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Youngest Kids in Class at Higher Risk of ADHD Diagnosis

82 points| daegloe | 10 years ago |npr.org | reply

107 comments

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[+] Spooky23|10 years ago|reply
It's a great illustration of the lack of rigor around this stuff.

My college provided significant benefits to ADHD diagnosed students. Rather than take finals in stadium seating, you got a personal, air conditioned office, received unlimited time and could use reference material.

A few of my friends found a "Do you need Ritalin" quizzes in a magazine, went to a doc-in-the-box and got the diagnosis. They sold the Ritalin and got better grades.

[+] rtpg|10 years ago|reply
This is very belittling to the amazing amount of research that goes into ADHD.

Many studies have been done with regard to treatment and diagnosis, and at this point we are better able to treat ADHD than we are able to treat depression

There might be a bit of an over-treatment culture (I'm not sure, though), but the science is extremely well developed and tested

[+] ap22213|10 years ago|reply
There's probably over diagnosis, but since ADHD medications are safe at low doses, there's not much downside with over diagnosis. On the other hand, there's 2-8% of the general population that has ADHD, and those individuals gain significant benefits from medication.

If you're unsure if ADHD really exists, it may be useful to read the genetic studies that show ADHD correlation with specific SNPs, and decide for yourself [1]. Personally, I find the evidence satisfactory.

That said, I personally believe that ADHD type symptoms could be caused by several different disorders. ADHD is kind of like bipolar disorder - it covers a lot of areas and is sort of a fallback category when other diagnosis don't fit.

http://www.ncbi.nlm.nih.gov/pubmed/?term=ADHD,SNP

[+] icanhackit|10 years ago|reply
you got a personal, air conditioned office, received unlimited time and could use reference material [...] They sold the Ritalin and got better grades

As unfair as that seems to the students who took their finals in stadium seating, that's a pretty sweet hack. The system is fucked up, but I can't help but admire your friends deciding to use it to their advantage.

[+] intopieces|10 years ago|reply
Your description of your school's accommodations surprises me. I looked into the one for my school and it appears much stricter. Just having ADHD doesn't cut it -- a full write up is necessary. In other words, wouldn't be worth the hassle to fake it.
[+] eruditely|10 years ago|reply
Yeah right? Lack of rigor, people like you are the people who hurt me who have it. Here's your rigor for you buddy

http://www.amazon.com/Attention-Deficit-Hyperactivity-Disord...

I'm going to edit my comment with my studies copy paste that I prepare every time someone "doubts" ADHD.

http://www.filedropper.com/russellabarkley-attention-deficit...

Here's the entire epub buddy. Please edit your post, gosh.

""By adolescence, these chronic and cumulative experiences with school failure, learning disorders, school misbehavior, and sometimes lower intelligence begin to generate other adverse educational outcomes. For instance, the academic outcome of the hyperactive (ADHD) adolescents was considerably poorer in Barkley and Fischer’s Milwaukee follow-up study at the teen follow-up than that of the typically developing adolescents followed concurrently. At least three times as many hyperactive (ADHD) children had failed a grade (29.3 vs. 10.0%) or been suspended (46.3 vs. 15.2%) or expelled (10.6% vs. 1.5%) (Fischer, Barkley, Edelbrock, & Smallish, 1990). Others have also identified such high educational risks in longitudinal studies dating back as much as 40 years (Ackerman, Dykman, & Peters, 1977; Mendelson, Johnson, & Stewart, 1971; Stewart, Mendelson, & Johnson, 1973; Weiss, Minde, Werry, Douglas, & Nemeth, 1971; Wilson & Marcotte, 1996). In another sample of clinic-referred teenagers with ADHD, a similar risk for school retention and suspension was documented (Barkley, Anastopoulos, Guevremont, & Fletcher, 1991). Almost 10% of the hyperactive sample followed into adolescence had quit school at this follow-up point in the Milwaukee Study, compared to none of the normal sample (Barkley, Fischer, et al., 1990). Fischer and colleagues (1990) also found that the levels of academic achievement on standard tests were significantly below normal on tests of math, reading, and spelling, falling toward the lower end of the normal range (standard scores between 90 and 95)." (Quoted from the 4th edition)"

