School Entry Age Linked to ADHD Diagnosis Rates

Author: Elsevier Health Sciences
Published: 2016/03/11 - Updated: 2025/05/27
Publication Details: Peer-Reviewed, Findings
Category Topic: ADHD and ADD - Academic Publications

Page Content: Synopsis - Introduction - Main - Insights, Updates

Synopsis: This research, published in The Journal of Pediatrics and authored by Elsevier Health Sciences, investigates how a child's age at school entry can influence the likelihood of being diagnosed with ADHD and receiving medication for it. By analyzing data from nearly 380,000 children in Taiwan, the study found that those born in August - the youngest in their school grade due to the August 31 enrollment cut-off - were more likely to be diagnosed with ADHD and prescribed medication than their peers born in September, the oldest in the grade. The effect was particularly pronounced in preschool and elementary-aged children, but not in adolescents, suggesting that immaturity related to relative age may be mistaken for ADHD in younger children, and that this risk diminishes as children mature.

This information is authoritative and valuable for educators, clinicians, parents, and disability advocates, as it highlights the need to consider a child's relative age within their class before diagnosing ADHD, potentially reducing unnecessary labeling and medication for children whose behaviors may simply reflect developmental immaturity rather than a neuropsychiatric disorder - Disabled World (DW).

Introduction

Attention-deficit hyperactivity disorder (ADHD) is typically diagnosed in childhood and manifests as an inability to sustain attention and control activity levels and impulse control.

Main Content

Attention deficit hyperactivity disorder, Similar to hyperkinetic disorder in the ICD-10, is a developmental neuro-psychiatric disorder in which there are significant problems with executive functions (e.g., attentional control and inhibitory control) that cause attention deficits, hyperactivity, or impulsiveness which is not appropriate for a person's age. These symptoms must begin by age six to twelve and persist for more than six months for a diagnosis to be made. Some reports have indicated a prevalence of up to 15% in Western countries.

In school-aged individuals inattention symptoms often result in poor school performance.

Although the causes of ADHD are still unknown, a new study scheduled for publication in The Journal of Pediatrics found that a child's age at school entry may have an effect on the diagnosis of ADHD.

Dr. Mu-Hong Chen and colleagues from Taipei and Taoyuan, Taiwan, examined cohort data from 378,881 children ages 4-17 years from 1997 to 2011 and evaluated the prevalence of being given a diagnosis of ADHD and/or prescribed ADHD medication.

Using the Taiwanese annual cut-off birthdate of August 31 for school enrollment, the researchers compared the youngest children in a grade (those born in August) with the oldest (those born in September) and assessed whether age was associated with being diagnosed with ADHD and/or being medicated.

When looking at the database as a whole, children born in August were more likely to be diagnosed with ADHD and/or receive ADHD medication than those born in September. When broken down and analyzed according to age, only preschool or elementary school-aged children born in August had an increased risk of being diagnosed with ADHD and receiving ADHD medication. However, adolescents born in August did not have an increased risk of ADHD diagnosis. This may imply that increasing age and maturity lessens the impact of birth month on ADHD diagnoses.

Worldwide, the number of children and adolescents being diagnosed with ADHD or receiving a prescription for ADHD has significantly increased. Evidence shows that relative age, which may be a proxy of neurocognitive ability, may increase the likelihood of ADHD diagnosis and medication.

According to Dr. Chen:

"Our findings emphasize the importance of considering the age of a child within a grade when diagnosing ADHD and prescribing medication to treat ADHD."

Insights, Analysis, and Developments

Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Elsevier Health Sciences and published on 2016/03/11, this content may have been edited for style, clarity, or brevity.