Are Black parents in denial about ADHD?

It’s difficult to accurately determine how many school-aged children suffer from attention-deficit/hyperactivity disorder [ADHD] but according to a recent report from the Centers for Disease Control and Prevention [CDC], the U.S. has experienced a 21.8 percent rise in a four-year period. That translates to 5.4 million children aged 4 to 17 diagnosed with the neurological disorder. And while it typically begins in childhood, it is estimated that half of those children will continue to be impacted by ADHD as adults.

States like Florida with large multicultural student bodies face even more challenges because based on CDC statistics, the “magnitude of increase [of parent-reported ADHD] was largest among older teens, multiracial and Hispanic children and children with a primary language other than English.”

According to the National Institute of Mental Health [NIMH], symptoms often appear between the ages of 3 and 6 but can be hard to recognize and easily overlooked.

“For example, silly or erratic behavior can be dismissed as adorable toddler antics,” says a recent NIMH report. “Once a child begins school, teachers may detect symptoms that include: trouble following class rules; sitting still; waiting turns; following instructions; or frequently ‘spacing out’ in the classroom or on the playground. Parents sometimes are the first to notice that their child is not succeeding in school or is having difficulty interacting socially with others.

 

What do the numbers look like in M-DC?

“It’s hard to give exact numbers because some children don’t carry the name or diagnosis of ADHD while others with ADHD may be in a program that doesn’t sort them out from other children,” said Dr. Terry Vaccaro, Miami-Dade County Public Schools [M-DCPS] executive director for exceptional student education. “I would say that those students with accommodation plans [specialized methods of helping students with ADHD learn better and handle their illness] is about 4 or 5 percent of our total student population [350K].”

However, Vaccaro points out that because ADHD is a dimensional disorder, meaning it can range from very mild to highly severe, some students continue along with school without ever being properly diagnosed.

“If a child has other strengths and without the proper evaluation, one could easily overlook them,” she added. “But the income of a student’s family does sway heavily in terms of what happens after a student is diagnosed. We are seeing kids from more affluent backgrounds often being over-diagnosed while children of color or those from lower-income families are being under-diagnosed.”

Does race make a different?

Ava Goldman, M-DCPS administrative director for exceptional student education and student support, attributes the differences in over- and under-diagnosing children to “cultural differences.”

“Across the board when there is any labeling of students we have seen that there is significant difference in terms of the level of acceptance by parents or guardians based on their cultural background,” she said. “This phenomenon has been documented in the research and we are aware that it comes with the territory. It can be something much more severe than just a little boy with the wiggles. That’s why it’s vital that parents and teachers communicate with one another, be aware of each child’s behavior and seek an accurate diagnosis. Some children may need a specific accommodation plan — others may need a behavior plan as well. But parents are key in the process to helping their child.”

Patricia Bryant, 52, is a 30-year veteran with M-DCPS where she is a counselor. She is also the mother of a recent high school graduate that was challenged with a learning disability [not ADHD].

“I have worked primarily among Black and Caribbean children and have found it difficult to get parents on board,” she said. “They are very engaged in the myth that children who take medication become like zombies. They are concerned that others will think their child is mentally ill. For some, the solution is to spank the child — especially boys — in order to ‘fix’ the problem. Of course, that doesn’t do it. In workshops I’ve attended, it seems that in culturally mixed settings, more white children are medicated. People of African descent tend to believe that the education system is not friendly towards Blacks and so they tend to blame the school and the teachers for their child’s learning problems.”

Does treatment help? Bryant gives a resounding yes.

“I have seen kids go from Cs to As when medicated and undergoing therapy,” she said. “But the school cannot mandate medication. Too often parents know there is a problem but they refuse to act or get help until the FCAT scores come in for their third graders. There’s so much we can do to help children including giving them more time to take tests or even putting them in a different environment to reduce distractions. But parents must realize that therapy is part of the solution — that means someone will have to devote time to taking their child to a psychologist and helping their child follow a strict routine. Sadly, many Black parents tell me they are working two jobs or raising the child alone and can’t find the time. But somehow, they have to.”

 The history of ADHD

While ADHD wasn’t always recognized, diagnosed or treated as much as it is now, doctors have known about it for some time. It is believed that some famous historical figures, including Mozart, Da Vinci and Ben Franklin suffered some form of it. In 1902, Sir George Frederick Still first described children with ADHD symptoms as having “a defect of moral control.” In the mid-1960s, the NIMH began awarding grants to researchers to study the effectiveness of stimulants for children with ADHD symptoms. Ritalin became the drug of choice for “emotionally disturbed children” in 1963 but faced an anti-Ritalin movement in the the mid-1970s. Most notably, Section 504 of the Rehabilitation Act of 1973 allowed for students with ADHD to get additional help and services at school to help them succeed.

ADHD in adults

According to The American Psychiatric Association, ADHD in untreated adults can cause numerous mental and physical health problems, difficulties with work and finances and put strain on relationships.

“Untreated it leaves millions of children and adults misunderstood and unnecessarily floundering, even incapacitated,” writes Dr. Edward M. Hallowell, author of the seminal text on ADHD, Driven to Distraction. “Many people [adults] with ADHD medicate themselves with alcohol, marijuana or cocaine — in different ways each of these drugs calms the person down. But only in the short run. That’s why psychotherapy and medication are key to adults’ understanding themselves and restructuring their lives.”

By D. Kevin McNeir
kmcneir@miamitimesonline.com