Youngest kids in kindergarten more likely be diagnosed with ADHD. Are we confusing immaturity with hyperactivity?

A lot of parents believe that their children are better off being the oldest in kindergarten and first grade rather than the youngest, and there is increasing research on academic achievement that supports that instinct. Now, there is another reason to be concerned about having the youngest child in the class: A misdiagnosis of attention deficit hyperactivity disorder.

Two studies find that the youngest children in kindergarten classes are the most likely to be referred for ADHD testing and prescribed medications, largely because they are younger and more immature than older classmates.

Over the years, I have heard arguments on both sides of this debate. I have had parents tell me that the schools are pushing them to medicate their sons for simply being high-octane little boys. Some of those parents have resisted and their boys grew out of the frantic stage and fared well in school.

However, I have also had teachers complain to me that parents refuse to see that their kids are not just “active” little boys, but have serious issues with focus and control. These parents wait so long to get their children tested and treated that the kids are far behind peers by fourth and fifth grade. (And they wreak havoc in their classes in the meantime, according to teachers.)

This study will give new ammo to the parents who believe that schools overreact to behaviors born of immaturity rather than any medical disorder requiring medication.

After reading a lot about a child’s age and how it affects classroom grades and behaviors, I would be leery of having the youngest in a class.

For those whose children’s birthdays are in August or July — given the cutoff here for kindergarten is Aug. 31 — what did you do? If you put your children in the class based on their birthday, did you wish you had held them out and waited a year so they were among the oldest rather than the very youngest?

I have to note that I also know people whose children skipped ahead a grade and they did fine. So, clearly, each child is different and there is no set answer. But I would still be nervous if my child had just turned 5  when a lot of the kids in the kindergarten had fall birthdays and were about to turn 6.

Here is a fascinating study out by Michigan State researchers:

Nearly 1 million children in the United States are potentially misdiagnosed with attention deficit hyperactivity disorder simply because they are the youngest – and most immature – in their kindergarten class, according to new research by a Michigan State University economist.

These children are significantly more likely than their older classmates to be prescribed behavior-modifying stimulants such as Ritalin, said Todd Elder, whose study will appear in a forthcoming issue of the Journal of Health Economics.

Such inappropriate treatment is particularly worrisome because of the unknown impacts of long-term stimulant use on children’s health, Elder said. It also wastes an estimated $320 million-$500 million a year on unnecessary medication – some $80 million-$90 million of it paid by Medicaid, he said.

Elder said the “smoking gun” of the study is that ADHD diagnoses depend on a child’s age relative to classmates and the teacher’s perceptions of whether the child has symptoms.

“If a child is behaving poorly, if he’s inattentive, if he can’t sit still, it may simply be because he’s 5 and the other kids are 6,” said Elder, assistant professor of economics. “There’s a big difference between a 5-year-old and a 6-year-old, and teachers and medical practitioners need to take that into account when evaluating whether children have ADHD.”

ADHD is the most commonly diagnosed behavioral disorder for kids in the United States, with at least 4.5 million diagnoses among children under age 18, according to the Centers for Disease Control and Prevention.

However, there are no neurological markers for ADHD (such as a blood test), and experts disagree on its prevalence, fueling intense public debate about whether ADHD is under-diagnosed or over-diagnosed, Elder said.

Using a sample of nearly 12,000 children, Elder examined the difference in ADHD diagnosis and medication rates between the youngest and oldest children in a grade. The data is from the Early Childhood Longitudinal Study Kindergarten Cohort, which is funded by the National Center for Education Statistics.

According to Elder’s study, the youngest kindergartners were 60 percent more likely to be diagnosed with ADHD than the oldest children in the same grade. Similarly, when that group of classmates reached the fifth and eighth grades, the youngest were more than twice as likely to be prescribed stimulants.

Overall, the study found that about 20 percent – or 900,000 – of the 4.5 million children currently identified as having ADHD likely have been misdiagnosed.

Elder used the students’ birth dates and the states’ kindergarten eligibility cutoff dates to determine the youngest and oldest students in a grade. The most popular cutoff date in the nation is Sept. 1, with 15 states mandating that children must turn 5 on or before that date to attend kindergarten.

The results – both from individual states and when compared across states – were definitive. For instance, in Michigan – where the kindergarten cutoff date is Dec. 1 – students born Dec. 1 had much higher rates of ADHD than children born Dec. 2. (The students born Dec. 1 were the youngest in their grade; the students born Dec. 2 enrolled a year later and were the oldest in their grade.)

Thus, even though the students were a single day apart in age, they were assessed differently simply because they were compared against classmates of a different age set, Elder said.

In another example, August-born kindergartners in Illinois were much more likely to be diagnosed with ADHD than Michigan kindergartners born in August of the same year as their Illinois counterparts. That’s because Illinois’ kindergarten cutoff date is Sept. 1, meaning those August-born children were the youngest in their grade, whereas the Michigan students were not.

According to the study, a diagnosis of ADHD requires evidence of multiple symptoms of inattention or hyperactivity, with these symptoms persisting for six or more months – and in at least two settings – before the age of seven. The settings include home and school.

Although teachers cannot diagnose ADHD, their opinions are instrumental in decisions to send a child to be evaluated by a mental health professional, Elder said.

“Many ADHD diagnoses may be driven by teachers’ perceptions of poor behavior among the youngest children in a kindergarten classroom,” he said. “But these ‘symptoms’ may merely reflect emotional or intellectual immaturity among the youngest students.”

The paper will be published in the Journal of Health Economics in conjunction with a related paper by researchers at North Carolina State University, Notre Dame and the University of Minnesota that arrives at similar conclusions as the result of a separate study.

