Barriers to detection, help-seeking, and service use for children with ADHD symptoms

Nigg

Clinical Psychology Review

2009

133

121

Samuel et al. [Samuel, V. J., Curtis, S., Thornell, A., George, P., Taylor, A., Brome, D. R., et al. (1997). The unexplored void of ADHD and African-American research: A review of the literature. Journal of Attention Disorders, 1(4), 197–207.] reviewed the literature on Attention Deficit Hyperactivity Disorder (ADHD) in African Americans, and found a paucity of research. The present review of 73 articles updates this assessment of available research and presents the current understanding of ADHD symptoms, assessment, diagnosis, and treatment in African American children ages 3–18. The authors conducted a qualitative review, as well as a mini meta-analysis of 5 studies of ADHD symptoms and 5 studies of ADHD diagnosis to clarify the question of racial differences in prevalence. African American youth had more ADHD symptoms (Cohen's d = 0.45, p<.001), yet were diagnosed with ADHD only two-thirds as often as Caucasian youth (OR = .66, p<.001). This pattern was not explained by teacher rating bias or by SES, but may be influenced by parent beliefs about ADHD, higher rates of risk, and lack of treatment access and utilization. Lower treatment rates may be related to high rates of classroom behavior problems among African American youth. Findings also suggest that existing assessment tools may not adequately capture ADHD manifestation in African Americans. Findings highlight the need for more investigation and awareness of relevant cultural issues to inform a culturally competent approach to assessment, diagnosis, and treatment of ADHD in African Americans.

Section: Resultsmentioning

confidence: 99%

Attention deficit hyperactivity disorder in African American children: What can be concluded from the past ten years?

Nigg

Clinical Psychology Review

2009

133

121

“…Bussing and colleagues 43 discuss the reasons that parents seek out services for their child’s behavior as multilayered, involving (1) the degree to which the behavior is problematic, (2) the origin of the behavior, and (3) whether or not the behavior is temporary. For example, a parent who does not view their child’s behavior as a problem, who attributes the onset of behavioral difficulties to TBI, or who views these behaviors as temporary even years post injury, may be less likely to seek formal services for their child 54–56 . Along these lines, as the number of need areas increase the rate of unmet need decreased.…”

Section: Discussionmentioning

confidence: 99%

Do Children Who Sustain Traumatic Brain Injury in Early Childhood Need and Receive Academic Services 7 Years After Injury?

Kingery

Narad

Taylor

et al. 2017

J Dev Behav Pediatr

Objective Examine the prevalence of academic need, academic service utilization, and unmet need as well as factors associated with academic service utilization 6.8 years after traumatic brain injury (TBI) in early childhood. Method 58 (16 severe, 42 moderate) children with TBI and 72 children with orthopedic injury (OI) completed the long-term follow-up 6.8 years after injury in early childhood (ages 3–7 years). Injury group differences in rates of need for academic services, academic service utilization, and unmet need as well as factors associated with service utilization and unmet need were examined. Results Students with TBI (both moderate and severe) had significantly greater rates of need than those with OI. A greater proportion of the severe TBI sample were receiving academic services at long-term follow-up than other injury groups; however, among those with an identified need, injury group did not affect academic service utilization. Below average IQ/Achievement scores was the only area of need predictive of academic service utilization. Rate of unmet need was high across injury groups (46.2%–63.0%); with rates in the moderate TBI group greater than the OI group (although similar to the severe TBI group). Conclusion There is a high need for academic services among patients with a history of TBI during the preschool years 6.8 years post injury. Findings underscore the importance of continued monitoring of behaviors and academic performance in students with a history of early childhood TBI. This may be especially true among children with less severe injuries who are at risk for being underserved.

Journal of Developmental &Amp; Behavioral Pediatrics

“…26-28 Themes describing normalization and denial of ASD symptoms are also consistent with recent qualitative work with parents of children with ASD, 8 as well as other studies showing normalization of other mental health problems in Latino and other minority communities. 23,29 .…”

Section: Discussionmentioning

confidence: 99%

Conceptualization of Autism in the Latino Community and its Relationship With Early Diagnosis

Zuckerman

Sinche

Cobian

et al. 2014

Objective Early identification of autism spectrum disorders (ASD) has been linked to improved long-term developmental outcomes. However, Latino children are diagnosed later than white non-Latino children. We aimed to qualitatively assess the understanding and conceptualization of ASD in the Latino community in order to understand potential community barriers to early diagnosis. Method We conducted 5 focus groups and 4 qualitative interviews with 30 parents of typically-developing Latino children in Oregon. Participants were asked structured questions concerning video vignettes that follow a Latina mother from the time she begins to worry about her 3-year-old son's behaviors to the time he receives an ASD diagnosis. Focus groups and interviews were audio-recorded, transcribed and independently coded. Coded data were analyzed using thematic analysis. Results Many Latino families in the study had not heard of ASD or had little information about it. Families sometimes assumed ASD red flags were normal or could be attributed to family dysfunction. Families also had concerns about provider communication and access to language services. Having a child with a developmental delay was associated with embarrassment, rejection, and family burden, making it difficult for parents to raise developmental concerns with providers. Conclusion Pediatric providers should not assume that Latino parents have heard of ASD or know its symptoms. Providers should be aware that parents may be reluctant to mention concerns due to cultural factors. The health care system needs to improve resources for Latino parents with limited English proficiency. Policies should encourage the use of developmental screening in primary care.