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and University of Wisconsin for helpful comments. We are responsible for the remaining shortcomings of the paper. AbstractSeveral previous studies have relied on religious affiliation and the proximity to Catholic schools as exogenous sources of variation for identifying the effect of Catholic schooling on a wide variety of outcomes. Using three separate approaches, we examine the validity of these instrumental variables. We find that none of the candidate instruments is a useful source of identification of the Catholic school effect, at least in currently available data sets. We also investigate the role of exclusion restrictions versus nonlinearity as the source of identification in bivariate probit models. The analysis in the paper may be useful as a template for the assessment of instrumental variables strategies in other applications.

This paper presents evidence that diagnoses of Attention-Deficit/Hyperactivity Disorder (ADHD) are driven largely by subjective comparisons across children in the same grade in school. Roughly 8.4 percent of children born in the month prior to their state’s cutoff date for kindergarten eligibility – who typically become the youngest and most developmentally immature children within a grade – are diagnosed with ADHD, compared to 5.1 percent of children born in the month immediately afterward. A child’s birth date relative to the eligibility cutoff also strongly influences teachers’ assessments of whether the child exhibits ADHD symptoms but is only weakly associated with similarly measured parental assessments, suggesting that many diagnoses may be driven by teachers’ perceptions of poor behavior among the youngest children in a classroom. These perceptions have long-lasting consequences: the youngest children in fifth and eighth grades are nearly twice as likely as their older classmates to regularly use stimulants prescribed to treat ADHD.