91 comments Add your comment

East Cobb Parent

August 20th, 2010
1:36 pm

My daughter is always the youngest in the class and has never missed a beat, performs, pays attention etc. In fairness, last year she was the second youngest and thrilled to no longer be the youngest. I’ve subbed in Cobb County for several years and have never been able to pick out the youngest in the class based on behavior or ADHD tendencies. I’ve also noticed that many parents are holding back their kids with April, May, June birthdays thinking it would give them an advantage, yet are frustrated that it doesn’t.

Maureen – My daughter has a July 14th birthday and we did not hold her back.

My gut would say teachers are looking for ways to make children behave. What one parent thinks is appropriate behavior another parent does not. In today’s public school room the thought of missing recess is not the same as the old paddling children used to receive for inappropriate behavior.

Boston Girl

August 20th, 2010
1:48 pm

I grew up in NY, where the school cutoff was December 1. My mother, who taught early grades and eventually opened her own preschool, always could pick out the children with November birthdays. And she saw, 35+ years ago, the phenomenon of the youngest in the class being “diagnosed” with hyperactivity (as it was called then), as opposed to just being the youngest. Certainly there are cases where parents wait too long and don’t realize that there is more to it than just “being a kid,” but it’s such a difficult thing to see when you see only your own children. And certainly there are teachers who are inexperienced and impatient and don’t understand that young children are not meant to function as automatons. This is another instance where the cry for a blanket solution simply fails. Children are not alike, and are not meant to be alike, or to be treated alike. When will the educrats realize this?!

Elizabeth

August 20th, 2010
1:49 pm

Yes, I think we are misdignosing. My daughter crawled at 4 months, walked at 8 months, and was climbing on things at 11 months. She was never still for long and rarely took a daytime nap for the first three years of her life. She was always active and moving and somtimes had difficulty focusing in her early school years. And she had a late birthday. Yet she never missed a step. Some people told me she should be medicated, but I ignored them. She was just an active child. She did fine in school and in college. Give kids time to be kids and to mature before throwing such a diagnosis at them. Expect behavior and performance and you will get it unless there is a real learning disability. ADHD is not a learning disability . It is caused by a failure to parent effectively.Most of the so-called ADHD kids today have simply never been appropriately disciplined. It is easier to medicate them.

Boston Girl

August 20th, 2010
1:50 pm

East Cobb — the thought of missing recess? Around here, the state has so many mandates on time, that there is no recess. It’s a tragedy of NCLB. And any early-grades teacher with any experience will tell you (as has been discussed on this blog before, even) that recess is so necessary, and makes all the difference in the world for those “ADHD” kids, both truly and incorrectly diagnosed, to spend some energy, refresh and refocus.

G'Vegas Dawg

August 20th, 2010
1:58 pm

Is there anyone else out there that is as irate as I am about the GAE endorsement of Roy Barnes? I am very disappointed in the fact that GAE would endorse any candidate without consulting the educators that they represent. I don’t think that it is too much to ask that the members of GAE have some sort of say in who thier association endorses. In this particular case it also upsets me that GAE chose to endores Governor Barnes, who has already been voted out by the educators of GA once before. I believe GB is full of empty promises and he will be unable to follow through on. He has said in his TV ads and radio spots that he will end teacher furloughs. I am sorry, but, that is out of his hands. The only way he can end teacher furloughs is to either cut teachers pay or put our state in a huge debt.

Oh Well

August 20th, 2010
2:34 pm

As a parent of two boys – I think that medicating is hogwash for the vast majority of boys. Granted, some may warrant a closer look, but the majority of others do not.

My oldest was born in early July…school starts in August. We have always had discussions with his teachers about his maturity level – however, he was always at the top of his class academically.

Our youngest is just as smart as his brother but (to me) has the maturity that the older lacked at his age. I chalk it up to being around an older child. The younger seems more grounded, conscious…

Thor

August 20th, 2010
2:46 pm

I find this study disturbing. For the sole purpose that is was conducted by an economist and not a psychologist. As a psychology student I am shocked that this research is getting the attention of people. First, ADHD should not be diagnosed by your regular Doctor. As this person will pass out a perscription. If your child’s school ask you to have your child tested for ADHD you NEED to have a clinical psychologist do this as they are the ones who are trained to give a proper evaluation of ADHD. Second, teachers only see the child in a school setting. For a correct diagnosis of ADHD the child must exhibit symptoms in several different settings. Such as school, home, church, sports, ect.

Please do not take this article serious an economist has no business commenting on ADHD.

Maureen Downey

August 20th, 2010
2:49 pm

@Thor, But the study is not on the disorder or treatment modes, but on who is diagnosed and how birth date emerges as a factor. Many studies are done by economists; in fact one of the leading education researchers in the country, Eric Hanushek, is an economist.
Maureen

Teacher in GCPS

August 20th, 2010
2:50 pm

I teach 7th grade, and last year I went through the 120+ students I taught and I picked out about 15 of the boys and said that they must be the youngest boys due to their immaturity. I was right in 14/15 of them. They acted as if they had ADHD, and while I bet few of them did, they seemed to have it because they were so much more immature than the girls.

You can tell. Boys need to be held back if they have a summer birthday, girls do just fine.

LG

August 20th, 2010
2:50 pm

My daughter has an October birthday. She started school in NY. Her kindergarten teacher was going to keep her back just because she was a fall baby even though cutoff was December 1st. Thank goodness she left school to have a baby and her replacement passed her because she shouldn’t have been held back. We moved to GA when she was in second grade, so she was a year younger than her classmates. She graduated with a B+. I’ll take it.

My son is a February baby. Can’t stand school and does poorly. His 4th grade teacher decided that he was ADHD and sent us to a shrink. He was going to put my son on meds just because the teacher said so. WHAT!!! There were no physical tests, no observations – it was all on the teacher’s word. When he got to classes where there were labs, he does much better. He needs to be busy with his hands to learn; many kids do and that’s why there are charter boy schools (of course in other states) where everything is hands on.

