The hyperkinetic label can impair self-image and create negative expectation. It should be used only with confidence in its accuracy and when its use confers help not otherwise available. Guidelines for appropriate diagnosis include prevalence considerations, teacher reports, extent of home difficulties, psychological testing and clinical evaluation. A hyperkinetic child (whether medicated or not) can be helped by attacks on the psycho-social-educational vicious cycle initiated by his original handicap. (EK)