Recently, JAMA Pediatrics published a cohort study of 1 million children in the UK. The study identified an association between children who are younger than their classmates (born in the last quarter of the school year) and the “likelihood of depression, attention-deficit/hyperactivity disorder and intellectual disability.” The study found that:
“…Relatively young children were 1.3 times more likely than the oldest quarter of children in the school year to be diagnosed with intellectual disability, 1.4 times more likely to be diagnosed with ADHD, and 1.3 times more likely to be diagnosed with depression.”
As the mother of a January baby who spent 1.5 years in speech therapy (more on that later), I was bothered by the subject matter. So I’m throwing a flag on the play, and highlighting what bothers me about this study
The Nature of ADHD
When a younger child (relative to his classmates) has moments of fidgeting, disruption, and lack of focus or self-regulation, it’s easy to assign a diagnosis, even though these behaviors represent the chemical makeup of pretty much every preschooler on earth.
ADHD remains one of the most commonly (mis) diagnosed and medicated disorders in the world. Despite the American Psychiatric Association’s claims that there is “no biological marker” to accurately diagnose ADHD, third parties (namely parents and teachers) continue to designate this disorder to describe the “cure” for all disruptive behavior.
According to an Annual Research Review on the Wiley Online Library, while medical professionals formally diagnose ADHD, it’s the teachers who “usually play a central role by providing an assessment of a child’s behavior. Furthermore, a 2003 US study found that, in most cases, teachers were the first to suggest a diagnosis.”
Children, particularly young children, often encounter struggles with self-regulation. Is the answer then to label and medicate all of them? In the face of struggle, would it not be easier or more humane to extend a hand than a pill?
Teaching for the Ages
The logical fallacy of this study suggests that relative age has something to do with aptitude, when it’s more likely that children at different developmental stages perform differently from each other, even if they’re in the same classroom. Of course, a relative peer who is older is more likely to have skills that are more developed.
There are many instances of children being labeled due to their relative age. Take for example the practice of “redshirting” — postponing a child’s entrance into pre-school (junior and/or senior kindergarten) to allow extra time for emotional, intellectual, or physical growth.
Teachers can be forgiven for encouraging this practice because more mature children are easier to handle and produce better test scores, at least initially. The Frank Porter Graham Child Development Institute recently released its 2019 Impact Report, stating “teachers indicated that 48% of their students were not ready for the current kindergarten curriculum. High percentages of teachers indicated that half of their students lacked important skills, including “following directions” (46%), “academic skills” (36%), and the ability to “work independently” (34%).”
However, any “benefits” gained from initially holding a child back dissipate drastically by the time he/she/they reach high school. In fact, studies show that students who are held back from preschool for one year are less motivated, perform less well than their peers, and are no further ahead in wages as adults.
Simply put, how does keeping your child out of school help him/her/them develop the skills necessary to sit, focus and perform in a classroom? Consider the large-scale study at 26 elementary schools in Canada that reported, “first graders who were young for their year made considerably more progress in reading and math than kindergartners who were old for their year (but just two months younger).”
Yet another study claims that the youngest students in a fifth-grade subset scored marginally lower than their classmates, but five points higher in verbal I.Q.. In other words, if you want your child to have an academic advantage, put him in school.
There was no indication from the testers involved in this study as to which, if any, socioeconomic factors played into their results. Components such as class, race, and gender aren’t outliers; they inform and have a direct impact on children and their ability to learn.
The National Center for Education Statistics (NCES) reports that “white, non-Hispanic children are more than twice as likely as black, non-Hispanic children to have entered kindergarten later than their birthdays allowed.” This indicates that practices such as redshirting are prevalent among families of affluence who can afford to provide daycare for an extra year.
The research surrounding the effects of socioeconomic status (SES) and education are too numerous to cite or even list here. The American Psychological Association (APA) claims that “children from low-SES households and communities develop academic skills slower than children from higher SES groups.”
Further, low SES in childhood is related to “poor cognitive development, language, memory, socioemotional processing, and consequently poor income and health in adulthood.” Suffice it to say that a low SES will impact learning and self-esteem far more than the difference of a few months in age.
As a proponent of non-linear teaching methods and self-directed learning, I would warn the well-intentioned researchers of this cohort study against labeling children who don’t fit into the narrow concept of standardized pedagogy.
My little guy, a January baby who is one of the youngest in his class, was placed in speech therapy for 1.5 years; upon completion, we were told that had we waited a few months until he matured further and developed his speech patterns, he may not have required therapy at all.
There are factors beyond the scope of the JAMA Pediatrics study that impact a child’s likelihood to be diagnosed with ADHD, depression or a learning disability. It might be a better use of resources to focus on developing approaches that educate and empower all children, regardless of age, and set them up for success rather than scrutiny.