ITP Mom

August 20th, 2010
2:54 pm

Our son has an August b’day. We never held him back. Our son was always very “active” – teachers from PreK on up noticed and commented on it. He was/is generally well behaved but had problems controlling his impulses and would shout out the answer periodically and could not sit still (but would stay in his seat) and it was clear that sometimes his mind was elsewhere. I guess what I am saying here is that he wasn’t disruptive in class so that we were encouraged to get him seen or get a diagnosis, etc. Generally, it was viewed as “typical boy.”

He was slow learning to read and even a poorer writer. Without getting into every detail, in the middle of his 3rd Grade year he was diagnosed as mildly dyslexic and possibly ADHD – but also very intelligent. We (psychiatrist, teachers, special ed, and us together) decided to deal with the dyslexia first, OG Tutoring, Special Ed, and OT. Because we were introducing so much change and since he was young for his grade, we wanted to see if some interventions in the classroom (move his spot in class and who he was next to, special ed – smaller groups, quieter study area, manipulatives while he was listening to the teacher, allow him to step out of the class when he needed to “gather himself”, etc.) would make the difference on his behavior. We also decided to hold him back in 3rd Grade. The interventions related to focus and control made only minor differences. However, our other actions allowed him to make enormous gains academically, socially, and with regard to his self confidence. But we (again, the collective team) could tell he was still missing a lot of what was happening due to his lack of focus and control.

Last spring we tried the medication. It has definitely made a huge difference and been the missing piece of the learning puzzle. Our son has even noticed it. When we asked him if he wanted to stop taking the medication over the summer, he asked to keep taking it. He said he realized that so much was going on around him that he had never noticed before. He says he feels better when he takes it and that he can do and finish more things and listen to people.

I still have not totally come to terms with putting my child on the medication; however, I have to acknowledge that it has made a marked difference for him.

Atlanta mom

August 20th, 2010
2:57 pm

Pretty scary.
And I’m guessing that many more boys are diagnosed than are girls. We need to figure out how to teach our boys. Just from hours of volunteering in the classroom, it’s clear to me, education in public schools is geared towards how girls learn. Girls are so much more comfortable in the classroom setting. They are happy to sit in “circle time” for 30 minutes. There are of course exceptions, but those are my perceptions as a Mom who had the time to be in a classroom.

I_Teach

August 20th, 2010
3:01 pm

@LG:

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You had a crappy doctor.

NO doctor who is worth his weight in DIRT would EVER do that. EVER.

Also, after 16 years in elementary, I can always spot the spring/summer kids. Girls do develop faster, and since the traditional classroom suits their learning styles better, they don’t fare as poorly.

However, if your child is still exhibiting “rambunctious boy behavior” in 2nd or 3rd grade, and it is interfering with his/her academic ability? Time to look past “they’re just being KIDS.”

My oldest was born at the end of July. Cutoff in our state was Dec. 31st. He did fine-but he was developmentally ahead of nearly everyone. However, there was a girl in his class who wasn’t even “potty trained, ” a nd would wet the carpet every day, several times a day. They met with the parents after two weeks-and she was withdrawn.

It depends on the child-however, if the behavior is so disruptive, it probably IS something beyond “just being an active kid.”

And cut teachers a break; we don’t sit around in the teacher workroom plotting on who needs to be medicated. And, for all of the mis-diagnoses? I will wager a bet that there are lots of accurate ones.

And yes, my youngest was mildly ADD (not adhd). I resisted meds until HE came to me as a junior in HS and said he couldn’t focus on the GHGSTs…..talk about mommy guilt.

As for allowing kids to learn in their ’styles.’ We’d LOVE to do more hands on, engaging work. That has been pretty much taken out of the hands of the regular classroom teacher. (I am no longer one of them; THANKFULLY. I get to do hands-on stuff all day long.)

Those in charge making the rules haven’t been in a classroom in years; they don’t care what teachers think. As a parent, YOU need to make your voice heard. They do NOT listen to us!

catlady

August 20th, 2010
3:04 pm

Momania did this same article several days ago.

I taught before the date changed (January 1) and we had 4 1/2 year olds in kindergarten. Then the state found that some huge percentage (80%?) of kids who were held back in first grade (back when we did that) were those babies of the class, and something like 60% of the kids dropping out of high school were those same babies.

I can tell my summer birthdays almost without error in less than a week. My daughter called me after their first day and said she had at least 8 summer birthdays. When she looked, she found it was 10!

You can be bright as anything but not ready for the tasks school imposes on its kids.

My older kids were September bdays and were class leaders. The younger one is an August bday and I thought long and hard about allowing her to start at 5. Luckily, she made it (I was ready to put her back if needed) and now has a master’s in astrophysics. If she had been a boy, NO WAY would I have put her in at 5. Yes, there generally is a significant difference, intelligence being at least average.

ITP Mom

August 20th, 2010
3:09 pm

@Catlady – I am glad Maureen did this and that you commented over here. I can’t read Momania anymore – too much passing judgement for me. I gave it up about 4 years ago. (I think – might have been longer.)

Jan

August 20th, 2010
3:27 pm

@ Elizabeth
Having a child with ADHD is NOT a result of defective parenting and I resent your lumping all parents with ADHD kids into that category. It is a brain chemistry disorder. Just like epilepsy or autism. Do you judge those parents as having poor parenting skills due to their child’s medical condition?

Yes, I do believe that there are ineffective or lazy parents that just use ADHD as an excuse to allow bad behavior and poor performance. I also believe that it can be misdiagnosed. Particularly if the diagnosis is done by a pediatrician instead of an educational psychologist experienced with ADHD diagnostic testing for children. Meds do not correct behavior issues, the parents and teachers do that by setting clear and consistent rules and having consequences for failure to meet expectations.

We are attentive, effective and involved parents who set clear boundaries for behavior and performance at home and at school. You can check with any teacher or administrator at St. Thomas More Catholic School or St. Pius X High school that has had either of my children for verification.

