Overcoming challenges in the diagnosis and treatment of attention-deficit/hyperactivity disorder in African Americans.

The incidence of ADHD appears to be similar in African Americans and white populations. However, fewer African-American than white children are diagnosed and treated for ADHD. Reasons for this disparity have not been fully elucidated; causes are most likely complex. Whereas certain barriers to treatment are driven by patients and their families, others are due to limitations in the healthcare system. Patient-driven obstacles to care include inadequate knowledge regarding the symptoms, treatment and consequences of untreated ADHD and fear of overdiagnosis and misdiagnosis. A survey conducted to explore cultural differences between African-American and white respondents found that African Americans were more likely than whites to be unfamiliar with ADHD. In addition, African Americans felt that they were diagnosed with ADHD more often than whites and that teachers blamed ADHD for learning or behavior problems more often in African Americans. Health system barriers include a lack of culturally competent healthcare providers, stereotyping/biases and failure of the clinician to evaluate the child in multiple settings before diagnosis. Strategies to overcome these challenges include increased dissemination of ADHD information through community events; improved training of clinicians in cultural competence; and open communication among parents, clinicians and school personnel.