When Dr. Michael Anderson hears about his low-income patients struggling in elementary school, he usually gives them a taste of some powerful medicine: Adderall. The pills boost focus and impulse control in children with attention deficit hyperactivity disorder. Although A.D.H.D is the diagnosis Dr. Anderson makes, he calls the disorder made up" and "an excuse" to prescribe the pills to treat what he considers the children's true ill - poor academic performance in inadequate schools. "I don't have a whole lot of choice," said Dr. Anderson, a pediatrician for many poor families in Cherokee County, north of Atlanta. "We've decided as a society that it's too expensive to modify the kid's environment. So we have to modify the kid." Dr. Anderson is one of the more outspoken proponents of an idea that is gaining interest among some physicians. They are prescribing stimulants to struggling students in schools starved of extra money - not to treat A.D.H.D., necessarily, but to boost their academic performance. It is not yet clear whether Dr. Anderson is representative of a widening trend. But some experts note that as wealthy students abuse stimulants to raise already-good grades in colleges and high schools, the medications are being used on low-income elementary school children with faltering grades and parents eager to see them succeed.