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News: Children younger in school year more likely to be treated for ADHD

Posted 6 July, 2022 by Nina Joynson

A new study has revealed that children who are younger in the school year are more likely to receive treatment for ADHD, suggesting immaturity may influence diagnosis.

Researchers at Swansea University and the University of Glasgow have found a relationship between age within school cohort and treatment for Attention-Deficit Hyperactivity Disorder (ADHD).

Health and education records of more than one million children were linked in order to study associations between age and ADHD in primary and secondary pupils.

The research also considered the impact of holding children back in school. It accounted for pupils that were held back by one year either due to a belief that they would manage poorly when competing against older peers, or because they might benefit from additional schooling.

Research findings

The results of the study, which looked at children in both Scotland and Wales, revealed that:

  • Less than 1% (0.87%) of children in the study were treated for ADHD (0.84% in Scotland; 0.96% in Wales)
  • Children who were amongst the youngest in their class were more likely to receive an ADHD diagnosis and treatment
  • More children started school later than the school-starting age in Scotland (7.66%) than in Wales (0.78%)
  • Children who did not start school the same time as their peers were more likely to be treated for ADHD. Of these, 81.18% would have been the youngest in their school year
  • Children who started later more likely to be male, affluent, preterm and low birth weight
  • The prevalence of ADHD was higher in boys, and increased with deprivation, maternal smoking during pregnancy, lower maternal age, birth weight and APGAR scores.

Overall, the findings suggest that relational immaturity may influence whether a child is treated for ADHD. This discovery could have potential future clinical and policy implications.

Professor Michael Fleming, joint first author from the University of Glasgow said:

“Our findings revealed that children younger within the school year are more likely to be treated for ADHD, suggesting immaturity may influence diagnosis. However, this trend looks to be masked in countries with flexible start date policies where younger children with attention or behavioural problems are more likely to be held back a year.

"Holding back children does not appear to reverse the need for ADHD medication. It is possible that holding back children with ADHD might, nonetheless, improve other outcomes."

The Scottish part of the study was sponsored by Health Data Research UK.  The Welsh research was supported by the National Centre for Population Health and Well-Being Research (NCPHWR).

Click here to read the full press release from Swansea University