Children Born in Latter Part of the Year More Likely to be Diagnosed with ADHD
In comprehensive school, the age difference between the oldest and youngest pupil in the same school year can be 12 months. The immaturity of younger children can lead to a mistaken diagnosis of attention deficit hyperactivity disorder (ADHD), shows a new study by the University of Turku and University of Nottingham.
The population-based study examined the connection between relative age and diagnosis of ADHD and it was conducted as a collaboration between the University of Turku and University of Nottingham. The researchers used nationwide population data that included all the children who were born in Finland between 1991 and 2004 and were diagnosed with ADHD at the age of seven or older.
– The association between the diagnosis and the month the children were born in was especially strong towards the end of the follow up, in 2004-2011. Children born in May–August are 37 percent more likely to get an ADHD diagnosis and those born in September–August 64 percent more likely to get a diagnosis than children born in January–April, says Postdoctoral Researcher Roshan Chudal from the Research Centre for Child Psychiatry of the University of Turku.
The association could not be explained with any other behavioural or developmental disorders.
School Year Relative Age Should Be Considered in ADHD Assessment
The leader of the research group, Professor Andre Sourander from the Research Centre for Child Psychiatry, says that it is important that parents, teachers and clinics making ADHD assessments take the child's relative age within the school year into consideration.
– At the moment, age variation within a school year can lead to a situation where children born towards the end of the year are more likely to be diagnosed with ADHD, even though their behaviour could be explained with immaturity. It seems that children's different routes of personal development are interpreted from the perspective of diagnostic disorders, says Professor Sourander.
– It is a shortcoming that can have a significant impact on the start of school and later development. Furthermore, an ADHD diagnosis often leads to a several-year amphetamine derivative treatment, even though the primary method should be attending to the child's special needs in their environment. This is a great challenge for both early childhood education and the school system as well as for health care, Professor Sourander observes.
He suggests that those children who are less mature than their same-year peers should have greater flexibility and individual solutions for starting school than is currently offered. In addition, relative age should always be taken into account when considering the possibility of ADHD in a child.
The research was funded by the Academy of Finland, Finnish Medical Foundation, and Orion Pharma Foundation.
>> The research was published in The Lancet Psychiatry journal
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