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Kindergarten enrollment dates affect ADHD diagnosis rates
- hartror 16y agoNice. The first study I've heard of of it's type and it confirms the anecdotal evidence I've been reading about for years! Hope there are a few more studies like this around so doctors sit up and pay attention (pun unintended).
- joezydeco 16y agoWho's going to the first to mention Gladwell's Outliers? Oh wait, I just did.
- miloshh 16y agoActually, it might be that doctors are quite accurate with diagnosing ADHD. The problem is that the sample of kids that they even get to examine is already biased - they may be the younger ones, in which parents or teachers just observed immaturity (which is probably uncorrelated to ADHD). Just a guess - maybe the paper addresses this issue.
- antics 16y agoLet's nip this in the butt before people actually think this is correct. This study confirms ONLY (edit: [redacted]) that development is affected by what kids do with themselves. (Duuuuuh.) It does NOT erase the fact that there are real, empirical differences between the brains of kids with and without ADHD. For example, it doesn't erase the fact that kids with ADHD do have demonstrably abnormal cerebral myelination. ADHD is actually one of the most researched areas of Pediatric Psychiatry, so before everyone jumps on the Starbucks MD bandwagon, at least do the research. I don't want to be overly rude about this, and I apologize if I am, but it's hard to have patience for intellectual whack-a-mole.
- RK 16y agoI don't think the article or the parent comment make any claim that ADHD is not a real disorder. What the study is saying is that children who are relatively young compared to their peers are diagnosed with ADHD at a higher rate because their teachers report them acting in ways "consistent with ADHD" more often than their peers. The physicians use these reports as part of their evidence when making a diagnosis. The explanation is that these children are probably just less mature due to relative age. Their ADHD diagnosis rate is higher than the other group of children, who are essentially the exact same age, but relatively old compared to their classmates.
- deleted 16y ago[deleted]
- antics 16y agoSince the author of the parent comment expected other users to pick up what "anecdotal" evidence he was talking about, I took it to mean what it typically means. I know what the study is saying. I wasn't responding directly to it.
- JabavuAdams 16y agoHow many kids are diagnosed with ADHD due to some objective measurement of their bodies? No, it's "do you have problems with X or more of the following list items" + the physician's judgment. The study does not contradict what you're saying.
- drtse4 16y agoLuckily, ADHD is still unknown here (Italy, and as far as i know also in the rest of europe, UK excluded), i wonder what will happen when the gullible public will discover its existence. ADHD treatments could become even more popular than homeoteraphy. EDIT: Report about ADHD awareness in Europe: http://www.adhs-deutschland.de/pdf/pdf0007.pdf http://www.adhs-deutschland.de/pdf/pdf0007.pdf EDIT2: Why the downvotes?
- studer 16y agoWhere is "here"? Afaik (but I'm no expert), the diagnosis is used in large parts of Europe (even if some countries use other acronyms). The Swedes even came up with their own version of ADHD, called DAMP: http://en.wikipedia.org/wiki/Deficits_in_Attention,_Motor_control_and_Perception http://en.wikipedia.org/wiki/Deficits_in_Attention,_Motor_co...
- drtse4 16y agoSorry, updated. What i meant is that the general public still usually ignores (confirmed in the linked report, can't attest its accuracy, btw) the existence of this disorder and so i expect that the number of diagnosed cases is still quite small at the moment. What i fear is that with more awareness, more inept parents will find in the ADHD an easy way to explain what is only the result of their educational ineptitude. And sadly, it seems clear that this disorder can easily be misdiagnosed.
- aplusbi 16y agoYou are probably being downvoted because you are making the claim that ADHD is not a real disorder and that treatment for it is comparable to homeopathy.
- drtse4 16y agoYou are right, maybe i should have stated what i meant more clearly and in a different way, i'm not claiming that. See my other comment below.
- 16y ago
- jan_g 16y ago>Morrill explains that the study shows that children born just after the kindergarten cutoff date were 25 percent less likely to be diagnosed as having ADHD than children born just before the cutoff date. Anyone care to explain what is "kindergarten cutoff date" ? EDIT: nevermind, found explanation via google(http://users.stargate.net/~cokids/kindergarten_cut-off_dates.htm http://users.stargate.net/~cokids/kindergarten_cut-off_dates...)
- aplusbi 16y agoGenerally kids who are 5 years old (if I'm not mistaken) are in Kindergarten. Some kids start Kindergarten at 4 because their birthday is later in the year. However there is a cut-off date (probably in November or December) and students born after that cut-off date are enrolled in next years Kindergarten class. So if the cut-off date is December 1st, kids born on December 1st will start Kindergarten a year earlier than kids born on December 2nd.
