What drives the diagnosis of ADHD in kids? More than just severity of symptoms, certainly: income, race, educational attainment of parents and state residency all appear to play some part. So, somewhat disturbingly, does the disposition of teachers - who might have misidentified nearly 1 million kids as attention-deficit simply because they're younger (and less mature) than their classmates, according to a study released today:
“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,” said [Todd] Elder, assistant professor of economics [at Michigan State University]. “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.”
Researchers looked at a longitudinal study of 12,000 students, comparing ADHD diagnosis and medication rates between the youngest and oldest children in a grade. They found the youngest were 60 percent more likely to be diagnosed with ADHD than the oldest while they were in kindergarten; and by the time they reached fifth and eighth grades, they were twice as likely to be prescribed stimulants. The researchers conclude 20 percent of the 4.5 million U.S. children labeled ADHD have been misdiagnosed.
Needless to say, the implications of misdiagnosis are huge at the societal and personal level: Elder says as much as $500 million a year is wasted on unnecessary medication; and the health effects of long-term stimulant use by children are unclear.
The study will appear in the upcoming edition of the Journal of Health Economics.
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