with more ADHD reported as you go from west to east in the US.
That's probably a red herring. In part.
A better trend is that males from low income families are more often diagnosed. Boys are something like 75% of all ADHD diagnoses. For all the ranting about more prosperous families seeking an edge (this assuredly happens) it's still the case that overall low SES kids get drugged into compliance more often. (This makes sense, considering behavioral norms and child rearing.)
Another trend is that ADHD is more a white than a non-white thing--almost certainly because of disparities in health care, but also because of varying cultural norms. In some schools where teachers/administrators can recommend kids for screening this trend is sharply reversed.
To the extent that race and class has geography in the US, the geographical trends tend to be emergent.
One trend that isn't clearly emergent is the knock-on effect. Little Johnny goes on speed, Little Jonny's mother or father sees how much more manageable Little Jonny is and gets speed prescribed for her formerly irrepressible bundle of joy. And this really kicks in when the sexes start having their inhibition centers mature at different rates, so Little Jonny is always a bit behind Little Janey.
All my kids on ADHD meds have their core classes in the morning. By afternoon, the kids are zonked. They're useless for school by then as the meds wear off and leave them groggy. If they can get phys ed scheduled then, great. If they failed a class and can't get all their core classes scheduled for when they're artificially focused and alert it's not so good.
As for inattentive students ... Yeah. Less time to deal with them. And when you have class sizes over 30, it's harder. You tend to have at least one more, there's less time to repress them and more of them; they play off each other; and it's harder to position them at opposite corners of the classroom (you get 6, and they're always within or nearly within interaction distance ... oy!).
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