Gifted Issues Discussion homepage Forums General Discussion Younger Students in grade get more ADHD drugs

http://well.blogs.nytimes.com/2012/11/20/younger-students-more-likely-to-get-a-d-h-d-drugs/
Younger Students More Likely to Get A.D.H.D. Drugs
By ANAHAD O'CONNOR
New York Times
NOVEMBER 20, 2012, 11:25 AM

A new study of elementary and middle school students has found that those who are the youngest in their grades score worse on standardized tests than their older classmates and are more likely to be prescribed stimulants for attention deficit hyperactivity disorder.

The findings suggest that in a given grade, students born at the end of the calendar year may be at a distinct disadvantage. Those perceived as having academic or behavioral problems may in fact be lagging simply as a result of being forced to compete with classmates almost a full year older than them. For a child as young as 5, a span of one year can account for 20 percent of the child’s age, potentially making him or her appear significantly less mature than older classmates.

The new study found that the lower the grade, the greater the disparity. For children in the fourth grade, the researchers found that those in the youngest third of their class had an 80 to 90 percent increased risk of scoring in the lowest decile on standardized tests. They were also 50 percent more likely than the oldest third of their classmates to be prescribed stimulants for A.D.H.D. The differences diminished somewhat over time, the researchers found, but continued at least through the seventh grade.

The new study, published in the journal Pediatrics, used data from Iceland, where health and academic measures are tracked nationally and stimulant prescription rates are high and on par with rates in the United States. Previous studies carried out there and in other countries have shown similar patterns, even among college students.

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This study should not be used to prove that acceleration is always bad, although I fear it will be. Grade placement should depend on age, IQ, and maturity. I wonder how maturity can be quantified.

Thanks for the link.


Another conclusion could be that the current grade placement system should be chucked. Perhaps amorhphous classrooms or mastery oriented teaching or ability tracking/clustering are all counters. With tracking and mastery, some aspects of asynchrony could be better balanced; e.g. a 2nd grade gifted kid with K level handwriting might actually get some hands on help.

"They were also 50 percent more likely than the oldest third of their classmates to be prescribed stimulants for A.D.H.D."

That's a disturbing statistic, and I don't imagine it shows much difference in the US.

This is not the first such study. I researched a similar topic for work last year.

http://www.sciencedirect.com/science/article/pii/S0167629610000755

" Roughly 8.4 percent of children born in the month prior to their state's cutoff date for kindergarten eligibility – who typically become the youngest and most developmentally immature children within a grade – are diagnosed with ADHD, compared to 5.1 percent of children born in the month immediately afterward. A child's birth date relative to the eligibility cutoff also strongly influences teachers’ assessments of whether the child exhibits ADHD symptoms but is only weakly associated with similarly measured parental assessments, suggesting that many diagnoses may be driven by teachers’ perceptions of poor behavior among the youngest children in a classroom. These perceptions have long-lasting consequences: the youngest children in fifth and eighth grades are nearly twice as likely as their older classmates to regularly use stimulants prescribed to treat ADHD."

http://www.sciencedirect.com/science/article/pii/S0167629610000962

"We exploit the discontinuity in age when children start kindergarten generated by state eligibility laws to examine whether relative age is a significant determinant of ADHD diagnosis and treatment. Using a regression discontinuity model and exact dates of birth, we find that children born just after the cutoff, who are relatively old-for-grade, have a significantly lower incidence of ADHD diagnosis and treatment compared with similar children born just before the cutoff date, who are relatively young-for-grade. Since ADHD is an underlying neurological problem where incidence rates should not change dramatically from one birth date to the next, these results suggest that age relative to peers in class, and the resulting differences in behavior, directly affects a child's probability of being diagnosed with and treated for ADHD."

(apologies for the paywalls)

I have to say, this is why redshirting makes me insane.

To me, this study and others like it show that many teachers are quick to pathologize normal behavior. And, like ultramarina, I think redshirting makes things much worse.

Well, one of the risks is a non-issue for our kids - "80 to 90 percent increased risk of scoring in the lowest decile on standardized tests."

The other one is a major issue, because so many gifted kids get misclassified: "50 percent more likely than the oldest third of their classmates to be prescribed stimulants for A.D.H.D."

As for maturity, I think the old rule about obscenity also applies here. People think they know it when they see it.

+1 ultramarina.

I was flabbergasted when the mother of a child redshirted while born *5* months before the cut-off complained in front of me that some parents (in that case clearly targeting a child born a month before the cutoff) were just irresponsible, and their overly immature kids were dragging down the level of instruction for her own child (who was nearly 18 months older and bright/mature for his age to boot).

Oh dear. I can see that would be a real problem. Wait! I have a solution! If only the district would have allowed her child to attend a year earlier, he would be in a cohort more matched to his maturity level... Maybe he should be grade-skipped.

(Sorry, I just couldn't resist... Grrr...)

She red-shirted him rather extremely, I don't think she would have gone for a grade skip.

The funniest part? It was done in part to give him an edge in sports (he was also very athletic)... but local sports league go by birth date, not by grade. So while setting the mark way to high for younger age-appropriate Kindergarteners he was playing baseball with his age cohort of first graders anyway.