"Substantially fewer hyperactive than control children had ever enrolled in college (21 vs. 78%) or were currently attending at this follow-up point (15 vs. 66%). These findings were reaffirmed 6 years later at the age 27 follow-up (Barkley et al., 2008). In the Canadian follow-up study, approximately 20% attempted a college program, yet only 5% completed a university degree program, compared to over 41% of control children (Weiss & Hechtman, 1993). The longest running (30-year) follow-up study of hyperactive children into midlife likewise indicates that less education is an outcome of childhood ADHD, with 30% either not completing high school or getting a general equivalency diploma (GED), compared to just 4% of the control group (Klein et al., 2012). These findings demonstrate that the educational domain is major in terms of impaired functioning and reduced attainment for children growing up with ADHD."

[+] sjclemmy|10 years ago|reply
This doesn't surprise me. My youngest is a July baby and was constantly in trouble up to around the age of 11, for being a bit silly and immature. We, as parents, got to realise this and would often say, "If he was in the year below, his behaviour wouldn't be unusual."
[+] bsder|10 years ago|reply
ADHD -- middle class children with behaviors that annoy elementary school teachers

If they're poor, you call them thick. If they're rich, you get them a tutor. If they're middle class, you medicate them.

[+] ThrustVectoring|10 years ago|reply
Or middle class children with behavior that annoys their parents.

Well, it's both that and a legitimate medical condition. The problem is that the medication that works for ADHD also works for suppressing childish behavior that authority figures find annoying. Everyone involved are fallible humans that respond to incentives, and often the incentives align for teachers, parents, and psychiatrists to medicate children into compliance.

[+] damla|10 years ago|reply
The thing is, the youngest child is not just taken to the specialists with the suspect of ADHD, it really is diagnosed with ADHD. Gifted children also diagnosed frequently with ADHD, they even have a name for it, twice exceptional. The ADHD comes to me like a deviation from the social standarts. What's normal, and what's not. For most children, ADHD is not a cause of worry until school age. The normal student is defined by current education system. ADHD comes to me like being gay, you are not sick or nothing's wrong with you, just different than the average, and have problems with fitting in the current social standarts.
[+] drpgq|10 years ago|reply
Is there anywhere that divides up their younger grade classes into who is born in the first half of the educational year and who is born in the second half? That could help somewhat although the teacher of the second half kids probably is going to have a tough time.
[+] peleroberts|10 years ago|reply
Once upon a time no such reference letters existed, you had slow kids, fast kids and middle of the road kids. All of a sudden kids are getting the labels as if they belong on supermarket shelves. An old schooler would say there's a cure for that, either bad parenting, not eating the right foods or balanced diet, bad sleeping pattern. Or basically some parents just like to get extra government money to support their own needs. (I know a family that's done this - and it's disgusting) What's next?
[+] BurningFrog|10 years ago|reply
This is just one of several disadvantages for kids born towards the end of the year.

One logical solution is to have two classes per year. Kids born Jan-June start in the fall, the rest the following spring.

[+] RhysU|10 years ago|reply
Another, deliberately distasteful, one would be to incentivize reproducing to ensure one's family doesn't run afoul of the cutoffs.
[+] im3w1l|10 years ago|reply
> the difference in diagnosis rates vanished by the time the students reached their teenage years

