Ritalin use low in Md. schools That could signal missed diagnoses, head of study says

November 15, 1998|By Melissa Corley | Melissa Corley,CONTRIBUTING WRITER

COLLEGE PARK -- Fewer than 3 percent of Maryland's public school children take Ritalin at school for treatment of attention disorders, and the state has one of the lowest rates of use of the drug in the nation, state officials said here yesterday.

But that low rate might not be a good thing, the chairman of a task force studying Ritalin use cautioned as its findings were presented at a public conference.

The 19-member task force was formed by the Maryland General Assembly in 1997 to study the use of the stimulant Ritalin, or methylphenidate, for the treatment of conditions such as attention deficit hyperactivity disorder (ADHD).

Its chairman, Dr. Sidney B. Seidman, said Maryland has the fourth-lowest rate of Ritalin use in the nation.

"Should we be happy we're at the bottom?" said Seidman, an assistant professor of pediatrics at the Johns Hopkins School of Medicine. "Maybe we shouldn't be so happy. I'm wondering if we're doing a good job making the diagnosis of ADHD."

Maryland's health secretary, Dr. Martin P. Wasserman, told an audience of about 200 that the two-day conference that ended yesterday was intended to help officials and parents improve the lTC lives of children and the state's schools.

"If you don't have a healthy child ready to learn in the classroom, you won't have an effective educational system," Wasserman said.

Fidgeting, blurting out

ADHD is often characterized by fidgeting, difficulties in remaining seated, waiting, and concentrating or following instructions, and blurting out at inappropriate times. It is manageable in some children without medication.

Although the disorder usually affects children, symptoms can continue into adulthood. The symptoms are not always noticeable, and the problem can go undiagnosed as a cause of poor school performance or low self-esteem, said Dr. Patricia O. Quinn and other speakers.

Maryland's study -- the first of its kind in the nation, according to the task force chairman -- found that 2.92 percent of the 820,000 students in Maryland public schools received the medication in school last year.

Use appears to decline with age. Of students receiving Ritalin in Maryland schools, 63.71 percent were in elementary school, 26.62 percent in middle school and 9.67 percent in high school.

The study noted that 300,000 students took Ritalin nationwide in 1970, down from 2 million in 1996 and 1997.

Found in boys and girls

Although the majority of students receiving the medication are boys, that does not necessarily mean that boys are more likely to develop attention-deficit disorders, said Quinn, a developmental pediatrician from Washington.

"Girls show cognitive and language dysfunction" instead of the more visible signs of inattention and hyperactivity, Quinn said.

Experts taking part in the conference also noted that attention-deficit disorders affect 10 percent of the school-age population in the United States and that hyperactivity is not always a symptom or the only indicator of a need for medication.

Ritalin usually is combined with counseling, adaptation of a student's schedule and classroom routine, and the help of specially trained teachers.

'Spectrum of needs'

"The spectrum of needs varies from child to child and must be planned individually," said Richard Steinke, deputy superintendent of the state Department of Education.

Many parents are afraid of the drug because there is a stigma attached to it, said Nancy Ditman, who attended the conference as a consulting special education teacher in Carroll County's public schools and as the parent of a child with ADHD.

She said her son's behavior improved after he began taking Ritalin.

Pub Date: 11/15/98

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