I have a son with the real learning disability called ADHD. It runs in my husband’s family. My husband has it, so do both of his brothers and all three of my husband’s nephews.

My son was diagnosed in kindergarten just 3 months shy of his 7th birthday. Yes, his SEVENTH birthday. The child literally could NOT sit still because his BRAIN CHEMISTRY is defective due to his MEDICAL condition. He boosted his brain chemistry to NORMAL levels by moving constantly. But he had to move so much, it interfered with his learning. He could not focus enough to learn. It was not by any lack of effort on his Kindergarten teacher’s part, our part, or my son’s part that he was not very successful in kindergarten. We worked with him every nigh using flash cards with letters, numbers and sight words. He could not tell us the letters on the cards even if we worked on only two at a time. We had been working with him using flashcards since he was three and continued to do this throughout his entire kindergarten year. NEARLY 4 YEARS spent doing nightly flashcards. His real LEARNING DISABILITY got in the way of learning. After he was diagnosed and the school year ended, we started him on meds and the difference was night and day. In a summer school program at STM, we learned that the meds worked for him. He could focus, he could sit still for the lessons, and he could learn. He left summer school after 3 weeks with all of the education he missed in kindergarten due to his ADHD. Now he is an A-/B+ student at St. Pius.

So you were lucky and just had a very active child. Good for you. But you need to understand that your child is exactly that… YOUR CHILD. She is not MY child and doesn’t face my child’s issues. So get off your high horse and stop spouting such crap. If you walked a mile in my (or any other effective ADHD parent’s) shoes and you’d be changing your misguided, misinformed and judgmental attitude in a heartbeat.

Dan

August 20th, 2010
3:36 pm

@ Jan
It is not a brain chemistry disorder, if it were there would be a chemical test for diagnosis. It is simply a set of behavioral patterns deemed outside the normal range. If a doctor is telling you it is brain chemistry he/she is either misleading or misinformed

Ros Dalton

August 20th, 2010
3:55 pm

I don’t think age is the prime determinant of readiness for school. I was always the youngest in my class, and my daughter will always be one of the youngest in hers, but I don’t question her readiness. I don’t think there’s any reliable way to measure maturity. Some children, without regard to their age or size, struggle with it and need more help.

It’s very, very clear that we over diagnose and over medicate a vast array of conditions and syndromes that really amount to this: “Child needs more attention and time.”

Warrior Woman

August 20th, 2010
4:00 pm

My oldest has a September birthday. We felt she was ready for kindergarten, as she was already reading. Since we couldn’t enroll her in public school in Georgia (although we could have transferred her if we moved here from another state), we completed kindergarten and first grade in a private school and then transferred to public school. We’ve never regretted it. She’s been a great student all along, and I think she would have been bored if we’d waited until she met the state’s arbitrary age cut off.

Many school systems manipulate their age cut-off dates for reasons not related to student performance. Overall, I think kids would be better served by a “move on when ready” type of approach to starting school than a strict age guideline. I recognize, however, that this may not be workable in a public school setting.

The Joy of Consistent consequences

August 20th, 2010
4:05 pm

“These parents wait so long to get their children tested and treated that the kids are far behind peers by fourth and fifth grade. (And they wreak havoc in their classes in the meantime, according to teachers.)”

This is why consistent consequences are needed, and sorely lacking, in the schools. Separates the ADD from the BAD.

Lori

August 20th, 2010
4:16 pm

I think we are too quick to try to put a label on kids. Not all kids who can’t sit still are ADHD and need to be medicated. There are some kids who do. I don’t think it’s a teachers job to make this determination. I am shocked at the comment above about a doctor who was going to medicate a child based on the teachers recommendations. NO WAY I’d accept that as a parent. Medication should always be the last resort. I’m sure that some parents are probably in denial, but as a parent myself, I can’t imagine not knowing your child has a problem. I am very in-tune with my child and can certainly see that he is somewhat different that some of his peers. My son is not ADD or ADHD, but he is gifted, and sometime the normal class routines bore him. He doesn’t need meds, he needs to be challenged. My son’s birthday was Sept 5. Because of his intellect I considered having him begin Kindergarten early since he only missed the cut off date by 5 days, since he attends private school anyway, it wouldn’t have been a big deal. I chose not to, however, because I didn’t feel he was emotionally ready when he was just turning 5. He is in first grade now and I don’t regret that decision. He loves his school, he is always at the top of his class, he reads well, understands more advanced math and science concepts than he should at his grade. Sure, academically he could have made it through Kindergarten a year earlier, but I don’t think he would have enjoyed it as much as he did. I think there probably is a lot of validity to the claims of this study that sometimes the kids are just immature, but I have to wonder if there could be kids out there like my son who are misdiagnosed because they are gifted and bored, and are becoming behavior problems because of it.

blah blah blah

August 20th, 2010
4:23 pm

Everybody’s either ADHD or Gifted. Is my son, born late July, the only NORMAL kid in the bunch. I’m so sick of all these titles. For God sakes….let these kids be kids!

Pat in Atlanta

August 20th, 2010
4:31 pm

I teach one of the middle elementary grades and have for more than 15 years. Although I think that developmental issues are extremely important,they are not always a determiner of ADHD.And to those who say girls are just fine if they have late birthdays, I say that it depends on the child. I have seen children who perform well academically with a late birthday, boys and girls, and others who struggle.There are other issues as well which should be consisdered such as social maturity.How a child relates to others socially can affect how they perform also. I do think that medication should be the last possible resort, though some definitely need it.When I was a student years ago in the Boston area, we had recess both before school and after lunch.Kids often walked to neighborhood schools then, and we got more exercise just because of how we lived.There were some kids who had difficulty staying in their seats, but not as many.

ITP Mom

August 20th, 2010
4:36 pm

@blah blah blah – wow! Congratulations on your normal kid.