Makes me think this isn't that big a deal

[+] eruditely|10 years ago|reply
"By adolescence, these chronic and cumulative experiences with school failure, learning disorders, school misbehavior, and sometimes lower intelligence begin to generate other adverse educational outcomes. For instance, the academic outcome of the hyperactive (ADHD) adolescents was considerably poorer in Barkley and Fischer’s Milwaukee follow-up study at the teen follow-up than that of the typically developing adolescents followed concurrently. At least three times as many hyperactive (ADHD) children had failed a grade (29.3 vs. 10.0%) or been suspended (46.3 vs. 15.2%) or expelled (10.6% vs. 1.5%) (Fischer, Barkley, Edelbrock, & Smallish, 1990). Others have also identified such high educational risks in longitudinal studies dating back as much as 40 years (Ackerman, Dykman, & Peters, 1977; Mendelson, Johnson, & Stewart, 1971; Stewart, Mendelson, & Johnson, 1973; Weiss, Minde, Werry, Douglas, & Nemeth, 1971; Wilson & Marcotte, 1996). In another sample of clinic-referred teenagers with ADHD, a similar risk for school retention and suspension was documented (Barkley, Anastopoulos, Guevremont, & Fletcher, 1991). Almost 10% of the hyperactive sample followed into adolescence had quit school at this follow-up point in the Milwaukee Study, compared to none of the normal sample (Barkley, Fischer, et al., 1990). Fischer and colleagues (1990) also found that the levels of academic achievement on standard tests were significantly below normal on tests of math, reading, and spelling, falling toward the lower end of the normal range (standard scores between 90 and 95)." (Quoted from the 4th edition)

ADHD IS real and really bad and it goes away on meds, your brain is underdeveloped 30% compared to your peers, in exec functioning. So if you're 18, you're at 12.5 on average. It's called Barkley's 30% rule.

It's serious but responds great to meds, STOP believing the anti-adhd hype.

[+] conceit|10 years ago|reply
Backronym to Age Dependent H. [Age] Deficiency/Disorder?
[+] tibbetts|10 years ago|reply
This article fails to admit the possibility of mistaken non-diagnosis caused by the same phenomenon. It would be interesting to see the relationship between being old for grade and late (eg adult) diagnosis of ADHD.
[+] nommm-nommm|10 years ago|reply
What? Yes, it does mention this.

"But perhaps older, more mature-looking students are just being underdiagnosed and not get help they might need, he says. The studies didn't look into that."

[+] cheez|10 years ago|reply
This is some Malcolm Gladwell-level stuff... Damn.
[+] askafriend|10 years ago|reply
Can you expand on your criticism? I've heard people offhandedly criticize Gladwell's work but I've never really gotten a full explanation of why they dislike his style.
[+] fweespee_ch|10 years ago|reply
> The youngest students were between 20 percent and 100 percent more likely to get the diagnosis or ADHD medication than were the oldest students in the cohort, says Helga Zoëga, an epidemiologist at the University of Iceland who worked on the Icelandic and Israeli studies.

> "Within that age range there is a huge difference in developmental and social and emotional maturity," says Dr. Adiaha Spinks-Franklin, a developmental and behavioral pediatrician at Texas Children's Hospital who was not involved in any of the studies. "A 6-year-old is just not the same as a 7-year-old."

> And yet a first-grader might stand shoulder to shoulder with another student nearly 12 months her elder. "And the way we diagnose ADHD is we talk to the parent about the child's behavior, and we mail the teacher questionnaires," Spinks-Franklin says. "The teacher will be comparing the child's behavior relative to other children in the class."

That is disturbing. It is clear they aren't taking age into account except at the broadest levels when handing out ADHD medication.

This rings dangerous close to "That kid is too much trouble, just medicate them and move on."

[+] eruditely|10 years ago|reply
ADHD is a developmental disorder, they're 30% behind their peers anyways in exec functioning(front part of brain) in development, it's called "Barkley's 30% rule" It's very severe and bad but goes away if you just take your meds.

So if you're 18, you're when people were at 12.5 in your ability to perceive time/planning. It's worse than having low intelligence, EF deficits.

