10)  Pharmacy has not delivered exact medication prescribed by your doctor.  They may have substituted a "generic" for "real" or "brand" medication.

9)  Parent/patient failure to fully and carefully read and follow directions on the label of the prescription bottle.

8)  Parent/patient failure to read the physician's written directions describing details about use of the medications.

7)  Forgetting to administer medications according to prescribed schedule.

6)  Failure to carefully track times medication is administered compared to benefits.  If medication "works" for 4 hours, benefits will be maximal during that precise period, not before or after.

5)  Since parents usually do not see the child in a school class while the meds are working, failure to communicate with the teacher is often a major source of misperception of benefits.

4)  Not all teachers are a consistently reliable source of feedback about medication benefits and/or complications.

3)  Many patients and parents ignore or forget instructions to use half-doses when there seems to be complications or side effects.  Obviously when a medication seems "too strong," then cut the dose in half for a few days!

2)  Confusion about "rebound" and benefit.  When a stimulant medication is wearing off, there may be "rebound."  During this period a child getting excellent benefit at school may temporarily appear  "worse" at home when the meds have now worn off.

And the number 1 reason for trouble:

1)  Failure to fully discuss with the doctor the benfits which medication may achieve, side effects, and imagination of changes qwhich no medication alone could ever possibly deliver.  Medication alone is not a "magic bullet."