Functional Impairment in Latino Children with ADHD: Implications for Culturally Appropriate Conceptualization and Measurement

Abstract

Conceptualizing and measuring functional impairment related to childhood ADHD, particularly within the rapidly growing, yet underserved, Latino population, is an important area of research that is in its infancy in the field of psychology. The functional impairments related to academic achievement, social competence, and familial relations experienced by children with ADHD lead to long-lasting and debilitating difficulties that adversely affect the individuals themselves, their families, and society. In addition, limited available research suggests that Latino children are at a great or greater risk for developing ADHD, although they are much less likely to be identified by their parents as displaying problematic behavior and subsequently are less likely to receive proper assessment and treatment due to several practical and cultural factors. Fortunately, initial evidence suggests that the construct of functional impairment may be a more universal notion than the potentially culturally biased measurement of symptomatology. Therefore, in order to provide the best possible outcomes for all children with ADHD, research needs to be expanded to include examination of functional impairment related to ADHD, particularly when working with Latino children and their families. Thus, the primary aim of the current review is to examine and critique how the field of psychology has understood and measured functional impairment in school-aged Latino children with ADHD to date. Based on information reviewed, suggestions for moving toward a culturally modified assessment of functional impairment related to ADHD in Latino children will be proposed. This work is a necessary step toward providing culturally appropriate services for a currently underserved, yet rapidly growing, Latino population in our country.

Turkish validity and reliability study of the Weiss Functional Impairment Rating Scale-Parent Report

“…The FI experienced by patients with ADHD in school, social abilities, and family relationships negatively affect patients, their families, and the community (Haack and Gerdes 2011).…”

“…Assessing an individual's functioning is critical in differentiating the disorder from a temporary or small problem, designing a treatment plan for the patient, identifying treatment targets, and estimating future adaptive functions and prognosis (Haack and Gerdes 2011).…”

“…The lack of a comprehensive and practical functional impairment scale for ADHD makes it difficult to assess not only ADHD but also appropriate treatments (Haack and Gerdes 2011). Although general functional impairment scales, which evaluate functional impairment, are used all over the world, in Turkey, few scales that evaluate disease-related functional impairment are available.…”

Culturally Appropriate Assessment of Functional Impairment in Diverse Children: Validation of the ADHD-FX Scale With an At-Risk Community Sample

“…Despite the seemingly universal prevalence of the disorder, rates in ADHD diagnoses and treatment vary widely across ethnic and cultural groups (Bloom, Jones, & Freeman, 2013; Stevens, Harman, & Kelleher, 2005). Certain populations, such as Latino youth, appear especially vulnerable to under-identification and under-diagnosis of ADHD (Bloom et al, 2013; Haack & Gerdes, 2011; Rothe, 2005; Stevens et al, 2005). Experts posit that this disparity likely is the result of cross-cultural problem recognition and response-style differences rather than true etiological differences, especially when ADHD assessments are based on symptom rating scales only (Haack & Gerdes, 2011; Willcutt, 2012).…”

Racial/Ethnic Differences in the Prevalence of Anxiety Using the Vanderbilt ADHD Scale in a Diverse Community Outpatient Setting

“…20,50–54 However, our findings is supported by work done by others 55,56 who suggest that, among Latino families, examination of functional impairment from disruptive behaviors, rather than symptomatology alone, is an important part of a larger cultural appropriate assessment. 57 Moreover, when Hispanic youth screen positive for anxiety, it is usually a result of more somatic symptoms 51,58–60 and higher anxiety symptom sensitivity. 61,62 Authors have hypothesized that this may be due to greater cultural acknowledgement of somatic symptoms as opposed to mental health problems.…”