Poor diagnosis leaves minorities with ADHD without support
(Ill.) Black and Latino children are underdiagnosed for attention deficit hyperactivity disorder, or ADHD, highlighting the need for schools to increase screening efforts, according to new research.
Researchers at the American Academy of Pediatrics found that children of color were far less likely than their white peers to receive a diagnosis by 10th grade–only 10 percent of African-American and 4 percent of Latino students were diagnosed compared to 19 percent of their white peers.
“Disparities may be more likely related to underdiagnosis and undertreatment of African-American and Latino children as opposed to overdiagnosis or overtreatment of white children,” researchers wrote. “Because the rates of diagnosis and treatment are rising in the general population of US children, a significant need remains to identify and treat African-American and Latino children who have ADHD and avoid a widening of these disparities.”
The rate of diagnosis for ADHD has risen 5 percent each year since 2003, according to the U.S. Centers for Disease Control and Prevention, and as of 2011, approximately 11 percent of children have been diagnosed–totaling 6.4 million.
Prompted by such findings, the U.S. Department of Education called on schools last month to evaluate students early if they begin to show signs of being unfocused and distractible, but also warned against relying on generalizations about the disorder to t to avoid overidentification.
Of the nearly 4,300 families included in the American Academy of Pediatrics’ research, black children were found to show symptoms suggesting ADHD at higher rates across grades 5, 7 and 10–those age groups focused on in the study–and Latino students were equally as likely as white students to have symptoms.
Earlier research suggests the disparity between diagnoses lies, at least in part, in racial bias present in school disciplinary practices. Because ADHD often presents as an inability to stay focused or control one’s own behavior, or as hyperactivity and impulsivity, students may simply be labeled by teachers as disruptive.
Often, it is black and other minority students who are viewed as poorly behaved, rather than showing symptoms of ADHD, according to a separate study released last year from Pennsylvania State University. Based on that research, that sort of assumption contributes to the higher suspension rates at predominantly black schools, as well as the higher numbers of students receiving special education services at predominantly white schools.
“For the same minor levels of misbehaviors–for example, classroom disruptions, talking back–white kids tend to get viewed as having ADHD, or having some sort of behavioral problem, while black kids are viewed as being unruly and unwilling to learn," David Ramey, lead researcher for the Penn. State study, concluded.
Such assumptions can have negative long term effects, such as maintaining the current gaps in academic achievement between white students and minority groups. Additionally, the national spotlight on the school-to-prison pipeline has shown that almost 40 percent of those convicted of crimes as juveniles were students with disabilities–many of who did not receive proper services while in traditional school.
In order to close the gap in diagnosis and treatment of ADHD, researchers for the American Academy of Pediatrics recommend schools reach out to parents to discuss concerns about child behavior and academic performance both at home and in the classroom, and if necessary, link families with community resources that provide mental health education, guidance and services applicable to ADHD.