T’Yana Blackburn

Psy 492 xa, Advanced General Psychology

December 16th, 2011

-Attention Deficit Hyperactivity Disorder

-To be diagnosed should have at least six attention or six activity/impulsivity symptoms for at least six months in at least two observable different settings

-Symptoms must cause severe difficulties in everyday tasks

This disorder crosses all cultural, social and racial lines

-Gavvn is a six year old African American male

-Gavvn can be hyper and inattentive at times

-Gavvn was diagnosed by his teacher with ADHD according to the ARS (ADHD Rating Scale)

Gavvn’s mother had him tested with his pediatrician and the school psychologist

-Gavvn had been misdiagnosed by his teacher due to not wanting to deal with behavioral issues that were a result of a learning disability

-Behavioral issues in class

-Low socio-economical background

-Cultural differences in perceptions of children’s behaviors

-Clinician’s not understanding the dynamics involved in the assessment and diagnosis

-Preconceived bias

-Psycho-tropic Medication

-Behavior Modification

-Therapy

-Biofeedback

-Change in diet

-Structured environment

-Biological disorder

-Parents are generally the most accurate diagnosticians

-Young African American males are often misdiagnosed

-Other possible causes are not ruled out , a premature diagnosis is given

-Various treatments include medication, behavior modification, structured environment, therapy and change in diet

STRUCTURAL DIAGNOSTIC REVIEW

UNSTRUCTURED CLINICAL OBSERVATIONS

-To assess DSM IV diagnostic status of ADHD

-The computerized interview schedule for children was administered to the parents

-Closed ended questions related to specific behaviors (such as presence and duration of psychiatric symptoms

-Observations were conducted by 1 of 27 clinicians & trainees from a variety of disciplines

-Children were observed for 48.03 minutes

-Clinician rated the degree of both inattentive and hyperactive impulsive behaviors on a 5-point scale (1=low to 5=high)

Clinician provided a yes or no rating of their perception of whether the child’s inattentive/hyperactive impulsive behaviors were excessive for the child’s development

-African American males lead all other race and gender groups with learning disorders

-In 2006 in the United States 4.5 million children between the ages of 5 and 17 years of age had been diagnosed with ADHD

-African American male youths have a disproportionately high rate of ADHD with an estimated prevalence rate of 5.56% compared to Caucasian males at 4.33%

-Overrepresented in specific learning disabilities (18%)

-Emotional disturbances (28%)

-Inaccurate assessment and diagnosis for African American, cultural differences in perceptions of children’s behavior

-Replication modification- The Guilford Model- a collaborative approach following clear assessment protocols that might help reduce the misdiagnosis in African American males during the assessment

-Diagnostic issues involving African American adolescent males

-It’s either ADHD or Conduct Disorder -ADHD is attributed to the central

nervous system dysfunctions -Conduct Disorder is attributed largely to

social maladjustment -African American males who exhibit

ADHD symptoms characterized by a lack of impulse control are given an informal diagnosis of Conduct Disorder

-Clinicians’ personal perceptions and prejudices, unclear understanding of the DSM-IV criteria for diagnosing ADHD can result in misdiagnosis in African American males

-Stereotype, racism, prejudice and sexism are a few variables that impact clinical diagnoses

Through this explanatory study, (3) significant reasons that contribute to the misdiagnosis of African American males

1) schools do not have a significant number of African Americans in teaching positions

2)schools favor homogeneous or ability grouping over heterogeneous grouping

3)schools that do not support a curriculum that promotes multicultural awareness and sensitivity

-Empirical Study -3,998 elementary students

(ages 5-11) -2,124 African American

students -1,874 Caucasian students -The IOWA rating scale was

used to evaluate for ADHD -Results proved that African

American boys and girls received significantly higher scores than the Caucasian students

There was a significantly greater likelihood for African American males and females

To be rated 2+ standard deviations above the mean for inattention-over activity, aggression, or IOWA Connors Rating scale scores

-Exploratory Case Study on African American males between the ages of 6-12 years of age

-Sample population from 4 different low socio-economic communities

-100 students total with current ADHD diagnoses (25 students per school)

-Information regarding study will be sent home for the parent/guardian to review and sign an informed consent form for their child to participate in the study

-Face to face interviews at the participant’s home will be conducted to perform the assessment

-The parent/guardian will be administered a survey to rate the participants behavior (inattentive and hyperactive symptoms)

-A behavioral survey would have been completed from the participants teacher of at least 6months prior to this study

-Based on the research (previous diagnosis, current assessment, behavioral survey from teacher, parent/guardian) the results will determine if the participant had in fact been diagnosed accurately for ADHD

- Findings will suggest that at least 2 out of every 5 African American males will be misdiagnosed with ADHD due to preconceived, bias and prejudice perceptions about young African American males

-Understanding of what ADHD is and what it looks like

-Understand that all cultures are different

-Research other possibilities

-Remove all prejudices, preconceived ideas, biases, stereotypes, labels and prejudgments

-Be objective not subjective

-Diagnose according to the DSM-IV criteria for ADHD

-Do No Harm

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Edwards, M. C., Schulz, E. G., Echelons, J., Gardner, E., & Pediatrics, E. a. (2005). Estimates of the Validity and Utility of Unstructured Clinical Observations of Children in the Assessment of ADHD , 9.

Google Health. (nod.). Retrieved May 17, 2010, from Google Health-Attention deficit hyperactivity disorder (ADHD): https://www.health.google.com/health/ref/Attention+deficit+hyperactivity+disorder+(ADHD)

Pastor, P. &. (2008). Diagnosed attention deficit hyperactivity disorder and learning disability: United States, 2004-2006.NAtional Center for Health Statistics. Vital Health Statistics,10 (237).

Spencer, L. E., & Terry, O. (1999). Conduct Disorder vs. Attention Deficit Hyperactivity Disorder: Diagnostic Implications For African-American Adolescent Males , 5.

Tucker, C., & Dixon, A. (2009). Low-income African American Male Youth with ADHD Symptoms in the United States , 13.

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