Skip to main content
NCBI home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1999 Sep;89(9):1359–1364. doi: 10.2105/ajph.89.9.1359

The extent of drug therapy for attention deficit-hyperactivity disorder among children in public schools.

G B LeFever 1, K V Dawson 1, A L Morrow 1
PMCID: PMC1508779  PMID: 10474553

Abstract

OBJECTIVES: The purpose of this study was to determine the extent of medication use for attention deficit-hyperactivity disorder (ADHD) in southeastern Virginia. METHODS: Students enrolled in grades 2 through 5 in school districts in city A (n = 5767 students) and city B (n = 23,967 students) were included. Nurses recorded students who received ADHD medication in school. RESULTS: The proportion of students receiving ADHD medication was similar in both cities (8% and 10%) and was 2 to 3 times as high as the expected rate of ADHD. Receipt of drug therapy was associated with social and educational characteristics. Medication was used by 3 times as many boys as girls and by twice as many Whites as Blacks. Medication use increased with years in school, and by fifth grade 18% to 20% of White boys were receiving ADHD medication. Being young for one's grade was positively associated with medication use (P < .01). The prevalence of ADHD was 12% in district A, 63% in district B. CONCLUSIONS: These findings suggest that criteria for diagnosis of ADHD vary substantially across US populations, with potential overdiagnosis and overtreatment of ADHD in some groups of children.

