Abstract

Objective

To evaluate race-based discrepancies in informant ratings and in rates of Attention-Deficit/Hyperactivity Disorder (ADHD) diagnosis among a clinically referred sample of Black and White children.

Method

Demographic information and ratings of inattention, hyperactivity/impulsivity, and conduct were collected from caregivers and teachers as part of neuropsychological evaluations at an outpatient clinic. The final sample included 3,943 children (6-18 years), of which 70% were White and 30% were Black.

Results

Teachers, but not caregivers, endorsed more inattentive symptoms and conduct problems for Black than for White children, irrespective of ADHD diagnostic status and socioeconomic status (SES), and after controlling for child sex, child age, and learning difficulties. Teachers endorsed more hyperactive/impulsive symptoms for Black children with ADHD of lower SES than for White children with these characteristics. Caregivers of Black children of higher SES reported fewer hyperactive/impulsive symptoms than caregivers of White children of higher SES. Despite differences in teachers’ ratings by race, diagnostic rates of ADHD in the context of neuropsychological evaluations were comparable for Black and White children.

Conclusions

Consistent with previous literature, teachers endorsed more ADHD and conduct problems in Black children. Within our clinically referred sample, this may reflect teacher bias rather than actual prevalence differences by rafce, given that Black caregivers endorsed fewer or similar numbers of symptoms relative to White caregivers. This lack of racial disparities in rates of ADHD diagnosis is inconsistent with findings in community- and population-based samples, and reflectspossible benefit of the use of neuropsychological evaluations in diagnostic decision-making for ADHD.

中文翻译：

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种族有什么关系？多动症儿童神经心理学评估中的知情人评分差异

摘要

客观的

评估临床转诊的黑人和白人儿童样本中基于种族的知情人评级和注意力缺陷/多动障碍 (ADHD) 诊断率的差异。

方法

作为门诊神经心理学评估的一部分，从护理人员和教师那里收集了人口统计学信息和注意力不集中、多动/冲动和行为评级。最终样本包括 3,943 名儿童（6-18 岁），其中 70% 为白人，30% 为黑人。

结果

无论多动症诊断状态和社会经济地位（SES）如何，并且在控制了儿童性别、儿童年龄和学习困难后，教师（而非看护者）对黑人儿童的注意力不集中症状和行为问题比白人儿童更容易出现问题。与具有这些特征的白人儿童相比，教师认可的 SES 较低的多动症黑人儿童的多动/冲动症状更多。SES 较高的黑人儿童的照顾者报告的多动/冲动症状少于 SES 较高的白人儿童的照顾者。尽管教师对种族的评价存在差异，但在神经心理学评估的背景下，黑人​​和白人儿童的 ADHD 诊断率相当。

结论

与以前的文献一致，教师认可更多的多动症和黑人儿童的行为问题。在我们的临床参考样本中，这可能反映了教师的偏见，而不是 rafce 的实际患病率差异，因为黑人看护者认可的症状相对于白人看护者更少或相似。ADHD 诊断率缺乏种族差异与社区和人群样本中的发现不一致，并反映了在 ADHD 诊断决策中使用神经心理学评估的可能益处。