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zoom RSS 早生まれはADHDと誤診されやすい

<<   作成日時 : 2010/08/23 22:24   >>

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 年齢が若い子どもがADHDと誤診される。
 ミシガン州立大の研究者によれば、米国で100万人の学童がADHDと誤診されているという。
 行動が稚拙で注意力がなく落ち着きがなく静かに座っていられないのは、単に5才であるからであり、他の子どものように6才ではないためかもしれないと言う。
 CDCによれば、米国の学齢期の子どもの3-7%がADHDに苦しんでいる。2006年現在、5-17才の450万人の子どもが診断されている。
 研究によれば、12,000人の子どものデータベースより、幼稚園児の年少の児と年長を比べると年少児は60%多くADHDと診断されたという。
 ミシガンでは誕生日が12月1日で幼稚園入園を分けており、12月1日生まれは、1年後に入園となる12月2日生まれよりADHDと診断と診断される割合がずっと高い。
 1日生まれの違いで1年違いの級友と比較されたために違って評価されたのではないか。
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ADHDの症状はしばしば1年で軽快することがある
http://kurie.at.webry.info/201004/article_1.html
有機リン酸系殺虫剤で注意欠陥多動性障害(ADHD)を発症するリスクが高まる/米国
http://kurie.at.webry.info/201005/article_14.html
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ADHD Misdiagnoses Identified by New Study
There Are No Blood Tests or Other Neurological Markers for ADHD
By JIM HICKEY
Aug. 17, 2010
http://abcnews.go.com/Health/Wellness/adhd-misdiagnoses-identified-study/story?id=11418898

画像Many children who are disruptive in school classrooms are misdiagnosed with Attention-Deficit Hyperactivity Disorder, when all they really are ... are young, according to a new study.
Study finds one third of students with ADHD either drop out or delay graduation.

Michigan State University researchers found that as many as 1 million U.S. school kids may have been misdiagnosed with ADHD because they are the youngest and -- therefore, typically most immature -- students in class.

"If a child is behaving poorly, if he's inattentive, if he can't sit still, it may simply be because he's 5 and the other kids are 6," said Todd Elder, assistant professor of economics at Michigan State in Lansing.

His findings are to be published in the Journal of Health Economics.

Three to 7 percent of U.S. school-age children suffer from ADHD, according to the Centers for Disease Control and Prevention in Atlanta. As of 2006, 4.5 million children, ages 5 to 17, had been diagnosed with the disorder.

But there are no blood tests or other neurological markers for ADHD, researcher Elder said. Experts disagree on the disorder's prevalence among children.

Elder's study examined a data base of 12,000 children, measuring the difference in ADHD diagnosis between the youngest and oldest children of kindergarten age. The statistics showed the youngest were 60 percent more likely to be diagnosed with ADHD than the oldest, he said.

He also found that when students reached the fifth and eighth grades, the youngest were more often prescribed stimulants than their older classmates.

"Many ADHD diagnoses may be driven by teachers' perceptions of poor behavior among the youngest children in a kindergarten classroom," he said.

"But these 'symptoms' may merely reflect emotional or intellectual immaturity among the youngest students."

For example, Michigan children born Dec. 1, the state's kindergarten-eligibility cutoff date, were diagnosed with ADHD at a much higher rate than children born Dec. 2, who had to enroll a year later and, thus, were the oldest in their class.

Measure by Age, Not Grade-Level

Likewise, the Dec. 1 kids were the youngest in their class. Thus, Elder said, the students were a single day apart in age but were assessed differently because they were compared against classmate of a different age set.


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Measuring Inappropriate Medical Diagnosis and Treatment in Survey Data: The Case of ADHD among School-Age Children

Journal of Health Economics, In Press, Accepted Manuscript, Available online 4 August 2010
William N. Evans, Melinda S. Morrill, Stephen T. Parente

William N. Evansa, Corresponding Author Contact Information, E-mail The Corresponding Author, Melinda S. Morrillb, E-mail The Corresponding Author and Stephen T. Parentec, E-mail The Corresponding Author

a Department of Economics and Econometrics, University of Notre Dame, 437 Flanner Hall, Notre Dame, IN 46556

b Department of Economics, North Carolina State University, 4144 Nelson Hall, Box 8110, Raleigh, NC 27695-8110

c Department of Finance, Carlson School of Management, University of Minnesota, 321 19th Ave. Room 3-122, Minneapolis, MN 55455

Received 8 April 2010; revised 15 July 2010; accepted 15 July 2010. Available online 4 August 2010.

Abstract

We exploit the discontinuity in age when children start kindergarten generated by state eligibility laws to examine whether relative age is a significant determinant of ADHD diagnosis and treatment. Using a regression discontinuity model and exact dates of birth, we find that children born just after the cutoff, who are relatively old-for-grade, have a significantly lower incidence of ADHD diagnosis and treatment compared with similar children born just before the cutoff date, who are relatively young-for-grade. Since ADHD is an underlying neurological problem where incidence rates should not change dramatically from one birth date to the next, these results suggest that age relative to peers in class, and the resulting differences in behavior, directly affects a child's probability of being diagnosed with and treated for ADHD.


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