摘要：Objectives . This study estimated the prevalence of medication treatment for attention deficit–hyperactivity disorder (ADHD) among elementary school children in a North Carolina county. Methods . Parents of 7333 children in grades 1 through 5 in 17 public elementary schools were asked whether their child had ever been given a diagnosis of ADHD by a psychologist or physician and whether their child was currently taking medication to treat ADHD. Parents of 6099 children (83%) responded. Results . By parental report, 607 children (10%) had been given an ADHD diagnosis and 434 (7%) were receiving ADHD medication treatment. Seventy-one % of the diagnosed children were receiving medication. Treatment rates varied by sex, race/ethnicity, and grade. Conclusions . If treatment patterns observed in this study are representative, the public health impact of ADHD may be underestimated. (Am J Public Health. 2002;92:231–234) Population-based data on the prevalence of medication treatment for attention deficit–hyperactivity disorder (ADHD) are limited. Data on national prescribing trends are available and have been used to estimate the proportion of office visits in which a stimulant medication is prescribed. 1– 3 However, these data cannot be used to estimate the proportion of children with ADHD who are being treated with stimulant medication, because in any year, each treated child typically has multiple office visits and receives many prescriptions. 4 Some studies have estimated the prevalence of ADHD medication treatment on the basis of school records. In 1987, Safer and Krager 5 estimated that 6% of the elementary school children in Baltimore, Md, received medication treatment for ADHD. LeFever et al. 6 estimated that between 8% and 10% of second- through fifth-grade students in 2 Virginia school districts were receiving stimulant medication at school in 1995. In the Virginia study, treatment rates were particularly high among White boys: 17% took stimulant medication at school. 6 In 2000, a survey conducted among school nurses in Maryland reported that 3.7% of all public elementary school children took ADHD medication at school. 7 School-based surveys have an important limitation: they exclude children who take their medication only at home. Many parents choose to give medication at home by administering slow-release forms of stimulant medications. The authors of the Maryland school nurse study acknowledged this problem; they estimated that they missed about 20% of the children who were being treated for ADHD in their study population. 7 Few population-based parent surveys of ADHD medication treatment rates among schoolchildren have been done. The Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, a large epidemiologic survey of 4 US communities, reported that about 2% of the children in its sample were receiving ADHD medication treatment. 8 However, the children in the MECA study were aged 9 to 17 years. It is difficult to compare these data with those from samples of younger children, because medication rates tend to decline sharply among teenagers. 9 In this article, we use parent reports to estimate the prevalence of medication treatment for ADHD among public elementary school children in grades 1 through 5 in a North Carolina county and to examine how prevalence varies by grade, sex, and race/ethnicity.
