Why Black, Hispanic, and Asian Children Are Less Likely to Receive an ADHD Diagnosis
- The researchers say that black, Hispanic and Asian children are less likely to receive an ADHD diagnosis and treatment for the condition.
- Experts aren’t sure why the disparity exists, but say it’s important to investigate.
- They point out that children with undiagnosed ADHD are less likely to be successful in school and in life in general.
Getting a child diagnosed with attention deficit hyperactivity disorder (ADHD) can be a double-edged sword.
Some parents see the diagnosis as an unwanted label that can stigmatize their child, while others see it as a way to help their child get the resources they need to help them be more successful in school and in life.
That includes access to therapy and medication, specialized learning plans, and even giving parents the opportunity to better understand how to best help their children navigate the systems around them.
But new research suggests there are big gaps in who gets those diagnoses.
Mayo Clinic researchers looked at children born between 2006 and 2012. They found ongoing racial disparities in who receives an ADHD diagnosis and treatment.
Black, Asian and Hispanic children were also less likely to receive treatment for ADHD.
“Compared to other groups, white children were more likely to receive some type of treatment. Asian children were most likely to receive no treatment,” the study authors wrote.
That’s significant, the researchers noted, because people with ADHD have a poorer overall quality of life and higher medical costs.
That’s why clinical guidelines suggest that preschool children with a diagnosis of ADHD receive behavioral therapy as a first-line treatment and then medication starting in elementary school.
Researchers aren’t entirely sure why the disparities exist. It appears to be a mix of explicit and implicit bias among physicians, mistrust of the health system, and reluctance to seek such a diagnosis or treatment.
The Mayo Clinic team acknowledged in their study that because they used information from a national commercial insurance database, their underlying data may not be representative of all children in the United States.
Mayra Mendez, PhD, a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at the Providence Saint John Child and Family Development Center in Santa Monica, California, said the disparities could be explained in part by the fact that that the researchers were looking at populations with private insurance.
“It is possible that the sample of high-income and possibly white populations was inflated, resulting in a smaller pool of racially diverse populations,” he said.
“I am not surprised that research finds that children of color are diagnosed at lower rates than white children, because children of color are often identified as having disruptive behavior problems, conduct problems, opposition/defiance, and deficits in learning before considering explanations based on neurological development. for the challenges,” Méndez said.
“Furthermore, cultural factors strongly influence the identification of behavioral and/or learning challenges, resulting in increased tolerance for behavioral differences in some cultures and over-response in other cultures,” he said.
Dr. Bruce Wexler He is a professor emeritus at Yale University in Connecticut and the founder of C8 Sciences, a company that offers brain training programs to improve ADHD.
For him, fewer children receiving an ADHD diagnosis could be a good thing, considering other facts the study exposed.
The researchers noted that about half of the diagnoses were made by pediatricians, not psychologists, psychiatrists or neurologists, who may have a better idea of available treatment options other than powerful short-term stimulant medications.
“The moment you stop taking [the medications], the profits are gone,” he said.
Wexler said it’s hard to tell if one group is overdiagnosed or another group is underdiagnosed because there’s no benchmark for what ADHD rates should be in any racial or age group.
“We don’t know what the real level is,” he said.
But Wexler said there appear to be differences in some groups, particularly white parents, who are more likely to engage in “permissive parenting” and a “culture of medicalizing problems” rather than accept that their child is different from their peers. the rest.
“Let’s call it a medical problem and get a pill for it,” he said.
It is important to investigate who receives an ADHD diagnosis and who does not, as some research has suggested that behavior now attributed to ADHD was positive in terms of evolution.
Our hunter-gatherer ancestors survived longer if they constantly processed the stimuli around them, as doing so could indicate potential food or predators.
While children are more likely to be diagnosed with ADHD while in school, the modern classroom has not evolved to serve students with these traits.
“Schools are a big factor,” Wexler said. “That’s when they are given demands that they haven’t been asked before.”
That, for people with ADHD, means learning to survive in a new world, one that now includes endless distractions from pocket supercomputers and other gadgets.
Regardless of what an ideal world looks like for a child with ADHD, Mendez said everyone can play a role in closing the disparity gap.
That includes critical stakeholders like psychotherapists, psychiatrists, mental health professionals, teachers, school psychologists, nurses, principals, and behavioral support staff.
Mendez said those stakeholders can address social inequalities for children of color and close the gaps of racial disparities by increasing awareness and information about symptoms associated with ADHD.
They can also recognize cultural differences and increase awareness of different cultural norms regarding development, education, learning, and behavioral expression.
Professionals can also dispel misconceptions and myths about ADHD symptoms and treatment as harmful, harmful, and detrimental to a child, among other things.
“It is also extremely important to make accurate, culturally sensitive and realistic intervention options available to parents as stakeholders who know their children best. Well-informed parents are more likely to weigh options and openly address information,” Mendez said.
“Accurate information provided to parents increases the chances that they will take objective consideration,” he said, “and decreases the defenses that trigger their parenting insecurities.”
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