Linguistic Inequities in ADHD Diagnosis among School-age Children Screened for Attention Problems in Primary Care

A Quality Improvement Initiative for Detection of Attention-Deficit/Hyperactivity Disorder in an Urban, Academic Safety Net Hospital

“…Furthermore, we showed that even when screened positive with the PSC-17 in primary care for attention symptoms, children from low English proficiency families were more likely than other children to go without an ADHD diagnosis. 7 Therefore, we conducted an ADHD Detection Quality Improvement initiative in our large, urban, academic, safety-net, hospital-based pediatric primary care practice to improve the detection and evaluation of attentiondeficit/hyperactivity disorder (ADHD) in school-age children. We sought to operationalize and implement a formal two-step process of screening for ADHD with the PSC-17 followed by the Vanderbilt ADHD Diagnostic Rating Scale.…”

“…Furthermore, we showed that even when screened positive with the PSC-17 in primary care for attention symptoms, children from low English proficiency families were more likely than other children to go without an ADHD diagnosis. 7…”

“…At our urban safety net hospital that serves majority publicly insured and racial and ethnic minoritized children, we examined whether universal behavioral health screening was leading to appropriate evaluation for and detection of ADHD or whether changes were indicated. 7 Our practice had successfully implemented universal behavioral health screening with the Pediatric Symptom Checklist (PSC-17); over 80% of school-age children were screened with the PSC-17 at well-child visits. The PSC-17 is a brief, validated screening tool with an attention subscale that has a specificity of above 80% for detection of ADHD across multiple populations and settings.…”