- studer 16y agoThe title is somewhat misleading -- it's not like Kindergarten causes ADHD. The key observation is that if you grab any group of young kids with an age spread of a full year, "younger children may be mistakenly diagnosed as having ADHD, when in fact they are simply less mature." You cannot just pretend they're all at the same stage of development. You see a similar effect in sports (where again, older kids in the group will have a big advantage).
- aplusbi 16y agoThat's not quite it either. The reason Kindergarten is important is because it's examining kids among their peers. Kids who are on average 6 months younger than their peers are more likely to be diagnosed with ADHD.
- studer 16y agoYeah, but the Kindergarten cutoff mechanism is irrelevant -- the point is that if you group young kids by some system that's aligned with the calender year rather than their actual age, they're not really peers. You'd get the same effect if you group them by what year they were born in (i.e. used January 1st as the cutoff date).
- taylorwc 16y agoAnd VC's are accused of being lemmings...looks like doctors get to share that label.
- taylorwc 16y agoAnd VC's are accused of being lemmings...looks like doctors get to share that label.
- Marticus 16y agoMoral of the story: Being a kid = ADHD. Parents need to stop resorting to "parenting in a pill" for their own inadequacies, or pressure by society to "act" on their child being precisely that. That's not to say that ADHD doesn't exist or some-such nonsense, but I believe this study at least is going somewhat in the right direction to prevent overzealous diagnosis. As someone already stated (and with whom I definitely agree) - the test set is already biased for a large percentage based on age. Not to mention the pressure that is allowed by teachers. I myself was suddenly diagnosed after ONE of my teachers decided I was too active and made an enormous fuss about it. Took the meds for a couple of weeks, lost ~10 pounds (I'm already a stick), and told them to bugger off.
- miloshh 16y agoDoctors are actually very careful not to be overzealous in diagnosis. To meet the criteria for a real diagnosis, the symptoms must be "excessive, long-term, and pervasive". Similarly, not everyone with "blues" is clinically depressed, and not everyone with unexplained weight loss has cancer... the folk estimates of the prevalence of these conditions are way overblown.
- jacquesm 16y agoA while ago I wrote this: http://jacquesmattheij.com/content/adhd-ritalin-and-evolution http://jacquesmattheij.com/content/adhd-ritalin-and-evolutio... It's how I feel about the whole ADHD thing and the industry surrounding it.
- pvg 16y agoWasn't something like that Malcolm Gladwell's theory for the prevalence of top Canadian hockey players born in the early months of the year?
- ovi256 16y agoMalcolm just rehashed something than any coach or school teacher can tell you: the smarter, stronger kids are the older.
- pvg 16y agoInterestingly, that was one of the parts where he had some sort of numbers listed so it seems a little unfair to accuse him of rehashing anecdotal evidence. Not that he's shy about using anecdotal evidence.
- c00p3r 16y agoADHD isn't about age, it is about amygdala sensitivity and compensating behavioral habits, like shying away, avoiding eye contacts and playing alone with/in own imagination.
- brlewis 16y agoYes, that's why the study can use age to measure inappropriate diagnosis.
- c00p3r 16y agoAge is a wrong explanation.
- DerKommissar 16y agoThis is kind a little off topic but I have a question for you. I am in the middle of being diagnosed with ADHD (I'm 30). It was actually HN that prompted me to take action, but that's another story which I can expand on if anyone is interested. I haven't read much about ADHD being linked to shyness and introversion, although I certainly haven't done enough research. But it describes me very well, could you possibly say a little more or point me to some resources? Everything I've read talks about impulsiveness and extroversion. I would guess that shyness and introversion are learned reactions to the impulsiveness.
- c00p3r 16y agoI'm not a guru, but I have my own experience, which matches resent publicly accepted studies. http://www.amazon.com/Emotional-Intelligence-Matter-More-Than/dp/0553375067 http://www.amazon.com/Emotional-Intelligence-Matter-More-Tha... is a good starting point. I think everyone involved (I'm with Asperger's) should study the topic, to be able to understand (and then make a corrections to) one's own behavior, instead of believing what other people (including doctors) are saying.
