Are Black Boys Misdiagnosed With ADHD?
The research provides conflicting answers, and educators still aren’t sure
As a special educator in Baltimore City, Attention Deficit Hyperactivity Disorder (or ADHD) is a prevalent diagnosis among my students. You don’t have to be in a classroom long to know just how much of a sticky subject the disorder is, particularly for Black boys. Over the years I’ve taught many boys diagnosed with ADHD, but only one girl, since ADHD presents differently based on gender — just one of several factors in its routine underdiagnosis.
The critics who say there are too many ADHD diagnoses often charge that the education system is pathologizing normal behaviors, like students not staying in their seats. As an educator, I understand that perspective and know that many underfunded schools lack resources outside of special education to give students the extra assistance they need.
According to a 2020 meta-analysis in JAMA Psychiatry, Black Americans are at a higher risk of ADHD diagnoses than the rest of the U.S. population. That indicates the need for more ADHD assessment, monitoring, and accurate diagnoses. But some think children of color, especially Black boys, are being underdiagnosed with ADHD. Both sides are supported by conflicting research and data.
Gail Mattox, MD, and Sarah Vinson, MD, note in Psychiatric Times that cultural competency is required to tackle the problem of ADHD diagnoses for Black boys. “All that fidgets is not ADHD,” they write. “This may be particularly relevant in Black populations.”
So what is the problem in the first place, or is there even one? Are Black boys disproportionately diagnosed with ADHD, or are they underdiagnosed?
It’s an important issue to tackle. Correctly diagnosing and treating ADHD can change and help the lives of many. Underdiagnosing ADHD can be associated with risky behavior, drug use, and depression.
Diving into the data makes me unsure of what to believe. What’s certain is that in my classroom, it makes a world of a difference when an ADHD-diagnosed child is taking medication.