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Immaturity Versus ADHD in Diagnosis

Jenny Decker RN's picture

Typically appearing before age seven, ADHD may be hard to distinguish from immaturity. A child is energetic and sometimes hyperactive and impulsive at the age of concern. This has fueled an intense public debate as to whether attention deficit disorder has been overdiagnosed. New studies have been done to show that these concerns are well founded.

With experts who disagree on the prevalence of the disorder, no neurological marker, and the immaturity versus the disorder, clinicians face a tough dilemma in diagnosing these children. In an article from Parenting magazine, Dr. William Sears offers a suggestion to parents to help resolve some of the confusion. He suggests parents use a diary of the child, following the characteristics of ADHD. If it is immaturity, these characteristics should become steadily improved. However, if they do not get better, than ADHD may very well be what is causing the problem. Dr. Sears cautions that if it is left undiagnosed and untreated, this could negatively impact the child.

Younger Children More Likely to be Diagnosed with ADHD

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In a study at Michigan State University, it was found that children who were younger than their classmates were more likely to be diagnosed with and treated for ADHD. However, there is a variable here that must be considered. It is the teachers and their perceptions of the children. For instance, if the cutoff date for kindergarten entrance was December 1st, two children born a day apart could be perceived in a significantly different way.

Children born on December 1 will often be seen as immature or more disruptive because they are younger than their classmates. If a child is born December 2, the same year, than that child is less likely to be diagnosed and treated for ADHD. A study from North Carolina State University found similar findings.

Researcher Todd Elder from Michigan State University states that this may not necessarily be a case of overdiagnosing, but it may indeed be a case of misperceiving the older children as more mature, and thus, not seeing the symptoms in an older child. More research will need to focus on these areas to determine what is happening here.

A child suspected of the disorder will show impulsivity, inattention, and hyperactivity across several situations, mainly school and home. The child finds it difficult to sit still, cannot follow directions even when clearly defined, and are often labeled as the trouble makers of a classroom.