(HealthDay News) – Younger students in each grade are at an increased risk of lower academic performance, and are significantly more likely to be prescribed attention-deficit/hyperactivity disorder (ADHD) medications compared with older students in the same grade, according to a study published online Nov. 19 in Pediatrics.

Helga Zöega, PhD, of the Mount Sinai School of Medicine in New York City, and colleagues conducted a population-based cohort study involving 11,785 children in Iceland to determine whether younger relative age in class correlates with poorer academic performance or a higher risk of being prescribed ADHD medication.

The researchers found that, in the fourth grade, the mean test scores in mathematics and language arts were lowest among the youngest children, but the gap was reduced by seventh grade. At age 9, compared with the oldest one-third of students, the youngest students had a significantly increased relative risk of receiving a low test score in mathematics and language arts (relative risk, 1.9 and 1.8, respectively), while the relative risk was 1.6 for both subjects at age 12. Between the ages of 7 and 14 years, the youngest one-third of children were 50% more likely to be prescribed ADHD medication compared with the oldest students.

“Educators and health care providers should take relative age and gender into account when evaluating children’s performance in school and other criteria for ADHD diagnosis,” the authors write. “These findings can inform the decision of parents with children born close to birthday cut-offs regarding school entry.”

One author disclosed financial ties to the pharmaceutical industry.

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