ADHD? Autism? Or is this child just one of the youngest in the group?

New research led by experts at the University of Nottingham, has found that teachers in the early years of children’s schooling may be attributing signs of age-related immaturity in children, to conditions such as Attention-Deficit/Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD).

ADHD is a condition where individuals have significant challenges with attention and can be overly active. ASD is a complex developmental condition that relates to how a person communicates and interacts.

Published in the journal European Child and Adolescent Psychiatry the study showed that the youngest children in a class, with birth dates just before the school entry cut-off date, were overrepresented among children receiving an ADHD diagnosis or medication for the condition.

Adults involved in identifying or raising concerns over a child’s behaviour – such as parents and teachers – may be inadvertently misattributing relative immaturity as symptoms of ADHD, researchers said. 

For Professor Kapil Sayal this is a clear indication that a child’s age relative to their classmates needs to be considered when making a diagnosis of ASD or ADHD. 

Detailed searches were used to identify all studies written on this topic worldwide, with researchers reviewing 32 of the studies. The bulk of the studies (30) focused on ADHD, with the remaining 2 focused on ASD. 

The findings confirmed that younger students in the school year are more likely to be diagnosed with ADHD and receive medication for this, compared to their older classmates. The scale of this ‘relative age’ effect varied between the studies.

For ASD, the youngest children in a class were also more likely to be diagnosed but more research is needed due to there only being a small number of studies available. 

An interesting finding from the study was a more notable difference in how teachers rated these younger children compared to how parents do.

 “Teachers play an important role in identifying ADHD symptoms in children. Our findings suggest that they can be more likely to rate younger students in a class as having ADHD symptoms than their older classmates. It is important teachers are supported in considering the relative age of a child in a classroom when ADHD is being queried,” lead author Dr Eleni Frisira said. 

“This phenomenon has been shown in research for over a decade, but knowing about it does not seem to be changing practice.”

To access the full study please see here.