“Now sit still.«
“Stop interrupting.” “You’re making noise.”
Many children with ADHD have heard this kind of reprimand many times during their schooling.
Especially if the child’s challenges are only discovered late. It can not only affect self-esteem, but also have an impact on schooling.
A new Finnish study, published in the journal JAMA Psychiatry, points out that the timing of an ADHD diagnosis is related to how children and young people perform at school. The researchers followed around 580,000 people born in Finland between 1990 and 1999 until the age of 20.
Here, the researchers distinguish between early and late diagnosis. Early diagnosis covers an ADHD diagnosis in childhood, while a late diagnosis is typically made in the teenage years – from the age of 13 onwards.
The study shows that children who received an ADHD diagnosis earlier:
· had approximately 0.6-0.7 points higher grade point average as a 16-year-old
· had about 3 times higher probability of completing a secondary education
· and from around 30 percent to 10 percent lower risk of being dropped out of an education as a 20-year-old.
Diagnosis can open the door to help
The connection between an early ADHD diagnosis and a better school course is probably not only about the diagnosis itself, but also about what it can lead to.
That’s what one of the researchers behind the new study, Lotta Volotinen, a PhD student at the University of Helsinki, says. She says that a diagnosis is often what paves the way for support at school and possible medical treatment.
– Receiving the diagnosis is often an entry point to treatment and support measures that can contribute to improving the children’s results at school, she tells Videnskab.dk.
At the same time, the diagnosis itself can also change the understanding of the child, both by teachers and parents – but also by the child himself. According to the researcher, this can strengthen the child’s self-esteem, well-being and relationship with the other children at school.
Per Hove Thomsen, professor of child and adolescent psychiatry at Aarhus University, recognizes that explanation.
– The study confirms what we see in the clinic: that an early intervention can move more than a late intervention, he says to Videnskab.dk.
The defeats can pile up
According to Per Hove Thomsen, children who are first diagnosed as teenagers may have experienced many defeats both academically and socially. This is also concretely reflected in the children’s schooling.
The study shows that the risk of not being involved in or having completed youth education at the age of 20 increases significantly with the age at diagnosis.
Especially around the first teenage years, the researchers point out that the difference becomes evident. Here, it seems that a late diagnosis is connected with a markedly worse school course.
Per Hove Thomsen says that the problems have often been allowed to grow over time if the child has an undetected ADHD diagnosis.
– A lot of things can have gone wrong when you turn 13. The child may have been marginalized socially and fallen behind academically because of his challenges, he says.
When the child’s difficulties have not been responded to in due time, it can be difficult to correct.
So difficult that just under a third of those who were diagnosed as 13 to 16-year-olds were not in education or had completed youth education as 20-year-olds.
Uncertainty about the cause of early diagnosis
Although the results of the study are clear, Lotta Volotinen emphasizes that it does not prove that it is the diagnosis itself that improves school attendance.
– It is possible that an earlier diagnosis can contribute to better results at school, but there may be other underlying factors, she says.
For example, they did not take into account how obvious the children’s symptoms were, how quick their parents were to seek help, or how good the schools were at detecting the problems.
At the same time, ADHD with more outward-reacting and hyperactive symptoms is typically detected earlier, while more quiet and inattentive ADHD is often only caught later.
This means that the way the diagnosis is expressed in itself can affect both the time of the diagnosis and the rest of the child’s schooling.
Is the study relevant in a Danish context?
Although the study is Finnish, Per Hove Thomsen believes that the results can be transferred to a Danish context.
– We have a school system which in many respects is similar to the Finnish one, he says.
In Finland, you also start in kindergarten, go to primary school for nine years and then you can apply for upper secondary school or vocational training.
He emphasizes that the most important thing is how early you react to signs of ADHD.
– We can become better at generally being more knowledgeable about the signals that the child sends that this could be ADHD – and then of course we must also have a system that can meet the need for help, he says.
The question is therefore whether the study should lead to changes in Danish practice. Per Hove Thomsen does not believe that a single study will bring about major changes, but that it might help make us more aware of early signs of ADHD.
He believes that children with ADHD-like symptoms should not necessarily wait for a diagnosis before getting help at school.
– You don’t have to wait for the child to get a diagnosis to give the right support, he says.
Instead, it is about teachers, health nurses and other professionals close to the children becoming better at reacting to early signs, so that interventions can be made earlier in the process, before the problems become large.