Actually, I have two other children (boys) and they have birthdays earlier in the calendar year and are “normal” but I felt posting comments on their behaviors and intelligence wasn’t germain to the discussion at hand.

As for letting the kids be kids. Now that we have discovered and taken actions with regard to my other son’s difficulties – he is enjoying his childhood and schooling more than ever. He has formed closer friendships. He now understands that he learns differently and that he is not stupid, his self confidence has improved, he is more willing to put himself “out there” and was even elected in a leadership role in his class last year. I couldn’t be prouder of the young man that he is becoming, but we had to find out what the problem was and put a name (title) on it first.

Lori

August 20th, 2010
4:36 pm

blah blah blah – Your kind of missing the point. Kids ARE NOT kids. Every child is an individual and should be treated as such.

Michelle

August 20th, 2010
4:41 pm

My son is the youngest in his first grade class ( he will be six in January). He does very well academically (his ITBS test scores while in K-5 were on a second grade level in most subjects and first grade on others). Yes, sometime he does have focus issues…he does not complete his seat work timely (his teacher last year and this year) has said he knows the work….he just concerns himself with his classmates as to what they are doing or not doing…thus his work in incomplete. I asked his teacher last year repeatedly if he was mature enough for K-5 and was I doing harm to him being the youngest in the class. She has assured me that he was very intellegent and he should not be held back. Fast forward second week of first grade….his teacher has told me the same thing…he does stay focused on HIS tasks…knows the work…but thinks he is the co-teacher. She has already place him in the advanced learning group. We have talked and talked to our son about this to no avail…I’m just not sure what to do. My husband attitide is…as long as he is learning…get A’s and B’s…don’t worry about the rest….that’s not so easy for me. Any suggestions???

Atlanta mom

August 20th, 2010
4:51 pm

Michelle,
Starting in first grade, I always sent my children to school with a book and instructions. When they finished their work, they were to read silently and not interrupt anyone else.

Mom2Many

August 20th, 2010
5:03 pm

As the mother of 4, my first 2 daughters have started on time and are doing great. My 2 youngest, well we are waiting to see. They will both start Pre-K and Kindergarten on time, but we are very thankful that the school we have chosen has a Pre-1st “grade” nestled in between K & 1st, for those kids who seem to need it. My son has a July 4th birthday. We’ve always said, if we need to, we have no problem holding him back a year, in fact, we may do it just because we’re not in a hurry to rush him out the door to college when it’s all said and done. But again, thankfully, our school has an option that allows us to start them and keep them learning, even if we decide they do not need to move forward with the class that just happens to match up with their birth date.

irisheyes

August 20th, 2010
5:03 pm

Of course we’re overdiagnosing, because we’re expecting kids to do things that developmentally they aren’t ready for. Think back to your kindergarten, it was so much more appropriate for the development of a five year old than it is now. But since NCLB, you have to make sure that every minute of everyday, students are “actively engaged in learning”. We get 30 minutes in our schedule for recess, but according to administration, that 30 minutes includes the time walking in from the playground, going to the bathroom, and getting drinks so that when scheduled recess time is over, the kids are in their seats and ready to work. If I did that, my kids would only get about 10 minutes of recess! Maybe if we gave students (especially younger ones) more time to move around, and less time tied to their chairs, we wouldn’t see as many behavior problems.
That being said, I do believe that ADHD is a legitimate diagnosis. My middle son has ADHD, and while medication hasn’t made everything perfect, his life is much better.

catlady

August 20th, 2010
5:05 pm

I think some SES groups are more likely to be diagnosed with certain illnesses and disorders. In my area, there are relatively few kids medicated or even diagnosed, compared with higher SES areas. This is not scientific, but based on decades of observation. I cannot comment on diagnosing kids for that reason.

I CAN say UNEQUIVOCABLY that every child I have ever had on medicine benefited GREATLY from it. There were some things that had to be adjusted, but the benefits to the child and his/her classmates was dramatic. And teachers can tell every time a parent “forgets” the medicine!

What I hate is kids who have learned to excuse themselves by saying “I can’t control myself because mom forgot to give me my medication.”You would not believe what percentage of moms in my area “forget” or “run out” on a regular basis. Are their lives so unorganized, or is it so unimportant, (or do they sell it?) so that the child does not get the meds?

I would like to be able to send home or call DFACS when kids come to school without their meds, whether for ADHD or heart trouble or whatever.

atlmom

August 20th, 2010
5:45 pm

I’ve said this for years: The idea in this country is that our schools are failing because the kids are not learning enough. So they have been pushing curriculum down to the lower grades for a while. In doing so, they have made kindergarten more ‘academic’ – start pushing kids to do stuff in kindergarten (that is not even mandatory in GA) that they used to do in first grade, etc. And it’s highly detrimental to kids (why are so many going to OT’s? Because they are learning to write too early – just one example).
Another thing that has been done in the last 30/40 years is to try to teach more to girls. Well, girls at a younger age are able to sit still more than boys. It’s just the truth (on average, people). SO they push curriculum down, and teach more to girls. Lo and behold! We have an ‘epidemic’ of boys (yes BOYS – girls are RARELY diagnosed) with ADHD. It’s not rocket science to anyone who’s been paying attention.
I have two boys. My oldest has an April birthday and is among the youngest in the class (he’s also smaller, having been born more than 4 weeks early). He’s done a great job keeping up with his peers.
For my youngest, well, he’s always been more active and emotional than ‘typical.’ So we’ve been struggling this past year on what to do (he has a May birthday). So, we put him in a 1/2 day kindergarten, where he’ll get more attention, and won’t have to sit for 7 hours. We’ll figure out if we need to hold him back in a year. He’s academically ready, even for first grade. It’s the emotional/social stuff…which is pretty much the same with most boys, he’s just more sensitive and ‘active’ than others. I had him evaluated by APS and all they said was: oh, he’s VERY bright. He’ll be fine. If there’s a problem, we’ll be on top of it. AND they SAW that he *could not* sit still for the three hours of tests. They don’t evaluate at all – except for academics. Yes, I know he’s bright, that’s *not* why he was evaluated. *sigh*.

atlmom

August 20th, 2010
5:49 pm

Maureen: just like the study re: those kids who are oldest on sports teams do the best. Just the same.

