Are too many children being diagnosed with attention deficit hyperactivity disorder because they are younger than their classmates and tagged as ADHD because they are acting their age?
Michigan State University economist Todd Elder believes that is the case and could result in 900,000 kids being diagnosed and treated for the condition at tremendous cost without actually having ADHD.
In a soon-to-be-published paper written in conjunction with another similar study for the Journal of Health Economics, Elder examined data on 18,644 kindergarten students at more than 1,000 schools in 1998-99. The kids were interviewed again the next year in first grade and then in third, fifth and eight grades as part of the National Center for Education Statistics longitudinal survey. A total of 14,333 children from the initial sample were interviewed at least one subsequent time.
Elder found that the youngest children in their classes _ those whose birthdays fell in the month before their state’s cut off for kindergarten _ were nearly twice as likely to be diagnosed with ADHD, suggesting that the diagnoses could be related to age and maturity.
The economist found 8.4 percent of kids born the month before the kindergarten cut off were diagnosed with ADHD compared with 5.1 percent of those born the month after the cut off.
“If a child is behaving poorly, if he’s inattentive, if he can’t sit still, it may simply be because he’s 5 and the other kids are 6,” Elder said in a statement. “There’s a big difference between a 5-year-old and a 6-year-old, and teachers and medical practitioners need to take that into account when evaluating whether children have ADHD.”
The assistant professor of economics noted that in addition to the potential impact of long-term ADHD treatment on children’s health, over-diagnosis is costly, wasting an estimated $320 million to $500 million a year, much paid by Medicaid.
“Many ADHD diagnoses may be driven by teachers’ perceptions of poor behavior among the youngest children in a kindergarten classroom, but these ‘symptoms’ may merely reflect emotional or intellectual immaturity,” Elder said.
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