Michael Bloch, MD, MS: How astrological signs may be associated with risks for ADHD
December 01, 2020Associate Professor in the Child Study Center; Associate Director, Albert J. Solnit Integrated Training Program, Child Study Center; Co-Director of the Tic and OCD Program, Child Study Center
Information
- ID
- 5936
- To Cite
- DCA Citation Guide
Transcript
- 00:00I am Michael block.
- 00:02I'm associate professor in
- 00:03the Child study center.
- 00:05I was also a resident in the
- 00:08solar Program from 2004 to two,
- 00:102010 and now the associate
- 00:12Program Director of that program.
- 00:14Today I'm going to be trying to
- 00:17convince you that your astrological
- 00:19sign is associated with your
- 00:21risk for ADHD specifically,
- 00:23will be talking bout a meta analysis
- 00:26looking at the risk of 80 HD as
- 00:30a function of your birth date.
- 00:32So this is work that I've done with
- 00:35Jose Flores who's a resident in the
- 00:38adult psychiatry programs also work
- 00:41closely with the Child Study Center
- 00:43through the T 32 and we're going to
- 00:46be talking about ADHD and 80 HD is
- 00:49a child onset psychiatric disorder
- 00:51characterized by both inattention,
- 00:53hyperactivity,
- 00:54and impulsive iti that has
- 00:56an on set priority age,
- 00:5812 years and in affects hidden causes,
- 01:01symptoms in multiple settings.
- 01:03Home, school and or work and
- 01:06causes significant impairments.
- 01:07Also ADHD is quite heritable disorder,
- 01:10so it has a high degree of heritability
- 01:13as compared to other psychiatric
- 01:16disorders similar to autism.
- 01:18Schizophrenia, bipolar disorder.
- 01:20Much higher than depression or anxiety.
- 01:23When you look at a twin studies
- 01:26or molecular data.
- 01:28Also,
- 01:28there's a pretty clear brain
- 01:31signature associated with those CD.
- 01:33That is,
- 01:34with 80HD,
- 01:35that is that ADHD is associated with
- 01:38delayed development of the prefrontal
- 01:40brain regions that are involved in
- 01:43cognitive control processes involved
- 01:45in sustained attention and motor planning.
- 01:50So I'm going to be talking a
- 01:52little bit about my family,
- 01:55so this is a picture of my wife,
- 01:58Angie,
- 01:58and our three kids going from left to right,
- 02:01Sam, Paul, and Rachel.
- 02:03And this is a picture in Paul and Sam's
- 02:07and Rachel's kindergarten room at the
- 02:09Child Care Center at Bodel here at Yale.
- 02:12And Paul will be talking bout now
- 02:15is now bout to turn 8 years old.
- 02:18His birthday pretty soon he plans
- 02:20to have a YouTube channel where
- 02:22he where he plans to be a star.
- 02:25He doesn't know quite what he's
- 02:27gonna do on on his YouTube channel
- 02:29yet but he really likes to race
- 02:32Matchbox cars in my monster trucks.
- 02:34Watch Minecraft videos on YouTube and
- 02:36also really likes unboxing presence,
- 02:38so maybe he's I think he's hoping to
- 02:42have a career in that at this point.
- 02:45So a couple of years ago.
- 02:50Is the scene was very different
- 02:52in this kindergarten classroom,
- 02:53so both Sam and Paul were in kindergarten
- 02:56at Bloedel and I remember when I
- 02:58picked up all one day from kindergarten,
- 03:01he said I'm not as smart
- 03:03as all the other kids.
- 03:05I can't do what what they can do and and
- 03:08actually his experience was probably
- 03:10pretty accurate in that classroom.
- 03:13He was one thing you don't
- 03:15know about Paul and Sam,
- 03:17yet is that their birthday was right at
- 03:20the end of the calendar year in 2012,
- 03:23so they so they were born on December 13th,
- 03:272012.
- 03:27So it did day after 1212.
- 03:29Twelve. That was hoping for and a
- 03:32little before the Mayan Apocalypse,
- 03:34which was twelve 2112 chairs.
- 03:36Also hoping for, but like you don't
- 03:39know and relevant to this potentially
- 03:41is that the cut off date for.
- 03:44Kindergarten and grades in school in
- 03:47Connecticut is actually January 1st,
- 03:49so both Paul and Sam were extremely young
- 03:52for their for their grade in school when
- 03:56they were starting out in kindergarten.
- 03:59And so their experience that they were,
- 04:02you know Paul's experience that he was
- 04:04behind all the other kids may actually
- 04:06be accurate and true at that age Ann.
- 04:09And So what we were really interested
- 04:11in a lot of and similarly a lot of
- 04:14patients that I come across in clinic.
- 04:17They get evaluated for 80 HD and they
- 04:20are often kind of really young for
- 04:22their age for their grade and young.
- 04:25And so the question is,
- 04:26is birthday to actually associated
- 04:28with the risk of.
- 04:30Of being diagnosed,
- 04:31you're treated for ADHD and we
- 04:33actually did a meta analysis.
- 04:35Jose and I involving 14 studies that
- 04:38were actually involved more than 3
- 04:41million children across nine countries.
- 04:43Looking at is there Association
- 04:45between birthdate and risk of ADHD.
- 04:47And is it related to the school cut off date?
- 04:51You know, in schools?
