While psycho-stimulant medication has provided relief to many children suffering from behavioral disorders, the sudden increase in both the awareness and diagnosis of ADHD has raised concerns about potential over-diagnosis and about the liberal use of psychotropic medication to modify the behavior of children. Because minor children are often incapable of making their own medical treatment decisions, their parents or legal guardians bear the responsibility of deciding the best course of treatment for them. But parents, who are not always aware of their legal right to informed consent, increasingly report facing strong social, institutional, and legal pressures to medicate their children.

Behavior that is described as ADHD is often first observed by teachers, not parents. Well-meaning teachers, managing oversized classes with ever-diminishing resources, urge parents to place their children on drug therapy. In increasingly well-documented cases, school administrators have told parents that their child may not attend school unless he or she is placed on Ritalin or a similar medication.

In some circumstances, parents who decline to medicate their children are reported to child protective services by school administrators, and must then answer allegations of neglect or run the risk of having their children taken away by the state.