Some children in elementary school have more trouble than their peers — either they find it difficult to sit still, they have a problem with socializing, or they cannot concentrate enough to finish tasks that other kids are finding easy. To many, this would seem to be Attention Deficit Hyperactivity Disorder, but it is possible that it is only the fact that these children are just a bit young for their grade.
Studies in Israel, Iceland, Canada, Taiwan, and Sweden have shown that students on the young end of the spectrum for their grade cohort are more likely to be diagnosed with ADHD than their older counterparts.
The youngest children in the class were anywhere from 20% to 100% more likely to receive the diagnosis or be prescribed ADHD medication than the oldest students in the class, said Helga ZoÃ«ga, an epidemiologist at the University of Iceland who worked on the Icelandic and Israeli studies.
Most recently, Taiwan has produced evidence through research that the youngest pupils in a grade were approximately 75% more likely to receive ADHD diagnoses than the oldest kids. The Taiwanese report was published on Thursday in the Journal of Pediatrics. Since, in general, children are six years-old when they enter first grade, a mere few months can cover much mental development, says Angus Chen of NPR, .
"Within that age range there is a huge difference in developmental and social and emotional maturity," says Dr. Adiaha Spinks-Franklin, a developmental and behavioral pediatrician at Texas Children's Hospital who was not involved in any of the studies. "A 6-year-old is just not the same as a 7-year-old."
There are times when a first-grader has to measure up to a fellow student who might be a full year older.
"And the way we diagnose ADHD is we talk to the parent about the child's behavior, and we mail the teacher questionnaires," Spinks-Franklin says. "The teacher will be comparing the child's behavior relative to other children in the class."
ZoÃ«ga explains that only Denmark has young children whose relative age does not seem to affect the diagnosis of ADHD. This result is probably because the country has more flexibility for when children begin their schooling. Danish parents with children born just before the cutoff date may hold their child back one year.
ADHD is used to describe a variety of behavioral problems linked to poor attention span, such as impulsiveness, inability to focus, and restlessness. Roughly 3% to 7% of children in the UK are believed to have ADHD, which is approximately 400,000. Many are taking medications designed to improve their concentration.
The Telegraph's Sarah Knapton says drugs like Ritalin have been prescribed to 922,000 young people, which is double the amount prescribed ten years ago. Drugs like Ritalin can have adverse side effects including weight loss, suicidal thoughts, liver toxicity, and possible inhibited pubertal development.
Some neuroscientists are of the opinion that the condition does not exist. They suggest that most people will exhibit some or all of the behaviors associated with the disorder during their lifetimes.
Lead author Dr. Mu-Hong Chen from Taipei Veterans General Hospital in Taiwan said the data his team used showed that kids born in August are more likely to receive an ADHD diagnosis or be prescribed an ADHD medication than children born in September, reports Rina Marie Doctor for Tech Times.
In Taiwan, the cutoff birth date for beginning school is August 31, states Cari Nierenberg for LiveScience. Children born in August are usually the youngest in their class while September-born students are typically the oldest.
Chen was not surprised that the analysis did not find that teenagers who were born in August were likelier to be diagnosed with ADHD than those born in September. He did add that the study proves the importance for doctors to acknowledge the age of a young person within a grade when they diagnose ADHD.