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 Researchers examined data on almost 4,300 children whose parents
participated in surveys about ADHD symptoms, diagnosis and treatment
when the kids were in fifth, seventh and tenth grades.
When kids had symptoms of ADHD, parents of white kids were more
likely to report that children took medication, researchers report
in Pediatrics.
While the study didn’t explore the reason for the racial disparities
in ADHD treatment, it’s possible that non-white parents had more
difficulty with access or affordability of mental health services or
perceived discrimination that discouraged them from seeking
treatment for their kids, said lead study author Dr. Tumaini Coker,
a pediatrics researcher at the University of California, Los
Angeles.
“Our findings suggest that these disparities are more likely from
under-diagnosis or under-treatment of African-American and Latino
children than over-diagnosis or overtreatment of white children,”
Tumaini said by email.
“It may be that African-American and Latino children are less likely
to report taking a medication for ADHD because they are less likely
to be diagnosed, or have their symptoms recognized, or because when
diagnosed, they are less like to receive or accept a medication for
ADHD,” Tumaini added.
Overall 8 percent of parents reported that their child had symptoms
or a diagnosis of ADHD in fifth grade, with 7 percent of the kids
taking medication at some point that year.
By tenth grade, the parents reported 9 percent of kids had ADHD
symptoms or a diagnosis, and 8 percent had taken drugs.
In that last survey during tenth grade, parents reported symptoms
for 13 percent of African-American children and roughly 9 percent of
white and Latino children. White children were also more likely than
other kids to have a formal ADHD diagnosis.
One limitation of the study is that it relied on parents to
accurately recall and report any symptoms, diagnosis or treatment,
the authors note.
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“This study lacked an objective diagnosis or treatment for ADHD and
more detailed information on prescribed medications and adherence to
treatment protocols, which precludes more definitive support for the
hypothesis that black and Latino youth are undertreated,” Sean
Cleary, a public health researcher at George Washington University
in Washington, D.C. who wasn’t involved in the study, said by email.
Part of the challenge, too, is there’s no simple lab test to
diagnose ADHD, noted Joseph Raiker, a researcher at the Florida
International University Center for Children and Families in Miami.
Instead, doctors rely in part on subjective reports from parents and
teachers to diagnose ADHD in kids, Raiker, who wasn’t involved in
the study, said by email.
“We know that the extent to which individuals present for assessment
and treatment as well these parent and teacher reports can be
impacted by a host of factors such as the use of culturally
insensitive measures and bias in referral patterns for assessment
and treatment,” Raiker said.
“These factors, in turn, impact the extent to which a child is
likely to receive a diagnosis of ADHD or some other disorder such as
an anxiety or mood disorder, which ultimately impacts treatment,” he
said.
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