Nearly 1 million children are misdiagnosed as ADHD (attention deficit hyperactivity disorder), or background is born late in the grade

When I was a child of a kindergarten or elementary school, when I was born in April, many children born in April often listen to teachers' stories and can also study and sports "teacher's favorite" many, born in March is a troubled class in the reverse class "problem children" There are also many people who have felt that they often get treated.

There is also influence of the mediaADHD (attention deficit / hyperactivity disorder)In the United States where awareness is high and there are also a large number of patients who doubt about ADHD, more than 4.5 million children under the age of 18 are currently undergoing diagnosis of ADHD, but the possibility that nearly 1 million of them are misdiagnosed It was clear that it was high. Although it is a sense of ADHD having a sense of being begun to be picked up in Japan, it seems that it can never say that it is a fire on the opposite shore considering the possibility of a misdiagnosis similar to the United States.

Details are as below.Nearly 1 million children potentially misdiagnosed with ADHD, study finds | MSU News | Michigan State University

NCSU News :: NC State News and Information »Study Shows Birth Dates, School Enrollment Dates Affect ADHD Diagnosis Rates

According to these articles, one out of every 4.5 million children diagnosed with ADHD, one in five is due to being born slowly in the grade, that is, "When a 5-year old child behaves like a 5-year-old child behaves like 6 It seems that there is a high possibility that it is misdiagnosed as ADHD by "It looks restless compared with the old age classmate." Those children misdiagnosedRitalinIf it is said that it is receiving prescription, it is worried about long-term health effects, and the amount of 500 million dollars a year (about 43 billion yen) is wasted, experts point out doing.

ADHD characters often appear in movies and TV dramas,From Magic Johnson to Paris HiltonIn the United States where many celebrities profess to be diagnosed as ADHD, the words "ADHD" and "Hyper" are used on a daily basis when describing people, and the restless and impulsive children are not ADHD It is very common for teachers to suspect that they are introducing experts. However, Ritalin that is prescribed for ADHD (Methylphenidate) Are drugs that are highly abuse-resistant and dependently dependent on their stimulant effect, neurological diagnostic methods such as blood tests and electroencephalogram measurements have not yet been established, so how many ADHD patients are "misdiagnosed" There is no doubt as to whether or not it is "fraud".


Michigan State UniversityEconomist Todd Elder Associate Professor,North Carolina State UniversityIn the two separate studies conducted by economists such as economist Melinda Morrill et al., The findings leading to a common conclusion that "there are many children who are misdiagnosed as ADHD because of their late birth in the school year" It has come out.

It should also prevent cases where adults are not aware that children are ADHD and that if they are properly diagnosed and treated with drugs they will have difficulties in academic and social life because of the symptoms that should be improved Conversely, children are victims even if they are misdiagnosed that children who are not ADHD are misdiagnosed as ADHD, and risks such as the side effects of drugs and the possibility of drug dependence in the future will increase.

According to the estimate by Associate Professor Elder of the University of Michigan, an amount of about 320 million to 500 million dollars (about 27.5 billion to 43 billion yen) annually is used for medicine treatment for children misdiagnosed as ADHD 80 to 90 million dollars (about 6.9 billion to 7.7 billion yen)Medicaid (public medical insurance system)It is said that it is wasting money on taxes.


In the research by Associate Professor Elder,Early Childhood Longitudinal Study(A long-term research program on child development and early childhood education), using data of about 12,000 people, between the child who was born the earliest among the same grade at the kindergarten and the child who was born most recently, We compared the proportion of children diagnosed with ADHD and the proportion of receiving drug treatment.

as a result,Cut-off date(Depending on the state in the US, children born just after the cut-off date were born on the date "Can not enter the kindergarten if not 5 years old", April 1 in Japan) Compared to the child (born April 2 in Japan), the proportion diagnosed as ADHD is as high as 60%. Also, at the time when those children became the eighth grade (second grade in junior high school in Japan), the youngest child of the same grade is prescribed psychotropic drugs as compared with the first older child He said that he was twice as much.

