There’s no doubt that cases of Attention-Deficit/Hyperactivity Disorder are on the rise. One study, for example, reported a 36 percent increase over a 10-year period.

Now, a University of Nottingham study suggests that teachers could be confusing simple age-related immaturity for ADHD or Autism Spectrum Disorder (ASD).

The results hint at an overrepresentation of the youngest students in a classroom among those diagnosed with ADHD.

The research underscores how the youngest children in a classroom can influence the likelihood of receiving an ADHD or ASD diagnosis. Professor Kapil Sayal, the senior author, emphasized how critical it is to consider a child’s age.

Methodology

Sayal and the team of researchers examined 32 studies on this topic that spanned the globe. Most of the studies focused on ADHD. Two covered ASD. And what they found confirmed that younger students are more likely to receive an ADHD diagnosis. The extent of this ‘relative age’ effect varied.

For ASD, researchers found that the youngest children in a class were more likely to be diagnosed. But they did concede that the much smaller sample size suggests further research would be helpful. Notably, teachers rated younger children as exhibiting ADHD symptoms more often than the parents did.

Dr. Eleni Frisira, the study’s lead author from the School of Medicine, noted teachers’ significant role in identifying ADHD symptoms. She highlighted the need for teachers to consider a child’s relative age when assessing for ADHD.

ADHD Clinical Implications

Co-author Josephine Holland, MD, added that despite more than a decade of research pointing to this phenomenon, traditional diagnostic practices persist.

“Given the prevalence of ADHD, addressing the diagnostic challenges and accounting for biases becomes increasingly relevant,” the authors wrote. “From a research perspective, a more standardized methodology (e.g. choice of measures) across future studies would allow for a more reliable quantitative analysis due to more comparable results, which was not possible in this work.

“In terms of educational implications, studies investigating the effect of delaying school entry on children’s likelihood of being prescribed ADHD medication have found that held-back children were more likely to be treated for ADHD,” they added. “As this work is crucial to informing educational policies, further research on the impact of flexible school entry would be valuable, as current evidence is limited.”

Further Reading

Mental Health Diagnoses Take Unprecedented Leap

Addressing Diagnosis and Treatment Gaps in Adults With Attention-Deficit/Hyperactivity Disorder

A Review of Attention-Deficit/Hyperactivity Disorder in Women and Girls