Consumer Reports Health Blog: Is your child the youngest in class? If so, be wary of an ADHD diagnosis

Consumer Reports Health Blog: Is your child the youngest in class? If so, be wary of an ADHD diagnosis

Is your child the youngest in class? If so, be wary of an ADHD diagnosis

Like sports stardom, school achievement and behavior may depend on school-age cutoff dates. In his book Outliers, Malcolm Gladwell noted that boys who were born just after a cutoff date for age-based sports programs—and therefore months older than most other children in their group—were more likely to be selected for travel teams. As a result, they received better training, practiced more, and played with better competitors.

A similar phenomenon may occur in the diagnosis of attention deficit/hyperactivity disorder (ADHD). Children who were the youngest in their grade were more than twice as likely to be diagnosed with or treated for ADHD than their “older-for-grade” counterparts, according to a recent study in the Journal of Health Economics.

It's normal for children who are the youngest in their grade to act out more and perform slightly worse than older classmates. So if a child displays ADHD-like symptoms in only one place, like school, he should be assessed by age-based, not grade-based, measures. Otherwise, the child could start on medications and develop academically under the umbrella of ADHD, when he was just acting his age. Incomplete assessment could mean these youngest children will become academically hamstringed, while their older counterparts are placed on the path to high achievement.

ADHD is a real, neurologically-based disorder, that can affect learning. But not every disorderly child who also happens to be the youngest in his grade should be diagnosed with it.

—Andrew Schwartz, Ph.D., is a Consumer Reports survey research associate and licensed clinical psychologist.