The extent of drug therapy for attention deficit-hyperactivity disorder among children in public schools.
OBJECTIVE
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.
LeFever
G B
GB
Center for Pediatric Research, Children's Hospital of The King's Daughters, Eastern Virginia Medical School, Norfolk, USA. glefever@chkd.com
Dawson
K V
KV
Morrow
A L
AL
D001741:Black or African American / Q000706:statistics & numerical data; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D015982:Bias; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization; D004522:Educational Status; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012572:School Health Services / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D013334:Students / Q000706:statistics & numerical data*; D014768:Virginia / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data