To the Editor.
—In a school nurse survey of medication use for hyperactive/ inattentive students in Baltimore County, Maryland, public and private schools, Safer and Krager1 found a 39% decrease from 3.6% in 1987 to 2.2% in 1989 and 1991; they attribute the decline to the "apprehension of parents and involved professionals generated by the methylphenidate media blitz and the threatened lawsuit." Since they allege that scientific proofs, or the lack of them, concerning hyperactive/inattentive and methylphenidate therapy have nothing to do with the 39% drop observed, it is only appropriate to look at the possible reasons for the doubling every 4 to 7 years of the medication rate for hyperactive/inattentive students in Baltimore County that was observed from 1971 through 1987.Estimates of the frequency of hyperactivity/inattentiveness (hereafter referred to as attention-deficit hyperactivity disorder) range from a low of 1 per 10002 to a high of 33%
Baughman FA. Treatment of Attention-Deficit Hyperactivity Disorder. JAMA. 1993;269(18):2368–2369. doi:10.1001/jama.1993.03500180060031