Comparing treatment tactics with a hyperactive preschool child: stimulant medication and programmed teacher intervention.

Researchers worked with one hyperactive preschool child. They compared two treatments side-by-side. One treatment was Ritalin pills. The other was teacher praise and small food treats for calm play.

They used an alternating treatments design. Each day they switched between drug days and reward days. They counted how often the child moved from toy to toy during free play.

The teacher rewards cut toy-switching better than the pills. The pills helped the child stay seated longer. Yet the higher pill dose made the child talk less and respond slower.

Behavioral reinforcement gave the gain without the speech side-effects.

Winett et al. (1972) warned that classroom programs chase “be quiet and still” too much. This study shows the risk: pills can buy quiet at the cost of speech.

M-Ohan et al. (2015) looked at many ADHD studies. They found drugs help only about half of kids reach normal motor control. Our single case fits that picture—attention improved, but not every behavior.

Barrett et al. (1987) used the same alternating design to pick the best language method. The method works fast for comparing any two treatments, pills or teaching tricks.

You now have data that teacher rewards can beat stimulant medication for one key hyperactive behavior. Start with reinforcement before raising drug doses. Watch for slowed speech if the doctor does increase medication. Use an alternating treatments design to test the choice in your own classroom—two days on, two days off, and count what really changes.