An age difference of a few months has “a considerable impact on the frequency of initiation of methylphenidate but also of speech therapy”, suggests a study carried out by the Epi-Phare group, which brings together the Medicines Agency (ANSM) and Health Insurance.
According to the conclusions of this work, which followed a cohort of more than 4 million children aged 5 to 10 years born from 2010 to 2016, treatments based on methylphenidate (Ritalin and generics) which treat deficiency disorders Attention hyperactivity disorder (ADHD) and speech therapy sessions are more prescribed for children born at the end of the year.
In detail, among children of the same school level, those born in December have a 55% additional risk of starting treatment with methylphenidate and a 64% additional risk of receiving speech therapy sessions than those born in January of same year.
This risk increases regularly with the age difference: within the same level of education, compared to children born in January, those born in February have a 7% additional risk of being prescribed methylphenidate, those born in April 9 %, those of July 29%, those of October 46%.
The same trends were observed concerning speech therapy sessions, the use of which increased by 3% among children born in February, by 12% among those born in April, 30% among those born in July, 49% among those born in october.
Requirements too high for their age?
To explain these differences, the authors put forward several hypotheses. The youngest children in a class may face demands that are too high for their age, particularly in the early years of school.
Younger children would then be more likely to be mistakenly diagnosed with attention deficit hyperactivity disorder (ADHD) or with learning disorders, even though their difficulties are not abnormal. Conversely, “perhaps we underdiagnose the disorders of older students who manage to “compensate” for them with greater maturity,” says Alain Weill, public health doctor, deputy director of the EPI-PHARE group.
However, these results should, according to him, lead to certain recommendations: “Do not necessarily state that a CP child is supposed to know how to read at Christmas”, or “specify the month of birth in the event of prescription of Ritalin or speech therapy,” adds the doctor. He specifies that this work will be examined by the High Authority for Health which will soon provide new recommendations in the management of ADHD.