The reality is that a study like this should show us unequivocably that lumping kids together based on age is a terrible waste of time and we should figure out a better way to educate the kids.

trying hard to be patient

August 20th, 2010
6:07 pm

My son has a July 31 birthday. He was very small for his age because of a rare bone disease. He was reading at 4 and I had no issues with sending him at 5 with the cutoff being Sept. 1 in Georgia. He tested very high on the Kindergarten assessment and the teacher who tested him said he was more than ready and would be fine. He was placed with a 504 plan which stated that he could take “_____” breaks as needed for his juvenile osteoarthritis. He could not sit for long periods of time without getting stiff so he was able to get up out of his seat without asking and walk around the room or walk out in the hallway. The teachers, students(and their parents) were always told this on the first day of school and they all understood. In second grade a parent(with a new student) witnessed my son take one of his breaks. This was before going on a field trip and I was right beside her when she said, “I swear that child has ADHD and needs to be tested”. I said nothing to her. The teacher asked the parent and I to go to the hallway with her and we explained why my son had done that. She quickly added, “Well, I think he needs to ask before he gets up”. The teacher pulled out his 504 plan and let her read it. She didn’t even apologize, just stood there and shook her head. Then at the zoo as she watched him limp by(I had his wheelchair – for long walks – but he was walking at that moment) she made the remark, loud enough for all of my group to hear, “I still say he doesn’t have a problem, just hyper”. My son said, “Some people just don’t get it Mom”! He was always small for his age(he looked like a 2nd. grader in 5th grade) but was fine academically. Even with all his breaks he didn’t miss anything in class. He was teased but usually by students new to the school and he had great friends who would stick up for him and help him explain the reason for being small. He went through many surgeries between middle school and high school and missed a lot of school. The teachers were always great with him and his 504 plan.

I see immaturity in Kindergarten all the time. I also see kids who have not been disciplined at home before coming to school and it makes it hard for the teachers to have to correct these children with obeying the school rules. Yes, there are lots of rules to learn in school, but, if the child has been raised with manners at home, they should be able to learn theses rules at school and follow them.

Cobb Mom

August 20th, 2010
6:48 pm

So there are Kindergarten teachers out there who do not understand that the youngest child in the class is likely to be more immature than a child almost a full year older? Seems like they would have learned that in college. I think some teachers actually have a bias against the youngest kids in the class and look for issues to complain about. My son, who has a late spring birthday, thankfully has had only one teacher like that (in preschool). Sorry teachers, not every kid can be the September birthday that some of you prefer. Actually, one of the most immature friends my son has is a boy with a September birthday (we have a Sept 1 cutoff). He actually would have been a perfect example of a child who needed to be held back if his birthday had fallen in the summer before the cutoff.

So where does the academic red-shirting stop? It used to be just the summer birthdays, but now that has made the May/June kids the “immature” group. Ok, so let’s hold them back too. Wait, now the March and April kids seem too young.

I have no problem with people who decide to wait a year when their child is truly not ready for Kindergarten, especially with it being more demanding these days. Too many people do it when it is not needed, though. They don’t want their child to be the youngest, or they want to give their child an edge (which in reality probably goes away in a year or two). I can honestly say that in my kids’ classes the least mature are sometimes the oldest and the late spring and summer birthdays who started on time are some of the best students.

I am thinking of having a bumper sticker made that says “My late birthday boy has better achievement and behavior in school than your fall birthday child.” Sorry, I guess I get tired of hearing how my son is doomed because he is younger than most others in his grade. Had I seen a reason to hold him back I would have, but I was not going to do so because that is what some teachers prefer or that is what everyone else is doing.

Duh!

August 20th, 2010
7:05 pm

80-90% of the problems are from trying to force children to do and learn things that are not developmentally appropriate for them. It will only get worse as we push kids harder and harder.

cobb mother

August 20th, 2010
7:25 pm

Thanks Jan for setting Elizabeth straight.

My 15 year old daughter has a late September Birthday, but is a very bright child. I grew up NY which had a Dec. 1, cut off, but even lets you test to get in with a later December or January Birthday. I started first grade at 5 with a late December Birthday, without ever having gone to Kindergarten or Preschool, but I have read the Newspaper everyday since I was 3.

At 4, my oldest daughter was first diagnosed by the peditrician with ADD, we were referred to a Psychologist for testing. At 4 my daughter tested in the 60% trait wise for ADHD. We decided at that point to only treat it with therapy and only tell teachers if they said something first. Sure enough within a week, I get called into Pre K, for a talk that “B” could not sit still. At that time I disclose that she has ADHD. They then know how to handle her, she does fine. Same story with Kindergarten, which she ended up being one of the oldest kids, due to her late Birthday. The Pyschologist and I had decided not to treat with meds in these early years as therapy, and notifying the teachers seemed to work on all but when it was her Birthday week. In the 3rd grade of Public school, we had an influx of low income students in our school. Several of them were disruptive, along with a new Principal. One kid kept tapping and rapping on the desk. Despite my repeated pleas to do something about the disruption nothing was done. In the middle of third grade I had to move my daughter to Catholic School, where she did fine. Until the 6th grade. In the 6th grade they decided to do a grand experiment of going to 90 minute classes. At that point my daughter absolutely could not focus, and had to go on Concerta. ( My daughter found out at the 8th grade retreat that 1/2 of her Catholic School class had either ADD or ADH and was on medication, they were all lining up for medication distibution on there class overnight trip). Since, making the decision to go on medication, my daughters grades have improved. ( I understand the Catholic Schools are no longer allowed to have 90 minute classes in middle school, because my daughter wasn’t the only child that couldn’t pay attention for 90 minutes). My daughter is now a Sophmore in Public High Schools, on Concerta, for her ADHD, she is one of the top students in her class.

