The use of psychotropic medications for children and adolescents in psychiatric hospitals and residential programs has been questioned. Research has indicated that psychotropic medication has allowed psychiatrically ill children and adolescents to develop internal controls and overcome interference with cognitive functioning. P.R.N. medications are frequently required to supplement scheduled medications to target agitated behavior. The objective of this study was to better understand patient perceptions of p.r.n. medication for agitation used in institutional settings. An attempt was made to develop a tool with sufficient reliability to answer questions about acceptability, efficacy, and satisfaction in medication trials for agitated behavior in hospitalized youngsters. A questionnaire was administered to child and adolescent psychiatric inpatients within 12 hours of their receiving p.r.n. medication for agitation and repeated 4 hours later. A total of 42 patients participated in the episode one survey. The article focused on the frequencies of responses to the first 42 patients interviewed and the test-retest reliability of each question based on 41. One patient refused the retest. Results indicated that about 50 percent of the youngsters felt that the p.r.n. they received was the best for them. Thirty percent stated that either they could have done something themselves or by staff to avoid needing p.r.n. Lastly, 65 percent felt that something good happened from receiving the medication. The test-retest reliability of the instruments were consistent, offering encouragement with regard to prospectively conducting intervention studies of aggressive and agitated behavior of youngsters in institutional settings. Several study limitations are discussed in relation to the ability to generalize. Clinical implications involve current practice, policy development, and future research directions. The study supports general clinical impressions that p.r.n. medications work and are acceptable to patients. References