Age level vs grade level for the diagnosis of ADHD and neurodevelopmental disorders

Bonati, Maurizio; Cartabia, Massimo; Zanetti, Michele; Reale, Laura; Didoni, Anna; Costantino, Maria Antonella

doi:10.1007/s00787-018-1180-6

Cited by 25 publications

(20 citation statements)

References 37 publications

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“…It has been stated that any characteristics that set children apart from the group increases the likelihood of them being bullied. 2 The relative age effects found in mental health 10 and ADHD 12,13 have also been explained by differences in maturity 13,28,29 and cognitive and social skills 10 related to age.…”

Section: Discussionmentioning

confidence: 99%

Relative age is associated with bullying victimisation and perpetration among children aged eight to nine

et al. 2020

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Bullying is defined by the American Centers for Disease Control and Prevention as unwanted repetitive aggressive behaviour that occurs within an unequal power relationship and inflicts harm or distress on the victim. 1 The prevalence of involvement in bullying is approximately 20%-25%. 2 It has possible long-lasting negative impacts such as mental 3-7 and physical health problems, socioeconomic disadvantages, 5 and criminality. 4,5 Bullies have been shown to demonstrate proactive aggression and be motivated by social dominance, whereas their victims have been characterised as submissive and lacking in confidence in social interaction. 2 These characteristics may be increased by differences in growth and maturity.

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Section: Discussionmentioning

confidence: 99%

Relative age is associated with bullying victimisation and perpetration among children aged eight to nine

et al. 2020

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“…We used the methodology previously described and reporting details concerning: the local health setting [19], the characteristics of the ADHD Registry activated in Lombardy in June 2011 [20–22], the systematic work made by the18 ADHD centers belonging to the Lombardy ADHD Group [23], the rigorous diagnostic assessment (according to national and international guidelines, and DSM - IV - TR ) approved by all involved clinicians [24, 25], the evaluation of follow-up and the effect size of provided care [26].…”

Section: Methodsmentioning

confidence: 99%

Waiting times for diagnosis of attention-deficit hyperactivity disorder in children and adolescents referred to Italian ADHD centers must be reduced

Bonati

Cartabia

Zanetti

2019

BMC Health Serv Res

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Background To investigate timely access to and the time needed to complete the diagnostic path of children and adolescents with suspected attention deficit hyperactivity disorder (ADHD) in the 18 Italian Lombardy Region ADHD reference centers. Methods Data of children and adolescents enrolled in the Regional ADHD disease-oriented Registry for suspected ADHD who requested their first visit in 2013–2017 were analyzed. Results The sample comprised 2262 children and adolescents aged 5–17 years who accessed the ADHD centers for diagnostic classification and management. The median waiting time was of 177 days (range 66–375) from the request for the initial appointment to the completion of the diagnostic path, with a three - fold difference between centers. In addition to the center, the strongest significant predictors of long waiting times were age comorbidities, the severity of the disorder, and having already completed some diagnostic procedures provided by the common standard path. Conclusions To guarantee an equal standard of care in ADHD centers for all children and adolescents there is a pressing need to reduce the times to complete the diagnostic path. It is the task of both policymakers and each center to optimize the quality of the service and of the care delivered.

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“…5,6,34,37,40,41,44,47 Of the 12 included studies that focused on relative age, 11 studies showed that the youngest children in class were more likely to be diagnosed with ADHD than the oldest children. 22, [68][69][70][71][72][73][74][75][76][77] One study did not confirm this finding. 78 It was conducted in a low-prevalence setting in which only specialists diagnosed ADHD, suggesting that variation (and a potential reservoir) is much smaller where stricter adherence to diagnostic criteria may occur.…”

Section: Large Reservoir Of Potentially Diagnosable Adhdmentioning

confidence: 96%

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

et al. 2021

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IMPORTANCE Reported increases in attention-deficit/hyperactivity disorder (ADHD) diagnoses are accompanied by growing debate about the underlying factors. Although overdiagnosis is often suggested, no comprehensive evaluation of evidence for or against overdiagnosis has ever been undertaken and is urgently needed to enable evidence-based, patient-centered diagnosis and treatment of ADHD in contemporary health services. OBJECTIVE To systematically identify, appraise, and synthesize the evidence on overdiagnosis of ADHD in children and adolescents using a published 5-question framework for detecting overdiagnosis in noncancer conditions. EVIDENCE REVIEW This systematic scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews and Joanna Briggs Methodology, including the PRISMA-ScR Checklist. MEDLINE, Embase, PsychINFO, and the Cochrane Library databases were searched for studies published in English between January 1, 1979, and August 21, 2020. Studies of children and adolescents (aged Յ18 years) with ADHD that focused on overdiagnosis plus studies that could be mapped to 1 or more framework question were included.Two researchers independently reviewed all abstracts and full-text articles, and all included studies were assessed for quality. FINDINGS Of the 12 267 potentially relevant studies retrieved, 334 (2.7%) were included. Of the 334 studies, 61 (18.3%) were secondary and 273 (81.7%) were primary research articles. Substantial evidence of a reservoir of ADHD was found in 104 studies, providing a potential for diagnoses to increase (question 1). Evidence that actual ADHD diagnosis had increased was found in 45 studies (question 2). Twenty-five studies showed that these additional cases may be on the milder end of the ADHD spectrum (question 3), and 83 studies showed that pharmacological treatment of ADHD was increasing (question 4). A total of 151 studies reported on outcomes of diagnosis and pharmacological treatment (question 5). However, only 5 studies evaluated the critical issue of benefits and harms among the additional, milder cases. These studies supported a hypothesis of diminishing returns in which the harms may outweigh the benefits for youths with milder symptoms. CONCLUSIONS AND RELEVANCEThis review found evidence of ADHD overdiagnosis and overtreatment in children and adolescents. Evidence gaps remain and future research is needed, in particular research on the long-term benefits and harms of diagnosing and treating ADHD in youths with milder symptoms; therefore, practitioners should be mindful of these knowledge gaps, especially when identifying these individuals and to ensure safe and equitable practice and policy.

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Age level vs grade level for the diagnosis of ADHD and neurodevelopmental disorders

Cited by 25 publications

References 37 publications

Relative age is associated with bullying victimisation and perpetration among children aged eight to nine

Relative age is associated with bullying victimisation and perpetration among children aged eight to nine

Waiting times for diagnosis of attention-deficit hyperactivity disorder in children and adolescents referred to Italian ADHD centers must be reduced

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

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