Development of strategies to reduce the impact of the relative age effect on kindergarteners with ADHD

项目总结 注意力缺陷/多动障碍(ADHD)是一种慢性疾病，从儿童早期就开始出现， 这在整个生命过程中都会持续。现在有明确的证据表明，进入幼儿园的孩子， 对于该年级来说相对年轻(例如，在入学截止日期之前的几个月出生) 接受ADHD诊断和服用兴奋剂药物的风险要大得多。这些 当其他解释变量被控制时，风险似乎只与进入年龄有关(Elder，2010)。 这种情况，在本文献中被称为“相对年龄效应”，可能会对 幼儿园儿童(例如，更有可能被开出精神活性药物以控制行为； 长辈，2010)。 目前的建议旨在发展一种教师干预，以减轻相对年龄的影响。 对幼儿ADHD症状升高的影响，并检验两者之间的对应关系 与ADHD相关的假想机制和治疗结果(例如，症状、损害)。跟随 干预发展和细化，60名儿童秋季入园，低年级， 将被随机分配到(1)幼儿园照常(KAU)；(2)相对年龄效应预防干预 立即实施；或(3)年中实施的相对年龄效应预防干预。在 干预小组中，教师会被介绍到相对年龄效应，如何获得锚定信息 在发展规范中进行行为评级，并实施积极的行为支持以支持儿童的成长 这个孩子跨越了幼儿园的学年。 主要目标也将是证明干预方法的可行性和可接受性。 作为团队在纵向试验中留住幼儿的能力。此外，假设的机制 (例如，改善神经认知功能；改善教师对积极行为支持的使用) 测量并符合假设结果(例如，ADHD症状和损害减少) 将会被评估。收集的数据将被用来证明更大规模的基于疗效的试验是合理的，以支持积极的 在这一关键的发展转型期间，儿童多动症儿童的发展。

PROJECT SUMMARY Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition, present from early childhood, which persists throughout the lifecourse. There is now clear evidence that children entering kindergarten, that are relatively young for the grade (e.g., born in the months immediately preceding the school entry cut-off) are at significantly more risk for receiving an ADHD diagnosis and being prescribed stimulant medication. These risks appear to be related solely to age of entry when other explanatory variables are controlled (Elder, 2010). This situation, termed the “Relative Age Effect” in this literature has potentially serious consequences for kindergarten children (e.g., greater likelihood of being prescribed psychoactive medication to control behavior; Elder, 2010). The present proposal aims to develop a teacher intervention to attenuate the impact of the relative age effect on young kindergarteners with elevated ADHD symptoms, and test the correspondence between the hypothesized mechanisms and treatment outcomes related to ADHD (e.g., symptoms, impairment). Following intervention development and refinement, 60 children entering kindergarten in the fall, and young for the grade, will be randomly assigned to (1) Kindergarten as Usual (KAU); (2) a Relative Age Effect prevention intervention administered immediately; or (3) a Relative Age Effect prevention intervention administered mid-year. In the intervention groups, teachers will be introduced to the relative age effect, receive information on how to anchor behavioral ratings in developmental norms, and implement a positive behavioral support to support growth in the child across the kindergarten school year. Primary aims will be to demonstrate the feasibility and acceptability of the intervention approach as well as the ability of the team to retain young children in a longitudinal trial. Further, the hypothesized mechanisms (e.g., improved neurocognitive functioning; improved teacher use of positive behavioral supports) will be measured and correspondence to hypothesized outcomes (e.g., reduced ADHD symptoms and impairment) will be evaluated. Data collected will be used to justify a larger efficacy-based trial to support the positive development of children with ADHD during this critical developmental transition.