Students are increasingly being prescribed stimulant medication to treat the symptoms of attention-deficit/hyperactivity disorder (ADHD). Although several authors have advocated specific procedures for monitoring the effects of this medication in school settings, recent evidence suggests that these procedures are not being used adequately. In this article, we delineate the components of published medication evaluation procedures and discuss the barriers to their effective implementation in diverse settings. To address these barriers, we use a flexible model for school-based medication evaluation, and we present a case example. In this model, an assessment of the acceptability and feasibility of evaluation components is integrated into a behavioral problem-solving framework. We argue that to increase the quality of the evaluation of medication in children with ADHD, it is important to balance the internal validity of assessment procedures with their feasibility and acceptability. (Contains 7 figures.)