A growing body of research is highlighting wide disparities in the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) in the youth of certain demographics, primarily African-Americans and Latinos. Whereas the understanding of ADHD is riddled with misconceptions in the general population, the problem appears to be more pronounced among ethnic minorities, resulting in lower diagnoses. Child psychiatrists highlight situations where black families are surprised to know and are even reluctant to accept, that their child has ADHD.
Quite often, parents dismiss ADHD as a behavioral problem and believe that kids will overcome it with time. Among the black community, reactions to a child’s ADHD diagnosis are a mix of “mistrust and disbelief.” Most of them feel that doctors are over-diagnosing what is essentially “bad” behavior which can be remedied with physical punishment. Racial prejudices also creep into schools, where African-American children with ADHD are labeled “defiant” or “out-of-control” and not as those suffering from a mental disorder. Such children are often misdiagnosed with conduct disorder or oppositional defiant disorder.
There are wide variations in ADHD estimates among children. The American Psychiatric Association (APA) puts the number at 5 percent whereas the Centers for Disease Control and Prevention (CDC), estimates that nearly 11 percent children/adolescents between 4 and 17 years have been diagnosed with ADHD. Despite these variations, ADHD remains one of the most common neuro-developmental childhood disorders which, if left untreated, can continue into adulthood.
Minority children experience higher symptoms
Past research shows that ADHD diagnoses among African-American, Hispanic and other ethnic minority children were 69 percent, 50 percent and 46 percent, respectively than their white counterparts. Paul L. Morgan, professor of education, director of the Center for Educational Disparities Research at Pennsylvania State University and one of the study’s authors, expresses concerns about ADHD becoming “a condition for wealthy white families.” He adds that although there is a willingness to help children with disabilities, irrespective of their ethnicity, “consistent evidence” shows a higher likelihood of ADHD diagnoses among “white and English-speaking children.
These findings have been further substantiated in an August 2016 study published in Pediatrics, which shows significant disparities between African-American/Latino children and white children with regard to ADHD diagnoses and treatment. A more recent study, published in Pediatrics in May 2017, has found that African-American youth with ADHD had a higher likelihood of giving up their medication and a lower likelihood of adequate medical follow-up than their white peers. The study also found that many parents, dissatisfied with the outcome of medications or worried about their side-effects, forced the children to discontinue their medication.
They rather opt for psychotherapy or alternative treatment approaches for their child’s disorder. While in many cases such treatments are preferred due to their positive impact or to avoid side-effects of medication, fear and misconception lead to avoidance of the right course of treatment in other cases. Due to the stigma surrounding mental illnesses, some parents fear that their children will be given illicit drugs by the doctors.
Undiagnosed ADHD carries significant ramifications
Psychiatrists encourage parents to do proper research to ascertain the best treatment suited to their child’s needs. If children are made to discontinue medications, parents will have to deal with the repercussions too. Experts highlight that reasons for disparities are complex, and remedying them will require a multi-dimensional approach which can take several years to implement. In no case, however, should ADHD symptoms be ignored since under-diagnosis or misdiagnosis can adversely impact areas such as academic performance, relationships and career. It can also lead to the adoption of risky behavior such as substance abuse, and the development of depression and other mental disorders.
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