How to Handle an Unmedicated Student

Dear Kid Whisperer,

I am a third-grade teacher and I have a student who is medicated for attention and behavior problems. He is generally fine when he has taken his medicine, but he is totally out of control when he doesn’t. My principal and I have tried everything to try to get his parent to give him his medicine every day. I know the behaviors will get worse when there are no consequences for his actions, whether he is on his medication or not. I don’t know what to do. -Mary, Biloxi, Mississippi


I have been in this same situation with many, many families. I never had much success trying to figure out how to get parents to remember to give kids meds. This answer will concentrate on how to deal with this kid on those days that he doesn’t take his medicine.

You are correct, by the way. Unmedicated kids still need consequences. This does not mean that we should punish unmedicated kids. In fact, we shouldn’t punish any kids. Consequences involve learning and practicing positive behaviors, as well as solving the problems that are caused by negative behaviors. They are prefaced by sadness and empathy. Punishment, on the other hand, is never appropriate with any student. Punishment involves randomly assigning pain to a student when they do something that they shouldn’t do. Punishment is especially terrible for kids who have legitimate medical reasons for having trouble using positive behaviors.

You will be able to have the most success possible with this kid when you are using interventions to gently guide him towards positive behaviors, and also using logical consequences, often delayed, when that gentle guidance fails.


Place yourself, as much as possible, next to the student in question. This is easier said than done. Try to avoid putting his desk next to yours. Instead, have his permanent desk with the group. Just happen to have it near where you spend a lot of time.

Try to be within arm’s length of him as much as possible and teach from there. Give laser-like attention away from this student’s negative behaviors and toward students from all around the room who are doing what they should be doing.

Gently guide him back to the learning situation at hand by staying near him, putting a gentle hand on his shoulder (if you, he, and your administrator are comfortable with that) and, when he remains off track, whispering the following questions:

“What should you be doing?”

“What’s next?”

Questions have a much better chance of success for prompting students when compared with demands (“sit down” and “pay attention”, for example). You can use these with all students.


The key to consequencing kids is to delay those consequences to a time when they can process and learn from the consequence, and you have time to give the consequence without interrupting instruction. This is never more true than with an unmedicated kid.

Kid (while taking another student’s pencil and breaking it): I AM KING OF THE WOLFBOYS!!!

Kid Whisperer (whispering): Yikes. Oh, no. Ugh. I am going to do something about that. Don’t let it ruin your day. What’s next?

Notice that I didn’t try to “make” the kid do anything. Why? Because I can’t! Why would I try? This kid isn’t in his right mind anyway. He can’t learn anything from an immediate consequence at that moment. However, he does know that he will have to do something later, and that he is not in a consequence-free environment. Later, when he is medicated, he will take some time to buy and sharpen a pencil for the affected student and do some good deeds for him. He will simply learn that he must solve the problems that he causes, no matter what is going on in his life.