""By adolescence, these chronic and cumulative experiences with school failure, learning disorders, school misbehavior, and sometimes lower intelligence begin to generate other adverse educational outcomes. For instance, the academic outcome of the hyperactive (ADHD) adolescents was considerably poorer in Barkley and Fischer’s Milwaukee follow-up study at the teen follow-up than that of the typically developing adolescents followed concurrently. At least three times as many hyperactive (ADHD) children had failed a grade (29.3 vs. 10.0%) or been suspended (46.3 vs. 15.2%) or expelled (10.6% vs. 1.5%) (Fischer, Barkley, Edelbrock, & Smallish, 1990). Others have also identified such high educational risks in longitudinal studies dating back as much as 40 years (Ackerman, Dykman, & Peters, 1977; Mendelson, Johnson, & Stewart, 1971; Stewart, Mendelson, & Johnson, 1973; Weiss, Minde, Werry, Douglas, & Nemeth, 1971; Wilson & Marcotte, 1996). In another sample of clinic-referred teenagers with ADHD, a similar risk for school retention and suspension was documented (Barkley, Anastopoulos, Guevremont, & Fletcher, 1991). Almost 10% of the hyperactive sample followed into adolescence had quit school at this follow-up point in the Milwaukee Study, compared to none of the normal sample (Barkley, Fischer, et al., 1990). Fischer and colleagues (1990) also found that the levels of academic achievement on standard tests were significantly below normal on tests of math, reading, and spelling, falling toward the lower end of the normal range (standard scores between 90 and 95)." (Quoted from the 4th edition)"

"Substantially fewer hyperactive than control children had ever enrolled in college (21 vs. 78%) or were currently attending at this follow-up point (15 vs. 66%). These findings were reaffirmed 6 years later at the age 27 follow-up (Barkley et al., 2008). In the Canadian follow-up study, approximately 20% attempted a college program, yet only 5% completed a university degree program, compared to over 41% of control children (Weiss & Hechtman, 1993). The longest running (30-year) follow-up study of hyperactive children into midlife likewise indicates that less education is an outcome of childhood ADHD, with 30% either not completing high school or getting a general equivalency diploma (GED), compared to just 4% of the control group (Klein et al., 2012). These findings demonstrate that the educational domain is major in terms of impaired functioning and reduced attainment for children growing up with ADHD." (quoted from the 4th edition handbook) linked below

http://www.filedropper.com/russellabarkley-attention-deficit...

http://www.amazon.com/Attention-Deficit-Hyperactivity-Disord...

[+] amelius|10 years ago|reply
Perhaps astrology has some truth to it after all :)
[+] foota|10 years ago|reply
I was diagnosed with ADHD as a kid in elementary school but I didn't want to take the medication (Or I may have just been being contrary...). and now as a junior in college I'm considering talking to a doctor to see whether medication might be able to help me focus. I find myself constantly unable to fin-
[+] eruditely|10 years ago|reply
""By adolescence, these chronic and cumulative experiences with school failure, learning disorders, school misbehavior, and sometimes lower intelligence begin to generate other adverse educational outcomes. For instance, the academic outcome of the hyperactive (ADHD) adolescents was considerably poorer in Barkley and Fischer’s Milwaukee follow-up study at the teen follow-up than that of the typically developing adolescents followed concurrently. At least three times as many hyperactive (ADHD) children had failed a grade (29.3 vs. 10.0%) or been suspended (46.3 vs. 15.2%) or expelled (10.6% vs. 1.5%) (Fischer, Barkley, Edelbrock, & Smallish, 1990). Others have also identified such high educational risks in longitudinal studies dating back as much as 40 years (Ackerman, Dykman, & Peters, 1977; Mendelson, Johnson, & Stewart, 1971; Stewart, Mendelson, & Johnson, 1973; Weiss, Minde, Werry, Douglas, & Nemeth, 1971; Wilson & Marcotte, 1996). In another sample of clinic-referred teenagers with ADHD, a similar risk for school retention and suspension was documented (Barkley, Anastopoulos, Guevremont, & Fletcher, 1991). Almost 10% of the hyperactive sample followed into adolescence had quit school at this follow-up point in the Milwaukee Study, compared to none of the normal sample (Barkley, Fischer, et al., 1990). Fischer and colleagues (1990) also found that the levels of academic achievement on standard tests were significantly below normal on tests of math, reading, and spelling, falling toward the lower end of the normal range (standard scores between 90 and 95)." (Quoted from the 4th edition)"

