.)
CHECK LIST
ACADEMIC SKILLS
Firstly, evaluate the student for Limmudei Kodesh educational deficiencies with a focus on the following:
◦Kriah – recognition of letters, nikudos, unit reading and regilos.
◦Translation including dikduk.
•Comprehension.
•CLASSROOM
•Does the student have a good view of the rebbe /teacher?
•Are there continuous disruptions from other students?
•Are there any visible distractions in the classroom? e.g. writing on the blackboard from previous lessons, broken desks, drafty windows or wobbly chairs
•Is the classroom set up in an organized fashion?
•Is there adequate lighting in the classroom?
•Is the ratio of student per rebbe/teacher adequate?
•Is there enough fresh air in the classroom to avoid sleepiness?
•( Due to the sensitivity involved, the following checks should be done discreetly. )
◦Does the rebbe/teacher have patience and listen to the student?
◦Does the rebbe/teacher put too much pressure on the student to complete homework assignments?
◦Does the rebbe/teacher know his material well? Does he over express himself? Can the teacher defined terms well? Can he explain the concepts concisely an in a joyful pleasant manner?
◦Does the rebbe/teacher speak in his mother tongue or does he use multiple languages in one sentence?
◦Does the rebbe/teacher ask the student to leave the class regularly?
◦Does the rebbe/teacher show fatigue in class?
◦Does the student show any signs of abuse either from the rebbe/teacher or other students?
◦Is the rebbe/teacher punctual to class?
•Are tests printed clearly and with proper sentence structure?
•INTER PERSONAL RELATIONSHIPS
◦Does the student get bullied or made fun in his classroom?
◦Does the student have friends?
◦Does the student get along at home with siblings and parents?
◦Are there shalom bais issues at home?
•Are there financial issues at home which prevent child from dressing or fitting in appropriately?
•HEALTH
•Does the student have enough nutrition in the day, starting the day with adequate breakfast?
•Does the student get adequate sleep at night?
•Has the student’s sight and hearing been checked by professionals?
•Are there any other medical issues bothering the student? Once an educational evaluation has been performed, and any deficiencies have been identified and rectified, if symptoms are still recurring, then a medical evaluation is required to assess if medication will help. We must take note that both educators and medical practitioners should be a part of a child’s development, however, care should be taken when one over steps into the other’s field, which may have led to how 30 percent of some classes are now on medication. And where educators have promoted medication, without having prior checked the student for educational deficiencies.
• The Gemara states that if we see a person holding a dagger whilst running after another person with what appears to be the intention to kill him, and then they have both run into a cave, if the man with the dagger re-appears a short while later holding a dagger full of blood, circumstantial evidence is not accepted and he cannot be considered a murderer. Witnesses are required to warn him not to kill and they must see him actually killing the person thereafter. This analogy can be applied here. Circumstantial evidence is not enough to push the student to take medication and we should do our utmost to find the source of the student’s issues, and not to use band aids for deeper cuts.
Rabbi Dovid Abenson is the founder and director, author and lecturer at Shaar HaTalmud, a unique yeshiva based online program, featuring evaluations and remediation, working with students to upgrade skills in Hebrew reading, chumash/rashi and gemara studies, consulting school principals world – wide to improve their ability to help students who possess under-developed skills. Also available for in house training for schools and yeshivos. He can be reached at [email protected] or 1-877-HATALMUD (428 2568).
Although I agree that medication should be only used as a last resort, I am afraid that some parents reading this article may used this information to insist that there child definitely does not need medication. It should be noted medication only works in conjunction with a structured behavioral program that must be instituted both in school and at home. Of course a child be tested to rule out any learning disabilities or social issues that may affect his learning and behavior.
