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The Youngest Get the Pill: ADHD Misdiagnosis and the Production of Education in Germany

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  • Schwandt, Hannes

    (Northwestern University)

  • Wuppermann, Amelie

    (Martin-Luther University, Halle-Wittenberg)

Abstract

Attention Deficit/Hyperactivity Disorder (ADHD) is a leading diagnosed health condition among children in many developed countries but the causes underlying these high levels of ADHD remain highly controversial. Recent research for the U.S., Canada and some European countries shows that children who enter school relatively young have higher ADHD rates than their older peers, suggesting that ADHD may be misdiagnosed in the younger children due to their relative immaturity. Using rich administrative health insurance claims data from Germany we study the effects of relative school entry age on ADHD risk in Europe's largest country and relate the effects for Germany to the international evidence. We further analyze different mechanisms that may drive these effects, focusing on physician supply side and demand side factors stemming from the production of education. We find robust evidence for school-entry age related misdiagnosis of ADHD in Germany. Within Germany and internationally, a higher share of misdiagnoses are related to a higher overall ADHD level, suggesting that misdiagnoses may be a driving factor of high ADHD levels. Furthermore, the effects in Germany seem to be driven by teachers and parents in an attempt to facilitate and improve the production of education.

Suggested Citation

  • Schwandt, Hannes & Wuppermann, Amelie, 2015. "The Youngest Get the Pill: ADHD Misdiagnosis and the Production of Education in Germany," IZA Discussion Papers 9368, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp9368
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    References listed on IDEAS

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    1. Moses, Tally, 2010. "Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders," Social Science & Medicine, Elsevier, vol. 70(7), pages 985-993, April.
    2. Currie, Janet & Stabile, Mark & Jones, Lauren, 2014. "Do stimulant medications improve educational and behavioral outcomes for children with ADHD?," Journal of Health Economics, Elsevier, vol. 37(C), pages 58-69.
    3. Andrea M. Mühlenweg & Patrick A. Puhani, 2010. "The Evolution of the School-Entry Age Effect in a School Tracking System," Journal of Human Resources, University of Wisconsin Press, vol. 45(2).
    4. Schwandt, Hannes, 2017. "The Lasting Legacy of Seasonal Influenza: In-Utero Exposure and Labor Market Outcomes," IZA Discussion Papers 10589, Institute of Labor Economics (IZA).
    5. Elder, Todd E., 2010. "The importance of relative standards in ADHD diagnoses: Evidence based on exact birth dates," Journal of Health Economics, Elsevier, vol. 29(5), pages 641-656, September.
    6. Hendrik Jürges & Kerstin Schneider, 2011. "Why Young Boys Stumble: Early Tracking, Age and Gender Bias in the German School System," German Economic Review, Verein für Socialpolitik, vol. 12(4), pages 371-394, November.
    7. Kelly Bedard & Elizabeth Dhuey, 2006. "The Persistence of Early Childhood Maturity: International Evidence of Long-Run Age Effects," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 121(4), pages 1437-1472.
    8. Anna Aizer, 2008. "Peer Effects and Human Capital Accumulation: the Externalities of ADD," NBER Working Papers 14354, National Bureau of Economic Research, Inc.
    9. Evans, William N. & Morrill, Melinda S. & Parente, Stephen T., 2010. "Measuring inappropriate medical diagnosis and treatment in survey data: The case of ADHD among school-age children," Journal of Health Economics, Elsevier, vol. 29(5), pages 657-673, September.
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    Cited by:

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    2. Chorniy, Anna, 2016. "Sex, Drugs, and ADHD: The Effects of ADHD Pharmacological Treatment on Teens' Risky Behaviors," VfS Annual Conference 2016 (Augsburg): Demographic Change 145766, Verein für Socialpolitik / German Economic Association.
    3. Schwandt, Hannes, 2017. "The Lasting Legacy of Seasonal Influenza: In-Utero Exposure and Labor Market Outcomes," IZA Discussion Papers 10589, Institute of Labor Economics (IZA).
    4. Marie Connolly & Catherine Haeck, 2018. "Le lien entre la taille des classes et les compétences cognitives et non cognitives," CIRANO Project Reports 2018rp-18, CIRANO.
    5. Michael Bailey & Drew M. Johnston & Martin Koenen & Theresa Kuchler & Dominic Russel & Johannes Stroebel, 2022. "The Social Integration of International Migrants: Evidence from the Networks of Syrians in Germany," NBER Working Papers 29925, National Bureau of Economic Research, Inc.
    6. Marcus, Jan & Reif, Simon & Wuppermann, Amélie & Rouche, Amélie, 2020. "Increased instruction time and stress-related health problems among school children," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 70.
    7. Chorniy, Anna & Kitashima, Leah, 2016. "Sex, drugs, and ADHD: The effects of ADHD pharmacological treatment on teens' risky behaviors," Labour Economics, Elsevier, vol. 43(C), pages 87-105.

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    More about this item

    Keywords

    education; misdiagnosis; ADHD; age cutoff;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I2 - Health, Education, and Welfare - - Education
    • J1 - Labor and Demographic Economics - - Demographic Economics

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