An amendment to the IDEA Reauthorisation Act of 2004 prohibits school authorities from requiring parents to obtain a prescription to a drug subject to the Controlled Substances Act as a condition for either attending school or receiving services under IDEA.(20 U.S.C. §1412(a)(25) - Prohibition on mandatory medication.)
This explains one approach a parent or student may take in asserting the student's rights under 20 U.S.C. §1412(a)(25) .
This is not legal advice.
This is just something you found on the Web. This is not properly researched legal advice, and should not be regarded as such. The author is not a lawyer in any jurisdiction where this would be relevant, and his only qualification is that he posted something that apparently made it into the IDEA Reauthorisation Act. If you want legal advice, find a website which provides proper legal advice. One place to look would be a government agency website. If all you want is someone's personal opinion (not legal opinion) on a webpage you're already at the right place.
So if I called it proper legal advice, I'd be misleading.
While informal suggestions may be made to obtain a prescription for Ritalin or similar drug, if pressure is to be applied to the parents, it will be in a live conference. The school's "requests" will be well-scripted to sound like ultimatums. The conference will be either a conference pursuant to IDEA (an IEP conference) or a general conference. The conference will generally include the teacher and another representative of the school in a "double-team" effort.
The pressure (besides using multiple school representatives) are an inference that the student will be "held back", placed in a special education class, will be denied educational services, or perhaps denied education. Under §1412(a)(25) of the IDEA Reauthorisation Act (20 U.S.C. §1412(a)(25)), the school is required to avoid directly stating that a prescription of Ritalin is a requirement for the child's receiving educational services. Regardless, expect some sort of pressure.
Effects of 20 U.S.C. §1412(a)(25)20 U.S.C. §1412(a)(25) has placed major restrictions on the ability of school personnel to coerce parents to obtain a Ritalin prescription. Regardless, expect the school to attempt to use various "persuasive" techniques to encourage parental cooperation. A typical approach is ask about "evaluation" by a doctor.
BUT also expect that school personnel to tiptoe around the issue of requiring a prescription. That is the weak point to any attempt to coerce a parent to cooperate in obtaining a prescription. Respond by enthusiastically asking whether obtaining a prescription is required.
The strategy is to hold the school to the constraints of the law and not respond to innuendo, and not accede to pressure based on innuendo.
The first part of the strategy is to know what to expect. If the school is "double teaming" you, treat this as an adversary proceeding. "Adversary" does not mean hostile, and it is generally beneficial to be cordial; only expect that the school's interests may not be the same as those of your child. If in fact the school turns out to be sincerely interested in the welfare of the student, then that is fortunate; however, this does not affect your own strategy. Your own strategy is to be an advocate for the student (or yourself if you are the student).
Beyond that, there are several possibilities:
- Comply with the school's requests, obtain a prescription and drug your child.
- Stand your ground. State your expectation of full compliance with the letter and spirit of 20 U.S.C. §1412(a)(25)
- Comply with the school's requests, but refuse to drug your child (i.e., don't get the prescription filled), which you are entitled to do under 20 U.S.C. §1412(a)(25) (The student simply states, "My family considers medical matters private.")
- Respond by obtaining psychiatric services on your own terms, in a manner which does not lead to drug therapy.
If at any point the school personnel state that they cannot clearly state their request due to constraints of the law, state that you expect them to follow both the letter and spirit of the law. The law states that they cannot expressly state a requirement or mandate for "medication".
In other words, the response is that you expect that they fully comply with 20 U.S.C. §1412(a)(25). You see no advantage to complying with recommendations intended to circumvent the law.
It helps to memorize the citation 20 U.S.C. §1412(a)(25), because referring to the law by citation makes it clear that you expect compliance.
Do not discuss your reasons for not wishing to drug your child. If school personnel are truly interested in the reasons, they would probably not ask a parent or student. If they're asking those type of questions, presume it to be a well-scripted challenge to your judgement.
If asked about obtaining services of a doctor, explain that you do seek medical attention when necessary, but under HIPAA (or pertinent health privacy laws outside the US) provide medical information only on a "need-to-know" basis. It is not their business what your child's doctor says except where their cooperation is required to comply with the doctor's recommendations.
In any formal meeting or any meeting of consequence, take notes. If you think it may be beneficial, bring your own notes outlining what you want to do or say. (If Ritalin is expected to be an issue, a copy of 20 U.S.C. §1412(a)(25) should be in your notes.)
