A new study recently published in The Journal of Pediatrics showed that the child’s age at school entry has a possible effect on the diagnosis of attention-deficit hyperactivity disorder (ADHD). This suggests that ADHD, a neurodevelopmental disorder, may be vastly overdiagnosed because the children are just naturally immature.
Researchers from Taipei and Taoyuan looked into 1997 to 2011 data from nearly 400,000 children ages 4-17 years old and evaluated the prevalance of ADHD, in terms of diagnoses or being prescribed with ADHD medication. They then compared the prevalence rates of the children that started school young and children that started school relatively older than the other children.
The annual cut-off birthdate used was August 31, as this is the date for school enrollment in the country. “Youngest” students were born in August while “oldest” students were born in September. Furthermore, they tried to see the link between the age of entering school with the prevalence rate of ADHD.
Results show that just 2.8 percent of boys born in September were diagnosed with ADHD. However, the the figure jumps to 4.5 percent in August, rising steadily over the school year. For girls it rose from 0.7 to 1.2 percent.
The authors indicates that the increased diagnoses may be due to the teachers comparing the behavior of children with varying levels of maturity, and subsequently leading them to believe that there would be a need to have the younger child be checked for the disorder.
“Relative age, as an indicator of neurocognitive maturity, may play a crucial role in the risk of being diagnosed with ADHD and receiving ADHD medication among children and adolescents,” said lead author Dr. Mu-Hong Chen, as quoted in Telegraph. Chen is from the Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan. He continued that their findings “emphasize the importance of considering the age of a child within a grade when diagnosing ADHD and prescribing medication to treat ADHD.”