Monday , December 6 2021

Attention deficit hyperactivity disorder and school start bear – Medical News



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When the school starts, younger children are more likely to be diagnosed with ADHD.

fund

Older children in a school-class cohort are more likely to be diagnosed with ADHD than in older cohorts, due to the variation in age-based behaviors attributable to ADHD. the place of the youngest children.

Most of the US states are UUs. They have arbitrary age limits to enter public schools. Therefore, children with birthdays close to the last days in the same class may differ by age. 1 year.

methods

To compare the diagnostic rate of ADHD in congenital children, we used data from a large insurance database from 2007 to 2015. August born September Children in the daily care of September 1 to 5 years old and not in the condition of the state.

The diagnosis of ADHD was determined on the basis of the diagnostic codes of the 9th Revised International Classification of Diseases. We also use prescription registries to compare ADHD treatment with and after September 1st in children born in August and in children born in September.

results

Including study population 407 846 Children in all states of the United States UU. She was born in 2007 to 2009 and was followed until December 2015.

diagnostic rate Based on allegations between states cut off on September 1, ADHD 85,1 for every 10,000 children (36,319 children between 309 cases, confidence interval [IC] 95% of those born in September, 75.6 from 94.6 to 63.6 per 10,000 children (35.353 children, 95%; CI, 55.4 & # 39; s; an absolute difference of 10,000 children (CI) 95, 8.8 to 34.0); The corresponding difference in states with no 1 September limit was 8.9 for 10,000 children (95% CI, -14.9 to 20.8).

Treatment rate ADHD & # 39; s 52,9 per 10,000 children Among those born in September (36.319 children 192%, 95% CI, 45.4 (60.3) and 40.4 per 10,000 children among those born in September (35.335 children, 143 tan 95% CI, 33.8 36 from 47.1 & Lt; tb & gt; & lt; 12 & gt; e) 12.5 per 10,000 children (95% CI, 2.43 to 22.4).

These pensions were not observed during the month-to-month comparisons. Furthermore, they were not observed for the beginning of kindergarten on the same dates as the dates of September.

Also, in the states with a limit on September 1, no significant difference Children born in August and children born in September in the rates of asthma, diabetes or obesity.

Differences in the rate of diagnosis of ADHD by gender and the month of birth. A broken line indicates no difference. The bars show a 95% confidence interval. The diagnosis of ADHD is defined according to an ICD-9 diagnostic code for ADHD or a filled prescription for a drug for ADHD in bill claims.

results

The diagnosis and treatment of ADHD are higher in children born in August than in children who were stopped on September 1 in September in order to be admitted to kindergarten. (Funded by the National Institutes of Health.)


Harvard Newspaper reviews

Can a child's birthday put him at risk for ADHD?

The answer seems YeahAccording to a new study conducted by researchers at Harvard Medical School, it is one of those children born in August starting school in the states where they were enrolled in at least September 1st.

The findings published in the New England Journal of Medicine on November 28 show that children born in August are 30 percent more likely to be diagnosed with ADHD. same degree

In the last 20 years, the rate of ADHD diagnosis has increased dramatically in children. In 2016 alone, more than 5 percent of US children were UUs. They were treated with active drugs for ADHD. Experts believe that this increase is due to a combination of factors such as greater recognition of the disorder, a real increase in the incidence of the disease and, in some cases, inadequate diagnosis.

The results of the new study emphasize that the diagnosis may be a factor in a subgroup of at least primary school students. early registration at schoolAccording to the research team.

Ina Our findings reveal the possibility that a large number of children will receive over-diagnosis and over-treatment for ADHD because they are relatively immature compared to older classmates in the early years of primary school. Araştır Study, Timothy Layton, Assistant Professor of Health Policy at the Blavatnik Institute of Harvard Medical School.

Most states have arbitrary birth limits that determine when a child will be placed and when they can start school. In states with a limit of 1 September, a child born on August 31st will be almost a year younger than the child born on September 1 on the first day of school.

At this age, Layton pointed out that the youngest child can still be more difficult to sit and concentrate for a long time in class. This can lead to a medical referral to extra unrest, said Layton, then the diagnosis and treatment for ADHD.

