Racial and ethnic disparities occur with ADHD

Racial and ethnic disparities concerning the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) appear as early as kindergarten and persist through 8th grade, according to a new study.

After controlling for various time-invariant and time-varying conditions, investigators found that African American, Hispanic, and other racial and ethnic minority children are 69%, 50%, and 46%, respectively, less likely to receive an ADHD diagnosis than white children behaving the same way. And in 5th and 8th grades, all minorities diagnosed with the condition are half as likely or less to take prescription medication for the condition as white children.

The study looked at a large, nationally representative cohort of schoolchildren attending kindergarten through 8th grade.

The researchers also found that boys are twice as likely as girls to be diagnosed with ADHD, and that more frequent externalizing behaviors increase the risk. Other factors that increase the likelihood of diagnosis are having a mother aged older than 38 years, having access to health care, and being raised by English-speaking parents.

Conversely, more frequent learning-related behaviors and greater academic success decrease the likelihood of receiving the diagnosis. Similarly, children living in Western states are less likely to be diagnosed with ADHD than children from the Midwest.

The researchers cautioned that the study was based on parent reports. Whether minority children are underdiagnosed or white children are overdiagnosed remains unclear. Nevertheless, perhaps ADHD screening methods require review for cultural sensitivity.

Reports of how many children in the US have ADHD vary from about 3% to almost 10% of the population.