One in 10 Virginia Elementary School Students Receives ADHD Treatment
Nov. 16, 1999 (New York) -- ADHD (attention deficit hyperactivity disorder)
appears to be reaching epidemic proportions in Virginia. A report published in
a recent issue of the American Journal of Public Health delivers
alarming news: in two Virginia cities, between 8% and 10% of children in grades
two to five receive medication for ADHD at school.
"We found the rate of ADHD medication use in two school districts in
Virginia was ... two to three times higher than national estimates of the
disorder," Gretchen B. LeFever, PhD, who headed the reporting team, tells
WebMD. "Although we can't generalize from these findings to what's going on
across the country, the DEA [Drug Enforcement Agency] suggests there are
regions within almost every state that look similar to our region in
LeFever is with the center for pediatric research at Children's Hospital of
The King's Daughters, affiliated with the Eastern Virginia Medical School in
In the study, information was gathered during the 1995-1996 school year on
almost 30,000 public school children in grades two to five in the two cities.
One city was larger and poorer overall and had a higher percentage of black
inhabitants. The health-related information was merged with 1990 U.S. Census
information, which contained specific regional data. The researchers then
looked through school records to identify those children taking medication for
ADHD from a school nurse.
While the overall proportion of children taking ADHD medication was 8% to
10%, the percentage increased as children got older. By the fifth grade, almost
20% of boys were taking ADHD medication at school.
One of the most surprising findings, according to LeFever, is the high rate
of medication use in the more affluent school districts, especially among
children who were young for their grade. Almost 63% of these children in one
city were being treated for ADHD. "This is an extraordinary figure. It
suggests parents, health professionals, teachers, or some combination of those
may have important misunderstandings," LeFever says, about what constitutes
'normal' inattention for grade-school children.
"It raises a lot of questions as to whether immaturity is being seen as
a . . . disorder instead of part of the normal developmental process,"
LeFever tells WebMD.
The report also showed that white children are more likely to be treated for
ADHD than their black classmates, a finding supported by other studies of the
extent to which ethnic background affects whether children receive needed
psychiatric treatment. "One of their more interesting findings is, why do
[white] children get evaluated and treated and [black] children do not?"
Dan Connor, MD, tells WebMD in an interview seeking an independent opinion of
the report. Connor is director of pediatric psychopharmacology at the
University of Massachusetts Medical School in Worcester.
Connor adds that while the report produced interesting findings, the
experiences of two school districts can?t be generalized to the entire
population. He also believes that, in general, "ADHD is underdiagnosed and
undertreated" in U.S. children.
Peter Jensen, MD, associate director for child and adolescent research at
the National Institute of Mental Health in Bethesda, Md., agrees with Connor.
He says that concerns about overprescribing of stimulants for ADHD are
unwarranted. "Based on the national data, it is likely that only about half
of ADHD children are being treated [with medication]," Jensen tells
Concerning the high rates reported in Virginia, Jensen says, "There are
bound to be site-to-site and regional variations, so all regional variations
should be put in that perspective."