The Surprising Factor That Makes an ADHD Diagnosis More Likely

Is your child's birthday on the cusp of his grade's cutoff date? Then you might want to think twice before rushing off to register him for his first year of school.

childSuzanne Tucker/ShutterstockIf your preschooler seems advanced for his or her age, you’re no doubt thrilled. And after they’ve gotten a bit older and performed well in school, there could be big advantages to having your child skip a grade. But don’t be tempted to sign him up for kindergarten as soon as he’s old enough if that means he’ll be the youngest kid in the class. According to new research, you might be setting up your child for an ADHD diagnosis.

Not too long ago, a study revealed that starting school on the younger side may negatively impact a child’s mental health. This newer study, published in The Lancet Psychiatry journal, indicates that kids who are on the younger side of their grade are more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD). ADHD symptoms in children include behaviors like hyperactivity, impulsivity, and a lack of focus that are inappropriate for the child’s developmental level, noted the study authors, who were led by child psychiatrist, Kapal Sayal, PhD, professor of Child and Adolescent Psychiatry at the University of Nottingham‘s School of Medicine, and included researchers from the University of Turku in Finland. However, young grade-school children who demonstrate hyperactivity, impulsivity, and inattention may simply be showing signs of immaturity—or rather, their maturity level is appropriate to their age but young for their grade.

To tease out the potential influence of age on an ADHD diagnosis, Dr. Sayal based his study in Finland, where children start school in the calendar year that they turn seven years old. Diagnostic rates for ADHD are much lower there than in other developed countries like the United States. But even in Finland, children with birthdays later in the year were at much higher risk of getting an ADHD diagnosis: Younger boys were 26 percent more likely, and the younger girls had a 31 percent increased risk of a diagnosis. With older grades, the risk declined, which, according to Dr. Sayal, suggests the possibility that immaturity is behind many diagnoses. These results build on those from a study from last year, which found that the likelihood of an ADHD diagnosis was much higher for kids who start school young—and declines as the children get older.

“Teachers, parents, and clinicians should take relative age into account when considering the possibility of ADHD in a child or encountering a child with a pre-existing diagnosis,” the study authors urge. Otherwise, children who are merely a bit immature for their grade could end up saddled with a diagnosis that will follow them for far longer than any lingering immaturity.

If your child is diagnosed with ADHD, here are some questions to ask yourself before starting him or her on medication.

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Lauren Cahn
Lauren Cahn is a New York-based writer whose work has appeared regularly on Reader's Digest, The Huffington Post, and a variety of other publications since 2008. She covers health, fitness, yoga, and lifestyle, among other topics. An author of crime fiction, Lauren's book The Trust Game, was short-listed for the 2017 CLUE Award for emerging talent in the genre of suspense fiction.