My 10 year old Daughter who has a March Birthday, started school in Catholic school and ironically in Private and Catholic schools that is considered a late date. Only girls with that late of Birthday are accepted, boys simply are not accepted with March or Later birthdays in Private or Catholic Schools.

“H” was diagnosed at age 8 with ADD and Immediately had her put on Concerta. She scored a 99% on the IOWA Math sections. But her self-confidance is erased in two seconds when schools do idiotic drills math drills on how many math facts or problems you can do in 5 minutes. This smart child gets frustrated under ridiculous time constrains that do not allow her to check her work and gives up.

Several of my cousins on both sides of the family have children with ADD or ADHD. I suspect I had it as well as my report cards were “M day dreams”. I got all A’s.

There are alot of very bright people with ADD and ADHD, too. It is a learning disability, but parents need to medicate their children so their potential can be realized.

My 15 year old can pick out a 4-5 year old ADHD or ADD kid in an instant. She had instant repore teaching them in Sunday School. Parents looked at her like she was nuts when she would tell the parents their kids had, it. She would say they were just like me. She was the only babysitter one family could keep for their son with ADHD, the two of them just clicked.

Good for Kids

August 20th, 2010
7:29 pm

We are confusing ADHD (and other serious diagnoses in young children) with immaturity and lots of other things. Normal wide range of development has become more and more narrow. Play, especially imaginative play is no longer valued as learning. And I say this as someone who is licensed to assess, diagnose and treat young children. Don’t even get me started on the overuse of psychotropic medications with young children on whom there is little to no research about the long term effects of those medications. Not to worry. Just give them anti-psychotics b/c now they are bipolar…

Anon teacher

August 20th, 2010
8:11 pm

IrishEyes-I agree with everything you said!

BTW, we do not get recess this year. My principal cut it out completely. It makes me so angry. My Kindergarteners are so wild in the afternoon. If I could just get ten minutes….

Really amazed

August 20th, 2010
8:50 pm

Well, my now 10th grade son was one of the youngest in his kindergarten class and still is now as a 10th grader. I remember his kindergarten teacher saying… your son handles things so well for a kindergartener. She mentioned that he was so mature. I had to remind HER that he was actually one of the youngest in his class. SHE WAS SCHOCKED!!!!!!SO can’t say I agree with this one!!!!!

k teacher

August 21st, 2010
12:34 am

I’m one of the few male kindergarten teachers in the state of Georgia and agree that a lot of the ADHD mess with regards to boys is just boys being boys. Early Childhood Education is very feminized with boys expected to sit quietly, not talk, and be into fiction books when they would rather be reading about sports heroes or manga or magazines/newspapers or serials or other non-fiction selections. At my school, students get 30 minutes of physical education per week (yes, per week – which is a shame) and many of the teachers rarely take them outside for recess because it’s too hot or too cold or there’s too much to do to get ready for THE TEST. I take mine out everyday unless absolutely told by administration we can’t or it is raining.

Parents really need to wake up and get into the schools and get these kids active and demand recess time and more P.E. for the benefit of not only the boys, but girls as well. They need that time, especially in the early grades to run off the steam. They need to be up out of those chairs moving around going from center to center. The boys don’t need to be yelled at every time they move … let them stand at their desk as long as they are on task and doing their work for goodness sake. What difference does it make as long as they’re getting their work done. Oh, THE TEST again. (I have to leave my k-kids with my parapro those five days to administer THE TEST because we have so many small group accommodations.) They aren’t even allowed to breath or go to the bathroom for those 3-4 hours and have to be trained to sit and not even flinch without having a form filled out because it could create an abnormality.

They are kids. Granted, there are those who can and do benefit from medication … my nephew, my great-niece, my cousin’s child … they couldn’t function without it. But, too many are labeled needlessly.

Teacher Mom

August 21st, 2010
6:07 am

@ Jan, thank you so much for saying what I so badly wanted to say to Elizabeth!

@ Dan, you should really do your research before you make any comments. As a mother of an ADHD child, I have done DAYS worth of research from professional sources. ADHD is a chemical imbalance in the brain. Perhaps you might use yours before you make another comment ont he subject.

Elizabeth

August 21st, 2010
8:14 am

Jan did not set me straight. If ADHD were a chemical imbalance in t he brain, the medical personnel could find it. That is just an excuse for allowing behavior that would never have been tolerated 30 years ago. I agree that immature kids should be held back a year and that boys tend to be more immature and hyperactive than girls. And yes, as a teacher, I could tell when medicine had not been taken because then the kids acted like normal misbehaving kids who needed firm consequences. All the research in the world will not prove otherwise. Alcoholism is also supposedly a chemical imbalance in the brain. The solution for my father: He stopped drinking. You CAN control your impulses if you are expected and taught to do so. Instead teachers are expected to buy into this garbage and make exceptions for countless kids who are interfering with the teaching learning process. Bottom line: if your child cannot behave and stop disturbing others in the classroom, you child needs to be removed until he/she can. It is not my job to parent your child. It is my job to TEACH and I cannot do that if I have to stop and deal with discipline problems every 2 minutes. If you want higher test score and increased learning, then deal with those whose children are not expected to do anything but sbe disruptive and be spoon-fed and coddled by the teachers. I have students with real learning problesms. ADHD is not one of them.

ScienceTeacher671

August 21st, 2010
10:02 am

“schools are pushing them to medicate their sons”????

We’ve been told that we can’t make any suggestions of the sort, because ADHD is a medical diagnosis we are not qualified to make. Do other systems allow teachers to suggest this?