If anyone makes a request or significant statement, write down what that person said, and who said it. This obviously has significance in the case of potential violations of the law, but it is not necessary to decide whether a particular statement or request is proper before writing it down. When taking notes, do not try to decide if what you are writing is useful.
Your school district may allow taping the conference. Whether to do so is of course up to you.
Try to decide in advance what your intentions are for your child.
Respond calmly no matter what they say. That's one advantage of bringing notes and knowing what you would say. If you don't have an answer, tell them you need time to decide. If asked the same question twice, state that you already answered that question.
- If you intend to accept the advise to obtain a prescription for drugs, you probably already had made that decision prior to the meeting.
- If you decide to confront the school directly over compliance with 20 U.S.C. §1412(a)(25), make your statements as necessary, and take notes.
- "I expect full compliance with the letter and spirit of 20 U.S.C. §1412(a)(25)."
- Another strategy is to comply with school requests, but refuse to administer drugs therapy if the drug happens to fall under the Controlled Substance Act (which includes Ritalin and similar drugs).
- It is possible to select professional services through a psychologist (not a psychiatrist) and never reach the point of prescriptions.
20 U.S.C. §1412(a)(25) is the weak point to school attempts to coerce a parent to cooperate in obtaining a prescription. Expect school personel to tiptoe around this issue.
Attempts to circumvent the 20 U.S.C. §1412(a)(25) law give you a significant advantage in negotiations. Respond by enthusiastically asking whether obtaining a prescription is required:
- 1. Wait for some sort of ambiguous or non-committal statement suggesting they are avoiding literal violation of 20 U.S.C. §1412(a)(25)
- It really doesn't matter if they are wrong or right in their approach; your approach is the same.
- 2. Understand that they know they are on tenuous grounds or do not have the backing of the law.
- 3. "Call them" on it!
- "Is obtaining a prescription for Ritalin required for any services by the school?"
"Is obtaining a prescription for Ritalin ever going to be a requirement for my child to attend school"
Whatever the answer,"Could I please get that in writing."
(Explain how getting things in writing is important, and how it is important to be assured that their requests are "lawful".)
"If you are not willing to put it in writing, I would appreciate it if you could please leave it out of this discussion."
"Leave it out" is phrased as a bit of conversation, but what it really does is makes it clear that you know the law and have every intention of insisting that they follow the law.
At this point, expect them to have a lot less enthusiasm at coercion or perhaps to back down entirely. They are unlikely to be prepared for this sort of challenge.
20 U.S.C. §1412(a)(25) specifies "a substance covered by the Controlled Substances Act (21 U.S.C. 801 et seq.)" This covers Ritalin and related drugs, but may not cover other drugs not subject to the Controlled Substances Act. It is unlikely that the school would recommend or mandate such other drugs for behaviour control, however.
The school can recommend psychiatric services, but would be required to pay for these services if they are a school requirement. Nevertheless, the school cannot mandate the use of a drug subject to the Controlled Substances Act based on a psychiatric recommendation.
I had accompanied a mother at one of these meetings. I asked if they were prescribing the drugs. Since there was no qualified professional within spitting range, they dropped the suggestion. (Besides, I don't think they liked the way I was dressed -- I wore a full business suit!)
The following relates to public school systems. I believe that the incidence of administrators "prescribing" Ritalin in private schools is now rare.
The above meeting was prior to 20 U.S.C. §1412(a)(25). With the enactment of 20 U.S.C. §1412(a)(25) - Prohibition on mandatory medication, public schools may be less aggressive about coercively "prescribing" drugs.More on declining to prescribe Ritalin under the provisions of 20 U.S.C. §1412(a)(25) can be found at http://skoozeme.com/r-ball/declineritalin.htmlBe prepared with what you wish to ask for. Small class size. In-class teacher's assistant or helper. Whatever.
Small class size is often a major issue because of budgetary restraints. If the administrator objects, offer to accept an in-class assistant. Do not accept out-of-classroom sessions unless you have reason to trust the program (e.g., recommendations from other parents).
There are alternatives to drug therapy for ADD.
- Natural Therapy
- There are a number of approaches to this, including St. John's Wort, and others. Just search for "Ritalin AND natural" (or "+Ritalin +natural" in AltaVista and others).
Also try it spelled "Ritilin" -- on the computer; not yourself!
- Coffee. Last I checked, coffee wasn't listed as a Schedule II drug.
- Expect the school to drop the idea of drugs for that student.
