School Performance and Theophylline

To the Editor.— The study by Rachelefsky et al (Pediatrics 1986;78:1133-1138), concerning behavior abnormalities caused by theophylline, is not helpful. The behavior check lists performed by the parents and teachers were apparently not the same. The items listed in Tables 1 and 2 test a wide range of behaviors. Both mood items and hyperactivity items were present in different forms. The standardization of these check lists is difficult to assess because they are unpublished. I don't understand how one can conclude that theophylline causes problems with school performance because it is impossible to tell what the authors meant by school performance, and psychologic testing did not detect any effect of theophylline.