Lefty

August 21st, 2010
10:27 am

Elizabeth, your willful ignorance is absolutely stunning.

I am an adult with ADHD. I made it through school 30 years ago, but barely. I continuously struggled with concentrating. As a girl, ADHD showed itself through my chattiness and my inability to complete work. I graduated with a B- but my ITBS scores put me in the top 2% of my grade. My score on the ACT test was in the 98th percentile. I finished college courses 25 years ago but only just now have completed my degree in 2010. An administrative error forced me to take one more course then, but I simply had used up all my stores of concentration with a particularly difficult senior year. I feel good that I have finally gotten around to finishing. But I’m not proud that it took me 25 years. And I continue to wonder, “What if?” What if I had been able to focus better? Where might I be now?

Socially, I was never “one of the girls.” The ADHD impulsiveness would lead me to blurt out or do something inappropriate. I still feel ashamed of those moments, but I try to remind myself that I did my best. I still struggle with “foot in mouth” moments. But if only folks knew how many times I held my toungue. It’s inevitable that I will say something ill-timed or lose my temper at the wrong instant.

In my family history there are some problems that most likely stem from ADHD — alcoholism (begun as self-medicating the depression and low self image that are part of ADHD). I had an uncle who had 4 children with his wife and then just left them. I had another uncle who never held a job in his lifle outside of serving in the army during WWII. Several family members obsessively keep their lives in order. Anything out of place is a distraction. Obviously, ADHD manifests in different ways for different people. Some more extreme.

You truly have no idea about how destructive ADHD can be. And it’s truly alarming that as a teacher, you sit in judgement of children who struggle every day to do their best. I can’t imagine the damage you have done to the self-confidence of some of your students. It’s your duty as a teacher to have an open mind. I ask that you do some research and talk to some people to have a better understanding of ADHD.

Lefty

August 21st, 2010
11:37 am

One more thought — medication may be necessary for a few ADHD students. With understanding and behavior techniques, ADHD can be managed. Elizabeth, you probably raised your daughter using many of these techniques. But many parents don’t have the insight or ability to do this. And if the parent is an ADHD sufferer and doesn’t realize it, that can be more challenging.

AlreadySheared

August 21st, 2010
3:19 pm

@ScienceTeacher671,

Here’s how you do it:
Teacher/Learning Team – We’ve observed your son for a while now and he just doesn’t seem to act like other kids. We think he should meet with a psychologist to get a psycho-educational evaluation.

Parent – A “psycho-educational evaluation”? What do you think is going on?

Teacher/Learning Team – Oh, gosh. We don’t know – let’s wait and see what the psychologist says.

THEN, when you as a teacher get a behavioral questionnaire from the psychologist, mark it up to indicate the kids is REALLY REALLY ADHD. A LOT! If you’re working with a pliant shrink, she will ignore the results of the intelligence and achievement tests she administers, ignore the results of the questionnaire the parents fill out, and render the desired diagnosis.

Despicable.

Neil Murray

August 21st, 2010
3:20 pm

I believe misdiagnosis is common throughout elementary school. When I reported on education in upstate New York, I identified what seemed to me the best elementary school in the region. Among other factors, the number of ADD and ADHD students was very low. The reasons given were (1) children moved from one section of an open classroom to another frequently and often worked with their hands, standing and (2) outdoor recess occurred twice a day and children were encouraged to be active while outside. If kids don’t blow off excess energy, it gets bottled up until there’s an explosion.

AlreadySheared

August 21st, 2010
3:21 pm

cobb mother

August 21st, 2010
3:24 pm

Elizabeth, to call yourself a teacher, is a shame. You are clearly why this state sits at the bottom of the Education heap. Elizabeth, you should resign and find a new career or be fired. You are not a teacher, you are a narrow minded paycheck collector.

When my oldest daughter was first diagnosed with ADHD first by an MD and then a Psychologist at 4. For your ignorant as* to learn their are standard computerized test that a Psycholosist now administer to a child suspected of having ADHD. They can not push the key board enter button to hit the “x”’s, they can’t pay attention. There is a whole battery of tests that Psycholgists who are spealists in the diagnosis and treatment of ADD and ADHD administer. My daughters have gone to multiple doctors and psycholgists starting at age 4, the results come back the same. My daughters still come back testing above the 90% on the IOWA test ( They are exceeded on the worthless CRCT).

The first thing the Psycologist told me, was that I was not a bad parent, in fact I was a great parent for recongnizing this at age 4 and doing something about it at 4. That “B” was a challenging child for any parent. She is a great wonderful kid, that is in the top of her class, has lettered in two sports freshman year, takes AP and Honors classes, is aiming for Harvard Law. She just happens to need a medication called Concerta to function at her best. She also can’t pay attention, if she is stuck with teachers who speak in Monotono voices, don’t propery speak English ( eg. Ax for Ask or thick foriegn accents), distractions form other students ( eg. Rapping, tapping on the desks) large classes)and she must sit in the front of the class.

Elizabeth, unfortunately you were not trained properly. You are not a doctor or a Psycholgist.

AlreadySheared

August 21st, 2010
3:45 pm

@ScienceTeacher671,

Here’s how you do it:
Teacher/Learning Team – We’ve observed your son for a while now and he just doesn’t seem to act like other kids. We think he should meet with a psychologist to get a psycho-educational evaluation.

Parent – A “psycho-educational evaluation”? What do you think is going on?

Teacher/Learning Team – Oh, gosh. We don’t know – let’s wait and see what the psychologist says.

THEN, when you as a teacher get a behavioral questionnaire from the psychologist, mark it up to indicate the kids is REALLY REALLY ADHD. A LOT! If you’re working with a pliant shrink, she will ignore the results of the intelligence and achievement tests she administers, ignore the results of the questionnaire the parents fill out, and render the desired diagnosis.

Despicable.
p.s. – can’t seem to get this past the filter