Suffer the Children

The case against labeling and medicating children, and effective alternatives for treating them

Why Younger Kids Have More ADHD

Studies show that an ADHD diagnosis may simply signify a lack of maturity

    A child may well have an important advantage if he is one of the oldest in his classroom instead of being among the youngest. Several new studies indicate that many children are being diagnosed with ADHD because they are among the youngest in their classroom. A study from Iceland that tracked nearly 12,000 children, found that children in the youngest third of their class were fifty per cent more likely to be diagnosed with ADHD and medicated with ADHD medications. The study found that being younger relative to one’s classmates affects a child’s academic performance all through school.

   

According to two other studies, reported in Scientific American (August, 2012), a child who is easily distracted, fidgety or disruptive in the classroom does not necessarily have ADHD. Instead, these behaviors might mean simply that the child is acting his own age. Children who are a year or even six moths older than their classmates have had more time to develop their attention span and ability to sit still. So if a child's birthday is close to the cutoff date for enrollment in kindergarten, parents might want to think about giving him an extra year to mature.

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     According to Professor Melinda Morrill of North Carolina State University, “younger children may be mistakenly diagnosed as having ADHD, when in fact they are simply less mature." ADHD diagnosis rates are significantly different for children who are among the oldest, rather than the youngest, in their class. She finds that being young for his grade more than doubles the child's chance of being diagnosed with ADHD.

     A child who starts kindergarten at a younger age also has a greater chance of having to take ADHD medications like Ritalin later on. Professor Todd Elder (Michigan State University) comments that if a child is inattentive or can't sit still, it may simply be because the child is 5 and the other kids in his classroom are 6. These "symptoms" often signify immaturity instead of a "mental disorder" like ADHD.

     Parents need to be aware that ADHD has become a kind of catch all diagnosis for many sorts of differences among children. This includes a child’s normal lack of maturity as compared to older children in the same classroom.

     A Canadian study (University of British Columbia) focused on children in a province where the cutoff age for school entry is December 31. The results were published in the Canadian Medical Association Journal. Researchers found that kids with December birthdays were 48 per cent more likely to be diagnosed with ADHD, and given medication, compared to children with January birthdays.

The Canadian researchers stressed that there are significant health risks associated with a wrong diagnosis of ADHD. Kids who take ADHD medications (known as stimulants) have a higher risk of sleep disruption, increased risk of heart problems and slower growth rates. These kids are also exposed to social issues, since teachers, parents and peers may perceive them negatively.

     Liz Didcock is the lead mental health expert at the Royal College of Pediatrics and Child Health, She says that the Canadian study “reminds us of the importance of understanding behaviour in its context.” Like many doctors in the U. S. and the U. K., Dr. Didcock is concerned about the increasing potential for “over-medicalisation” of normal childhood behavior.

      Besides decreasing your child's chances of being labeled with ADHD, waiting to enroll a child in kindergarten has another important advantage. In his best seller Outliers, author Malcolm Gladwell points out that having a January-April birthday is correlated with higher academic achievement. Kids whose birthdays fall in these months are among the oldest in their class. In a study of fourth graders taking the TIMSS (math and science tests given to many children around the world), the oldest children scored significantly better than the youngest children. Older kids were also more likely to be placed in a higher ability grouping where they learned better skills.

     So even if your child has the ability to enter kindergarten, his maturity as compared to the other children in his classroom is an important factor to consider. Allowing a child extra time to mature may give him a significant advantage for his emotional development as well as an academic edge. It might also prevent him from getting a diagnosis of ADHD.

Marilyn Wedge, Ph.D., is a family therapist and the author of Suffer the Children: The Case Against Labeling and Medicating and an Effective Alternative.

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