Surprising Reason Why ADHD Is Over-Diagnosed

Recent study results reveal that kids who are young for their grade are significantly more likely to be diagnosed with ADHD. The study found children born just prior to their state’s kindergarten enrollment cut-off date were 60 percent more likely to be diagnosed with ADHD. In other words, the rate of ADHD diagnoses among the youngest children in the classrooms was almost double that of the older children.

Plenty of debate exists among mental health professionals about the accuracy of Attention Deficit and Hyperactivity Disorder (ADHD) diagnoses in children. In part, this problem arises because the primary symptoms of the condition–inattention, hyperactivity, and impulsivity–are subjective to the observer who reports them.

Experts investigated the effect that the ages of children relative to their classmates has on the frequency of ADHD diagnoses. They analyzed the data from 11,784 children taken from a survey of 18,644 kindergarteners conducted by the National Center for Education Statistics. The data include the parent and teacher reports of ADHD symptoms, diagnoses, and stimulant-based treatments for all the children. In particular, they compared the data for children born just before and just after the cut-off date for enrollment in their kindergarten programs. As an example, a child who turns five in August would be able to start kindergarten right away in a state with an enrollment cut-off date of September 1. However, a child who turns five two months later, in October, would have to wait almost an entire year to start kindergarten in the same state. This leads to significant age variations among the kids in a kindergarten class, which the researchers expect may account for differences in maturity and behavior.

They found the youngest children in each class were significantly more likely to be taking behavior-modifying prescription drugs. Furthermore, teachers were four times more likely than parents to report symptoms of ADHD in young-for-their-grade children. One explanation is that teachers see the kids in the classroom context with the youngest alongside the oldest, whereas parents do not.

What does all this mean to you as a parent? They found that the “symptoms” used to make the diagnoses can sometimes be explained by the simple fact that these kids are younger and less mature than their peers. If your child is among the youngest of his classmates and a teacher wants to discuss concerning behaviors, remind them your child is at the younger end of the age spectrum. The results may or may not affect whether your child has ADHD, but they can at least make you more confident in the diagnosis.

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