March 8, 2012
ADHD or Just Too Young?
(Ivanhoe Newswire) — You might want to think twice about letting your child start kindergarten too early or skip a grade. Studies show that the youngest children in classrooms are significantly more likely to be diagnosed with attention deficit/hyperactivity disorder (ADHD) than their peers in the same grade.
Two recent studies have shown a link between the relative age of children and diagnosis of ADHD and prescription of medication. Younger children in the same grade as children who may be almost a year older may appear to be immature compared with their older peers. This apparent lag in maturity has been called the "relative-age effect" and influences both academic and athletic performance.
Researchers from the University of British Columbia looked at a large cohort of 937,943 children in British Columbia, a province where the cut-off for entry into kindergarten is Dec. 31. The research included children who were between 6 and 12 years at any point during the 11-year study.
They discovered that children were 39% more likely to be diagnosed and 48% more likely to be treated with medication for ADHD if born in December compared to January. Due to the Dec. 31 cut-off birth date for entry into school in British Columbia, children born in December would typically be almost a year younger than their classmates born in January.
"The relative age of children is influencing whether they are diagnosed and treated for ADHD," Richard Morrow, lead author, was quoted saying "Our study suggests younger, less mature children are inappropriately being labeled and treated. It is important not to expose children to potential harms from unnecessary diagnosis and use of medications."
There are significant health and social ramifications of inappropriate diagnosis of ADHD. Medication to treat ADHD can have negative health effects in children such as sleep disruption, increased risk of cardiovascular events and slower growth rates. As well, younger children who have been labeled ADHD may be treated differently by teachers and parents, which could lead to negative self-perception and social issues.
"This study raises interesting questions for clinicians, teachers and parents," noted coauthor and psychiatrist Jane Garland, University of British Columbia and BC Children's Hospital. "We need to ask ourselves what needs to change."
"The potential harms of over-diagnosis and over-prescribing and the lack of an objective test for ADHD strongly suggest caution be taken in assessing children for this disorder and providing treatment," conclude the authors.
SOURCE: Canadian Medical Association Journal, March 2012.