Identifying, Evaluating, Diagnosing, and Treating ADHD in Minority Youth

Hervey-Jumper, Heather; Douyon, Karl; Falcone, Tatiana; Franco, Kathleen

doi:10.1177/1087054707311054

Cited by 23 publications

(18 citation statements)

References 41 publications

(47 reference statements)

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“…Cultural factors may also result in some minority groups attributing their children's perceived lower academic behavioral functioning to systemic prejudice or other non-biological explanations (Danesco, 1997; Yeh, Forness, Ho, McCabe, & Hough, 2004; Yeh, Hough, McCabe, Lau, & Garland, 2004). The stigma associated with disability identification may further reduce a racial, ethnic, or language minority family's willingness to have their child identified as disabled (Hervey-Jumper, Dougan, & Franco, 2008; O'Hara, 2003; Zuckerman et al, 2014), particularly for conditions considered highly stigmatizing (e.g., intellectually disabled). Minority families may experience fewer interactions with pediatricians and other health professionals who often diagnose disorders (e.g., autism) during early childhood (Palfrey, Singer, Walker, & Butler, 1987).…”

Section: Contradictory Explanations and Evidence Of Minority Dispropomentioning

confidence: 99%

Minorities Are Disproportionately Underrepresented in Special Education

Morgan

Farkas

Hillemeier

et al. 2015

Educational Researcher

302

315

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We investigated whether and to what extent minority children attending elementary and middle schools in the U.S. are over- or under-identified as disabled and so disproportionately represented in special education. To address existing limitations in the field's knowledge base, we (a) analyzed multi-year longitudinal data, (b) used hazard modeling to estimate over-time dynamics of disability identification across five specific conditions, and (c) extensively corrected for child-, family-, and school-level potential confounding variables (e.g., child-level academic achievement and behavior, family-level socioeconomic status, school-level state location). Despite long-standing and on-going federal legislative and policy efforts to reduce minority over-representation in special education, our analyses indicated that this has not been occurring in the U.S. Instead, minority children are less likely than otherwise similar White, English-speaking children to be identified as disabled and so receive special education services. From kindergarten entry to at least the end of middle school, racial and ethnic minority children are less likely than otherwise similar White children to be identified as having (a) learning disabilities, (b) speech or language impairments, (c) intellectual disabilities, (d) health impairments, or (d) emotional disturbances. Language minority children are less likely to be identified as having (a) specific learning disabilities or (b) speech or language impairments.

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Section: Contradictory Explanations and Evidence Of Minority Dispropomentioning

confidence: 99%

Minorities Are Disproportionately Underrepresented in Special Education

Morgan

Farkas

Hillemeier

et al. 2015

Educational Researcher

302

315

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“…Minority parents are often found to have a higher threshold for concern or distress about certain behaviors (Weisz and Weiss 1991), to be less likely to medicalize behavioral problems (Arcia and Fernandez 2003;Leslie et al 2007;McKay and Bannon 2004), and more reluctant than Caucasian parents to seek MH treatment for their children (Bussing et al 2003(Bussing et al , 2005Cauce et al 2002;dosReis et al 2007;Ho et al 2007;McMiller and Weisz 1996). Cross-cultural differences in problem recognition or in help-seeking are often explained as related to minorities' greater distrust of labels and social services and/or lack of culturally competent services (Breland-Noble 2004;Forehand and Kotchick 1996;Hervey-Jumper et al 2008;Lambert et al 2001).…”

Section: Factors Related To Parents' Problem Conceptualizationmentioning

confidence: 99%

Parents’ Conceptualization of Adolescents’ Mental Health Problems: Who Adopts a Psychiatric Perspective and Does It Make a Difference?

