ADHD Diagnosis in Younger Students No Less Stable Than in Older Classmates

A diagnosis of attention-deficit/hyperactivity disorder (ADHD) is just as likely to persist in the youngest students in a class as it is in their older classmates, according to study findings published in The Lancet Psychiatry.

“We know the youngest children in their year group are more likely to be diagnosed with ADHD, but many believe this is because they lag behind their older classmates,” said senior lead author Samuele Cortese, MD, PhD, a child and adolescent psychiatrist and professor at the University of Southampton in the United Kingdom. “However, no one has ever explored if these younger children who are diagnosed with ADHD retain the diagnosis later on — until now. Our study shows for the first time that these youngsters are no more likely to lose the diagnosis over time than older children.”

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The study was a meta-analysis of individual participant data for 6504 children with ADHD from 57 prospective studies in more than a dozen countries. Follow-up periods ranged from 4 to 33 years.

Going into the analysis, researchers hypothesized that younger relative age at ADHD diagnosis would decrease the likelihood of ADHD persistence over time. However, they found no association between younger age at ADHD diagnosis and any significant difference in the persistence of the diagnosis over follow up.

Additional analyses confirmed the robustness of the primary analysis’ finding, according to the study.

“Our work shows the diagnosis of ADHD in children with a young relative age is not especially unstable,” said Corentin Gosling, PhD, an associate professor at the Paris Nanterre University in France. “However, it could not assess whether it is an appropriate diagnosis or it is because, once a child receives the ADHD label, parents and teachers consider the child as having ADHD and are influenced by the diagnosis. Future studies should solve this question.”

References

Gosling CJ, Caparos S, Pinabiaux C, et al. Association between relative age at school and persistence of ADHD in prospective studies: an individual participant data meta-analysis. The Lancet Psychiatry. Published online October 25, 2023. doi:10.1016/S2215-0366(23)00272-9

Youngest children in class with ADHD as likely to keep diagnosis in adulthood as older pupils, find scientists. News release. University of Southampton; October 26, 2023. Accessed October 27, 2023.