GOOD IDEAS: SIX VALUABLE STATE AND LOCAL EDUCATION REFORMS
By Robert Holland and Don Soifer 

Introduction

Public education in the United States is intrinsically a local endeavor. The notion that state and local decision makers should have maximum flexibility in the use of education dollars is rooted in the belief that many of the most useful innovations in education are emerging, and are likely to continue to emerge close to home. Even the No Child Left Behind Act, itself a high-water mark for the federal government's involvement in education, is constructed around progress, assessments and reforms begun at the state and local levels.

This study recognizes six noteworthy reform ideas which originated from the grassroots of American public education. Each of these reforms presents a locally designed solution to local challenges, and are models worthy of consideration by other communities facing similar challenges. The programs include:

Chattanooga, Tennessee's model for rewarding high-performing teachers; Florida's corporate tax credit scholarship program;

Massachusetts' reforms to ensure that bilingual education programs have teachers who are themselves fluent in English;

Arizona's Rio Salado College's online teacher preparation program; Colorado's school report cards;

A Southeast Virginia community program to lower pediatric Ritalin use and optimize treatment for children.

Chattanooga Rewards for High-Performing Teachers Willing to Accept a Challenge

Typically, teachers in United States public schools are paid according to their placement on the seniority scale. There have been sporadic efforts to reward teachers for outstanding performance, but often such attempts fall victim to controversy over motives and methods of evaluation.

Chattanooga, Tennessee has come up with a merit-based approach to teacher compensation that is so tightly focused on a specific problem that it could become a model for the nation. First, the economic rewards are part of a plan to recruit the highest-performing teachers to those inner-city schools that have been the lowest performing - and then to encourage those teachers to stay. Second, teachers are deemed "high-performing" not on the basis of hearsay but according to an objective statistical system that determines how successful each teacher is year to year in helping students raise their achievement levels. Finally, and not least in importance, the merit system is the product not of an administrative edict but rather a collaboration of business, foundation and local governmental leaders who wanted to do something to uplift the lowest-performing of the city's schools.

Chattanooga's leaders exercised innovative thinking by taking advantage of an existing system for objectively gauging the difference that teachers are making with their students. It is an approach that gained a foothold with statewide education reforms initiated in Tennessee more than a decade ago. Developed by statistician William Sanders, the Tennessee Value-Added Assessment System (TVAAS) shows how productive teachers have been in raising student achievement.

TVAAS is focused on improvement, which levels the playing field for teachers who accept the challenge of teaching supposedly hard-to-teach children. A teacher who enables previously low­- achieving students to make significant gains during a year receives full credit for his or her accomplishments.

Thus, TVAAS was a useful measuring stick for civic leaders of Chattanooga when they collectively decided that it was simply unacceptable for the city's lowest-performing schools to be stuck in a vicious cycle of failure because of a perpetual shortage of effective teachers.

During his successful campaign for Mayor in 2001, Bob Corker had found that one of the main obstacles to raising the quality of public education was the recruitment and retention of high-­ performing teachers. He convened the Community Education Alliance, a group of business and community leaders which includes the Benwood Foundation, Hamilton County Department of Education, Chattanooga Bar Association, Chattanooga Neighborhood Enterprise, Lyndhurst Foundation and the Public Education Foundation (PEF), to address this problem. The local Benwood Foundation had made a major five-year $5-million commitment to the improvement of nine elementary schools which the state of Tennessee had identified as being among the 20 lowest-­ performing in the state. The Public Education Foundation provides leadership in the use of the grant and has itself pledged $2.5 million to the effort.

As one of his first acts, Mayor Corker brought together a group of business leaders to see how the City could complement the Benwood initiative. The corporate group, called the Community Education Alliance, decided to focus on the issue of recruitment and retention of high-performing teachers in the nine elementary schools.

