To the Editor.—
Dr. Sleator and her colleagues recommended that physicians who prescribe stimulant drugs for hyperactive children periodically stop the drug prescription to find how the children do without them (JAMA 229:316, 1974). This advice is sound, but I question the reasoning that led them to it. The authors explain their finding that drug could be withdrawn from a quarter of the children in their follow-up without harm as meaning that the hyperactivity had remitted. Since follow-up studies1-3 of hyperactive children suggest that their characteristic behavior persists into adolescence and early adulthood, other explanations are likely.The authors say that they judged how their patients were doing largely on teachers' ratings of behavior in the classroom. However, teachers' attitudes towards restlessness and distractability vary widely and so does their confidence in being able to cope with difficult children. Some teachers accept such children and work with them gladly,
Stewart MA, Haller IP. Hyperactive Children. JAMA. 1975;231(2):134–135. doi:10.1001/jama.1975.03240140008005
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