Why Seeing Black Children with ADHD as a "Discipline Problem" Must Stop
MSM professor and Chair of Psychiatry and Behavioral Sciences Dr. Sarah Vinson urges clinicians to work alongside the parents of Black children with ADHD to build trust and a treatment plan that suits the child's unique needs.
By Tannistha Sinha, The Defender
Temetric Reeves was pursuing a second master’s degree in occupational therapy when she noticed she was struggling. Despite working hard, she could not strategize her way out of feeling overwhelmed and “frazzled.” It took a conversation with a classmate and three clinicians to get a diagnosis: she had ADHD or Attention-Deficit/Hyperactivity Disorder.
At 49, while going through the menopausal symptom of brain fog, she looked back at her life and felt both relief and grief: why was she overlooked for so long?
Thus, when it came to her children, she wasted no time. She identified at once that her daughter was struggling, decided to get a diagnosis and started to shift her language with her to make her feel empowered in her own skin.
“I started to live my life out loud for her so that she has the language and she can speak up for herself, and she’ll know what she’s going through and not feel like it’s a character flaw in her,” Reeves said. “Our brains are wired differently.”
Today, Reeves is pursuing a PhD in self-advocacy skills in African American women with ADHD from the University of Memphis, where she also started a support group for college students. She organized it partly because her son, who was also diagnosed, goes to the same school.
“I offer it to students so they can have at least once a month come together and share. I can give them that moment so they don’t feel alone, because in college it could be very lonely,” Reeves said.
Immediately after her son’s diagnosis, the doctor prescribed medication, which did not suit him. A musician and a creative child, the medication “dampened” his spirits. “It did allow him to calm himself enough to take in the information in school. The teachers were no longer complaining,” she recalled. Finally, she took a coaching program to help him.
Over the years, she has realized identification of neurodivergence in children is key, followed by acceptance and walking the path with them.
The genetic component of ADHD
ADHD symptoms often cause functional impairment and have a heritability of approximately 80%. Researchers also agree genetics play a vital role in this diagnosis, with a child with ADHD having a one in four chance of having a parent with the condition.
People with ADHD may find the condition makes it hard them to manage their emotions and thoughts. They also face trouble managing their behavior, paying attention, controlling overactivity, regulating their mood, staying organized, concentrating, following directions and sitting still.
According to the Centers for Disease Control and Prevention, around 11% of U.S. children between the ages of 2 and 17 have received an ADHD diagnosis.
Such mental health conditions can be interpreted through the intersectionality of race and health care: studies have shown that Black children with ADHD symptoms are treated more negatively by teachers or are misdiagnosed. Moreover, access to testing and a lack of specialists of color add to the challenges faced by this demographic.
“When you have a Black child who’s up and down out of their seat, who’s not able to focus enough to respond to the teacher in the classroom, that is often perceived as disruptive,” said Alfiee M. Breland-Noble, the founder and president of AAKOMA, a nonprofit that empowers Black, indigenous, people of color (BIPOC) and their families about mental health. “Our kids are often misdiagnosed because people look at their behaviors more punitively than they might look at the same set of behaviors in a white child or another child of color.”
Paul Morgan, professor of education and director of the Center for Educational Disparities Research at Pennsylvania State University, conducted a study that analyzed 17,000 U.S. children, which found that by the time students reached the eighth grade, African American children were 69% less likely, and Latino children were 50% less likely, to receive an ADHD diagnosis than their white counterparts.
Health disparities follow even after a diagnosis as children of color are much less likely to take ADHD medication. Only 36% of Black children and 30% of Latino children diagnosed with ADHD took medication, compared to 65% of white children.
Black children with ADHD are seen as a discipline problem
IngerShaye Colzie, a Licensed Social Worker and ADHD leadership coach who assists professional Black women, ran her psychotherapy practice for 15 years before being diagnosed with ADHD at 52 years of age. At first, she mistook the brain fog from menopause as a symptom of early onset Alzheimer’s.
When her son was in the fifth grade, he too was diagnosed with ADHD. In the predominantly white neighborhood where they lived, Colzie’s son was seen as a “discipline problem.”
“It’s doing it a disservice because when you only look at it as a behavior problem, it doesn’t allow you to see the whole child and doesn’t allow the child to flourish,” she told the Defender. “When you’re not doing well in school or when they see you as a discipline problem, you miss a lot of school.”
She has observed the impact of ADHD through her son — trouble with executive functioning and reading books for more than 20 minutes, which according to her was “like torture.” Moreover, the attitude of parents, too, stood out to her.
“For parents to learn how to parent differently and know that your kid has ADHD, it doesn’t mean – they don’t have to take medication unless you want to, but to build the skills that are going to help your kid to be successful at home and at school does require a diagnosis,” she said.
During an ADDitude Magazine webinar, “Cultural Considerations When Diagnosing and Treating ADHD in African American Children,” given by Sarah Vinson, MD, Morehouse School of Medicine professor and Chair of the Department of Psychiatry and Behavioral Sciences, along with other experts, Vinson urged clinicians to work alongside the parents of Black children with ADHD to build trust and a treatment plan that suits the child's unique needs.
“Speak with the child and make the effort to gain her trust and build a rapport,” she suggested.
She also urged Black parents to understand their expertise of their own children and the complexities of the neurobiological condition of ADHD. This leads to overcoming barriers such as accepting the diagnosis by overcoming stigma, taking the prescribed medication and following a comprehensive treatment plan.