City funds were pledged to pay bonuses to high-performing teachers and principals. In addition, two local private foundations were asked to provide funds to help teachers purchase or rehabilitate homes in inner-city neighborhoods near the nine schools. Another private foundation agreed to fund the creation of an urban education master's degree program, available at no cost to teachers in the schools. Local attorneys have agreed to provide free legal services to the teachers.

The context of community cooperation is something that Jack Murrah, president of the Lyndhurst Foundation and a long-time backer of public-school improvements, stresses highly:

"In Chattanooga," commented Murrah, "we are testing the use of monetary incentives (about 10 to 15 percent of salary) to recruit and retain high-performing teachers in high-poverty schools. The evidence suggests that such incentives are a very powerful tool, but probably not if used in isolation.

"Teachers are not likely to be moved by money alone to take a huge professional risk in an era of increasing accountability. They look for evidence of a broader commitment to reform in such challenging schools.

"Because we are dealing with a school district and a private philanthropic community that already have made such commitments, and have begun to demonstrate some success with their efforts, the Mayor's Community Education Alliance could bring the incentive pay into the picture as a new tool that complemented those already at work. And I think it is working just exactly as we hoped."

Implementation began with the school superintendent enabling the principals to remove inexperienced and underperforming teachers, who were overrepresented in these nine schools. He asked each one of the elementary-school principals throughout the county district to take on one or two of these teachers to help strengthen them or document their failure to meet system standards.

The next big step was luring high-performing teachers (HPTs) to accept positions in the nine low-­performing schools. In identifying potential candidates, the project relied on portfolio and personal evaluations in the early grades. For grades 4 and 5 they turned to TVAAS, which grades teachers according to how much their students' test scores improve from one year to the next. TVAAS also is one tool to measure teachers' continuing ability to help students improve their achievement.

A teacher score of 100 is about average. A teacher who scores 110, on the other hand, has been about 10 percent more effective than average at boosting student achievement. The Chattanooga coalition set 115 as the TVAAS mark for a high-performing teacher (HPT).

The incentives, which are guaranteed through the 2004-05 school year, work like this:

HPTs who choose to work in the Benwood schools and who score at least 115 on the TVAAS receive a $5,000 annual bonus. In addition, if a Benwood school attains an overall TVAAS of at least 120, every teacher in the school receives a $2,000 bonus. Other incentives provided by members of the coalition include a $10,000 loan toward purchase of a house in one of the nine downtown neighborhoods, free legal services, and free tuition toward earning a master's degree in urban education.

Results are evident even in the short time the program has been in existence.

In fall 2002, on the first day of school, there were 30 vacancies in core teaching positions. On year later there was only one vacancy.

So far, the Benwood schools have 25 HPTs, some of whom were already in place and have been encouraged by the new incentives to stay. Recruitment is continuing toward an eventual goal of 54, with six in each school.

Early evidence is that student scores are improving at a rate greater than that of suburban schools. In the most recent round of testing, Benwood schools had NCE gains ranging from 4.10 to 5.66, compared to gains ranging from 0.79 to 2.60 in the district's Title I and non-Title I schools. The gap between the inner-city and suburbs remains significant, but it appears to be narrowing.

NCE stands for normal curve equivalent, a scoring system from 1 to 99 that is similar to national percentiles but better suited for comparisons requiring statistical calculations. The Benwood schools are progressing toward the national average of 50 NCE: in three years, reading scores have increased from 32.90 to 37.96; language arts from 35.13 to 40.79; math from 35.75 to 40.13; science from 29.89 to 33.99; and social studies from 32.70 to 37.93.

In two years, we have almost doubled the percentage of third graders who are reading above or at grade level, according to the Terra Nova, a national, standardized test.

In two years, we have almost doubled the percentage of third graders who are reading above or at grade level, according to the Terra Nova, a national, standardized test," noted Dan Challener, president of the Public Education Foundation. "Even more encouraging, in all nine schools and in all five subject areas, our students have posted large, statistically significant gains. While our teachers and principals have focused relentlessly on the teaching of reading, the students have made large gains in all five subjects - proving reading is the linchpin to academic success."