This means that even if you compare children in each state in different states with different cut-off dates, they were born at the same time but because the cut-off date of the living state is different, it will be "prematurely born" It is said that a clear pattern was seen in the same way even by comparing children who became late ".

For example, in Michigan State where the cut-off date is December 1, a child born December 1st (the youngest in the grade) was born December 2nd (ADHD diagnosis than the child of the oldest year) A child born in August (born in March in Japan) living in Illinois where the proportion is high and the cut-off date is September 1 is a child born in Michigan even though it was born in the same August (Born in December in Japan) is higher ADHD rate, and so on.

Diagnosis of ADHD is carried out by a specialist doctor, but kindergarten where ADHD is often found - In children of the lower grade of elementary school, the findings by the teacher who observed the behavior of the child in the class greatly affect the diagnosis Professor Elder says.

According to Professor Elder's research, it is highly likely that 20% of all children diagnosed with ADHD are "misdiagnosed" affected by "relatively young in the grade", the final conclusion At the moment, it is said that there are about 900,000 children misdiagnosed as ADHD because they are born late in the academic year.

"There is no attention or restlessness, even if there is a child who can not sit still, it may be because the child is a 5-year-old child who was misunderstood among the six-year-olds," Elder Associate Professor. "It's a big difference between 5 and 6, and teachers and medical professionals should consider that when diagnosing whether a child is ADHD"


Meanwhile, in a study by associate professor Melinda Morrill of North Carolina University, using the data of the National Health Survey and private medical insurance, as with Associate Professor Elder, in various ways, the child is younger or older in the grade Analysis of the difference in the rate of receiving diagnosis of ADHD depending on whether the child was born immediately after the cut-off date (the youngest student) compared with the child (the youngest year) who was born just before the cut-off date, It seems that there is a result that the rate diagnosed as ADHD is 25% lower.

Even if it was assumed that the born season such as cold season or born in a hot season affected the ADHD incidence rate for some reason, the birthday of children born in the same season were cut off in research Since it was shown that the rate of being diagnosed as ADHD greatly depends on whether it is just before or just after the date, the influence by the season can be ignored.

"This implies that there are children who are being diagnosed or not being diagnosed with ADHD due to factors other than the potential biological and medical reasons," said Morrill Associate Professor. Considering that the incidence of ADHD in children born in the same season should be constant, the difference in the rate diagnosed was "I was restless because the 6 year old was behaving like a 6 year old in the environment surrounded by a 7 year old child "It is a reasonable explanation that it seems that it seems that calmness seems to be due to the fact that a 6-year-old child seemed to be 6 years old in an environment surrounded by a 5-year old child".

For example, if identical monozygotic twins with the same behavior and ADHD onset risk are also born across cut-off dates and entering a different grade, then the child born earlier is older than yourself class Children surrounded by a mate and seen in childhood, children born later are surrounded by younger classmates and can also be seen as adults, so the twins do the same behavior in each class Even if it is, it can be said that the findings of the two homeroom teachers are totally different when receiving a diagnosis whether it is ADHD or not.

Photo byOude School

If we can reduce the misdiagnosis of ADHD for younger children in the grade, we can reduce medical expenses and reduce health risks such as side effects to children who should have been unnecessary drug administration originally, so important important It may be a challenge. It is important to keep in mind that when a teacher observes a child, considering whether the child is older or younger in the grade, "The difference between 5 and 6 year olds is big" It seems to be a point to prevent misdiagnosis.

August 20th, 2010 11:42 Postscript:In addition, the data used for the research by Prof. Elder mentioned above is the data of children who entered the US kindergarten (one year before becoming a first grade primary school, the older group of kindergartens in Japan) in the year beginning in September 1998 Data, the proportion of data that received drug treatment including Ritalin and its generics at the time when those children became fifth graders and eight grades (2003 and 2006). Ritalin was not prescribed at kindergarten.