Starting School and ADHD: When is it Time to Fly the Nest?

Abstract

Does deferring school entry for children born just before the enrollment cutoff date improve their mental well-being? We address this question using administrative data on prescriptions for attention deficit hyperactivity disorder (ADHD) in England. Higher ADHD rates among early school starters are often attributed to a peer-comparison bias caused by differences in relative age among classmates. However, previous studies do not consider other potential underlying mechanisms. By adopting a more comprehensive framework, we can confirm that relative age is the primary driver of the gap in ADHD rate in the long term. Furthermore, we find that such a long-term gap is driven by first-time prescriptions between ages 5 and 8, which is a critical period when the accuracy of ADHD diagnosis is most important. Based on these findings, our policy recommendations include sorting children by age and refining diagnostic decision-making in early primary school.

Note:
Funding Information: Funding from the Economic and Social Research Council (grant number ES/T008415/1).

Declaration of Interests: We have no conflicts ofinterest to disclose.

Ethics Approval Statement: This study used non-public microdata provided by QResearch via a remote access facility and complies with the respective data agreement. QResearch pre-viewed the findings before publication to ensure that privacy-sensitive, individual-specific information is not revealed. This project involves data derived from patient-level information collected by the NHS, as part of the care and support of cancer patients. The hospital, cancer and mortality data are collated, maintained and quality assured by the National Disease Registration Service which is part of NHS England. Access to the data was facilitated by the NHS England Data Access Request service.

Keywords: children, mental health, school starting age, ADHD, England, NHS

JEL Classification: I10, I20, J13