Challener also pointed out the important role that professional training and additional staff played in improving the test scores. Through grants from the Benwood Foundation and the PEF, each Benwood school was able to spend $100,000 each year for extensive training after school, on weekends and during the summer. He noted that the training helped all staff members gain skills and knowledge. In addition, all the schools added part-time reading experts who worked with the lowest­-achieving children.

"Test scores are rising, teachers are staying, and perceptions are changing as to these being 'failing schools,' " noted Kenneth U. Jordan II, Special Assistant to Mayor Corker. "Everything is headed in the right direction."

Todd Womack, the Mayor's communications director, noted that the Community Education Alliance conducts a steady stream of events, such as receptions at the Mayor's home and public rallies, to honor the teachers for accepting a challenge and doing a good job. Those working at the nine schools in the past had battled the low morale that is common to those on "a losing ball team." Now, successes are celebrated and that seems to be making a difference.

Ken Jordan believes that Chattanooga's business and civic leaders are engaging in a collaborative effort that may be unique and could be a model for the nation. They recognize how crucial an educated workforce is to their own enterprises and to recruiting new business and industry to the region. They realize that when children aren't taught to read by the third grade, their prospects of achieving a decent education are poor. By focusing intensely on achievement in schools that have been the most distressed, they intend to ensure that truly "no child is left behind."

Florida Corporate Tax Credit Scholarship Program

The 2001 session of the Florida Legislature established the Corporate Tax Credit Scholarship Program (CTC), an initiative intended to offer expanded K-12 educational opportunities to children from low-income families. It began at the start of 2002.

In a little more than two years, this latest addition to Florida's broad array of school choice programs has established a strong base of support. Indeed, in response to published criticisms of the state's allegedly lax oversight of the program, more than 3,000 supporters held what was believed to have been the largest school-choice rally in U.S. history in March 2004, marching through the streets of downtown Tallahassee to the steps of the Capitol.

Governor Jeb Bush assured parents, students, teachers and others assembled of his continuing strong support for CTC, which is otherwise known as "Step Up for Students." The rally was sponsored by two organizations prominent in working for education choice for minority citizens - the Hispanic Council for Reform and Educational Options and the Black Alliance for Educational Options.

The program works like this:

A corporation may direct up to 75 percent of its Florida corporate income tax to a nonprofit Scholarship Funding Organization. The corporation receives a dollar-for-dollar credit. For instance, a business taxpayer owing $1 million may direct $750,000 to fund scholarships for needy children, and the remaining $250,000 to the state treasury. They can take this credit on a first-come-first­-served basis. There is an aggregate tax-credit for the entire state of $50 million per year.

The Scholarship Funding Organizations must distribute 100 percent of their funds to children who meet federal poverty guidelines. The funds may not be used for administrative costs. Scholarships are limited to $3,500 per year per student, or the cost of tuition, whichever is less. The scholarship organizations must be approved by the Florida Department of Education and submit to annual audits.

As of spring 2004, some 13,000 Florida children were attending their school of choice as a result of these scholarships, with 20,000 more students on a waiting list. The average annual income of families being helped was approximately $20,000.

As of spring 2004, some 13,000 Florida children were attending their school of choice as a result of these scholarships, with 20,000 more students on a waiting list.

CTC is an important addition to other opportunities available to Florida students. Among these are: the McKay Scholarships, which were created five years ago as a voucher program for children labeled as "disabled" by the public school system; and state-funded vouchers for children in public schools that fail state accountability standards under Governor Bush's A-Plus Program.

One significant difference is that the corporate-generated scholarships are awarded to parents, rather than to the schools, and the ultimate accountability is to the parent. If parents are dissatisfied with a school, they are free to move their child, and the scholarship, to another school.

