Society of pediatric psychology presidential address: toward a social ecology of pediatric psychology.

health care providers. I hope that this article will contribute to pediatric psychologists’ broader thinking of systems in both their programs of research and the clinical issues we negotiate daily. Much of my thinking regarding social ecology has been derived from a program of research in pediatric psychopharmacology (for review, see Brown, Dreelin, & Dingle, 1997; Brown & Sawyer, 1998). Under double-blind conditions, the effects of stimulant medication on children’s behavior and learning were that their capacity to deploy attention and their on-task behavior were much improved. Also, teachers who were unaware of the children’s diagnosis or whether the children were receiving active medication or placebo reacted in distinct ways (Whalen, Henker, & Dotemoto, 1980, 1981). They reacted with more intensity and control toward boys who were receiving placebos than toward the boys who were medicated. In the midst of engaging in everyday classroom activities, teachers were quite responsive to the stimulant medication status of the children. Thus, a treatment that produces significant behavioral changes in children also produces concomitant changes in those who interact with children. But pediatric psychologists manage not just one child on medication but a network of other people as well. Based on this research examining the effect of stimulant medication on parents, teachers, and peers with whom medicated children interact, we can now conclude definitively that stimulant medication exerts a significant effect not only on the Journal of Pediatric Psychology, Vol. 27, No. 2, 2002, pp. 191–201