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Jan
05

According to research done at Michigan State University, nearly one million children in kindergarten in the United States are misdiagnosed with ADD/ADHD each year. For years, studies have shown that teachers will rate 50% of the children in the class with scores indicating possible ADD/ADHD when the prevalence is known to be no more than 10%.

The study attributes this, in part, 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 younger children are more likely to be rated by their teacher as being inattentive and hyperactive — and potentially put on medication for it.  However, it’s more likely that these ratings by teachers reflect the immaturity of the children rather than actual ADD or ADHD.

ADD/ADHD is considered a developmental disorder.  But all children within the same age range don’t all reach a given developmental milestone at the same time. In fact, most children do not develop selective attention until 6 or 7 years of age. Children are also 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.  The pressure from teachers, 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 ADD/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 for all concerned so that decisions can be made based on all the appropriate factors.  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.

Dr. Bob Myers is a clinical psychologist with 25 years of experience working with children and adolescents with Attention Deficit Hyperactivity Disorder and learning disabilities, and is the creator of The Total Focus Program.


     

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  • Tom near Boston Says:

    I couldn’t agree more with Dr. Meyers. I’m a school psychologist and see lots of parents who are thinking medication and/or special ed referrals for their children who are simply not ready for the curriculum. We’ve “beefed up” the primary grades curriculum, thinking we’re doing some great service to the kids. Not so. My personal pet peeve is mandatory fullday Kindergarten. Anybody else?

  • Debbie Says:

    My son (6) was diagnosed with ADHD which he may or may not have but after he heard that he had this, he constantly tries to use it as an excuse to get by with anything. I wish there was a better way to test for it besides being “hyper”. I thought all boys were hyper.

  • Glenna Says:

    I hate to hear that so many children are misdiagnosed and that ADHD as a diagnosis gets such a bad rap. We live with ADHD, OCD, and ODD daily. My 10 year old (11 this month) was diagnosed at 4 1/2 years old at my insistence. To the credit of the local mental health agency that did the diagnosis, they did not want to see him. Having had another diagnosed ADHD child who is now a productive adult, I was keenly aware of the signs that were being exhibited by my youngest child. The first interview with the psychiatrist gained us medication that helped my child immediately. Since that time, medication has been tweeked and adjusted to meet his needs. We have also made adjustments in his daily life – we homeschool to limit his stressors and facilitate learning – and in his food to make the most of his abilities, as well as limit the amount of medication he needs. I do think too often children who are merely acting like children are medicated as hyperactive or diagnosed as having attention deficit disorder. In our case, we have done very well with our son. He is active, participates in many activities outside our home – it helps that we have a very active homeschool community – at our church, plays soccer, and is a very well rounded 10 year old. We still have our problems. They will probably never completely go away. But we are teaching him to understand what he has to deal with so he will eventually become a productive adult working with society, not against it.

  • Dr. Jim Says:

    I remember hearing of a study on NPR radio about 15 years ago that spoke to the misdiagnoses of ADD/ADHD. It was true then, and is true now, I believe.

    One of the concerns as I see it is that when parents take their child to the family doctor, they often expect some sort of “treatment.” A pill is the easiest and quickest treatment, and it doesn’t directly infer any changes in lifestyle or interaction. Unfortunately, I don’t see the problem improving anytime soon.