An analysis of the CTC program by the Collins Center for Public Policy, a think tank named for the late LeRoy Collins (a Democratic Governor who was an apostle of "New South" moderation), conducted a fiscal impact analysis indicating that the tax-credit scholarships will generate large increases in statewide revenues available for education or other state purposes. This increase stems from the transfer of CTC scholarship recipients from public to private schools. For example, the current cost of public education per pupil in Miami-Dade County is $7,922.

Assuming a conservative annual growth rate in 1.9 percent for future state education revenues, the Collins Center calculated that, as a result of the CTC, increases in statewide net revenues could amount to more than $600 million over the next 10 years. The net revenue increases could be used to increase per pupil spending in public schools or to bolster other state services.

At the rally, students from Miami Christian Academy presented Governor Bush with an oversized check symbolizing the $58 million the CTC is thought to have saved the state in its first two years of existence.

An audit by the state's chief financial officer contended that lax rules allow for potential abuse on the part of those who dispense and use the scholarships. In response, the state has tightened some rules, and a policy debate is underway on how much accountability the state should impose on private schools as opposed to leaving accountability in the hands of the parents.

John Kirtley, the Tampa businessman who was instrumental in winning approval for creation of the CTC, has welcomed the audit, and argues it will only strengthen the program.

"Any new program goes through growing pains," Kirtley was quoted as telling the Palm Beach Post, a newspaper that has been an editorial critic of school vouchers.

Massachusetts Ensures that Bilingual Education Teachers Are Fluent in English

In November 2002, Massachusetts voters resoundingly approved a law that made major changes to the state's bilingual education programs. The ballot initiative effectively replaced bilingual education with structured English immersion classes that teach children mostly in English. An important provision required all teaching personnel responsible for teaching children English to also be fluent in the language themselves.

This stipulation may appear to be simple common sense, but for Massachusetts' school districts seeking to comply with the law, it proved a problematic obstacle for a troubling number of teachers. More than 24 teachers were dismissed from the Lowell Public Schools for failing to meet the English-fluency requirement. Five Somerville teachers were fired for failing the same requirement. And 20 Lawrence teachers were placed on unpaid leave for one year after failing an oral English fluency test, while their district pays for some of them to attend English classes. Several filed discrimination complaints and threatened to sue. Other districts considered "sabbaticals" for teachers for intensive English assistance classes.

A Superior Court Judge ruled against four Lowell teachers who sued their school district for discrimination after failing the fluency test. The district later offered to allow teachers to retake the test as many times as they required to pass it.

A spokesperson for the Massachusetts Education Association made it clear the union would get

involved to ensure that all teachers were treated fairly. But the spokesperson told the Associated Press that the MEA, which had opposed the ballot initiative, "absolutely believes teachers should be fluent in English."

"The MEA absolutely believes teachers should be fluent in English."

The Lowell Public Schools, where the problems seemed most significant, have demonstrated serious problems in the past. A 2001 study reviewed grant data filed by the district with the federal Department of Education. It found the rate at which English learners transitioned to English fluency to be extremely low, reaching an apex of only 15 percent in the 1999-2000 school year. These "fluent" students compared very poorly with mainstream students. According to one official report filed by the district, "even the highest-performing 26 percent of the bilingual elementary students classified as Competent English Readers and Writers would be the lowest-performing students in standard curriculum classes."

Many Massachusetts school districts have chosen to use an oral English fluency exam recommended by the state Department of Education. This only partially satisfies the earlier law's requirement which explicitly mandates that teachers demonstrate both oral and written English proficiency. Further, state rules allow administrators in each district to decide which teachers must take the test. According to a report published in the Lowell Sun, teachers with at least six years experience teaching in mainstream classes were exempted from taking the fluency test in Lowell.

