Kids Who Start School Early 30% More Likely to be Diagnosed with ADHD

New research suggests parents of children with late summer birthdays may want to consider holding their kids back one more year before starting school.

When young children are held up to a standard of behavior they aren’t yet developmentally prepared for, they may be misdiagnosed with ADHD. Getty Images

The start of kindergarten is a big deal for a lot of families.

It’s the beginning of a new stage of childhood and parenting, and it brings with it all of the excitement and anxiety that come along with such a change.

But for parents of kids with late summer birthdays, the transition can be even more daunting. This is because those parents usually have a choice to make: Allow their child to be among the youngest in the class, or give them another year to develop in both maturity and attention skills prior to beginning their educational career.

Decisions, decisions

There are a lot of factors that can go into making this choice.

On the side of holding kids back, parents may be considering the potential for athletic opportunities in the future, a child’s individual ability to sit still, and the fact that research has consistently shown better outcomes for kids who tend to be among the oldest in their class. This includes higher test scores, improved college attendance rates, and reduced juvenile criminal activity.

On the side of starting early, however, parents might cite the appeal of saving money on childcare, or of simply being convinced their child truly is ready.

The latest research

These are fair points. But a new study published in The New England Journal of Medicine may give those parents one more reason to reconsider.

According to the latest research, children born in August attending schools with September 1stenrollment cutoffs are 30 percent more likely to receive an ADHD diagnosis when compared to their only slightly older peers.

For the study’s lead author, Timothy Layton, PhD, these results bring up some important points for parents to keep in mind.

“I think parents of children with summer birthdays (or birthdays close to the cutoff in their state) should be skeptical when teachers come to them suggesting their child has ADHD,” he told Healthline.

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Over-diagnosis

The results indicate a possibility that younger children are being over-diagnosed with ADHD, held up against a standard for behavior they just aren’t yet developmentally prepared for.

According to the Centers for Disease Control and Prevention (CDC), the percentage of children who have been diagnosed with ADHD at some point in their lives rose nearly 38 percent between 2003 and 2016.

Layton warned that parents “should also do everything they can to help their children weather the storm of being the youngest child in their class, which brings with it numerous disadvantages for the child.”

He suggests parents at least consider holding their children with late summer birthdays back a year, so they can be the oldest in the class rather than the youngest.

Under-diagnosis?

Dr. Mark Wolraich, a professor of pediatrics and Chief of the Section of Development and Behavioral Pediatrics at Oklahoma University Health Sciences Center, told Healthline that while over-diagnosis may be a valid concern, he worries that there is also a fair amount of under-diagnosis when it comes to ADHD.

And he expressed concern that fears of over-diagnosis may actually keep kids who really need the help from receiving a proper diagnosis.

“One of the important aspects of making the diagnosis is determining if the symptoms are impairing the child’s function,” he told Healthline. “Those children who are having problems need to have those problems addressed, because the experience with failure and not doing well can be very negative for these kids.”

He said it’s important for practitioners to look at the child’s environment when making a diagnosis — which includes their teachers and their school. He also wants to make sure parents know that ADHD does not have to be a permanent diagnosis.

“Clearly, if they improve with maturity, they no longer have a diagnosis,” he said.