After a child has been carefully evaluated and all types of interventions have been applied there are those children that need medication to succeed; unless a parent makes the decision to put their child in a special setting with a very small teacher student ratio. Even then in my many years as a professional educator some forms of ADD could not be addressed even on a one to one. Those children that fail in the school system come out with a low self-esteem and are extremely high risk adolescents. As a principal I will try everything before even considering medication; however, if necessary I send my parents to a neurologist that specializes in ADD and ADHD using specific computerized testing. I know that this doctor is unbiased because there are times where he feels medication is not necessary. Again, medication is not a quick fix but scaring parents is not the answer either. Many parents are in total denial which only harms their child. All testing should be done of course, but when necessary, medication can be a child’s salvation.
What an interest article!
I remember my Rebbe giving me a test which he’d written. No grammar. No layout whatsoever. I failed.
The rebbe then said “he’ll read it to me” oh. what a joke.
I brought it home and still today I remember my parents trying to not laugh next to me.
That was one of my many childhood stories.
I apreciate the honesty and truth about overuse of powerful and not at all harmless medications. There used to be a time only a few decades ago when people were upset about anyone telling scary stories about harm caused by cigarette smoking. And many religious Jews unfortunately still smoke and destroy their bodies created for them. Rabbi Abenson shlita, should be invited to give seminars and upgrade all school educators based on the points listed in this article.
the real medicine is Tehillim & davening. ONLY HASHEM can help you & your children & save them. all the other things we do are agents between you & Hashem, from the Doctor, rebbe & Medicine etc… it is all fake. i.e. they cannot save you or your child even %1 of the issue without Hashem decreeing that you should be helped/saved.
Hundreds of years ago there were no doctors-there was no need for them-cause the most simple ignorant person knew you open your siddur & turn to Hashem for help
Now in todays generation, we are on a much lower level of Bitachon & emunah so we need messengers to act as if they are the ones saving us. but we all know the truth that it all comes from Hashem & a person can’t remain alive for even 1 minute without Hashem decreeing that a person should.
may all this become a part of our lives so we know we can get help 24-7 from hashem in any sitation at any time by turning to Hashem for help
I don’t remember 100yrs ago each child being evaluated, all I remember was the more hyper the child was the bigger Rosh Hayeshiva he turned out to be. I guess the world thrives on looking for and creating problems, trying to bank on their new created problem as the new solution, hoping their newest method of exercise will become the new national gym, and ignores the real problems. Yes a child is tested and challenged today on a much greater levels, joined by a inflated ballon of stigma. The greatest results returned in recent years on the most valuable Portfolio of all times, (a child) was the child who in a climate controlled Environment, was allowed a free natural growth. Those were the ones who out performed beyond all expectations. Being great examples makes great examples. Real sacrifice brings the greatest joy!
Well written article! Applauds
I hope my submission here is not understood. The world of chinuch, nowdays, has become a maze of challenges that both parents and children must traverse. I have had many children go through the system, and have much experience dealing with honhala members of different mosdos. There are many fine individuals who have dedicated their lives to chinuch, and unfortunatly there are those individuals that do not belong in chinuch altogether. First things first. The school’s purpose should be to educate the children. Period. It does not exist to feed the menahal’s ego or to be able to brag look how frum we are, look how much we learned, We are #1 etc. If that is how the school is run then it should close down because it is not about the kids, and school must be about the kids. If there is a problem with a child’s learning then there are steps, in order, that should be taken by the parents.
1.) Do homework with your child in a quiet place so you can see where he is holding. See if he understands beyond repeating back his teitch sheets
2.) Be in touch with the rebbe on a regular basis, do not wait for PTA
3.) talk to the other parents in the class (and even parents in last year’s class) and see if their kids are also having difficulty (sometimes it’s the Rebbe (not always, but sometimes it is)
4.) if the school suggests/insists on medicine realize they are not doctors. They are trying to make life easy for themselves. You should seek out your own independent health care practitioner for an evaluation. The school may recommend their favorite doctor since he is known to prescribe freely. It is critical you use your own doctor. Legally the school can not talk to the doctor without your written permission. This is a great thing since they will not be able to sway the doctor’s opinion.