Moses

2009

Community Ment Health J

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How parents give meaning to the problems of adolescents diagnosed with mental disorders and receiving treatment is likely related to important outcomes including parental well-being and commitment to treatment, as well as their own behaviors and reactions to their child. The aim of this cross-sectional, mixed-method study of 70 parents of adolescents receiving wraparound mental health services is to examine: (1) how parents conceptualize their child's MH problems; (2) factors related to parents' conceptualization of youths' problems using medical model terms; and (3) associations between parents' problem conceptualization and their emotional or coping responses to their child having psychiatric problem(s). Content analysis indicated that 54.3% of parents definitively conceptualized adolescents' problems using psychiatric terms, 37.1% reported uncertainty about the nature of their child's problems, and 8.6% gave alternative, non-psychiatric explanations for their child's problems. We found significant relationships between parents' problem conceptualization and their attitudes and experience with MH treatment, demographics, as well as with adolescents' clinical characteristics. Parents who conceptualized problems using psychiatric terminology were more likely to express sadness and pessimism relative to other parents, though there were no differences in expressions of worry, guilt, pragmatism and optimism by problem conceptualization.

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“…15 Additional hypothesized mechanisms include a lower likelihood of referral by school professionals, limited ability to pay for health care, and negative attitudes toward disability identification and treatment in some racial/ethnic subcultures. 16,17 Research investigating ADHD diagnosis and treatment has typically used crosssectional designs or convenience samples 2, 18 or focused on limited time frames. 7 The onset and over-time dynamics of racial/ethnic disparities in ADHD diagnosis throughout early and middle childhood are unknown.…”

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confidence: 99%

Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

Morgan¹,

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Minority children are less likely than white children to be diagnosed and treated with attentiondeficit/hyperactivity disorder. However, diagnosis patterns over time in early and middle childhood and whether confounding factors explain these disparities are not currently well understood.WHAT THIS STUDY ADDS: Racial/ethnic disparities in attentiondeficit/hyperactivity disorder diagnosis occur by kindergarten and continue until eighth grade. Racial/ethnic disparities among diagnosed children in medication use occur in both fifth and eighth grades. These disparities are not attributable to confounding factors. abstract OBJECTIVE: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur across early and middle childhood is currently unknown. We examined the over-time dynamics of race/ethnic disparities in diagnosis from kindergarten to eighth grade and disparities in treatment in fifth and eighth grade. METHODS: Analyses of the nationally representative Early ChildhoodLongitudinal Study, Kindergarten Class of 1998-1999 (N = 17 100) using discrete-time hazard modeling.RESULTS: Minority children were less likely than white children to receive an ADHD diagnosis. With time-invariant and -varying confounding factors statistically controlled the odds of ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were 69% (95% confidence interval [CI]: 60%-76%), 50% (95% CI: 34%-62%), and 46% (95% CI: 26%-61%) lower, respectively, than for whites. Factors increasing children' s risk of an ADHD diagnosis included being a boy, being raised by an older mother, being raised in an English-speaking household, and engaging in externalizing problem behaviors. Factors decreasing children' s risk of an ADHD diagnosis included engaging in learning-related behaviors (eg, being attentive), displaying greater academic achievement, and not having health insurance. Among children diagnosed with ADHD, racial/ethnic minorities were less likely than whites to be taking prescription medication for the disorder.CONCLUSIONS: Racial/ethnic disparities in ADHD diagnosis occur by kindergarten and continue until at least the end of eighth grade. Measured confounding factors do not explain racial/ethnic disparities in ADHD diagnosis and treatment. Culturally sensitive monitoring should be intensified to ensure that all children are appropriately screened, diagnosed, and treated for ADHD. Pediatrics 2013;132:85-93

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Identifying, Evaluating, Diagnosing, and Treating ADHD in Minority Youth

Abstract: Quality evaluation by a competent provider, careful choice of assessment tools, clear communication with parents, and close follow-up of progress are all needed.

Cited by 23 publications

References 41 publications

Minorities Are Disproportionately Underrepresented in Special Education

Minorities Are Disproportionately Underrepresented in Special Education

Parents’ Conceptualization of Adolescents’ Mental Health Problems: Who Adopts a Psychiatric Perspective and Does It Make a Difference?

Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

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