The fluency requirement had actually been passed previously by the state legislature in a law, signed by the Governor a few months earlier, that was widely viewed as an effort to prevent the referendum from gaining momentum. The federal No Child Left Behind Act contains very similar language in addition to other changes focused on improving English fluency. It requires that any entity receiving NCLB funds under that section of the law (Title III, Limited English Proficient Students, Section 3116) certify that "all teachers in any language instruction educational program for Limited English Proficient children . . . .are fluent in English and any other language for instruction, including having written and oral communications skills."

As a result, any school district anywhere in the United States that receives federal funds under Title III of the No Child Left Behind Act is therefore subject to this requirement.

So, in fact, this common sense "good idea" is now engrained in three separate laws with jurisdiction over Massachusetts' public schools (the first to pass was the federal requirement). But the state requirement goes somewhat further in its reach, covering all school districts with English learner populations whether or not they receive federal funding for those students.

Salado College (Arizona) Online Teacher Preparation

Schools need well-qualified teachers not simply to ease shortages but to raise the quality of classroom instruction. Many bright college graduates aspire to teaching but find full-time enrollment in a university-level College of Education to be a forbidding obstacle.

Thanks to Rio Salado College in Arizona, would-be teachers now have instructional preparation as close to them as their home computers and on a schedule they can work into their own busy lives. Many of them have full-time jobs and appreciate being able to do their coursework online at any time of day or night, 24/7. New courses begin every two weeks. Each course lasts 14 weeks but can be accelerated with permission of the instructor.

Creation of this innovative program became possible when in 1998 the Arizona Board of Education made a policy change allowing entities besides state universities to offer teacher preparation. Within the state's community college system, Rio Salado had the lead role in distance learning and therefore was the logical candidate to bring e-learning to aspiring teachers.

Students who have earned a bachelor's degree can obtain certification as elementary, secondary or special education teachers by completing the Rio Salado requirements.

"The quality of the program itself is simply outstanding," said a January 2003 graduate. "I'm finding that even more so because I'm out there teaching with a full-time job. I can see other teachers coming from other universities and I can just tell I have a confidence level they don't have because of the background Rio gave me."

When the program launched two years ago, Rio Salado's Faculty Chairman of Education, Dr. Janet Johnson, said she didn't know what level of enrollment to expect. With 2,200 enrollees as of January 2004, from not only Arizona but across the U.S. and the world, the response "has far exceeded our expectations."

In recognition that teaching is a profession which calls for intensive human interaction, the designers of the Rio Salado program have supplemented online instruction with "in-person components," including a practicum that must be completed in a participating local school for many courses. Students observe teachers at work and also help tutor children. In addition, Johnson noted that the program hires master teachers to give monthly talks to gatherings of enrollees "to make sure they know what teaching is all about."

Would-be teachers now have instructional preparation as close to them as their home computers and on a schedule they can work into their own busy lives.

Teacher candidates located in remote areas are able to call in through the college conferencing network to participate with the master teachers and/or receive videotapes of the meetings.

All of that precedes a traditional 9-week period of student teaching after coursework is completed.

"The thing I like most about Rio Salado's practicums is that they get the teacher in the classroom very early in their training," said Dr. Bob Donofrio, Superintendent of Murphy School District. "They get them interacting with kids, they get them interacting with other teachers so they have a true understanding of what is going to happen when they become a teacher."

Dr. Johnson noted that K-12 teachers work with instructional designers to produce the online courses. Also, all of the e-instructors are current K-12 teachers employed as adjunct faculty members. From development to delivery, the curriculum is very much "practitioner-oriented," she said.

Rather than forcing online students to fend for themselves, the Rio Salado program offers a technological "help desk" six days a week. All the usual student services, including registration, academic advising, bookstore, tutoring and library help, are available online.

While it was conceived, developed and put into operation at Rio Salado College, the program has attracted attention of school reformers nationwide, and has led to partnerships with organizations like Troops to Teachers, which assists retired military personnel in making a transition to second careers in teaching. Among other partnerships is one with Walden University that enables students to apply up to 12 credits from the Rio program toward Walden's new Master's Degree with a focus on Curriculum, Assessment and Instruction.

