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In the last decade, the number of kids diagnosed with ADHD has risen 66%! A new study reveals statistics in the current issue of the journal, Academic Pediatrics. Northwestern Medicine spearheaded the study and analyzed the trends from 2000 to 2010 among children under 18 years of age who had been diagnosed and treated for ADHD. According to the study, “in 2010, 10.4 million children and teens under age 18 were diagnosed with ADHD at physician outpatient visits, versus 6.2 million in 2000.”

Some theories presented in the study state that “ADHD is commonplace among children and teens.” Another theory states that this rise is “due to increased awareness.”

Immaturity?
Another recent study published in the Canadian Medical Association Journal reveals that ADHD may be misdiagnosed and the child may simply be immature. This study suggests consideration of the youngest child in the classroom. Researchers found that the youngest children in a classroom were 39% more likely to be diagnosed and 48% more likely to be treated with medication for ADHD. The prevalence of ADHD is about three times higher in boys than in girls, however, in this study, younger girls were 70% more likely to receive an ADHD diagnosis.

Three months can make a huge difference in developmental ability at the primary educational level. The youngest child in the class simply cannot be measured against the bulk of others who may have a 6-12 month advantage over him. This gap in maturity levels has been called the “relative age effect” and can influence academic, athletic and social performance.

These younger children may appear to the teacher and classmates to have a behavioral disorder, but if measured against children in a grade below would they find that the behavior is actually age appropriate?

The study suggests that these younger children are being labeled with a diagnosis and are then subsequently treated differently by teachers. This different treatment can ultimately impact a child’s developing self-esteem creating a negative perception of self and impacting how their peers view them.

Expert Weigh In
“These studies each point to the importance of a full and accurate diagnosis. ADHD is not immaturity – it’s a real biological disorder that must be accurately diagnosed, not assumed based on behavior. ADHD should not be diagnosed based simply on the presences of the common symptoms of inattention, impulsivity, and hyperactivity. Each of these behaviors can have a different explanation.”, explains Cindy Goldrich, Ed.M., ACAC of PTS Coaching.

Goldrich elaborates, “A proper diagnosis may be made by a variety of professionals (clinical psychologists, physicians, psychiatrist to name a few) as long as they have been specifically trained for the differential diagnosis of ADHD from other problems.”

“Observations by parents and teachers are very valuable, however since these can be subjective they must be balanced by broader assessment including an extensive interview, neuropsychological or cognitive testing, family history and physical examination of the child to rule out other explanations for the symptoms (for example sleep apnea, depression, anxiety, or a thyroid problem).”, Goldrich continues.

Possible Solutions

  • Consider the relative age of children for their grade when selecting classroom demographics. Group children whose ages are within 3-6 months, decreasing the “relative age effect”.
  • Adjust the grade age requirements. Today, curriculum is so much more advanced compared to 10 years ago. Kids are expected to read and write coming out of kindergarten. A decade ago, emphasis was placed on developing motor, sensory and social skills.
  • Watch Sir Ken Robinsons video, Changing Education Paradigms
  • Arrange seating so that the youngest more distractible children are placed in the front of the classroom. Perhaps curved seating allowing for more seats at the front of the class with less children being in the back.
  • Implement regular movement breaks. Don’t restrict recess as a form of discipline as this is the only opportunity for the kids to run and play and release their excess energy.
  • Implement calming and focusing activities in the classroom such as mini yoga breaks.
  • Give every child a fidget bag.
  • Teach the children organizational skills. Color code notebooks, create and use place savers or clip on paperclips to save a place in a work book. Send home the week’s homework assignment to the parents. Remind children what to pack up at the close of the day.
  • Determine the type of overall learning style of the students in the class. Are they visual? Kinesthetic? Musical? Artistic? If 25% or more of the class are kinesthetic learners and need to move, adapt the lesson plan to include movement for the whole class.
  • Create fun social skill opportunities for children during class or in an after school club. Teach them the appropriate situational skills that are expected of them in a fun learning environment as opposed to punishing the child for not measuring up.
  • Rule out other potential issues such as a sensory processing issue, hearing issues, vision issues. A visit to an audiologist can rule out hearing issues. A trip to the eye doctor can determine if there are any visual problems, even if your child appears to see well. Ask your pediatrician for a referral to an occupational therapist to evaluate for sensory processing disorder.
  • Determine what might be creating anxiety in the child. Could it be that they lack the fine motor skills to perform the handwriting assignment timely enough? Could it be that they cannot see the board from the back of the room? Could it be that the child is bored? Anxiety can develop when the child feels inadequate.
  • Allow for regular snack breaks. Oral sensory input has a calming effect.
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Tiffani Lawton, R.N.
Using her background in health care administration, education and marketing, Tiffani created Special-Ism, an educational resource for parents, teachers, and clinicians of children with various isms. Currently, Tiffani serves as the Editorial Director at Special-Ism, focusing on solutions to the isms for all children at home, in the classroom and community.