Division of Paediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany.
Department of Child and Adolescence Psychiatry, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Eur Child Adolesc Psychiatry. 2022 Nov;31(11):1753-1764. doi: 10.1007/s00787-021-01813-7. Epub 2021 Jun 5.
Young age at school entry (ASE) is related to attention-deficit/hyperactivity disorder in higher grades. The reason for this association is unclear, but medical oversupply and stress-related factors are discussed. We aimed to investigate whether ASE is associated with reported symptoms of attention-deficit/hyperactivity (ADH) already in first grade. Data of a population-based prospective cohort study (N = 2003; Mainz-Bingen region; Rhineland-Palatinate; Germany) with baseline assessments prior to school entry and two follow-ups during first grade were analysed. ADH symptoms were assessed by parent and teacher versions of the Strengths and Difficulties Questionnaire. Associations between ASE and scores of the hyperactivity/inattention subscale (range 0-10) were investigated by regression analysis and adjusted for potential confounders and baseline symptoms prior to school entry. In total, 1633 children (52% boys, mean ASE 6.5 years) were included. There were no relationships between ASE and parent-reported scores of the hyperactivity/inattention subscale prior to school entry and 3 months thereafter. However, at the end of first grade, ASE was negatively associated with the hyperactivity/inattention subscale in parent (- 0.7 subscale points per year ASE, standard error = 0.16, p < 0.0001) and teacher reports (- 1.2 subscale points per year ASE, standard error = 0.25, p < 0.0001). This ASE effect appeared more pronounced in girls than in boys. Young ASE is related to more reported symptoms of ADH at the end of first grade, but not before. The evolvement of this effect during first grade may be a clue to ASE-related stress factors.
入学年龄较早（ASE）与高年级的注意力缺陷/多动障碍（ADH）有关。这种关联的原因尚不清楚，但讨论了医疗供应过剩和与压力相关的因素。我们旨在研究 ASE 是否与一年级时报告的注意力缺陷/多动（ADH）症状有关。对一项基于人群的前瞻性队列研究（N = 2003；美因茨-宾根地区；莱茵兰-普法尔茨州；德国）的数据进行了分析，该研究在入学前进行了基线评估，并在一年级期间进行了两次随访。ADH 症状通过家长和教师版的《长处与困难问卷》进行评估。通过回归分析研究了 ASE 与多动/注意力不集中分量表（范围 0-10）得分之间的关系，并调整了潜在的混杂因素和入学前的基线症状。共有 1633 名儿童（52%为男孩，平均 ASE 为 6.5 岁）被纳入研究。ASE 与入学前和此后 3 个月的家长报告的多动/注意力不集中分量表得分之间没有关系。然而，在一年级末，ASE 与家长报告的多动/注意力不集中分量表呈负相关（每增加 1 岁 ASE，分数降低 0.7 个分量表点，标准误差=0.16，p<0.0001）和教师报告（每增加 1 岁 ASE，分数降低 1.2 个分量表点，标准误差=0.25，p<0.0001）。这种 ASE 效应在女孩中比在男孩中更为明显。入学年龄较早与一年级末报告的更多 ADH 症状有关，但在入学前则没有。这种效应在一年级期间的演变可能是与 ASE 相关的压力因素的线索。
