There has been a lot of response to my article Part 1, “Medicating our children - is this 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.)
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.
- 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?
- 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?
- 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 firstname.lastname@example.org or 1-877-HATALMUD (428 2568). Web: Shaarhatalmud.com.