ADHD More frequent diagnosis in early school children

ADHD diagnosis more common in early-school children

A few years ago, German scientists reported that late school enrollment had negative consequences for school performance. However, too early enrollment is not beneficial. As reported by American researchers, these children are diagnosed with ADHD more frequently.

Number of ADHD diagnoses is increasing

Research has shown that more and more children in Germany are diagnosed with attention deficit hyperactivity disorder (ADHD). The number of such diagnoses is also increasing in the USA. This could also have something to do with the fact that many children were born in the "wrong" month. Because according to a recent study by researchers at Harvard Medical School, ADHD is diagnosed significantly more frequently among August children in the US than in children born a month later. The reason is therefore the deadline for enrollment, which takes place in many US states on 1 September.

According to a new study, ADHD is diagnosed significantly more frequently among August children in the US than in children born one month later. (Image: Robert Kneschke / fotolia.com)

More frequent diagnosis of children born in August

The study's findings, recently published in the New England Journal of Medicine, show that children born in these states in August are 30 percent more likely to have an ADHD diagnosis compared to theirs a little older classmates.

According to a Harvard Medical School report published in the journal "EurekAlert!", The number of ADHD diagnoses in children has risen dramatically in the last 20 years.

In 2016 alone, more than five percent of children in the US were treated with anti-ADHD drugs.

Experts believe that the increase is due to a combination of factors, including better detection of the disorder, a true increase in frequency, and in some cases a false diagnosis.

The findings of the new study support the view that, at least in a subset of primary school children, the diagnosis can be attributed to earlier school enrollment, according to the research team.

"Our findings suggest that a large number of children are overdiagnosed and over-treated for ADHD because they are relatively immature compared to their older classmates in early elementary school years," said study leader Professor Timothy Layton of the Blavatnik Institute of Harvard Medical School.

Classmates can be around one year younger

As stated in the communication, most states have random birthday dates that determine which grade a child is assigned to and when it goes to school.

On the frequent September 1 deadline, this may cause a child born on August 31 to be almost one year younger than a classmate born on September 1 on the first day of school.

At this age, it may be more difficult for the younger child to sit still and concentrate in class for a long time.

According to Layton, this extra fidget could result in the child being sent to a doctor, followed by the diagnosis and treatment of ADHD.

Normal behavior may seem unusual in comparison to older people
As the researchers further explain, what is seen as normal behavior in a 6-year-old may seem relatively uncommon compared to older classmates.

This dynamic could be particularly applicable to younger children, as an age difference of eleven or twelve months could lead to significant behavioral differences.

"As children get older, small age differences are similar and dissipate over time, but behaviorally, the difference between a 6-year-old and a 7-year-old can be quite pronounced," said senior author Anupam Jena of Harvard Medical School.

Early school enrollment is a reason for ADHD diagnosis

To get their results, the researchers compared the difference in the ADHD diagnosis by month of birth - August compared to September - with the help of documents from a large insurance database.

These 407,000 primary school children born between 2007 and 2009 were observed until the end of 2015.

The analysis found that in countries using September 1 as the school enrollment date, children born in August had a 30 percent higher chance of being diagnosed with ADHD than children born in September.

In states with other cut-off dates, no such differences were found between children born in August and September.

According to data, 85 out of every 100,000 August-born students were diagnosed or treated with ADHD. For those born in September, there were 64 students per 100,000.

When researchers focused solely on ADHD treatment, it was found that 53 out of 100,000 August-born students were on medication compared with 40 out of 100,000 in September.

Layton concludes from the findings that early school enrollment is a common reason for diagnosing ADHD and prescribing medications. (Ad)