NIH News Release

National Institute of
Environmental Health Sciences

Monday, February 4, 2002
NIEHS Contact:
Tom Hawkins (919) 541-1402

Parental Report:
Impact of Attention Deficit-Hyperactivity May Be Underestimated

The public health impact of Attention Deficit-Hyperactivity Disorder may be greatly underestimated by school and public health officials, scientists at the National Institute of Environmental Health Sciences said today.

The NIEHS scientists and colleagues at the University of North Carolina School of Medicine in Chapel Hill reported that when they queried parents in a "typical" county of rural and suburban homes — Johnston County, N.C. — the parents reported more than 15 percent of boys in grades one through five had been diagnosed with ADHD and about 10 percent (or two-thirds of those diagnosed) were taking medication for the condition. Asking the parents was a key to the higher figures, the researchers thought, because school nurses might not be aware of children who are receiving medication treatment entirely at home.

"Treatment rates are usually viewed as abnormally high if they exceed the three to five percent prevalence estimate for ADHD cited in an American Psychiatric Association manual in 1994," the authors said. "Therefore, the national public health impact of ADHD may be greatly underestimated by both educators and public health officials."

The information gathered from parents also indicated:

The study utilized parental and teacher reports of 6,099 children in 17 public elementary schools in the semi-rural county. Because Johnston County has a racial/ethnic and educational profile similar to North Carolina as a whole, the authors of the study said they feel that medication treatment rates are probably similar in many other counties in North Carolina and elsewhere. The researchers said similar data needs to be collected nationally to better understand ADHD medication treatment patterns.

Authors of the study are Andrew S. Rowland, Ph.D.; Dale P.Sandler, Ph.D.; and David M. Umbach, Ph.D., of NIEHS, which is part of the National Institutes of Health but located in Research Triangle Park, N.C., near Johnston County; A. Jack Naftel, M.D., of the department of psychiatry, University of North Carolina School of Medicine, Chapel Hill; and Lil Stallone, M.P.H., and E. Michael Bohlig, both of the private research firm CODA/Westat of Durham, N.C.

The research appears online in the February issue of the American Journal of Public Health, a publication of the American Public Health Association. The journal is accessible at

The principal investigator, Dr. Rowland, may be reached for interviews at (505) 272-1391. Dr. Sandler, the senior investigator, is available at (919) 541-4668. (Dr. Rowland is now with the University of New Mexico Health Sciences Center.)

The National Institute of Environmental Health Sciences is a component of the National Institutes of Health, U.S. Department of Health and Human Services.