- DerKommissar 16y ago
- zeteo 16y agoWell, considering the criteria used to diagnose ADHD, pretty much any kid who fails to be in exact lockstep with the rest of his/her class runs the risk of being forced into conformity with psychoactive drugs. Below are the currently official criteria (from http://www.neurosurvival.ca/ClinicalAssistant/scales/dsm_IV/child.html#Attention http://www.neurosurvival.ca/ClinicalAssistant/scales/dsm_IV/...; note that these criteria are the ONLY means of diagnosis). I think personally I failed more than half the things on the list back when I was 6; thank Goodness they didn't have ADHD diagnostics back then. -Fails to pay close attention to details or makes careless errors in schoolwork, work or other activities -Has trouble keeping attention on tasks or play -Doesn't appear to listen when being told something -Neither follows through on instructions nor completes chores, schoolwork, or jobs -Has trouble organizing activities and tasks -Dislikes or avoids tasks that involve sustained mental effort (homework, schoolwork) -Loses materials needed for activities (assignments, books, pencils, tools, toys) -Easily distracted by extraneous stimuli -Forgetful -Squirms in seat or fidgets -Inappropriately leaves seat -Inappropriately runs or climbs -Has trouble quietly playing or engaging in leisure activity -Appears driven or "on the go" -Talks excessively -Answers questions before they have been completely asked -Has trouble or awaiting turn -Interrupts or intrudes on others
- trafficlight 16y agoThis just sounds like a normal 6 year old to me.
- glhaynes 16y ago
- mcantor 16y agoThey did a similar study about sports expertise. Being born at the wrong time makes you less likely to become a sports star, because the kids who are nominally your "peers" are physically superior, and it creates the perception that you are not as skilled. Pretty rough deal.
- Splines 16y agoI believe RadioLab touched upon this in their recent podcast "Secrets of Success". My memory is a bit fuzzy on the details, but IIRC they interviewed someone who noticed that most hockey teams were made up of players that were born in the first few months of the year.
- wmf 16y agoI guess parents can turbocharge their kids's future by holding them back a year, so they'll be the biggest, strongest, and most mature kids in the class.
- Digital 16y agoMost American babies are born around August and September: http://abcnews.go.com/Health/Science/story?id=945911 http://abcnews.go.com/Health/Science/story?id=945911 Which happens to be the cut off date for Kindergarten in many states. http://users.stargate.net/~cokids/kindergarten_cut-off_dates.htm http://users.stargate.net/~cokids/kindergarten_cut-off_dates... Since most children are born in Aug/September, you'd probably have the most premature births around then too right? Premature children are 70% more likely to have ADHD: http://www.medicalnewstoday.com/articles/44574.php http://www.medicalnewstoday.com/articles/44574.php Could it be that a lot of premature children happen to come right before the early/mid September deadline at the peak of the "birthing season"? If the relationship between ADHD and prematurity is correct, these children would face a double whammy...being young for their grade and ADHD.
- antics 16y agoThat's very insightful, but it's my guess is that it's not as salient as one would think. Scientists (at least in the lab) will typically use a number of metrics to measure ADHD, most notably cerebral myelination. ADHD tends to involve improper development in this regard (i.e., the brain does NOT myelinate as fast as one would expect). Since the authors posit that younger children may simply be less mature, my suspicion is that they are talking about this. And the obvious thing to do would be to correct for what you talk about (in fact, it's hard to see how they could get into a journal and not do so).
- RK 16y agoHere's a link to the authors' presentation: http://www.academyhealth.org/files/2010/saturday/morrill.pdf http://www.academyhealth.org/files/2010/saturday/morrill.pdf
- leot 16y agoImplicit in the study seems to be the assumption that the development of ADHD would occur irrespective of developmental context. It could be that always being the least mature person in one's class helps cause ADHD-like behaviors (e.g., your peer group's conversation is less interesting, so you act up or become easily distracted). Indeed, the whole study is predicated on ADHD being entirely genetic.
- j_baker 16y agoThis doesn't prove anything at all. It simply proves that school makes you more likely to be diagnosed with ADHD, which is hardly shocking. However, the idea that this implies that kids are getting misdiagnosed is a non sequiter. How do you know that this isn't a sign that kids aren't getting the medical attention they need until they get to school.
- Groxx 16y agoAn alternate theory based on the same information (and I'd be interested in others' opinions on this): Younger kids have different stresses on them than older kids in the same grade. You don't often hear of the youngest in a class bullying the oldest. The increase in ADHD diagnoses could also be because they may be more ADHD prone, and not just because of age. I just think we need to lose the focus on medication for ADHD. For some: absolutely. For most: hell no, they just need to learn to manage it. Many of the most productive people were clearly ADHD, but managed it to at least some degree.