According to a recent study by a Michigan State University economist, nearly one million children in kindergarten in the United States are misdiagnosed with ADHD. The study attributes this to the disparity of ages in a kindergarten classroom. Most kindergarten classrooms have children who are either 5 or 6 years old. The study shows that the younger children are more likely to be rated by their teacher as being inattentive and hyperactive. However, these ratings may more likely reflect the immaturity of these children rather than a mental disorder.
ADHD is considered a developmental disorder. There is always a disparity in when children within the same age range reach a given developmental milestone and this of course is more pronounced when there is also a disparity in age as well. Actually most children do not develop selective attention until 6 or 7 years of age. For years, studies have shown that teachers will rate 50% of the children in the class with scores indicating possible ADHD when the prevalence is known to be no more than 10%.
Children are starting kindergarten later due to increased academic demands. It make sense that a class of kindergarten children are able to do first grade work since many of them are 6 years old. Imagine the stress of a five year old who may be somewhat on the late side of developing selective attention being required to achieve at least one grade level above his age level. The pressure from teachers and parents and peers can lead to acting out behavior that might be expected under the circumstances but could lead to a professional evaluation.
Parents, teachers, and physicians should be careful to consider not only the chronological age of the child but also the developmental age when considering a possible diagnosis of ADHD. Perhaps the child should be placed in a pre-K class where he or she is truly with peers and the work is more appropriate to the child’s development. This would be a far more appropriate intervention than medication. Unfortunately, I have found that school districts may not want to put a 5 year old in preschool or pre-K because they may not receive funding for the child when state guidelines say a child of 5 must be in kindergarten.
For now, hopefully, this study will evoke caution in all concerned so that decisions will be made based on all of the factors that should be considered. In the future, the whole issue of the mismatch between child development and academic expectations needs to be re-evaluated but that is another blog post.
The earlier you can diagnose ADHD, the better. Kids often struggle in school and in the community due to a lack of help and from a misunderstanding of their condition. This often leads to frustration, increased inappropriate behavior, poor academic achievement, and eventually low self-esteem and depression, not to mention an increased likelihood for substance abuse. Early and appropriate intervention can prevent these serious consequences, and instead promote healthy development with the prospects for a more satisfying life in childhood and as an adult. If you suspect that your child may have ADHD, start with a trip to a trusted pediatrician and go from there.
And if your child is diagnosed with ADHD, I would recommend that parents look into the type of cognitive behavioral therapy or program that provides cognitive exercises and simple biofeedback to improve attention, concentration and executive functioning that leads to improved academic achievement and success in other activities. Make sure it helps children to understand the difference in brain function, and to learn coping strategies that foster a positive self-image, as well.
“I never suspected my nine-year-old daughter’s inability to concentrate was due to ADHD,” said Diane, the mother of three girls. “She isn’t ‘hyper’ or noisy—in fact, just the opposite. Kayla is the middle child—she’s quiet and tends to daydream a lot. We were frustrated because she couldn’t ever seem to concentrate or get her schoolwork done…But we were still really surprised when our pediatrician finally diagnosed her with ADHD last year.”
When many people hear the term ADHD, the first thing that usually comes to mind is a young, out-of-control boy running all over the place or having a major meltdown at the mall while his frantic parents try to calm him down. Unless you personally know a girl struggling with this disorder, the “wound-up boy” is the image most associated with ADHD. Of course, one reason for this is the fact that boys with the diagnosis outnumber girls by a whopping 3 to 1. Another reason is that ADHD in girls is more often associated with impaired attention and concentration—girls who are labeled as either “dreamy” or “spacey,” rather than hyperactive and impulsive.
Unfortunately, research has shown that this stereotype often leads parents, teachers, and health professionals to misdiagnose girls with depression or anxiety. Sometimes the significant difficulties they’re experiencing are dismissed altogether. Whether boy or girl, a child who has trouble learning and maintaining healthy peer relationships is more likely to be ignored, while the child exhibiting disruptivebehavior is not only more likely to be noticed, but also more likely to be referred for evaluation and treatment. The sad result is that girls are often under-treated, which results in years of suffering in silence, and subsequently leads to self-doubt and low self-esteem. Recent studies have even shown that women with ADHD suffer from depression much more frequently than men with the same disorder. Continue reading →