ADHD Bias Awareness Resource Page
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Know the facts about who is affected by ADHD: CDC Data and Statistics on ADHD
Despite the common prevalence and treatable nature of ADHD, barriers to management exist throughout the continuum of care, with socioeconomically disadvantaged and racially and ethnically minoritized children being disproportionately impacted (National Academies of Sciences & Medicine, 2024; Spencer et al., 2021).
Consider ways to optimize your engagement with patients and families to improve adherence and outcomes: Stages of Engagement Across ADHD Treatment
Consider the potential for diagnostic overshadowing in assessment and diagnosis. Knowledge of the similarity in presentation between various mental health conditions, as well as the frequency of co-existing conditions is imperative to avoid both over- and under-diagnosis of ADHD (Becker-Haimes et al., 2023; Leppert et al., 2023; Sainsbury et al., 2023). It is also important to assess whether the onset of symptoms began after a specific event or age, as this may help facilitate differential diagnosis (Siegfried et al., 2016).
What you can do:
- Ask patients/parents/caregivers what barriers exist to receiving care or exchanging information (i.e., treatment hesitancy, cultural stigmatization, internet service, lack of transportation, etc.) and how you can help.
- Work with nurses/social workers/family navigators if available to evaluate barriers and provide support.
- Consider scheduling screening visits even if paperwork has not been submitted and assist in completing documentation as needed.
- Consider scheduling additional visits to discuss steps in care process.
- When considering ADHD diagnosis, be mindful that a range of other conditions may have similar presentations or may co-occur with ADHD.
References
Becker-Haimes, E. M., Wislocki, K., DiDonato, S., Beidas, R. S., & Jensen-Doss, A. (2023). Youth Trauma Histories are Associated with Under-diagnosis and Under-treatment of Co-occurring Youth Psychiatric Symptoms. J Clin Child Adolesc Psychol, 52(2), 184-195. https://doi.org/10.1080/15374416.2021.1923020
Center for Disease Control and Prevention. (2024, May 16). Data and Statistics on ADHD. U.S. Department of Health and Human Services. https://www.cdc.gov/adhd/data/index.html
Leppert, M. L., Bettencourt, A., & Harrison, J. N. (2023). Behavioral Concerns in Early Childhood Consultation: Diagnostic Overshadowing and Comorbidity. Clin Pediatr (Phila), 62(11), 1315-1317. https://doi.org/10.1177/00099228231157960
National Academies of Sciences, E., and , & Medicine. (2024). Ending Unequal Treatment: Strategies to Achieve Equitable Health Care and Optimal Health for All. In Ending Unequal Treatment: Strategies to Achieve Equitable Health Care and Optimal Health for All. National Academies Press (US) Copyright © 2024, National Academy of Sciences. https://doi.org/10.17226/27820
Sainsbury, W. J., Carrasco, K., Whitehouse, A. J. O., McNeil, L., & Waddington, H. (2023). Age of Diagnosis for Co-occurring Autism and Attention Deficit Hyperactivity Disorder During Childhood and Adolescence: a Systematic Review. Review Journal of Autism and Developmental Disorders, 10(3), 563-575. https://doi.org/10.1007/s40489-022-00309-7
Siegfried, C. B., Blackshear, K., National Child Traumatic Stress Network, with assistance from the National Resource Center on ADHD: A Program of Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). (2016). Is it ADHD or child traumatic stress? A guide for Clinicians. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.
Spencer, A. E., Sikov, J., Loubeau, J. K., Zolli, N., Baul, T., Rabin, M., Hasan, S., Rosen, K., Buonocore, O., Lejeune, J., Dayal, R., Fortuna, L., Borba, C., & Silverstein, M. (2021). Six Stages of Engagement in ADHD Treatment Described by Diverse, Urban Parents. Pediatrics, 148(4). https://doi.org/10.1542/peds.2021-051261