CLEVELAND — Where school-age children live in the United States might play a role in the frequency of prescriptions of Ritalin — a stimulant used to treat attention deficit disorder and hyperactivity, The Plain Dealer reported Sunday.

        The newspaper analyzed data from the U.S. Census Bureau and Drug Enforcement Administration to show which parts of the country had the highest prescription rates of Ritalin, taken by more than 3 million U.S. children each day.

        In remote areas of the Northeast and upper Midwest, children were three times more likely to get the drug than in the Southwest, according to the newspaper's analysis of generic and brand-name Ritalin distribution nationwide.

        Doctors in Hawaii and New Mexico prescribe considerably less Ritalin than doctors elsewhere. Medical and education experts say that's likely because in warm climates, children can burn off energy outdoors.

        The newspaper said the analysis helps show what many of the experts contend — attitudes about Ritalin vary by city and region.

        They say that the chances of a child being prescribed the drug can depend on doctors' preferences, climate, heredity, diet, lifestyle, insurance coverage and local publicity about the drug.

        Two northeast Ohio counties show how community attitudes play a role in whether the drug is prescribed.

        Summit County, made up of the city of Akron and Cleveland suburbs, has one of the state's highest Ritalin prescription rates with 3.6 percent of its children being prescribed the drug.

        Just 30 miles away, Holmes County, a rural area that's home to the nation's largest settlement of Amish people, has one of the lowest rates in the nation and the lowest rate in the state at .37 percent.

        Parents in Summit County tend to believe the drug will help their child succeed in school, while expectations about school in Holmes County differ and parents are more likely to rely on home remedies for ailments, said Dr. Margaret McBride, director of the division of Child Neurology at Children's Hospital and Medical Center of Akron.

        Dr. Maurice Mullett, a Holmes County health commissioner who has treated the Amish for 27 years, couldn't recall ever treating an Amish child for an attention deficit problem.

        In Ohio, Marion County posted the state's highest and the nation's 27th highest Ritalin prescription rate at 5.11 percent.

        In that county, pediatrician Joseph Geiger said he's “doing a good job” diagnosing and treating attention deficit disorder.

        Nationwide, Dickinson County, Mich., and Dukes County, Mass., which is home to Martha's Vineyard, posted the highest prescription rates of Ritalin, with 7.8 percent and 7.2 percent of children being prescribed the drug, respectively.

        Other counties with high Ritalin rates include Emmet and Grand Traverse, Mich., a pair of tourist areas, which rank third and fifth nationally.

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