BMJ  2003;327:1287 (29 November), doi:10.1136/bmj.327.7426.1287

Letter

Child psychiatric disorder and relative age in school year

Peer effects need to be considered

EDITOR—Goodman et al show clearly how small effects at an individual level can create opportunities at the population level for public health interventions.¹ As they say, the differential behaviour of teachers towards slightly younger pupils in the classroom may increase their risk of developing mental health problems. However, there are other players learning their parts in the classroom drama: the older children.

As professionals and adults it is easy for us to neglect the long term impact of early social adversity,² but patterns of bullying and sexual aggression can undermine mental wellbeing in the school age population. At 5, if there are going to be targets for classroom bullying, the younger (smaller, less articulate, less assertive) child may be at greatest risk. At 11 and older, the young people who reach puberty first may show aggression towards their less developed classmates.

Most children do not experience trauma during "the best years of their lives," but for some Lord of the Flies can be closer to their experience of schooldays. When young people do become trapped in harmful social situations, quite subtle differences in age and development might increase the risks. However, this growing knowledge base on child development and life trajectories could also improve our interventions to promote mental health.¹

Department of Public and Family Health, APU, Chelmsford, Essex CM1 1SQ a.w.caan{at}apu.ac.uk

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Competing interests: WC is chair of the school health research group, 2001-3.

References

1. Goodman R, Gledhill J, Ford T. Child psychiatric disorder and relative age within school year: cross sectional survey of large population sample. BMJ 2003;327: 472-5. (31 August.)[Abstract/Free Full Text]
2. Caan W. Good for mental health—an academy for the social sciences. J Mental Health 2000;9: 117-9.

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Relevant Article

Child psychiatric disorder and relative age within school year: cross sectional survey of large population sample

Robert Goodman, Julia Gledhill, and Tamsin Ford
BMJ 2003 327: 472. [Abstract] [Full Text] [PDF]