Pediatricians?? Reported Practices in the Assessment and Treatment of Attention Deficit Disorders

Copeland, Linda; Wolraich, Mark L.; Lindgren, Scott D.; Milich, Richard; Woolson, Robert F.

doi:10.1097/00004703-198708000-00001

Cited by 61 publications

(33 citation statements)

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“…Similar findings have been reported by Copeland et al (1987) and Moser and Kallail(l995). While these figures suggest relatively high levels of use of behavior therapies, they do not reflect what was done with individual children and are suspect on the grounds of likely overreporting due to social desirability factors and physicians' presenting their treatment practices in a favorable light.…”

Section: How Much Is Being Prescribed? Data From Safer Andsupporting

confidence: 92%

Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities

Jensen

Kettle

Roper

et al. 1999

Journal of the American Academy of Child & Adolescent Psych

269

158

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Objective: To address rising concerns about the possible overdiagnosis of attention-deficit hyperactivity disorder (ADHD) and overtreatment with stimulants.To date, almost no studies have examined ADHD in unbiased community-based studies, ascertaining both the prevalence of the diagnosis within nonreferred populations and the extent to which various treatments (i.e., stimulant medication, mental health treatments, and educational interventions) are used. Method: As a part of the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, the authors examined epidemiological survey data obtained from 1,285 children and their parents across 4 US. communities. Analyses examined the frequency of children's ADHD diagnosis, the extent to which medications were prescribed, as well as the provision of other services (e.g., psychosocial treatments, school-based educational interventions). Results: Findings indicated that 5.1% of children met full DSM-//I-RADHD criteria across the pooled sample. Only 12.5% of children meeting ADHD criteria had been treated with stimulants during the previous 12 months. Some children who had been prescribed stimulants did not meet full ADHD diagnostic criteria, but these children manifested high levels of ADHD symptoms, suggesting that the medication had been appropriately prescribed. Children with ADHD were generally more likely to receive mental health counseling and/or school-based interventions than medication. Conclusions: Medication treatments are often not used in treating ADHD children identified in the community, suggesting the need for better education of parents, physicians, and mental health professionals about the effectiveness of these treatments. On the basis of these data it cannot be concluded that substantial "overtreatment" with stimulants is occurring across communities in general. J. Am. Acad. Child Adolesc. Psychiatry: 1999, 38 (7):797-804. Key Words:attention-deficit hyperactivity disorder, attention deficit, hyperactivity, stimulants, misdiagnosis, services, treatment.Recent media reports indicate that the public has become increasingly concerned about the apparent dramatic rise in the diagnosis of attention-deficit hyperactivity disorder (ADHD) and the prescription of psychostimulant

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Section: How Much Is Being Prescribed? Data From Safer Andsupporting

confidence: 92%

Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities

Jensen

Kettle

Roper

et al. 1999

Journal of the American Academy of Child & Adolescent Psych

269

158

View full text Add to dashboard Cite

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“…They fail more grades, achieve lower marks, are more likely to drop out of school, and often have a diagnosis of a learning disability . Academic underachievement figures prominently in the referral and diagnostic processes (Copeland, Wolraich, Lindgren, Milich, & Woolson, 1987). In general, MPH treatment results in marked improvement in classroom behavior, attention to academic tasks, persistence, and effort (Rapport et al, 1994).…”

Section: Academic Effectsmentioning

confidence: 99%

“…Various methodological limitations in existing follow-up studies could account for the apparent lack of long-term benefits of MPH . Poor compliance (Brown et al, 1987;Firestone, 1982), premature termination (Firestone, 1982), habituation to the effects of medication Winsberg, Matinsky, Kupietz, & Richardson, 1987), treatment of cases with uncertain diagnoses (Copeland et al, 1987), and inconsistent medical management (Sherman & Hertzig, 1991) could also account for the reduced efficacy in some cases. The long-term outcome of ADHD also may not be altered by drug treatment because the acute effects of MPH (e.g., on core symptoms) are not those (e.g., impaired parent-child, adult, and peer relationships; learning disability) that are crucial determinants of the long-term outcome (Parker & Asher, 1987).…”

Section: Clinical Implications Limitations Of Medication and The Logimentioning

confidence: 99%

Pharmacological Treatment of Attention-Deficit/HyperactivityDisorder

Schachar

Ickowicz

1999

Handbook of Disruptive Behavior Disorders

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“…In the final year, 5.96% of elementary-aged public school children were on stimulant medication in the area studied (13). Second, there have been concerns brought forth about the criteria used to diagnose ADHD (6,14,15). The use of the DSM-IV criteria to define ADHD has not been universally accepted (14).…”

mentioning

confidence: 99%

School board survey of attention deficit/hyperactivity disorder: Prevalence of diagnosis and stimulant medication therapy

Sgro¹,

Roberts²,

Grossman³

et al. 2000

Paediatrics &Amp; Child Health

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BACKGROUND: Attention deficit/hyperactivity disorder (ADHD), a well described, common problem affecting school-aged children, has an estimated prevalence in Ontario of 7% to 10% of boys and 3% of girls in the age range of four to 11 years. There has been a documented trend to increased use of stimulant medications in the treatment of this disorder in the United States. OBJECTIVE: To assess the prevalence of stimulant medication therapy for ADHD in three southern Ontario school boards. PATIENTS AND METHODS:A cross-sectional epidemiological study was performed by distributing a survey to all parents of children in kindergarten through grade 6 in six to eight schools selected randomly in each of the three participating school boards. The completed questionnaires were collated, and the comparative data were analyzed using c 2 . RESULTS: A total of 5100 surveys were distributed among the three school boards; 1465 (28.8%) questionnaires were returned completed. Within the three school boards -Hastings County Board of Education, Metropolitan Toronto Separate School Board and the East York Board of Education -the prevalence of ADHD for the age groups surveyed was 4.3%, 3.4% and 6.8%, respectively (average 4.7%), with a peak average of almost 9% by 12 years of age. The percentages of children with diagnosed ADHD who were on stimulant medication were 43%, 3% and 13%, respectively. The differences between the school boards were statistically significant (P<0.05). The male versus female prevalence of a diagnosis of ADHD was 7.1% versus 1.2%, 3.8% versus 3.3% and 10.1% versus 3.6%, respectively, with a combined school board average of 7.1% of males versus 2.9% of females. The average percentage of males versus females who were diagnosed with ADHD and who were on stimulant medication was found to be 27% versus 5%. CONCLUSIONS: The prevalence of ADHD was 4.7% in the study population. The overall percentage of children who were on stimulant medica-

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Pediatricians?? Reported Practices in the Assessment and Treatment of Attention Deficit Disorders

Cited by 61 publications

References 0 publications

Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities

Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities

Pharmacological Treatment of Attention-Deficit/HyperactivityDisorder

School board survey of attention deficit/hyperactivity disorder: Prevalence of diagnosis and stimulant medication therapy

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