Full text

PDF
1359

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bird H. R., Canino G., Rubio-Stipec M., Gould M. S., Ribera J., Sesman M., Woodbury M., Huertas-Goldman S., Pagan A., Sanchez-Lacay A. Estimates of the prevalence of childhood maladjustment in a community survey in Puerto Rico. The use of combined measures. Arch Gen Psychiatry. 1988 Dec;45(12):1120–1126. doi: 10.1001/archpsyc.1988.01800360068010. [DOI] [PubMed] [Google Scholar]
  2. Cantwell D. P., Baker L. Association between attention deficit-hyperactivity disorder and learning disorders. J Learn Disabil. 1991 Feb;24(2):88–95. doi: 10.1177/002221949102400205. [DOI] [PubMed] [Google Scholar]
  3. Cohen P., Cohen J., Kasen S., Velez C. N., Hartmark C., Johnson J., Rojas M., Brook J., Streuning E. L. An epidemiological study of disorders in late childhood and adolescence--I. Age- and gender-specific prevalence. J Child Psychol Psychiatry. 1993 Sep;34(6):851–867. doi: 10.1111/j.1469-7610.1993.tb01094.x. [DOI] [PubMed] [Google Scholar]
  4. Costello E. J., Costello A. J., Edelbrock C., Burns B. J., Dulcan M. K., Brent D., Janiszewski S. Psychiatric disorders in pediatric primary care. Prevalence and risk factors. Arch Gen Psychiatry. 1988 Dec;45(12):1107–1116. doi: 10.1001/archpsyc.1988.01800360055008. [DOI] [PubMed] [Google Scholar]
  5. Esser G., Schmidt M. H., Woerner W. Epidemiology and course of psychiatric disorders in school-age children--results of a longitudinal study. J Child Psychol Psychiatry. 1990 Jan;31(2):243–263. doi: 10.1111/j.1469-7610.1990.tb01565.x. [DOI] [PubMed] [Google Scholar]
  6. Findling R. L. Open-label treatment of comorbid depression and attentional disorders with co-administration of serotonin reuptake inhibitors and psychostimulants in children, adolescents, and adults: a case series. J Child Adolesc Psychopharmacol. 1996 Fall;6(3):165–175. doi: 10.1089/cap.1996.6.165. [DOI] [PubMed] [Google Scholar]
  7. Goldman L. S., Genel M., Bezman R. J., Slanetz P. J. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association. JAMA. 1998 Apr 8;279(14):1100–1107. doi: 10.1001/jama.279.14.1100. [DOI] [PubMed] [Google Scholar]
  8. Jacobvitz D., Sroufe L. A., Stewart M., Leffert N. Treatment of attentional and hyperactivity problems in children with sympathomimetic drugs: a comprehensive review. J Am Acad Child Adolesc Psychiatry. 1990 Sep;29(5):677–688. doi: 10.1097/00004583-199009000-00001. [DOI] [PubMed] [Google Scholar]
  9. Jensen P. S., Watanabe H. K., Richters J. E., Cortes R., Roper M., Liu S. Prevalence of mental disorder in military children and adolescents: findings from a two-stage community survey. J Am Acad Child Adolesc Psychiatry. 1995 Nov;34(11):1514–1524. doi: 10.1097/00004583-199511000-00019. [DOI] [PubMed] [Google Scholar]
  10. Morrow R. C., Morrow A. L., Haislip G. Methylphenidate in the United States, 1990 through 1995. Am J Public Health. 1998 Jul;88(7):1121–1121. doi: 10.2105/ajph.88.7.1121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Richters J. E., Arnold L. E., Jensen P. S., Abikoff H., Conners C. K., Greenhill L. L., Hechtman L., Hinshaw S. P., Pelham W. E., Swanson J. M. NIMH collaborative multisite multimodal treatment study of children with ADHD: I. Background and rationale. J Am Acad Child Adolesc Psychiatry. 1995 Aug;34(8):987–1000. doi: 10.1097/00004583-199508000-00008. [DOI] [PubMed] [Google Scholar]
  12. Safer D. J., Allen R. P. Stimulant drug treatment of hyperactive adolescents. Dis Nerv Syst. 1975 Aug;36(8):454–457. [PubMed] [Google Scholar]
  13. Safer D. J., Krager J. M. A survey of medication treatment for hyperactive/inattentive students. JAMA. 1988 Oct 21;260(15):2256–2258. [PubMed] [Google Scholar]
  14. Safer D. J., Krager J. M. The increased rate of stimulant treatment for hyperactive/inattentive students in secondary schools. Pediatrics. 1994 Oct;94(4 Pt 1):462–464. [PubMed] [Google Scholar]
  15. Safer D. J., Zito J. M., Fine E. M. Increased methylphenidate usage for attention deficit disorder in the 1990s. Pediatrics. 1996 Dec;98(6 Pt 1):1084–1088. [PubMed] [Google Scholar]
  16. Shaywitz S. E., Shaywitz B. A. Attention deficit disorder: current perspectives. Pediatr Neurol. 1987 May-Jun;3(3):129–135. doi: 10.1016/0887-8994(87)90077-4. [DOI] [PubMed] [Google Scholar]
  17. Sroufe L. A., Stewart M. A. Treating problem children with stimulant drugs. N Engl J Med. 1973 Aug 23;289(8):407–413. doi: 10.1056/NEJM197308232890806. [DOI] [PubMed] [Google Scholar]
  18. Swanson J. M., Lerner M., Williams L. More frequent diagnosis of attention deficit-hyperactivity disorder. N Engl J Med. 1995 Oct 5;333(14):944–944. doi: 10.1056/NEJM199510053331419. [DOI] [PubMed] [Google Scholar]
  19. Szatmari P., Offord D. R., Boyle M. H. Ontario Child Health Study: prevalence of attention deficit disorder with hyperactivity. J Child Psychol Psychiatry. 1989 Mar;30(2):219–230. doi: 10.1111/j.1469-7610.1989.tb00236.x. [DOI] [PubMed] [Google Scholar]
  20. Vaughn B. E., Lefever G. B., Seifer R., Barglow P. Attachment behavior, attachment security, and temperament during infancy. Child Dev. 1989 Jun;60(3):728–737. doi: 10.1111/j.1467-8624.1989.tb02753.x. [DOI] [PubMed] [Google Scholar]
  21. Velez C. N., Johnson J., Cohen P. A longitudinal analysis of selected risk factors for childhood psychopathology. J Am Acad Child Adolesc Psychiatry. 1989 Nov;28(6):861–864. doi: 10.1097/00004583-198911000-00009. [DOI] [PubMed] [Google Scholar]
  22. Wilens T. E., Biederman J. The stimulants. Psychiatr Clin North Am. 1992 Mar;15(1):191–222. [PubMed] [Google Scholar]
  23. Wilens T. E., Spencer T., Biederman J., Wozniak J., Connor D. Combined pharmacotherapy: an emerging trend in pediatric psychopharmacology. J Am Acad Child Adolesc Psychiatry. 1995 Jan;34(1):110–112. doi: 10.1097/00004583-199501000-00021. [DOI] [PubMed] [Google Scholar]
  24. Wolraich M. L., Hannah J. N., Pinnock T. Y., Baumgaertel A., Brown J. Comparison of diagnostic criteria for attention-deficit hyperactivity disorder in a county-wide sample. J Am Acad Child Adolesc Psychiatry. 1996 Mar;35(3):319–324. doi: 10.1097/00004583-199603000-00013. [DOI] [PubMed] [Google Scholar]
  25. Wolraich M. L., Lindgren S., Stromquist A., Milich R., Davis C., Watson D. Stimulant medication use by primary care physicians in the treatment of attention deficit hyperactivity disorder. Pediatrics. 1990 Jul;86(1):95–101. [PubMed] [Google Scholar]
  26. Zito J. M., Safer D. J., dosReis S., Magder L. S., Riddle M. A. Methylphenidate patterns among Medicaid youths. Psychopharmacol Bull. 1997;33(1):143–147. [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES