Abstract

OBJECTIVE: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur across early and middle childhood is currently unknown. We examined the over-time dynamics of race/ethnic disparities in diagnosis from kindergarten to eighth grade and disparities in treatment in fifth and eighth grade. METHODS: Analyses of the nationally representative Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (N = 17 100) using discrete-time hazard modeling. RESULTS: Minority children were less likely than white children to receive an ADHD diagnosis. With time-invariant and -varying confounding factors statistically controlled the odds of ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were 69% (95% confidence interval [CI]: 60%-76%), 50% (95% CI: 34%-62%), and 46% (95% CI: 26%-61%) lower, respectively, than for whites. Factors increasing children's risk of an ADHD diagnosis included being a boy, being raised by an older mother, being raised in an English-speaking household, and engaging in externalizing problem behaviors. Factors decreasing children's risk of an ADHD diagnosis included engaging in learning-related behaviors (eg, being attentive), displaying greater academic achievement, and not having health insurance. Among children diagnosed with ADHD, racial/ethnic minorities were less likely than whites to be taking prescription medication for the disorder. CONCLUSIONS: Racial/ethnic disparities in ADHD diagnosis occur by kindergarten and continue until at least the end of eighth grade. Measured confounding factors do not explain racial/ethnic disparities in ADHD diagnosis and treatment. Culturally sensitive monitoring should be intensified to ensure that all children are appropriately screened, diagnosed, and treated for ADHD. Pediatrics 2013;132:85-93.

Original languageEnglish (US)
Pages (from-to)85-93
Number of pages9
JournalPediatrics
Volume132
Issue number1
DOIs
StatePublished - Jul 1 2013

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Attention Deficit Disorder with Hyperactivity
Confidence Intervals
Health Insurance
Hispanic Americans
African Americans
Prescriptions
Longitudinal Studies
Mothers
Learning
Pediatrics
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

@article{50231b65ec96464b94d45607d72ad35f,
title = "Racial and ethnic disparities in adhd diagnosis from kindergarten to eighth grade",
abstract = "OBJECTIVE: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur across early and middle childhood is currently unknown. We examined the over-time dynamics of race/ethnic disparities in diagnosis from kindergarten to eighth grade and disparities in treatment in fifth and eighth grade. METHODS: Analyses of the nationally representative Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (N = 17 100) using discrete-time hazard modeling. RESULTS: Minority children were less likely than white children to receive an ADHD diagnosis. With time-invariant and -varying confounding factors statistically controlled the odds of ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were 69{\%} (95{\%} confidence interval [CI]: 60{\%}-76{\%}), 50{\%} (95{\%} CI: 34{\%}-62{\%}), and 46{\%} (95{\%} CI: 26{\%}-61{\%}) lower, respectively, than for whites. Factors increasing children's risk of an ADHD diagnosis included being a boy, being raised by an older mother, being raised in an English-speaking household, and engaging in externalizing problem behaviors. Factors decreasing children's risk of an ADHD diagnosis included engaging in learning-related behaviors (eg, being attentive), displaying greater academic achievement, and not having health insurance. Among children diagnosed with ADHD, racial/ethnic minorities were less likely than whites to be taking prescription medication for the disorder. CONCLUSIONS: Racial/ethnic disparities in ADHD diagnosis occur by kindergarten and continue until at least the end of eighth grade. Measured confounding factors do not explain racial/ethnic disparities in ADHD diagnosis and treatment. Culturally sensitive monitoring should be intensified to ensure that all children are appropriately screened, diagnosed, and treated for ADHD. Pediatrics 2013;132:85-93.",
author = "Morgan, {Paul L.} and Jeremy Staff and Hillemeier, {Marianne M.} and George Farkas and Steven Maczuga",
year = "2013",
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Racial and ethnic disparities in adhd diagnosis from kindergarten to eighth grade. / Morgan, Paul L.; Staff, Jeremy; Hillemeier, Marianne M.; Farkas, George; Maczuga, Steven.

In: Pediatrics, Vol. 132, No. 1, 01.07.2013, p. 85-93.

Research output: Contribution to journalArticle

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T1 - Racial and ethnic disparities in adhd diagnosis from kindergarten to eighth grade

AU - Morgan, Paul L.

AU - Staff, Jeremy

AU - Hillemeier, Marianne M.

AU - Farkas, George

AU - Maczuga, Steven

PY - 2013/7/1

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N2 - OBJECTIVE: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur across early and middle childhood is currently unknown. We examined the over-time dynamics of race/ethnic disparities in diagnosis from kindergarten to eighth grade and disparities in treatment in fifth and eighth grade. METHODS: Analyses of the nationally representative Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (N = 17 100) using discrete-time hazard modeling. RESULTS: Minority children were less likely than white children to receive an ADHD diagnosis. With time-invariant and -varying confounding factors statistically controlled the odds of ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were 69% (95% confidence interval [CI]: 60%-76%), 50% (95% CI: 34%-62%), and 46% (95% CI: 26%-61%) lower, respectively, than for whites. Factors increasing children's risk of an ADHD diagnosis included being a boy, being raised by an older mother, being raised in an English-speaking household, and engaging in externalizing problem behaviors. Factors decreasing children's risk of an ADHD diagnosis included engaging in learning-related behaviors (eg, being attentive), displaying greater academic achievement, and not having health insurance. Among children diagnosed with ADHD, racial/ethnic minorities were less likely than whites to be taking prescription medication for the disorder. CONCLUSIONS: Racial/ethnic disparities in ADHD diagnosis occur by kindergarten and continue until at least the end of eighth grade. Measured confounding factors do not explain racial/ethnic disparities in ADHD diagnosis and treatment. Culturally sensitive monitoring should be intensified to ensure that all children are appropriately screened, diagnosed, and treated for ADHD. Pediatrics 2013;132:85-93.

AB - OBJECTIVE: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur across early and middle childhood is currently unknown. We examined the over-time dynamics of race/ethnic disparities in diagnosis from kindergarten to eighth grade and disparities in treatment in fifth and eighth grade. METHODS: Analyses of the nationally representative Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (N = 17 100) using discrete-time hazard modeling. RESULTS: Minority children were less likely than white children to receive an ADHD diagnosis. With time-invariant and -varying confounding factors statistically controlled the odds of ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were 69% (95% confidence interval [CI]: 60%-76%), 50% (95% CI: 34%-62%), and 46% (95% CI: 26%-61%) lower, respectively, than for whites. Factors increasing children's risk of an ADHD diagnosis included being a boy, being raised by an older mother, being raised in an English-speaking household, and engaging in externalizing problem behaviors. Factors decreasing children's risk of an ADHD diagnosis included engaging in learning-related behaviors (eg, being attentive), displaying greater academic achievement, and not having health insurance. Among children diagnosed with ADHD, racial/ethnic minorities were less likely than whites to be taking prescription medication for the disorder. CONCLUSIONS: Racial/ethnic disparities in ADHD diagnosis occur by kindergarten and continue until at least the end of eighth grade. Measured confounding factors do not explain racial/ethnic disparities in ADHD diagnosis and treatment. Culturally sensitive monitoring should be intensified to ensure that all children are appropriately screened, diagnosed, and treated for ADHD. Pediatrics 2013;132:85-93.

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