Colorado School Accountability Report (Report Card)

In this era of school accountability, many states and localities publish report cards on their schools to give parents and the community an idea of how they are performing. But it is doubtful that any state surpasses Colorado in the sheer quantity of useful information conveyed to the public via school report cards.

The report cards began in 2001 with the backing of Governor Bill Owens. The system built on an evaluation system that had been pioneered by the Independence Institute. According to Pamela Benigno, director of the Institute's Education Policy Center, the organization believes the state's report cards, while not perfect, are sufficiently helpful to parents and so has discontinued the Independence Institute program.

By visiting Colorado School's Accountability Reports (SARs) online, an education consumer can look up any school in the state and quickly find data on that school's academic performance, including the latest results on the Colorado Student Assessment Program (CSAP), and whether the school is performing well or needs improvement. In addition, the report card contains information about each school's safety and discipline, student/teacher ratios, teacher qualifications (such as the percentage teaching the subject in which they earned their college degree), and patterns of school spending.

Also, in a refreshing display of candor, the site provides within each school site a list of other schools in the area, with links to data on their performance. Under the federal No Child Left Behind Act, parents in persistently low-achieving schools are supposed to be given the option of transferring to a better-performing public school, but many school systems do not provide readily accessible data as to how other schools are ranked. Colorado does.

In addition to being available online, the SARs are also sent home with students in printed form. Thus a parent can quickly find answers to such questions as.

· Is my child's school improving?

· How experienced are my child's teachers?

· How many children are dropping out of school?

· How safe is the school?

The 2003 report cards (released December 4) showed a general pattern of slow but steady improvement. Statewide, 32 schools enrolling a total of 4,320 students rated unsatisfactory. Last year, 45 schools with 9,497 students were ranked unsatisfactory.

Forty percent of the state's 1,775 schools received the two highest possible rankings - excellent or high. The mid-range score is "average." Fewer than a quarter of the state's schools received either low or unsatisfactory, the two lowest ratings.

But to the average parents, the statewide averages probably mean far less than the information for their children's schools.

For example, patrons of Dunn Elementary School in Fort Collins received good news in the latest report card: overall academic performance was "excellent" and on the trend line of achievement the school also earned "significant improvement." Average daily enrollment was 397 in a school enrolling 417. Dunn's proportion of children achieving at the proficient or advanced levels has shown an impressive year-to-year upswing - i.e., in reading up from 80 percent in 2001 to 82 percent in 2002, and to 89 percent in 2003; in writing, up from 63 percent in 2001 to 70 percent in 2002, and to 80 percent in 2003; and in math, up from 72 percent in 2001 to 80 percent in 2002, and to 81 percent in 2003. Dunn had only eight safety and disciplinary incidents in 2003.

On the other end of the spectrum, Cole Middle School in Denver is the only school that has ranked unsatisfactory for the past three years. One more year of an unsatisfactory ranking would activate a provision allowing the state to convert Cole to a charter school under new management.

In addition to an unsatisfactory rating for 2003, Cole showed a troubling lack of improvement. For instance, the percentage of students reading at the proficient or advanced levels was 15 percent in 2001, dropped to 9 percent in 2002, and was up just to 13 percent in 2003. The proportion of students performing proficiently or higher in math, was steady but was hardly something to celebrate: just 2 percent in each of the past three years.

The principal of the school, who was in only her second year at Cole, pointed out that students made gains on the most recent testing, and she expressed a conviction that tutoring and improved discipline would elevate the school from the bottom rung in 2004. Governor Owens said that is the kind of outcome the state would consider a victory, though the charter school option is also a good one to have when a change of management is in order.

The report card does have its critics, some of whom object that it hasn't been showing the performance of subgroups of children, such as low-income, minority, or disabled. (For annual reading and math testing in grades 3-8, No Child Left Behind (NCLB) requires that results be broken down by subgroup, with annual progress shown within each group in order to receive a federal stamp of approval.

