Dr. Feder will consider medication if there is a good plan in place but poor progress. When you’re doing everything you can, yet you’re not making headway, he’ll think about medication. Medication might help particular things that get in the way. Emotional dysregulation, poor sleep, poor nutrition, or distractibility could all be things that medication can help. Safety issues are another concern that warrants thinking about medication, such as severe self-injurious behaviour. And sometimes medication makes patients more regulated, which can help them then develop where they were unable to before.
Dr. Feder also talks about how ridiculous it might be to give children Ritalin only to sit still at school. Children are meant to be active and run around. Sometimes cultural expectations make us think our children need medication when it is not necessary. Dr. Feder also discussed some other cultural norms that dictate other behaviours of ours like the Western cultural expectation of sleeping through the night, when as a species humans seem to be meant to sleep in the evening and before dawn and be up at night. Should we really be medicating people to stay asleep?