For example, the researchers said that a noisy 6-year-old could appear abnormal in what might be normal behavior, in relation to the behavior of older partners in the same class.

Researchers, this dynamic can be true especially among young children, because an age difference of 11 or 12 months can cause significant differences in behavior.

”As children grow up, small differences in age are synchronized and distributed over time, but in terms of behavior, the difference between a 6-year-old boy and a 7-year-old boy can be quite evident,“ he said. The author of the study, Anupam Jena. Ruth L. Newhouse is a Health Services Policy at Harvard Medical School and a medical doctor at Massachusetts General Hospital. "Normal behavior may appear abnormal in relation to the child's peer group."

Using the records of a large insurance database, the researchers compared the difference between the month of August and the diagnosis of ADHD versus September between September 2007 and 2009 among more than 407,000 primary school children. Followed by the end of 2015.

According to the analysis, 1 September Children born in August are 30% more likely to be diagnosed with ADHD than their children born in September, due as a deadline for enrollment to school. No difference was observed between the children born in August and September on 1 September.

For example, 85% from 10,000 Students born in August were diagnosed with ADHD or were not treated. 64 students from 10,000 He was born in September.

When the researchers looked at ADHD treatment alone, the difference was also great: 53 of the 10,000 students born in August received medication for ADHD compared to the 40th of September in September.

Jena pointed to a similar phenomenon described in Malcolm Gladwell's book "Outliers". Canada's professional hockey players are more likely to be born earlier this year, according to a study by Gladwell. The Canadian youth hockey leagues are using January 1 as the deadline for age groups.

In the early years of youth hockey training, players were older and more mature in the early years of the year, and so the elite leagues, better training, more time on ice, and more talented team mates Over the years, this accumulated advantage has been advantage.

Similarly, Jena said that a 2017 study document by the National Bureau of Economic Investigations suggested that children born after the deadline to start school had longer educational performance than their relatively young peers. year after year.

"In all these scenarios, the moment and age seem to be the strongest factors affecting the results," Jena said. Said.

The study showed great differences in the diagnosis and treatment of ADHD in different regions of the USA. U. The diagnosis and treatment rates of ADHD have also increased significantly in the last 20 years.

In 2016 alone, more than 5 percent of all children in the US were UUs. The authors said they were taking medications for ADHD. All these factors have caused concerns about excessive ADHD diagnosis and over-treatment.

Jena said the reasons for the increase in the incidence of ADHD are complex and multifactorial. She added that arbitrary deadlines are probably one of the many variables driving this phenomenon.

In recent years, many countries have adopted measures to encourage teachers to recommend ADHD and to advise educators on any child with symptoms suggesting ADHD for a medical evaluation.

Ilgili The diagnosis of this condition is not just about symptoms, but about the context, “he said. Yönetmelik The relative age of children, laws and regulations and other conditions in the classroom is coming together. “

Jena said it was important to consider all of these factors before diagnosing and prescribing treatment.

"According to their peers in the same class, the age of a child should be taken into consideration and the reasons for reference should be examined carefully."


Additional co-authors are the Health Service Policy, the National Bureau of Economic Research and the Department of Health Policy and Management, and Harvard T.H. Chan Public Health School.

Using the records of a large insurance database, the researchers compared the difference between the month of August and the diagnosis of ADHD versus September between September 2007 and 2009 among more than 407,000 primary school children. Followed by the end of 2015.

According to the analysis, children born in August on 1 September as the application deadline for school enrollment are 30% more likely to be diagnosed with ADHD than children born in September. No difference was observed between the children born in August and September on 1 September.

For example, 85 out of 10,000 students born in August were diagnosed with ADHD or received treatment. When the researchers looked at ADHD treatment alone, the difference was also great: 53 of the 10,000 students born in August received medication for ADHD compared to the 40th of September in September.

Jena pointed to a similar phenomenon described in Malcolm Gladwell's book "Outliers". Canada's professional hockey players are more likely to be born earlier this year, according to a study by Gladwell. The Canadian youth hockey leagues are using January 1 as the deadline for age groups. In the early years of youth hockey training, players were older and more mature in the early years of the year, and so the elite leagues, better training, more time on ice, and more talented team mates Over the years, this accumulated advantage has been advantage.

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