Why are some children misdiagnosed with ADHD? The month of birth could be a clue


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By Meghan Holohan

While the number of children diagnosed with ADHD has increased, parents, teachers, doctors, and researchers are struggling to understand why.

A study published in the New England Journal of Medicine indicates a surprising explanation: the deadlines of elementary schools. The youngest children in a class – those who have recently had 5 years before the kindergarten enrollment deadline – are more likely to suffer from Attention Deficit Hyperactivity Disorder (ADHD). than their older peers.

The researchers were shocked to find that babies in the month of August were more likely to be treated and diagnosed with ADHD than those born in previous months, NBC economist Timothy Layton told the department. Health Care Policy from Harvard Medical School and author of the paper. News, by email.

Layton and his colleagues examined data from 407,846 children in an American insurance company database born between 2007 and 2009. The researchers looked at children until 2015 and focused on the diagnosis ADHD based on the month of birth and the end of school enrollment, where children had 5 before September 1 to go to kindergarten. They found that children born in August, who were the youngest in the class, had a higher rate of ADHD than older members of the class.

According to estimates by the Centers for Disease Control and Prevention, about 6.1 million American children aged 2 to 17 years, just over 9%, have already had a diagnosis of ADHD. But a large percentage of children could be mislabeled, according to experts of children's behavior. Why would the month of birth make a difference?

This could be the level of maturity of the child in school, compared to slightly older classmates, suggested David Anderson, senior director of the Center for ADHD and Behavioral Disorders and Director of programs at the Child Mind Institute.

"Some of the inattentive or distracting behaviors of ADHD might be aligned with the behaviors typical of younger children," said Anderson, who did not participate in the study. "What the study tells us is more of a check."

Kimberly Blair, a psychiatrist at the University of Pittsburgh, began her career as a school psychologist and found how a 5-year-old and a 6-year-old behaved very differently in school. She understands why teachers sometimes report that young children have ADHD.

"The six year olds are going to have a whole year of development and they will look more mature," Blair said TODAY. "In terms of staying still and following the instructions, they will be different."

Experts know that differences in development between young children can lead people to make a diagnosis of ADHD incorrectly.

"It's something we're looking for and against what we're doing," Ben Fields, a clinical psychologist for children and adolescents at Children's Nationwide Hospital in Columbus, told Field Today. "We must be careful in assessing ADHD for all children, especially the youngest."

Do not redshirt the child

This is one of the reasons why the Centers for Disease Control and Prevention recommend that clinicians offer behavioral therapy to children.

This does not mean that parents must avoid treatment until the child is 6 years old.

"I do not think the message is to delay getting an appointment," Anderson said. If the parent says, "He is the youngest in the class and has ADHD," we might not start a medication, but rather look at the overall trajectory of the child. "

Anderson also warns against keeping in school children whose birthday is the month of August, a practice known as academic redshirt.

"We have to be wary of any study like this," Anderson said. "We do not want to decide that every child with a behavior of July or August is withheld."

The fields are in agreement.

"Many of these children who are young for kindergarten … are doing well," he said. "I would not take any general decision."

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