Speech therapy sessions are prescribed more for children born at the end of the year, underlines a large study published Thursday.
The same goes for treatments that treat attention deficit hyperactivity disorder.
The latter could be faced with demands that are too high for their age, the authors conclude.
Does being born late in the year increase the risk of being diagnosed with ADHD? This is, in essence, what a study published this Thursday and carried out by the Epi-Phare group, which brings together the Medicines Agency (ANSM) and Health Insurance, reveals, and followed a cohort of more than 4 million of children aged 5 to 10 years old, born from 2010 to 2016. It appears that treatments based on methylphenidate (Ritalin and generics) which treat attention deficit hyperactivity disorder (ADHD) and sessions of Speech therapy is more prescribed to children born at the end of the year.
An age difference of a few months has thus “a considerable impact on the frequency of initiation of methylphenidate but also of speech therapy”, conclude its authors.
A risk that increases with the age difference
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. And this risk increases steadily with the age difference. Thus, 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 born in July 29%, those born in July 29%, 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.
Several hypotheses
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. In this case, the youngest children would then be more likely to be mistakenly diagnosed with ADHD or with learning disorders, even though their difficulties are not abnormal.
On the contrary, “perhaps we underdiagnose the problems of older students who manage to ‘compensate’ for them with greater maturity”, estimates Alain Weill, public health doctor, deputy director of the EPI-PHARE group. These results should, according to him, lead to certain recommendations: “Do not necessarily say that a first grade child is supposed to know how to read at Christmas,” or “specify the month of birth in the event of a prescription for Ritalin or speech therapy”, he lists.
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According to him, this work will be examined by the High Authority of Health which will soon provide new recommendations in the management of ADHD.
As a benchmark, ADHD affects 5.9% of people under 18 and 2.8% of adults in France, we can read on the Health Insurance website. The latter also seems more common in boys, but it is probably underestimated in girls, for whom the symptoms are less visible.