- 04:53And so when you look at risk of
- 04:57ADHD being diagnosed or treated by
- 05:00by birth month in school districts
- 05:03that have a January cut off,
- 05:06you see that there's a.
- 05:08There's an increasing risk of being
- 05:11diagnosed or treated for ADHD.
- 05:13As you get later in the calendar year.
- 05:17So as as when you're younger for your grade,
- 05:21so the largest odds ratios.
- 05:24For risk of 80 HD is in October,
- 05:27not November.
- 05:27The seven December,
- 05:29right before the January cut off,
- 05:31and it's the least in January,
- 05:33February, March,
- 05:34right after the January cut off.
- 05:36And if you look similarly in
- 05:38studies where the cut off for
- 05:40school district is September 1st,
- 05:42you see a very similar trend.
- 05:45I'll be it offset by four months for
- 05:48the different cut off date and then
- 05:50you see the highest risk of ADHD
- 05:53occurring in kids that are born.
- 05:55In August, July,
- 05:57June,
- 05:57right before the that our youngest for their
- 06:01school grade and you see the lowest risk
- 06:04of being diagnosed or treated for ADHD,
- 06:07being right after the school
- 06:10cut off date September October,
- 06:12November, December.
- 06:14And not surprisingly,
- 06:16when you overlay these two possible.
- 06:21Patterns for school cut off dates and
- 06:24you line them based on cut off date.
- 06:27You see a very similar pattern where
- 06:29kids are most likely to be diagnosed
- 06:32with ADHD and have an odds ratio
- 06:35of about 1.2 in the in the month.
- 06:37Birth month right before the school
- 06:39cut off and have the least risk in
- 06:42the month after the school cut off.
- 06:46Furthermore, another way of
- 06:48looking at this is based on your
- 06:51likelihood of being diagnosed with
- 06:53ADHD or being treated for ADHD.
- 06:56If you were born 120 days,
- 06:59so the four months before this school
- 07:02cut off first is 120 days after
- 07:05the school cut off and you see the
- 07:09odds of being diagnosed with ADHD,
- 07:12the odds ratio is about one point 1.38.
- 07:15If you were born in the 120
- 07:18days before the school,
- 07:19cut off rather than 120
- 07:21days after the school,
- 07:23cut off date and so that's associated with.
- 07:26So being younger is associated with a
- 07:30fairly substantial increase risk of ADHD.
- 07:32And if you look at this heat map,
- 07:35which looks at how the odds ratio
- 07:38depends on when you set the the
- 07:40interval time before and after you
- 07:42see that the closer the interval
- 07:44time is to the cut off date,
- 07:47the higher the odds ratio of 80 HD.
- 07:50So if you're born in the 30 days
- 07:52before the school cut off compared
- 07:54to 30 days after the odds ratios
- 07:57approximated to be about 1.5,
- 07:59meaning that you're about 50%,
- 08:01you have about a 50%.
- 08:03Higher likelihood of being
- 08:05diagnosed with ADHD.
- 08:06If you were born in the month
- 08:09before the school cut off date
- 08:12as opposed to the month after.
- 08:15And into the bottom line is hopefully
- 08:18first of all that I convinced you that.
- 08:21Your astral astrological sign is
- 08:24associated with your risk for ADHD,
- 08:26but that the month of your birth is
- 08:30strongly associated with your risk of
- 08:32being diagnosed and treated for ADHD.
- 08:35And this then the relationship is really
- 08:38defined by the school entrance cut
- 08:40off for the particular location you lived in.
- 08:44There's evidence that the affect
- 08:46re creases with increasing age,
- 08:48in that the odds ratio for treatment.
- 08:51But not diagnosis gets less as
- 08:53the kids get older so that this
- 08:56affect someone goes away as kids
- 08:58get further advanced in school.
- 09:00It's also clear that the effect
- 09:02is fairly substantial if you look
- 09:05at the the four months prior,
- 09:06the odds ratio is a little
- 09:09more than 1/3 higher,
- 09:10and if you estimate the month
- 09:12before it's about 50% higher,
- 09:14so this is quite a substantial risk,
- 09:16and I think this has significant
- 09:19implications for first of all,
- 09:20biological studies of children with ADHD.
- 09:23So that the important biological marker
- 09:25may not be your brain development compared
- 09:28to your actual chronological age,
- 09:31but it's what you're expected.
- 09:34Age is supposed to be in school.
- 09:37It also has profound implications for early
- 09:40childhood education and public policy,
- 09:43so Paul's doing great in school
- 09:45now we held both him and Sam back
- 09:49a year before they repeat repeated
- 09:51kindergarten at a different school.
- 09:54But then.
- 09:56That decision is significant
- 09:58financial implications,
- 09:59you know probably cost.
- 10:01I estimated about $36,000.
- 10:03The decision to have the kids stay
- 10:07at home for an extra year.
- 10:10It's actually probably much more
- 10:12than that and and clearly.
- 10:15Kids from more advantage
- 10:17households have more of an ability
- 10:19to delay the start of schooling
- 10:21and that may have significant
- 10:23effects over the long term.
- 10:26It also just emphasizes again the
- 10:28importance of school readiness
- 10:30programs that I was, you know,
- 10:32I was well aware of Paul and Sam being
- 10:35behind before they started kindergarten.
- 10:38This definitely affected how we treated
- 10:40them in school and probably part of
- 10:43the reason why they're doing well.
- 10:46So I wanted to thank you for
- 10:49listening and hope you come to you.