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NCT05142826

Investigation of Strategies to Reduce the Impact of the Relative Age Effect in Kindergarten

Completed NA Results posted Last updated 19 November 2025
What this trial tests

NA trial testing Relative Age Effect Intervention in Attention Deficit Hyperactivity Disorder in 62 participants. Completed in 1 June 2025.

Timeline
1 June 2022
Primary endpoint
30 November 2024
1 June 2025

Quick facts

Lead sponsorFlorida International University
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposetreatment
Enrollment62
Start date1 June 2022
Primary completion30 November 2024
Estimated completion1 June 2025
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Florida International University

Who can join

Adults 4 to 5, any sex, with Attention Deficit Hyperactivity Disorder. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Disruptive Behavior Disorders Rating Scale Primary · Baseline (Fall), 3 Months (Winter), 6 Months (Spring) and 12 Months (First Grade Follow-up)

Average score for ADHD symptom ratings on the Disruptive Behavior Disorders rating scale Average score ranges from 0.0 to 3.0 with higher scores indicating greater impairment.

Baseline Fall Assessment
GroupValue95% CI
School as Usual.8± .51
Immediate Relative Age Effect Intervention1.12± .8
Delayed Relative Age Effect Intervention1.03± .72
Winter Assessment
GroupValue95% CI
School as Usual1.33± .83
Immediate Relative Age Effect Intervention1.15± .70
Delayed Relative Age Effect Intervention1.28± .85
Spring Assessment
GroupValue95% CI
School as Usual1.34± .91
Immediate Relative Age Effect Intervention1.13± .80
Delayed Relative Age Effect Intervention1.00± .65
First Grade Follow-up
GroupValue95% CI
School as Usual1.19± .58
Immediate Relative Age Effect Intervention1.12± .83
Delayed Relative Age Effect Intervention1.05± 1.03
Impairment Rating Scale Primary · Baseline (Fall), 3 Months (Winter), 6 Months (Spring) and 12 Months (First Grade Follow-up)

ADHD impairment - teacher rating. Average score ranges from 0.0 to 6.0 with higher scores indicating greater impairment.

Fall (Baseline
GroupValue95% CI
School as Usual1.48± 2.01
Immediate Relative Age Effect Intervention2.25± 1.84
Delayed Relative Age Effect Intervention1.84± 1.71
Winter
GroupValue95% CI
School as Usual2.48± 2.15
Immediate Relative Age Effect Intervention2.43± 1.43
Delayed Relative Age Effect Intervention1.7± 1.66
Spring
GroupValue95% CI
School as Usual3.24± 2.30
Immediate Relative Age Effect Intervention2.19± 1.58
Delayed Relative Age Effect Intervention1.57± 1.55
Fall (First Grade Follow-up)
GroupValue95% CI
School as Usual2.22± 2.40
Immediate Relative Age Effect Intervention2.44± 2.06
Delayed Relative Age Effect Intervention1.86± 1.94
Student Behavior Teacher Response Observation Code Primary · Baseline (Fall), 3 Months (Winter), 6 Months (Spring) and 12 Months (First Grade Follow-up)

Number of disruptive behaviors; higher counts equal the presence of more classroom rule violations

Fall (Baseline
GroupValue95% CI
School as Usual5± 4.27
Immediate Relative Age Effect Intervention5.67± 6.2
Delayed Relative Age Effect Intervention7± 6.7
Winter
GroupValue95% CI
School as Usual5.56± 8.12
Immediate Relative Age Effect Intervention5.21± 7.77
Delayed Relative Age Effect Intervention5.75± 4.9
Spring
GroupValue95% CI
School as Usual4.22± 4.02
Immediate Relative Age Effect Intervention4.36± 5.51
Delayed Relative Age Effect Intervention4.17± 3.74
First grade follow-up (Fall)
GroupValue95% CI
School as Usual3± 2.39
Immediate Relative Age Effect Intervention3.88± 3.74
Delayed Relative Age Effect Intervention2.6± 3.53
Academic Performance Rating Scale Primary · Baseline (Fall), 3 Months (Winter), 6 Months (Spring) and 12 Months (First Grade Follow-up)

Teacher rating of academic productivity. Average scores range from 1.0 to 5.0 with lower scores indicating academic underperformance.

Fall (Baseline)
GroupValue95% CI
School as Usual3.51± .83
Immediate Relative Age Effect Intervention3.22± .97
Delayed Relative Age Effect Intervention3.36± .97
Winter
GroupValue95% CI
School as Usual3.17± .55
Immediate Relative Age Effect Intervention3.36± .83
Delayed Relative Age Effect Intervention3.34± .94
Spring
GroupValue95% CI
School as Usual3.15± 1.03
Immediate Relative Age Effect Intervention3.5± .81
Delayed Relative Age Effect Intervention3.49± .84
First Grade Follow-up (Fall)
GroupValue95% CI
School as Usual3.7± .87
Immediate Relative Age Effect Intervention3.49± .8
Delayed Relative Age Effect Intervention3.01± 1.09
Number of Children Who Were Referred to Special Education Secondary · Collected at the end of the kindergarten school year, approximately 10 months from the start of study procedures.

Dichotomous parent rating of yes or no for referral for special education at the end of kindergarten

GroupValue95% CI
School as Usual1
Immediate Relative Age Effect Intervention2
Delayed Relative Age Effect Intervention3
Number of Children Who Were Prescribed Stimulant Medication Secondary · Collected at the end of the kindergarten school year, approximately 10 months from the start of study procedures.

Dichotomous parent rating of yes or no for initiation of stimulant medication at the end of kindergarten

GroupValue95% CI
School as Usual0
Immediate Relative Age Effect Intervention0
Delayed Relative Age Effect Intervention2
Number of Children Who Were Retained in Kindergarten Secondary · Collected at the end of the kindergarten school year, approximately 10 months from the start of study procedures.

Dichotomous parent rating of yes or no for retained in kindergarten at the end of kindergarten

GroupValue95% CI
School as Usual0
Immediate Relative Age Effect Intervention3
Delayed Relative Age Effect Intervention0

Sponsor's own description

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. This situation, termed the "Relative Age Effect"has potentially serious consequences for kindergarten children (e.g., greater likelihood of being prescribed psychoactive medication to control behavior). 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. Anticipated benefits include attenuation of any negative effects for children who receive intervention, and risks include breach of confidentiality and worsening of symptoms initially if an intervention is instituted. The knowledge to be gained is important as it could reduce untoward outcomes for the relatively youngest children in the grade.

Publications & conference data

No peer-reviewed publications indexed yet for this trial. Completed trials usually publish results within 12-18 months.

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Other recruiting trials for Attention Deficit Hyperactivity Disorder

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Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT05142826.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing