Posted tagged ‘kindergarten’

Holding children back: Can it “prevent” ADHD?

December 19, 2013

The Pediatric Insider

© 2013 Roy Benaroch, MD

I’ve been skeptical of the trend of “holding back” children with late birthdays. These are kids, usually born in the summer, who are just a few months short of the next grade cut-off. Some parents wonder whether it would be wise to hold them back a few months, so they end up one of the oldest (rather than youngest) kids in their class. This might seem to confer an advantage in terms of maturity, academic ability, and physical size, strength and coordination. Since children usually continue tracking up yearly, without later switching grades, kids “held back” in kindergarten will end up perhaps bigger and stronger and faster when trying out for teams in high school. A good idea?

Recent research has shown some stark differences in children who end up as the youngest versus the oldest kids in a classroom, which gives support to the idea of re-considering firm birthday-based rules for choosing when to start kids in school.

One good study was performed by researchers collaborating in Boston and Iceland. They looked at a nationwide cohort of Icelandic children, about 12000 kids, specifically grouping them by both birthdate and grade in school. Some findings from the study:

  • Mean test scores were lowest among the youngest children, especially in early grades. This gap lessened by middle school, but was still significant.
  • Children in the youngest third of a class were about 50% more likely to be prescribed medication for ADHD than kids in the oldest third of the class.

Similar findings have been reported by other researchers—this seems to be a real effect. Lumping children together by age creates a disparity in abilities within a classroom, with the youngest children being put at a relative disadvantage. That seems to create a greater likelihood of medical diagnoses and treatment for attention deficit disorder. It’s not known if holding back these younger kids with ADHD would allow them to become better students without fulfilling an ADHD diagnosis.

I’m not certain what the best approach is, here. Some kind of division between grades is inevitable, and some kids in any group are going to be the youngest. Perhaps smaller classes with a smaller age-range of children would help; or, perhaps an individualized approach to determining which kids will do best to start sooner versus later would address this disparity. In the held-back year, children who weren’t ready for school could get extra help with their attention abilities and other skills that will help them advance. However, this could lead to other problems later on, when kids of greatly varying age (and therefore physical and sexual maturity) are mixed together.

I don’t have a solution, but it seems like this is a genuine problem. We’d better figure out a way to work this out that doesn’t depend on more medications for the youngest kids in a grade.

Is he ready for kindergarten?

December 8, 2011

The Pediatric Insider

© 2011 Roy Benaroch, MD

Lydia wrote: “I live in a state with a December 1st cut-off and both of my kids have fall birthdays. We started the oldest when he was four and have never questioned our decision, but my younger son’s birthday is in late November, so he’d be four for the first 3 months of the school year. The kindergarten classes have over 25 kids and the district is starting full-day kindergarten for the first time next year. Are most four year olds ready for full-day kindergarten or for such large classes?”

I think most four year olds are ready for this kind of experience, if the classes are organized and supportive and well-run. With tight budgets, though, parents need to ensure that there are adequate resources for a strong kindergarten experience, no matter what the age of their children.

I’ve written kindergarten readiness on this blog before, and also recently on WebMD. My feeling has always been to allow most kids (boys and girls) to advance and proceed as recommended by the guidelines of the local school—that is, to follow “the usual track”—unless there’s a specific academic or emotional issue that’s holding your child back. Schools that indulge parents only for being “squeaky wheels” are not doing children or society any favors by allowing a handful of older children to stay back and mix with younger kids.

There is a downside to holding kids back. Some will get bored, and some will end up pushing around the smaller, younger kids. Children surrounded by same-age peers are more likely to pick up new, more mature skills than children who are with kids younger than they are. As held-back children age, they may feel especially awkward going through pubertal changes in fifth grade, long before most of their classmates will.

That being said, there certainly are some kids who should be held back. Some children, whenever their birthdays, may not be emotionally or academically ready to proceed forward. The best people to make this judgment are people from the local school, who know what the kids in their classes are like, and know what kinds of expectations there will be. Parents also need to keep in mind that not all kindergartens (or pre-Ks) are the same—a child may not quite be ready for “The Aristotle Scholars Academy,” but could do great in the “Learning Together Preschool” across the street. There isn’t one set of requirements that applies to all schools.

Parents know their kids best, and local teachers and administrators know their schools best. They should work together to help choose the best placement for children entering school.

Kindergarten penmanship– and a contest!

January 19, 2010

The Pediatric Insider

© 2010 Roy Benaroch, MD

Katie’s son has a kindergarten teacher that’s worried about his handwriting: “I have a 5.5 year old who loves kindergarten and is doing great in all subjects except handwriting. His teacher says he is behind the other kids and has suggested that I take him to get evaluated by an occupational therapist.” Mom says his handwriting is “legible, but not great,” and wonders if there are unreasonable expectations at his high-performing school.

Handwriting and penmanship are not skills that should be stressed in kindergarten. Kids ought to be coloring and doing mazes and painting and practicing hand-eye skills, but not by drilling and practicing letters all day. A kindergartener with handwriting that’s legible is already ahead of the game.

As I’ve written about before, schools have gone overboard with early academics and are stressing out kids and parents. Psychologists, occupational therapists, neurologists, developmental specialists, pediatricians, vision experts– we’re all involved now, and many children have multiple specialists to manage their academic shortcomings. Some children do need and benefit from early intervention for learning disabilities and other school problems, but that ought to be the exception, not the rule. Every child doesn’t need an evaluation, diagnosis, and therapy.

As long as your child’s handwriting doesn’t look like this, he’ll be fine. Even if it does, he can grow up to be a pediatrician!

Announcing The “Guess What Roy Wrote” contest!

The first person to post a comment deciphering even one of the three things on my hand-written todo list will get a free copy of one of my books! Enter as many times as you’d like, just post your guess as a comment below. My wife is disqualified, as is my kindergarten teacher.