"Substantially fewer hyperactive than control children had ever enrolled in college (21 vs. 78%) or were currently attending at this follow-up point (15 vs. 66%). These findings were reaffirmed 6 years later at the age 27 follow-up (Barkley et al., 2008). In the Canadian follow-up study, approximately 20% attempted a college program, yet only 5% completed a university degree program, compared to over 41% of control children (Weiss & Hechtman, 1993). The longest running (30-year) follow-up study of hyperactive children into midlife likewise indicates that less education is an outcome of childhood ADHD, with 30% either not completing high school or getting a general equivalency diploma (GED), compared to just 4% of the control group (Klein et al., 2012). These findings demonstrate that the educational domain is major in terms of impaired functioning and reduced attainment for children growing up with ADHD."

You get remission of symtoms very frequently if you take your meds, it works great. there's no way you can "overcome" it as you're a) time myopic (look it up) b) cannot execute knowledge you have acquired.

[+] Noge_Sako|10 years ago|reply
Removing actual firm discipline for all the young boys has been a disaster.

We replaced strict and perhaps unpleasant discipline in favor of medicine, and its worse long term side effect profile.

[+] skywhopper|10 years ago|reply
As an adult male with ADHD that went undiagnosed until I was in my late 20s, who was one of the youngest in his class, who faced the potential of "corporal punishment" (spanking on the rear-end with a wooden paddle was the threat) both at school and at home (it was only ever administered to me at home by my parents), and who now has a daughter who has just passed through the elementary years at a school that does not practice any physical punishment, and who has never practiced any sort of physical punishment on my daughter, I strongly disagree.

The biggest change I've seen in the style of schooling between my elementary years and today is not the administration of corporal punishment. Yes, it was an option when I was a child, but it was rarely administered. Less than half a dozen times a year across six grades and about 1000 children, perhaps, is my rough guesstimate.

Instead, the biggest change I see is the near total removal of recess as a part of the day. When I was in elementary school, we had two 15-minute recesses, one 25-minute recess, and an additional 10-15 minute recess period after lunch. My daughter, throughout her elementary school years, was given a single 15 minute recess, and this was often taken away from the entire class as a collective punishment. To me, it's no wonder the kids can't sit still or pay attention. Children that age need to run and play without structure and with as few rules as possible. That physical energy has to go somewhere. And it too often goes to acting up and inability to pay attention in class.

[+] benologist|10 years ago|reply
You say strict but don't you really just mean threatening children with violence?

The last time someone told me to stand still so they could hit me as hard as they could with a cane was when I was 7 or 8 years old. That's not education. Real educators, much like real democracy, do not rely on fear and violence to control others.

[+] afarrell|10 years ago|reply
> Removing actual firm discipline

What are some concrete examples of disciplinary tactics we should resume using?

[+] zhemao|10 years ago|reply
Or we could recognize that young boys are naturally energetic and that this is not a bad thing. If we could teach them in a way that channels that energy instead of forcing them to sit in a chair for 6 hours a day, they might actually learn something.
[+] financedfuture|10 years ago|reply
Although hated, this comment raises interesting points.

Indeed, kids are given much more freedom and are less "disciplined" than ever before.

At the same time, there's never been so much pressure and coerciveness than right now. You "don't have to take the meds", but you most likely will do that.

Sort of a hidden, more hurtful, authoritarianism.

[+] guard-of-terra|10 years ago|reply
Hey, have you seen The Lawnmower Man movie? Because you have that coming.