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40+ Things To Check Before Reaching for the Ritalin | Rabbi Dovid Abenson

To my readers,

I will be coming to Lakewood starting from the 11th of May. I have a tight schedule, but if you would like to set up a meeting with me or know someone that would benefit from our programs please contact our office as soon as possible. Tel. 15147393629, Cell/Whatsapp 15149935300, Email: ravabenson@shaarhatalmud.com

I recently received the following letter from a distressed parent (names have been changed).

Dear Rabbi Abenson

Please advise me. The Menahel of my son’s yeshiva is forcing me to give my son Dovid medication. He mentioned Ritalin as one option and in strong terms said to us that he will not allow him to return to his institution if he is not medicated.

I am desperate. How should I answer him? Please help me.

Kindly waiting to hear from you.

Dear Mrs. Goldberg

Thank you for your letter. Unfortunately, I frequently hear from parents who are threatened in this way, even forced to sign medication agreements to enable their child to remain in school. Some are eventually forced to go to non-Jewish schools despite the fact that our Gedolim have spoken out against the practice of expelling children from Torah schools without first securing a suitable alternative.

Medication today is a very big problem in our Torah system, especially in the States where it is often over-prescribed. An educator told me that in his community “we are in the third generation of medicating our children and roughly 1/3 get medicated each year.” This figure seems well out of proportion with the actual prevalence of ADHD as a medical condition. Whilst medications certainly have a place, to use them as a discipline tool is irresponsible and dangerous.

Many side effects of the medications actually exacerbate the problems they purport to be addressing. For example, I am seeing a ten-year-old who has been on medications for 5 years. He never eats breakfast in the mornings due to loss of appetite, a well-known side effect of his medication. Learning on an empty stomach does not improve his concentration. Other side effects include stunted growth, irritability, “spaced out” from reality, insomnia, dry mouth, and blurred vision. Unfortunately, suicidal thoughts are also a potential complication. In cases where medication is definitely needed, the benefits will usually far outweigh the risks, but given the drugs are not without risks, educators should be wary of pressuring parents to give them to their children if there are alternative ways to address the behavioral problems.

How to address the behavioral issues?

My first suggestion would be to give your son an educational evaluation. Low academic performance, behavioral problems, poor concentration, and poor retention of information are not automatically symptoms of ADHD. They can also be a result of underdeveloped skills. A full comprehensive educational evaluation could reveal hidden deficiencies that may be hampering his performance. A post-evaluation report will include recommendations and suggestions on how to fix the situation and can be shared with the Menahel.

Secondly, the following checklist can be given to your Menahel. This checklist is helpful in identifying the myriad criteria that contribute to poor concentration and behavior in school-aged children, many of which can be addressed without the need for medication.

CHECKLIST *

ACADEMIC SKILLS

Firstly, evaluate the student for Limudei Kodesh educational deficiencies with a focus on the following:

  • Kriah – recognition of letters, nikudos, unit reading, and regilos.

  • Translation including dikduk.

  • Comprehension.

CLASSROOM

Set-up

  • 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 whiteboard 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?

  • Can he see well?

  • Can he hear well?

Rebbe /Talmud relationship

( Due to the sensitivity involved, the following checks should be done discreetly. )

  • Is the rebbe loud enough?

  • 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 overexpress himself? Can the teacher define terms well? Can he explain the concepts concisely and 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 show interest in the student during the class?

  • Does the rebbe ignore the student?

  • Is the rebbe sarcastic to the student?

  • Does the rebbe embarrass the student in class?

  • Does the rebbe tell the parents to get a private rebbe at night to make sure that the student will know the Gemara for the next day in class?

  • Does the rebbe punish the student by telling him to write up Gemara because he did not have his finger on the place?

  • Can the student speak to the rebbe?

  • Does the rebbe let the student sleep in his class?

  • 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?

  • Is he a gifted student?

  • Does the rebbe pronounce his Hebrew reading the same way as the student?

HOMELIFE

The following investigations must be done very discreetly with care and love by the Menahel so as not to embarrass students anyway.

  • Are there shalom bayis issues?

  • Are there financial issues at home?

  • Does the student regularly come to yeshiva without lunch, necessary supplies, etc?

  • Is there a sibling bullying problem in the house?

  • Is the father home during the week? Or only comes home for Shabbos due to work?