As far as the state report cards are concerned, Governor Owens believes the fact that many schools with low-income and minority populations are scoring well on CSAP undercuts excuses other such schools might assert for low performance and so it's best the data put in the report cards. Citing such low-income and high­ performing schools in Pueblo and Fountain as examples, he noted that "implicit in these scores is the question, if they can do it then who can get up and say, 'We can't.' "

Implicit in these scores is the question, if they can do it then who can get up and say, 'We can't.'

Another criticism is that Colorado's report cards provide more data than some readers might want to wade through. However, there's much to be said for parents having too much information as opposed to having too little.

Early in 2004, The Fund for Colorado's Future, a bipartisan school-reform coalition chaired by the Governor and including such notables as community activist Phyllis Coors and football great John Elway, had produced a revised Colorado report card designed to be more helpful to parents, as well as addressing the NCLB concerns. The Fund consulted parents, teachers, principals, superintendents and testing experts in preparing SAR refinements. The three most important changes are:

1. The old card measured academic gains based on cohorts of students - for example, last year's seventh-graders compared to this year's seventh-graders. The new value-added approach will measure academic performance based on individual learning gains - that is, Johnny's seventh-grade reading score this year compared to his sixth-grade reading score last year. A school's score for Academic Growth of Students will be based on numbers of students making gains. The more students who improve year to year, the better the school's score will be.

2. In keeping with No Child Left Behind requirements, there will be a chart on the first page of each report card showing whether designated subgroups of children in the school are making "adequate yearly progress." The groups include racial/ethnic minorities, economically disadvantaged, students with disabilities, and English language learners.

3. In response to parents' complaints that historical charts were unhelpful, there will be suggested questions specific to a school's ratings to help parents make sound decisions with regard to their child's education. The objective is to enhance parental involvement. These are "Questions Parents Should Ask":

· Is my child's school using a literacy program that is supported by scientifically based research? Are students receiving sufficient research-based instruction in the core subjects?

· If your child is having problems with reading, ask your school about school-based reading 'intervention programs' such as after-school or summer-school classes or tutoring.

· Does the faculty meet regularly; review performance data and identify student

weaknesses to be targeted?

· Does your school use a curriculum aligned to academic standards and ensure that classroom instruction effectively delivers the curriculum?

The refined SAR goes further, informing parents that based on their schools' academic performance their child may be eligible for transfer to a better-performing public school, supplemental services such as free tutoring, or even in certain cases the right to attend a private or parochial school with the school district picking up the tuition bill.

Colorado's Report Card is far more than a dry recitation of statistics. It is a tool for parental empowerment.

Community Works Together to Lower Pediatric Ritalin Use and
Optimize Treatment for Children in Southeast Virginia

Ritalin and other powerful stimulants are being prescribed to U.S. schoolchildren with dramatically increasing frequency: the prescription rate has tripled since the early 1990s, according to one recent study. It has been estimated that between three and four million American children are currently receiving Ritalin-like stimulants as treatment for Attention Deficit Hyperactivity Disorder (ADHD).

Much recent evidence indicates that the rate at which children are being placed on these medications varies greatly from one region of the country to another - and even from one school district to another. A continuing series of studies conducted in Southeast Virginia by Dr. LeFever and her colleagues of the Center for Pediatric Research in Norfolk have shown that over one-third of white boys in that region have been diagnosed with ADHD.

The group documented that 17 percent of elementary and middle school students in the Hampton Roads, Virginia area had been diagnosed with ADHD, and 14 percent were actively medicated for the disorder. Among Southeast Virginia students taking medication for ADHD, 28 percent were taking two different types of psychiatric drugs simultaneously and 8 percent were taking three. They noted that children were typically medicated even during the summer months when many medical authorities (including the drug's manufacturer) indicate they should be on "drug holidays."

