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Background: Estimates of ADHD diagnosis and stimulant medication use vary across studies. Few studies ascertain the teacher perspective on these rates. Objective: To ascertain teachers' perceptions of ADHD prevalence and medication treatment within their classrooms. Method: The present school survey collected teacher report of identified children with ADHD as well as unidentified but suspected children with ADHD in an effort to determine the occurrence of ADHD and related behaviors in elementary and middle school classrooms. The number of children treated with stimulant medication was also collected. Results are grouped by elementary/middle school level. Results: Results indicated 5.58 % of elementary and 3.53 % of middle school students were identified to the teacher as diagnosed with ADHD. A comparable number were suspected to have ADHD, but were not formally identified. Three-quarters of identified elementary school, and two-thirds of middle school students, received medication treatment. Few moderators of prevalence rates were identified. Conclusion: Teacher perceptions suggest an under-identification of children with ADHD in elementary and middle school classrooms. Stimulant medication treatment wanes as children progress to middle school, per teachers' reports.