An Erratum has been published for this article in Psychology in the Schools 42(2) 2005, 227 [ ]. This research utilized parent report to examine the prevalence of attention deficit hyperactivity disorder (ADHD), related treatment, and associated educational outcomes among elementary school children in southeastern Virginia. In a representative sample of elementary school children, 17% had been diagnosed with ADHD. The majority of diagnosed children had been medicated for ADHD (84%). More than one third of students taking medication had received no other interventions for ADHD. Over half of the diagnosed students received behavioral therapy and almost half received a combination of medical and behavioral interventions. Children diagnosed with ADHD were 3 to 7 times ( p values < 0.001) more likely than other children to receive special education, be expelled or suspended, and repeat a grade. Based on parental opinion, children diagnosed with ADHD are at high risk for school failure. Results are discussed in terms of distinctions between clinical efficacy/effectiveness and schoolwide and public health interventions implemented in the study region. © 2002 John Wiley & Sons, Inc.

OBJECTIVES: The purpose of this study was to determine the extent of medication use for attention deficit-hyperactivity disorder (ADHD) in southeastern Virginia. METHODS: Students enrolled in grades 2 through 5 in school districts in city A (n = 5767 students) and city B (n = 23,967 students) were included. Nurses recorded students who received ADHD medication in school. RESULTS: The proportion of students receiving ADHD medication was similar in both cities (8% and 10%) and was 2 to 3 times as high as the expected rate of ADHD. Receipt of drug therapy was associated with social and educational characteristics. Medication was used by 3 times as many boys as girls and by twice as many Whites as Blacks. Medication use increased with years in school, and by fifth grade 18% to 20% of White boys were receiving ADHD medication. Being young for one's grade was positively associated with medication use (P < .01). The prevalence of ADHD was 12% in district A, 63% in district B. CONCLUSIONS: These findings suggest that criteria for diagnosis of ADHD vary substantially across US populations, with potential overdiagnosis and overtreatment of ADHD in some groups of children.

A regional study of ADHD medication use was conducted to address community concerns about an apparently high prevalence of attention deficit hyperactivity disorder (ADHD). The study documented that the use of ADHD medication among elementary school children in two southeastern Virginia school districts was two to three times higher than published prevalence estimates. This study contributed to community leaders' desire for a regional school health coalition to ensure continued community involvement in school health assessment and planning. The case history of this coalition, the School Health Initiative for Education (SHINE) is presented as an example of effective community collaboration.

Relations between attachment security and temperament were studied in 6 samples. Ages at temperament assessments ranged from 5 to 42 months and attachment security was assessed between 12 and 45 months. Attachment security was assessed using the Waters and Deane Attachment Behavior Q-set. Principal component analyses were used with the temperament data, and scores for the first component (Emotional Reactivity) served as correlates of attachment security. Analyses revealed significant associations between temperament and attachment at all ages when mothers completed both instruments, and when Q-sorts were independent from maternal temperament perceptions, temperament and attachment security correlations reached significance for older children. These results may help clarify relations between the domains of attachment and temperament, rather than affirm distinctions between them.

In summary reviews and empirical research, investigators have suggested that attachment classifications derived from the Ainsworth Strange Situation may reflect variations along dimensions of temperament as well as, or perhaps instead of, individual differences with respect to infant-mother attachments. In this study, relations between temperament dimensions from the Infant Temperament Questionnaire (Revised) and Strange Situation behaviors were evaluated. Relations between the behavioral style scores and the categories of attachment quality were also tested. The hypothesis that temperamental difficulty would be related to negative emotionality, as indexed by infant distress during separation (but not during the reunions), was tested and supported. Neither the behavioral style dimensions nor the temperamental diagnoses (e.g., "easy" vs. "difficult") were associated significantly with attachment classifications. The results are consistent with previous findings that temperament measures do not predict attachment security. Nevertheless, certain behaviors indexing negative emotionality that may be observed in the context of the Strange Situation are related to temperamental variability.