CONCORD, N.H. (AP) -- Despite its No. 1 ranking in Ritalin distribution, New Hampshire is not out of line in diagnosing and treating children with Attention Deficit-Hyperactivity Disorder, according to a committee that spent a year studying the issue.

U.S. Drug Enforcement Administration data has shown New Hampshire leading the nation in per capita distribution of methylphenidate -- the generic name for the prescription drug Ritalin -- every year since 1998. Last year, then-Gov. Craig Benson put together a committee to investigate why and come up with policy recommendations for the appropriate use of Ritalin and similar medications.

After analyzing the federal data along with information from schools, private insurance companies and the Medicaid system, the committee concluded that compared to national norms, New Hampshire does not have a greater-than-expected number of children diagnosed with ADHD, nor does it have a higher percentage of children on Ritalin and similar drugs. It also ruled out the possibility that New Hampshire children get unusually high dosages or that the drugs are being sent elsewhere from New Hampshire-based mail-order businesses.

So why has the state topped the DEA's list for so many years? The most likely explanation is the state's small size, the committee said.

"Because New Hampshire is a small state with a small population and a small number of prescribers, it is possible for a very few high-volume prescribers to raise the state average," the group wrote in its final report.

For example, out of 1,200 physicians and nurse practitioners who wrote prescriptions for a stimulant from June to November 2004, the top two prescribers wrote 4 percent of the entire state's prescriptions. Prescriptions for methylphenidate averaged two per month among all providers, but the top prescriber averaged 57 per month.

Without knowing which providers were involved, the committee couldn't determine whether the high volume represented unique patient populations, unusual practice styles or even illegal diversion of the medication.

"The data was looked at from every which way through everyone's magnifying glass, but it just didn't show anything," said committee member Dina Dudarevitch, whose 17-year-old son was diagnosed with ADHD when he was in first grade and has taken a variety of medications since then.

The committee also included psychiatrists, psychologists, physicians, school nurses, patient advocates, lawmakers and activists opposed to the use of psychotropic medication. Though they didn't come up with a definitive explanation for the statistics, members helped create new guidelines for physicians on recognizing and treating ADHD and a message to school officials reminding them that teachers and other employees are prohibited from insisting or even recommending that parents put their children on medication.

Katherine Rannie, a school health consultant at the Department of Education, said aside from a few anecdotal accounts, there was no evidence of school officials pressuring parents to medicate their children.

"The need didn't arise from our perspective, but certainly it was worth addressing given what we heard," she said.

That was the only positive outcome of the study, said committee member Kevin Hall, New England director of the Citizens Commission on Human Rights.

Hall, whose group was created by the Church of Scientology, doesn't believe there is any circumstance in which it would be appropriate to prescribe Ritalin or the other drugs to children. He called the guidelines for doctors "horrific," he said they will lead to more unnecessary drugging of children.

"I had to fight back against the committee to at least put in there that they should at least do a full medical workup before labeling a kid," he said.

Hall said the committee was made up of people who created the problem and spent most of their time trying to show it doesn't exist. Not surprisingly, Dr. David Fredenburg, a Hudson pediatrician, disagreed.

"One question that sort of got dropped a little bit that I would've liked to have considered was, maybe this is a health marker," he said of the state's high distribution rate. "Maybe we might just be doing a better job (than other states.)"

Fredenburg said he used to be skeptical about ADHD as a valid diagnosis.

"When I first trained, I thought it was crap," he said. But he now believes that medication can help children who are unable to put up with an education system that doesn't tolerate variation in how kids learn.

"We are not doing a good job adapting, and these kids are suffering for it," he said.

Copyright 2005 The Associated Press. All rights reserved.