  • Does the father lack the time/ability to learn with his son and go over the material with him?

  • Is the student having sexual issues (which include wasting seeds, having a tendency for the same gender?)

  • Is the student having אֱמוּנָה question and not been answered by the yeshiva?

  • Is he taking drugs or is he addicted to alcohol?

INTERPERSONAL RELATIONSHIPS

  • Does the student get bullied or ridiculed by peers?

  • Does the student have friends?

  • Does he dress inappropriately or fail to fit in (perhaps due to financial or other home problems)?

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 (even chronic pain from toothache, stomach upsets)?

An educational evaluation should reveal underlying learning deficiencies, whilst going through the above checklist will identify any other underlying issues. If once problems are identified and addressed, there are no significant improvements in concentration or behavior, then we would recommend a medical evaluation to assess if medication will help.

If you would like me to speak to the Menahel regarding the checklist and your son Dovid I would be happy to do so.

Waiting to hear from you

Dovid Abenson

*For a bais yaakov checklist contact our office.

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ASK THE RABBI is a new forum where readers are welcome to submit all questions on subjects regarding Jewish education to Rabbi Abenson and he will answer them in a timely fashion through TheLakewoodScoop.

Rabbi Dovid Abenson can be contacted at: Tel. 15147393629, Cell/Whatsapp 15149935300, Email: ravabenson@shaarhatalmud.com.

Rabbi Abenson is the founder and director of ShaarHatalmud, a unique yeshivah-based online program, which incorporates learning all Kodesh subjects, from Kriah up to learning Gemara, Rishonim, and Shulchan Aruch. He also conducts evaluations, remediation, and training, and consults with Roshei HaYeshiva and Menahelim to improve students’ underdeveloped learning and textual skills.

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There are 13 Comments to "40+ Things To Check Before Reaching for the Ritalin | Rabbi Dovid Abenson"

  • Quiet says:

    My nephew is a very good quiet boy. Learns well and behaves great. However his teachers seem to mostly ignore him, as he does not stir up any trouble or speak up for homself. I have talked with the principal and teachers to give him some positive attention and although they said they would, they never do.maybe they will call on him in class the next time he raises his hand after I speak with his teachers. But after the one time everything goes bvb back to ignoring him until the next time I call. How often should I call the teachers?

  • Neleg says:

    Does your nephew have parents? Why are you his advocate? Do his parents have relationship issues? Do they have parent-child relationship issues? Those answers may help to answer the question as to why he doesn’t feel comfortable participating in class.

  • Busy says:

    There are some good points here and certainly no one should give medication where it’s not needed but there are a few points I would like to make.
    Firstly, there is no reason why a child on Ritalin should not have breakfast they should eat before they take the pill for the day and it should be out of the system by dinner time.
    Secondly, you say to check for a deficiency in skills sometimes a child lacks skills because he is not concentrating! In my case a very smart teen boy was behind in gemarah skills because he had not been concentrating when they were taught in the younger grades- so sometimes not medicating a kid will cause the deficiency.
    Thirdly, Ritalin and other stimulant medications for ADHD do not carry a black box warning(suicidal thoughts) which anti anxiety/anti depressants do. They do not remain in the system from day to day meaning you can not take on a day when you are not in school without any withdrawal, if given the right dose at the right times should not cause insomnia,
    They should not be misused but neither should people be afraid to use these medications when needed they are literally life changing!!! There is no substitution for the feeling of success! It is unfair to withhold it from your child due to false information/fear you may have about medication. Speak to a competent doctor ( not your pediatrician) to guide you

    • Just me says:

      …..or simply give him the nutrition that he needs. More to come next year…….

  • Mobile says:

    Rabbi Abensen has good points, but EVERY TIME he seeks to paint the mainstream schools as monsters and himself as the savior. No principal I know would ever “force” a parent to give medication. They may demand that the child see a professional and then, if the professional medicates, they may demand that the parent medicate and not “experiment”. Of course, there are possible side effects which should be brought to the attention of the prescribing doctor.

    • write a comment says:

      I was forced by a Mossad to give medication to my child. But that Mossad has done enough to me that this is far from the worst.
      They demanded that I go see a professional, but they told me to whom to go. They knew where they would get the answer they wanted.

