Children who are relatively young within their school year have been shown to do less well academically than their older peers. They are also more likely to be diagnosed with a learning disability, in particular attention deficit hyperactivity disorder (ADHD). One study suggested that self-belief in these younger children was lower than their older peers. In this study we aim to confirm the association between relative school age and diagnosis of learning disability and ADHD in a large national database. We will further investigate whether relatively young children within the school year are more likely to be diagnosed with depression in childhood. For each of these conditions we will also explore whether this association is affected by gender or ethnicity. If children who are relatively young in their school year are more likely to be diagnosed with a learning disability or depression this would have implications for both school and health services, from providing support to the youngest in the cohort, to considering relative age in the diagnosis of both learning disabilities and depression.
This observational study will explore the association between month of birth relative to school entry cut-off age and three outcomes: diagnosis of learning disability, diagnosis of ADHD and diagnosis of depression in children up until the age of 16 years. All children up to 16 years of age in up to standard practices will be included in the study. Relative age compared to the oldest of the school cohort will be calculated by comparing month of birth with the school entry cut-off. This will be categorised into four 3-month relative age bands. Cox regression will be used to determine the relative rate of each diagnosis by relative age band. Age in years, year of birth, socioeconomic status (measured by practice level IMD) will be considered potential confounders and gender and ethnicity and will be considered as potential effect modifiers. The above analyses will be used to estimate the population attributable risk from relative age and the number of 5 year olds entering school now who will receive a diagnosis as a result of their relative age in the school year.
Incidence of learning disability; Incidence of attention deficit disorder; Incidence of depression.
Ian Douglas - Chief Investigator - London School of Hygiene & Tropical Medicine ( LSHTM )
Adrian Root - Corresponding Applicant - London School of Hygiene & Tropical Medicine ( LSHTM )
Harriet Forbes - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Jeremy Brown - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Joseph Hayes - Collaborator - University College London ( UCL )
Krishnan Bhaskaran - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Liam Smeeth - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
HES Admitted Patient Care;Practice Level Index of Multiple Deprivation