And if doctors and teachers were confusing immaturity and disorder of attention?

Et si médecins et enseignants confondaient immaturité et trouble de l’attention?

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According to a study, the younger children of a class are more likely to receive a diagnosis of disorder of attention.

The youngest children in their class are more likely to be diagnosed with a disorder of attention, with or without hyperactivity (ADHD), that the older the class, according to an american study which should inform the debate on the surdiagnostics.

The topic is hot in the United States, where 5% of children age 2 to 17 took ADHD medications in 2016. The smaller ones are more and more concerned : the rate of diagnoses between 2 and 5 years has increased by half between 2007 and 2012.

The study, published in the New England Journal of Medicine, is significant by its size (400 000 children) and ingenious by the method.

The researchers compared children born in the month of August and those born in September, in the u.s. States that have a deadline strict and require that the children are 5 years of age on the 1st September so that they can come to the school this year.

In these States, children born in August are consistently the youngest in their class. Those born in September are older.

When flicking through data on more than 400 000 children born between 2007 and 2009, they discovered that children born in August (youngest in class) were 34 % more likely to have a diagnosis of disorder of attention, compared to those born in September.

In States without the cut-off date, the difference vanishes.

“One-quarter of children born in August and who have a diagnosis of disorder of the attention would not have received the diagnosis if they were born in September “, told AFP the co-author Anupam Jena, a professor at the school of medicine, Harvard.

This either means that the more young people are surdiagnostiqués, is that older children are under-diagnosed. But the doctor is leaning for the first option.

Teachers are often the first to report a disorder of attention. However, younger children may express symptoms similar to attention disorders — lack of concentration, distraction, etc.— that would be simply due… to their immaturity.

There is no objective test of absolute ADHD. The diagnosis is based on a subjective evaluation, where the opinions of teachers weighs.

These works reinforce studies with similar results in the United States and in other countries.

Teachers are, therefore, called for caution and patience by the authors of the study. And in case of doubt, “a doctor would have to wait five or six months in order to let the child mature a bit before you start a treatment,” says Anupam Jena.

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