The Importance of Relative Standards in ADHD Diagnoses: Evidence Based on Exact Birth Dates

37 Pages Posted: 19 Dec 2009

Date Written: December 18, 2009

Abstract

This paper presents evidence that diagnoses of Attention-Deficit / Hyperactivity Disorder (ADHD) are driven largely by subjective comparisons of children to their peers. Children born just prior to their state’s cutoff date for kindergarten eligibility – who typically become the youngest and most developmentally immature children within a grade – are 50 percent more likely to be diagnosed with ADHD than those born immediately afterward. A child’s birth date relative to the eligibility cutoff also strongly affects teachers’ assessments of whether the child exhibits ADHD symptoms but is only weakly associated with similarly measured parental assessments, implying that many diagnoses merely reflect teachers’ perceptions of poor behavior among the youngest children in a classroom. These perceptions have long-lasting consequences: the youngest children in fifth and eighth grades are nearly twice as likely as their older classmates to regularly use stimulants prescribed to treat ADHD.

Keywords: ADHD, symptoms, diagnoses, regression discontinuity

JEL Classification: I10, I21, J13, J24

Suggested Citation

Elder, Todd E., The Importance of Relative Standards in ADHD Diagnoses: Evidence Based on Exact Birth Dates (December 18, 2009). Available at SSRN: https://ssrn.com/abstract=1525556 or http://dx.doi.org/10.2139/ssrn.1525556

Todd E. Elder (Contact Author)

Michigan State University ( email )

110 Marshall-Adams Hall
Department of Economics
East Lansing, MI 48824
United States
517-355-0353 (Phone)

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