True story: I had a child that the menahel strongly suggested he be put on a pill. I told the menahel he is not a doctor and that he is nopt qualified to make that decision. He then told me he has two doctors he can reccomend, that will co-operate with the school and put him on a pill. I then told him, we will use our own doctors. Guess what? Our doctor said he doesn’t need a pill and it seems the menahel was quite high strung. (we later found he he was kicking kids out and screaming at them every other day. Then we hired a tutor who is an expert mechanech to learn with our son. After the first session he told me that “this child is not learning disabled what so ever. if anything he is a lttle weak in kriya.
Rabbosai who needed the pill here? While it may be mandated in some cases, be very careful. There are many storires like this. One last note. There is a big difference between helping a child focus and wanting to sedate him. Your doctor, not the school hanhala, can inform you of the side effects and short/long term effects of putting your child on a pill.
@ shocking
100’s of years ago there wasn’t
Indoor plumbing
Cars
Central heat
Central a/c
Phones
Internet
Electric
Natural gas service to tour home
Plastic goods
Penicillin
Etc,
So what are you suggesting? Turn off
All your utilities, don’t use indoor plumbing. And when someone gets sick due to overexposure to the elements they should walk miles in the snow to the nearest shaman to get healed without penicillin of course. After all we know the truth, anything less would be due to our low level of bitachon and emunah.
Ridiculous.
Wasn’t the Rambam a doctor more than 100 years ago.
to 6 & 7 & everyone else
it takes years of work on your level of building up your bitachon
& emunah in Hashem for it to become A PART OF YOUR SYSTEM
How fortunate I am that I have reached this level of realization that the food doesn’t give me strength. the medicine (if needed c”v) is not what revives & keeps me alive. & it has become a part of my life 24-7 ONLY HASHEM CAN REALLY HELP ME i.e. sure we can go to the doctor & take medicine etc… but its really Hashem that saved a person.
Many times Chassidim have approached me to go up to the rebbe for a bracha. I then grabbed him on the shoulder & told him JUST keep your faith in Hashem & everything will be all right rather you got a ברכה or not. I agree he is a big Rabbi his blessings can & do help & i should go & get a ברכה but just keep your faith in Hashem & everything will be all right. Thats the KEY to success in Judaism if you have faith in Hashem, Hashem has faith in you. (that you will do hisמצות). There’s nothing wrong with getting Chizzuk from a rebbe or a Rosh Yeshiva & learning from their ways etc… theres also nothing wrong with getting a bracha from a rebbe BUT getting a bracha from a rebbe & depending on it AKA: coming home & telling your wife we just got a bracha that were going to have a child or be rich or our daughter is going to have a refu’ah shleima etc… is a lack of Faith in Hashem. The Chovos Halevavos says in the chapter of faith that a person cannot have faith in 2 things (AKA Hashem & a Rebbe, Rav or friend) for when he does, he loses both. (he then brings a mashal (parable) of a Rabbi who needed tapes of his speeches made to sell so he asked 2 of his members to help make them, but he knew if he would ask them together, each one would say the other one is doing it so i don’t need to do it. Instead the Rabbi brought each one in separately & asked each one & was successful.) For when you depend on 2 you lose both.
May we all work on ourselves to reach this lofty madreiga
The bottom line is when you have a child who is diagnosed with adhd it is your responsibility to treat it and that is with medication and therapy. You will not have much to work with once your child grows up a complete failure. You will need a lot more help abd therapy that may not even work by that time.
To promeds. Who are you to tell parents they must medicate? Are you a licensed doctor or self appointed expert? Total failure? I dont think so. Prove that anyone who doesnt get drugged up is a failure. Therapy when needed is adifferent story. Not everyone with adhd needs medicine. Some need just a change of diet or more play time. Quick fix pills come with a variety of side effects, ask anyone who was on ritalin years ago if they now have thyroid problems. Many will answer yes. Parents research any medicine your child might be put on very carefully. Ask the doctor questions. If he doesnt have time for you than find a different one that does. Your childs health is too important to be comprimized by someone who is in a hurry. Last and most important Daven Daven Daven. Ultimately it is up to Hashem if your child suceeds.