By Richard A. Hudson
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Additional resources for A grammatical study of Beja
1997). A similar twofold racial/ ethnic disparity has been found by other investigators (Gadow and Kalachnik 1981; Cullinan et al. 1987; LeFever et al. 1999). In a 1998 Maryland statewide school-based survey, Safer and Malever reported that African American, Hispanic, Asian, and Native American students all had ADHD medication prevalence rates twofold or more below those of Caucasian students (Safer and Malever 2000). Of particular note is that the stimulant medication disparity of African American compared to Caucasian students in Maryland public schools increased in the higher grade levels and was highest in high school, when it rose to a ﬁve-fold difference (Safer and Malever 2000).
As described, these studies do not carry an anticipated direct beneﬁt to participants, but may be ethically acceptable if (1) they entail no more than a minor increase over minimal risk, (2) essential knowledge can be gathered on the disorder in question, and (3) children participating in the research suffer from the disorder or are at increased risk for it (Figure 1). Thus, studies of pharmacokinetics and drug metabolism can be generally considered in children who suffer from the disorder and are treated with the medication to be studied.
The rise in the number of other psychotropic drug classes for the treatment of youth has been even more dramatic. In two state Medicaid databases documenting psychotropic medication treatment for youths under age 20 from 1987 through 1996, the prevalence of α-agonist compounds rose 15- to 53-fold and that of antidepressants rose 4- to 10-fold (Zito et al. 1999a). These trends, reﬂecting the overall dramatic increase in psychotropic medication treatment for youths, have raised concern in the media and clearly merit more systematic study.