ADHD in African American Children

Attention Deficit Hyperactivity Disorder is a mental health illness which causes an individual to have behavioral problems such as inattentiveness, hyperactivity, and/or impulsivity. According to the statistical data provided by the Center for Disease Control, as of 2007 there have been approximately 5.4 million children aged 4-17 who have been diagnosed with ADHD.

ADHD is diagnosed through a series of verbal and written tests which are administered to the parents and teachers of the child to get their perspective on the child’s behavior in the past few months. The main goal of these tests is to determine if any behaviors observed in the child by parents or teachers are irregular for the age group of that child.

ADHD can be diagnosed by a pediatrician, psychiatrist or psychologist.

According to the American Psychiatric Association, there isn’t any biological means of screening for ADHD such as blood tests, MRIs, CT-scans, to check for brain abnormalities. Therefore, healthcare providers rely heavily upon the information that parents and teachers give.

There isn’t a lot of research about ADHD in the African American Community; however, based on existing research it is evident that the treatment and diagnosis of ADHD is especially difficult in African American children due to lack of adequate health care services and false perceptions of ADHD in the African American Community.

A 2005 study published in The Journal of the National Medical Association shows that many African American parents were unfamiliar with ADHD. Although the study indicated that 69 percent of African American parents have heard of ADHD, only 36 percent of African American parents actually knew some information about ADHD.

According to Dr. Blanche Benenson, Developmental-Behavioral Pediatrician at The Children’s Hospital at Montefiore, ADHD in the African American Community is “under-diagnosed and under-treated.”

She attributed the under diagnosis and treatment of ADHD in the African American community to a variety of factors such as cultural differences, lack of access to appropriate health care, and issues with health insurance.

“There is belief that ADHD is over-diagnosed in African American communities but in fact the data shows that it is under-diagnosed and under-treated,” says Dr. Benenson.

The same 2005 study shows that many African Americans may have false beliefs about the cause of ADHD and many parents do not believe that their children’s behavior is because of ADHD. Also, the study shows that merely 10 percent of African American parents know that ADHD is not caused by “too much sugar.”

Dr. Gail Mattox, Professor and Chair of Psychiatry at Morehouse School of Medicine, states that there isn’t any scientific evidence which supports sugar being the cause of behavioral problems in children with ADHD.

“..parents come in and they have misinformation, some studies have shown that African American parents may not get their information from health care providers (instead) they are getting information from non-medical providers,” says Dr. Mattox.

A 2009 study published in the Journal of Mental Health Counseling shows that many African American parents are deterred from seeking treatment for their children due to factors such as lack of funds, low expectations of healthcare providers, and not believing that treatment is necessary for their children. In addition, this study shows that many African American parents especially parents living in poverty do not know where to turn to for help for their children.

Various studies show that African American children with ADHD are a lot less likely to be treated with stimulant drugs than Caucasian children.

Dr. Mattox attributes the fact that African American children with ADHD are less likely to be treated with stimulant drugs to different factors such as children not being diagnosed with ADHD, parents’ reluctance to allow children to take medication, and children being misdiagnosed with another mental health disorder which usually isn’t treated with medication.

“Often times because it (ADHD) is undiagnosed they may be over diagnosed with a conduct disorder,” says Dr. Mattox. “…a culturally insensitive clinician may not make the right diagnosis…the symptoms of ADHD may manifest slightly different depending on how the parents provide the history.”

Carla R Knight, 46, a St. Paul, Minnesota resident and mother of a boy with ADHD selected to not allow her five year old son who has been diagnosed with ADHD to receive any medication therapy for his disorder.

“…a lot of kids now a days are medicated,” says Knight.

Because of her son’s inattentiveness and hyperactivity in school due to his ADHD, she is frequently called by her son’s school due to behavioral problems.

Knight stated that she does not receive any special education support services for her child from the school her son attends.

“I don’t know how much education the school system has on dealing with a kid that is not medicated,” says Knight. “I am not ruling out medicating him but I want to know what else is going on with him before I do that.”

Dr. Mattox urges for parents of children with ADHD to learn as much as possible about ADHD.

She also insists that parents make sure that the child has a primary health care provider and the child gets annual check-ups to screen for any physical as well as mental disorders.

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