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.
About Dr. Robert Myers, PhD
Dr Robert Myers is a child psychologist with more than 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®. Dr Myers is Associate Clinical Professor of Psychiatry and Human Behavior at UC Irvine School of Medicine. "Dr Bob" has provided practical information for parents as a radio talk show host and as editor of Child Development Institute's website, 4parenting.com, which reaches 3 million parents each year. Dr. Myers earned his Ph.D. from the University of Southern California.