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Can Starting School Early Cause ADHD?

In the US, about 8 to 10% of school-aged children are diagnosed with attention deficit hyperactivity disorder (ADHD). ADHD is a behavioral disorder characterized by inattention and disruptive behavior in class. Kids with ADHD are hyperactive, impulsive and lack the ability to concentrate. Because of their behavior, they have problems not only academically but also socially. Boys are 3 times more likely than girls to be diagnosed with ADHD.

A recent report in Medscape attracted my attention because it reviewed two articles on the same topic but conducted by different researchers using different data-sets and came up with similar results.

ADHD Studies

The gist of what came out of the study is this: a child’s birthday may be a determinant factor in his/her being diagnosed with ADHD. It has nothing to do with having a birthday on a specific month or season. It has something to do with how the birthday coincides with cut-off date for starting kindergarten or school.

Let us look at 2 groups of kids:

  • Group 1 kids had birthdays just before the kindergarten cut-off date. They tended to be younger than most of their kindergarten peers.
  • Group 2 kids had birthdays just after the cut-off date. These kids had to wait almost another year to get into kindergarten and thus were older than most of their classmates.

Which of these kids have the higher chances of being diagnosed with ADHD and even treated with anti-ADHD drugs? It is the Group 1 kids.

In a paper by a researcher in Michigan State University, 8.4% of Group 1 kids in the data-set were diagnosed with ADHD vs. 5.1% in Group 2. The results have long-lasting consequences because the study showed that younger pupils up to the 8th grade are still on ADHD medications.

The other paper by researchers at the University of Notre Dame concluded 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.”

Are Your Children Ready For School?

The results look intriguing and challenge current perceptions of ADHD and children’s behavior, leading to the following questions:

  • Is immaturity in the kindergarten setting wrongly perceived as attention deficit problems?
  • How strong is the contribution of teachers’ opinion and feedback to parents and school psychologists in reaching the ADHD diagnosis?
  • Are we expecting too much from younger children in a kindergarten group?
  • Should children be screened whether they are kindergarten-ready or not before entry?
  • Will holding back younger children who may not seem ready help prevent ADHD?

The study results interest me personally because my twin boys were always the youngest in their class or group wherever we enrolled them.

My husband and I, despite the disapproval of many, applied for early school entry for our boys two years ago because we felt they are more than ready for school. For this we needed a special evaluation from their kindergarten teachers plus a psychologist’s attestation that they are school-ready.

I am glad to report that they are now in the 2nd grade, top of their respective classes and with no sign whatsoever of ADHD. Maybe we are simply lucky. But we are happy that our decision not to hold them back for another year was the right one.

Rethinking ADHD

The results of the studies should really make scientists and pediatric mental health experts rethink what they know about ADHD. After all, there is still no lab test that can confirm ADHD. Diagnosis is based mainly of psychiatric evaluation.

For parents, the results should make them ponder if the time is right for their kid to go to kindergarten or not; for those with children diagnosed with and treated for ADHD, these might help them understand their child more.


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