- Food chemicals
- Related to natural therapy, except this simply consists of avoiding such things as artificial food colouring, nature-identical flavours, etc. Don't forget the school cafeteria under the Individuals with Disabilities Education Act (IDEA, US).The effect of food additives on hyperactivity was raised again in some UK studies. This appears in a Reuter's Article (which strangely has a Washington, DC byline), dated 5 sep 07.
- Class Size
- Under Public Law 94-142 - Individuals with Disabilities Education Act (USA), a public school must provide the necessary environment to meet the child's disabilities. In almost all cases, this is either small class size or a teaching assistant. If you seek outside counseling, discuss in-class teaching assistance with the professional.
- Expect the administrators to respond to a class size request in one of several ways. They may:
- Back off. They don't want the Federal requirement for a teaching assistant or smaller class size to be invoked by an IEP (Individual Educational Plan).
- Transfer the child to a smaller size classroom or AP (advanced placement) class. This is used for "problem children," -- except that "problem children" in this case means children whose parents know how to make the system work in their favour!
- Make threats. They're particularly skilled at that one. Just stand your ground. (but be prepared to go to detention!) But it is possible to "cave in" by enthusiastically choosing a professional of your choice.
- Time of Use
- If drugs are necessary, they should be administered while supervised at home and not at school. i.e., after 3 PM! (The problem with this approach is that it doesn't give the teacher a sedated kid.)
- More to the point, if it is unnecessary to drug your child after school, it is certainly unnecessary to drug your child during school.
A drug used only during school hours is likely not "treatment"; it is chemical restraint.
- Chose the Right Doctor
- In some parts of the country there are unethical psychiatrists who routinely rubber stamp school administrators' prescriptions (or rather issue them). Take your kid to the doctor, but go to a doctor of your choosing. (Hint: use your health insurance as an excuse to override the choice of the school administrator.)
- Agree WholeheartedlyThis may be the easiest approach with some backwards-thinking school districts. Then proceed to:
- Enthusiastically choose your own doctor, rather than theirs. (Can you say "Managed Health Care?") Point out that your doctor is one of the "best in the country."
- Ask the school administrators to what extent they will cooperate with your doctor's recommendations.
- Offer any suggestions from your doctor, such as smaller class size, in-classroom assistance, etc.
- Take your kid to a tutoring center. It will help the native intelligence to shine through. Also tutoring places, like their medical counterparts, make it their business to please the school. So they will make sure your child will "do well" in school.Under the "No Child Left Behind" Act (US), if a "Title 1 School" fails to reach its AYP goal for three years, the school can be required to pay for tutoring as supplemental services. If at all possible, either obtain vouchers or have the tutoring center to obtain the funds directly from the school district. The tutor they should know the proper procedures, and you don't want to be the arbitrator of this. From what I've seen the maximum is $2000/year, but a White House press release cites $500-$1000.
- Before choosing a psychiatrist, interview them on the telephone concerning their philosophy of using drugs for children referred to them with ADD. Don't bother discussing the merits -- your sole purpose is to get their opinion on the subject.
- Better yet, use a psychologist who holds a PhD or MS, rather than a psychiatrist who holds an MD. Since psychologists are not trained as MDs they
- do not prescribe drugs
- are disinclined to prescribe drugs through a doctor (MD), so they'll recommend a non-drug therapy if at all feasible!
- are specifically trained to deal with behaviour and socialisation issues
- If the physician fails to tell you the problems associated with the drug, xe has made another diagnosis -- that you are an idiot and cannot be allowed sufficient information to make an informed decision. Find a competitent doctor.
- Also note that consultation with a psychologist (as opposed to a psychiatrist) is much less likely to later be considered a history of treatment for mental disorders!
- Do not agree to any optional school testing which requires parental consent.
- Use testing readily available on the outside. Use services readily available on the outside. It's cheaper than the alternative - eventually withdrawing your child from school for private or parochial school. If they think you are circumspect about their motives, you've gotten your point across!
- Always chose a program which gives you control of the patient-doctor confidence privilege and which gives you control of the treatment regimen.
^ In most cases, the parent has the authority to decline placement in a special education program. In the case of students over 18, the student has the authority to decline special education placement. The school can often make this an "all-or-nothing" proposition, meaning that all IEP services would be refused; however, a school's threat to move the student to a "sp-ed" program can generally be ignored.
site first posted August 21, 1999; this page 25-Dec-2009
rev 18-Jan-15 This page copyright 2009, Stan Protigal