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In Reply.—Dr Hersher makes an excellent point regarding the use of stimulant therapy in teenagers and young adults with ADD. The indications for the use of medication should be based on the neurodevelopmental status of the individual, not on his or her chronologic age. However, when stimulant drugs are used in teenagers, a special approach is needed. The teenager must be an active participant in the decision and in the use of medication. The teenager must understand the circumstances that indicate the necessity and potential benefit of the stimulant therapy. He or she should accept that motivation and personal effort will determine a successful response. The teenager should be assisted in selfmonitoring his or her response to the medication and any adverse pharmacologic effects. In addition, precautions should be taken when administering the drug. Many youngsters for whom it is indicated have poor social skills and are quite isolated