To address these and related problems, Dr. LeFever and her colleagues joined with parents, community members and educators to form the School Health Initiative for Education (SHINE). The coalition's mission is "to improve the physical and mental health of children in Hampton Roads schools through community based research, planning and action."

In addition to publishing regular bulletins containing useful information for parents and educators alike, SHINE holds community forums as well as sessions specifically geared toward school board members, superintendents and legislators. LeFever was recognized as an Outstanding Partner in Education by the Virginia Beach City Public Schools in 2002.

Informed by the Center's timely research, SHINE puts that research to use in a way that serves children and families. Taking note of the observation that teachers' positive reinforcement has proven to be an effective way to reduce children's ADHD symptoms, the program undertook an effort to increase teacher knowledge of effective behavior strategies. The researchers observed that stimulant medications have been shown to improve the core symptoms of ADHD as well as short­ term performance, but do not cure the disorder or fully alleviate symptoms and associated problems.

A subsequent study of the Virginia Beach Public Schools by the group explored the different ADHD treatments used by the district. It found that 75 percent of children receiving a behavioral treatment were maintained effectively over the 14-month study without the use of any stimulant medication. Children receiving medical management treatment (with stimulants) "received superior scores on parent and teacher ratings of hyperactivity and teacher-only ratings of hyperactivity, but not on the other 16 of 19 outcome measures such as social skills and aggressive behavior." SHINE launched a campaign to raise awareness among parents and educators of their important findings.

Their active involvement in their community has also provided the team with insights to help further their research. They found that boys were significantly more likely than girls (28 percent vs. 11 percent) and white students were more likely than black students (22 percent vs. 16 percent) to be diagnosed with ADHD. Of those students diagnosed, the rate of overall medication use was not significantly different between white and black students. But white students were far more likely to receive behavioral interventions (69 percent vs. 43 percent) and combined treatment (61 percent vs. 31 percent) than black students, who were more likely to receive only the medication. Health insurance status and race were not significantly associated.

It was also observed that white boys in elementary and middle school grades were most likely to be diagnosed with the disorder. Over one-third of these in the study population were in fact being treated for ADHD. What's more, over half of the children diagnosed with ADHD had received the diagnosis during their preschool or kindergarten years.

Further, it was noted that the symptoms for which many of the children were being treated were in fact developmentally appropriate impulsivity, hyperactivity or inattention.

SHINE also found that nearly two-thirds of health care providers in the area believe that children do not receive appropriate evaluations for ADHD. When the group surveyed providers, they found that pediatricians spend significantly less time making diagnostic evaluations for ADHD than psychologists or mental health providers. In testimony last year before the President's Council on Bioethics, Dr. Stephen Hyman, Harvard University Provost and former Director of the National Institutes for Mental Health, stated that most prescriptions for ADHD are written by well-meaning family physicians who are untrained to know what questions to ask, and have insufficient time to do so.

Virginia law bars teachers from diagnosing ADHD or recommending the use of behavior-modifying medications. But a SHINE publication noted that while school personnel are not barred from consulting with health care providers or recommending that students be evaluated for ADHD, their input is an essential part of ADHD evaluation.

"Think Carefully! When a child is inattentive, hyperactive and/or impulsive, do not jump to the conclusion that the child has ADHD. Get a thorough evaluation." - 2002 SHINE School Health Bulletin

"Think Carefully!" cautioned a 2002 SHINE School Health Bulletin.

"When a child is inattentive, hyperactive and/or impulsive, do not jump to the conclusion that the child has ADHD. Get a thorough evaluation." The notice concluded by noting that other problems should be considered and ruled out before a diagnosis of ADHD is made.

Another bulletin advised parents to ask questions about what their child's teacher has observed. "Teachers are not equipped to diagnose ADHD, but they can be excellent sources for information about a child's behavior in school." Every bulletin lists a telephone number and website where parents or teachers can contact SHINE to get more information.