NORFOLK – Legislators and school officials responded with calls for action Thursday after hearing that Hampton Roads cities have some of the highest rates in the nation for use of Ritalin, a drug for attention deficit disorders.

“It’s scary, in my opinion, because I don’t know why,” Del.-elect Winsome Sears said at a legislative forum at Children’s Hospital of The King’s Daughters. “The fact that we’re not the only one in the country is not comforting. I want to know why so many children here are on Ritalin.” 

At the forum, sponsored by the School Health Initiative for Education, participants urged:

More in-depth study of the prevalence of attention deficit/hyperactivity disorders and how that compares with the region’s use of Ritalin and other ADHD medications.

Examination of insurance coverage. Dr. Albert Finch, executive medical director at Children’s Hospital, said many pediatricians who would like to refer patients for more thorough mental-health evaluations when diagnosing ADHD find that insurance does not cover the evaluation.

Consideration of hiring more school psychologists. Chesapeake school psychologist LaVerne Alebiosu said she has her hands so full evaluating children for possible ADHD that little time is left for prevention efforts and for helping children who have already been diagnosed.

Study of genetic, environmental and demographic factors that might contribute to high Ritalin use.

Local researcher Gretchen LeFever, a psychologist and assistant professor of pediatrics at the Center for Pediatric Research, presented statistics at the forum showing that Hampton Roads cities ranked in the top 10 percent for Ritalin use in a comparison of 2,994 communities across the country. The center is a joint project of Children’s Hospital and the Eastern Virginia Medical School.

Virginia ranked fourth in the country. Portsmouth was in the top 1 percent of the nation’s communities, Virginia Beach in the top 3 percent, Chesapeake in the top 5 percent, and Hampton, Norfolk and Newport News in the top 10 percent.

There are other ‘hot spots’ of Ritalin use across the state, including Richmond, Charlottesville and Northern Virginia. Other states with high rates include Montana, Michigan, Indiana and Iowa.

LeFever said her studies of local school districts have shown that the children on medication and diagnosed with ADHD have higher rates of absenteeism, expulsions and repeating grades. So while the medication may be helping with symptoms, it’s not always helping with schoolwork.

To address that issue, LeFever recommended more emphasis on behavior management in schools. Birdneck Elementary in Virginia Beach is in the first year of a four-year pilot program in which teachers and other school personnel are learning how best to shape student behavior. LeFever hopes that Project PRAISE (Promoting Responsible Actions through Intervention and School-Wide Education), and can be duplicated across the state and nation.

Virginia Beach parent Vikki Flescher did not attend the forum, but she worries that studies such as LeFever’s may unfairly stigmatize children on ADHD medication. “I don’t understand the concern over the usage of it, if it’s working,” she said.

Flescher’s 9-year-old son has taken the drug Adderall for the past two years to treat ADHD. She said her son went from failing classes to becoming an honor roll student. “These studies make people think ADHD is imaginary, that it’s not real.”

At the forum, LeFever said she supports the use of medication when it’s appropriate and when a child truly has the disorder, which the National Institutes of Health says affects 3 percent to 5 percent of the school-aged population. But attention deficits, because they lack any biological marker, are prone to misdiagnosis.

State Sen. Yvonne Miller, D-Norfolk, urged people who have concerns or suggestions for more research or legislative changes to contact members of a legislative joint subcommittee studying the issue. The subcommittee, which Miller proposed and serves on, plans to make recommendations in December.

For more information about the School Health Initiative for Education, a coalition of educational and health professionals, call 668-6497 . For more information about the joint subcommittee (HJR 660) studying use of Ritalin among Virginia students, call Dawn Smith at (804) 698-1540

Written by Elizabeth Simpson for The Virginian-Pilot, and published on DrKelley.info, December 11, 2001. Embedded links (if any) may no longer be active. (Ed. 12.31.10)

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