A new study on the underdiagnosis of attention-deficit/hyperactivity disorder (ADHD) in minority children shows that between Kindergarten and eighth grade, black and Hispanic children are half as likely as their white peers to be diagnosed with ADHD.
Among those diagnosed with ADHD, children who are ethnic or racial minorities are less likely to use prescription medication for the disorder, even when researchers account for factors including health insurance coverage, socio-economic status and academic achievement.
"There's no reason to think that minority children are less likely to have ADHD than white children, so these are worrisome findings that suggest a systemic problem," said Paul Morgan, lead author of the study published in the journal Pediatrics.
Using the nationally representative Early Childhood Longitudinal Study Morgan and colleagues analyzed data collected by the federal government on 17,100 children in the Kindergarten Class of 1998–1999, based on parent reports.
By the spring of middle school, about 7 percent of white children had received an ADHD diagnosis, while 4.4 percent of Hispanic children, 3 percent of black children, and 3.5 percent of children of other minority groups were diagnosed.
Compared with whites, the odds of an ADHD diagnosis was 69 percent lower for black children, 50 percent lower for Hispanic children and 46 percent lower for children of other minorities.
Among children diagnosed, children of all racial and ethnic minorities were less likely to be prescribed medications including Vyvanse, Ritalin and Concerta compared with white children. Prescription medication was used 47 percent less by Hispanic children, 65 percent less by black children and 51 percent less by children of other minorities.
Despite noted skepticism among some minority communities about ADHD diagnosis and their beliefs about its treatment, the authors say the lack of treatment is due to underdiagnosis in the first place.
"Other research has already identified a range of different effective treatments for ADHD, including medication, behavioral therapy, specialized educational programming and parent training," says Morgan, an associate professor of education at Penn State University. "These findings suggest that children who are racial and ethnic minorities are not accessing those treatments because they are comparatively underdiagnosed."
ADHD is the most common mental health condition among kids and teens, and despite their findings, the authors note that further study is needed to determine overdiagnosis among other groups -- possibly boys.
Boys in this study were twice as likely as girls to be diagnosed with ADHD -- regardless of race or ethnicity. Boys who engaged in fighting, bullying and similar problem behaviors had increased odds of diagnosis.