African-American and Latino children don't take as much medication for ADHD, and the American Academy of Pediatrics just published a study that tries to figure out why. Could it be that white children are getting overdiagnosed and overtreated for the disorder? Or is the problem one of underdiagonsis and undertreatment in non-white communities?
It's a nuanced question, and one that required both time and a large pool of subjects to study. Accordingly, the research team talked to parents and caregivers at 118 schools across the nation over a span of several years. Parents filled out questionnaires—which are certainly not a perfect research tool, but the best one at hand— when their children were in fifth, seventh, and 10th grades.
What they found was this: "In fifth and 10th grades, white children were much more likely to have received a diagnosis of ADHD (16 percent in fifth grade and 19 percent in 10th grade) than African-American children (9 percent and 10 percent, respectively), Latino children (4 percent at both grade levels), and children of other race/ethnicity (10 percent at both grade levels). Among kids with an ADHD diagnosis or symptoms, African-American children had lower odds of medication use across all three grade levels, and Latino children had lower odds at fifth and 10th grades.
The reasons are complex—they could be cultural, economic, and/or personal—and they're outside the scope of this study. But the researchers hope their findings will improve care in order to close this gap in diagnosis and treatment.
They concluded their published findings with tangible ideas for improvement: [we should be] "actively and universally eliciting parental concerns about child behavior and academic performance (at home and school) at well-visits, providing care that is culturally relevant in families' preferred languages, and linking with community resources to provide mental health education, guidance, and services to families (eg, parent training courses for parents of children with ADHD)."