      The outside world is starting to see the terrible effects of behavior modifying medication on children, just as the Charedi world is starting to get into it.

      The problem is, when Mosdos see medication as an option, they are no longer motivated to actually address the issues, they just blame the instrangient parents, who have the gall to think that their children are theirs, not the schools

  • Mutty says:

    Brain medication is dangerous for adults and is much more dangerous for kids; parents are kvetching that their kid is dumb, well those parents are 10 times dumber than the kid;
    I see what goes on today: kids are schlepped to very costly therapists whom are nothing more than smooth talking crooks.
    Kids are schlepped to Optometrists ( they’re refractionists & not eye doctors whom are Ophthalmologists) whom are very lousy optometrists but real professional crooks and scam artists, the poor kids are prescribed unnecessary Prisms, unnecessary Bifocal, unnecessary reading glasses etc , the kids claim that they must wear it even though they struggle and have headaches from them.
    I have a grandson whom is now 8, a very bright kid, but when he was 3 he was very active and didn’t listen, they took him to therapy for not listening and my son comes to me that his insurance is running out and his son must have his therapy that I should pay for it, you know what I gave him, I told him that you and your wife need a physiatrist beyond therapy. Unbelievable what goes on today.

  • Name witheld says:

    I have a legit ADHD son. He does well on concerta. It’s not a focus thing. Kid doesnt sit still without and cant learn. If the teacher/school thinks he needs meds then maybe he does!!! Maybe the kid is distracting other kids instead of other way around!! I don’t know why the parent assumes the teacher doesnt have the child best interest at heart. My son is doing amazing on his meds. He also takes guanfacine. Maybe the parents can look into that. It’s another ADHD med that’s not a stimulant. It’s a blood pressure medication used to relax hyperactive kids. They can also look into supplements like omegas, magnesium and L theanine.

  • Too Much Stereotyping and Junk Food says:

    That Rebbe or school’s attitude is nothing less than child abuse. They are not Doctor’s. The author is 100% correct.

    We need to stop trying to fit our unique individual children into some misguided robotic stereotype. One size does not fit all.

    The Torah says to “teach your child according to his way”. Not stuff him with medications to get him to conform and stunt the purpose for which each of their precious neshamas were uniquely created to succesfully perform their individual contribution to perfect Hashem’s creation.

    Pushing a square peg into a round hole destroys them both.

    BTW, stop stuffing them with sugar and all the garbage that is in the snacks and lunchmeats. There are plenty of healthy alternatives to buy. They might be more expensive but consider it an investment in your precious child’s future.

  • yehuda Shain says:

    He is 100% correct, the schools are raking it in with the medications, therapists, optometrists, etc.
    The teachers don’t have what it takes to have the child’s “interest”.
    The Menahalim will not allow proven experts to work with the students to bring them up to par, because they can’t skim money for the school.

    Those tutors will be tutoring the students for the rest of their schooling, with no end in sight. The experts n the other hand will get them up to par in a few months, but the menahlim can’t skim dollars.
    I know some of those experts, I have seen their results.

  • Not a Lakewooder says:

    Am I the only one seeing some serious underlying issue here? These are very strong words coming from a Menahel. Not something to take lightly and I’m sure he does not tell every parent of a fidgety kid that the boy meed medication. Many boys fidget and space out. But not all need “Ritalin” for it. Obviously he sees there is an underlying issue that needs evaluation. But why does the mother not see that the child obviously has some underlying issues or does she and is in denial? Or is she just worried about the stigma and refuses to medicate regardless?. From the harsh wording The child seems like he may really does need some serious psychologic evaluation and may possibly need medical intervention. The way I’m seeing it is so does the mom! You all say it’s child abuse to medicate a kid and NONE of know the full story!!! HOW DARE ALL OF YOU!!

  • Ut! My Son the Psychiatrist says:

    So, nu? Now you’re a psychiatrist. Even you can do telepathic diagnosis. What happens in your waiting room? You walk in and scream (in all caps) “HOW DARE ALL OF YOU” think each other is nuts?

  • annonymous says:

    i am a talmud of rabbi abenson, for thoses of you who don’t understand, he is a lifesaver and because of him I’m going to yeshiva in a couple of months.
    i started the program not being able to read well and learning made it miserable.
    since I started I have enjoyed learning more than ever.
    thank you reb dovid.