School personnel are involved in the diagnosis and treatment of hyperkinetic children in many important ways: (a) schools identify and refer the hyperkinetic child to the physician, who then relies on behavioral reports provided by teachers and parents in making a formal diagnosis and in evaluating treatment; and (b) more recently, schools have begun to administer behavioral intervention programs which may well be as effective as drug treatment in reducing the off-task classroom behavior of many hyperkinetic children. There are many hyperactive children in classrooms who are not referred for medical evaluation and treatment. A group of teacher-identified hyperactive boys was rated significantly higher on the Hyperkinesis Index of the Conners Teacher's Questionnaire than a group of non-hyperactive classmate control boys, but the mean Hyperkinesis Index scores of teacher-identified hyperactives and clinic-diagnosed hyperkinetics did not differ from each other. The teacher-identified hyperactive boys were observed to be off-task 33% of the time in their classrooms, and the clinic-diagnosed hyperkinetic boys were off-task a comparable 37% of the time. It was suggested that if school personnel use their expertise to identify hyperactive children in the classroom and begin behavioral intervention programs a t the earliest possible time, medical referral and treatment will be unnecessary for many children.During the past decade, increasing interest in childhood hyperactivity has been shown by parents, physicians, psychologists, and school personnel. Consequently, confusion has developed among the professions and in the public about the importance of the school's role in diagnosing and treating hyperkinetic children. Some psychologists believe that the school should be responsible, not only for diagnosing hyperkinetic children, but also for persuading parents and physicians to place these children on medication (Tobiessen & Karowe, 1969). Many physicians, on the other hand, think schools have been assuming too great a role in the diagnosis of hyperkinesis, and several authors have warned against the dangers of yielding to school pressures to prescribe drugs (Browder, 1972;Grinspoon & Singer, -1973). Clearly, many of the problems in defining the appropriate role of the school are due to the assumption that once the child is diagnosed as hyperkinetic, central nervous system (CNS) stimulants should routinely be prescribed.
THE CHANGING ROLE OF THE SCHOOLDespite professional differences of opinion concerning the amount of responsibility teachers should have in diagnosis, teachers do readily recognize hyperactive children in their classrooms, and they are often responsible for initiating the process that ultimately results in the formal medical diagnosis of Hyperkinetic Syndrome. The typical referral sequence begins with the teacher identifying a hyperactive child in the classroom and referring the child to the school psychologist. Generally, the parents are notified, and the child is referred to a physician or mental health ...
