Community Perspectives of Childhood Behavioral Problems and ADHD Among African American Parents
Received 24 July 2006; accepted 13 February 2007.
Objective
To explore parents’ perceptions of childhood behavior problems and attention-deficit/hyperactivity disorder (ADHD) among a sample of African American (AA) parents.
Methods
Five focus groups were conducted in inner-city Baltimore and the Washington, DC, metropolitan region with 5 to 7 AA parents per group. Adults with children under the age of 17 years were recruited from pediatric practices. One investigator moderated each focus group, and a second took notes. Sessions averaged 1.5 hours long, were recorded on audiotape, and were transcribed verbatim. The narrative data were coded for recurring themes.
Results
Five major themes emerged from the analysis: causes of behavioral problems in children, the legitimacy of ADHD as a diagnosis, attitudes about doctors, opinions of medication, and perceptions of the school environment. Many participants felt that behavior issues, including those accompanying ADHD, were caused by inappropriate parenting and disciplinary practices. Some viewed the diagnosis as a label applied with racial inequality to exert social control over AAs. Several expressed distrust in physicians who were quick to make a diagnosis of ADHD and recommend medications. Others worried that medication would lead to drug addiction in adulthood. Some perceived that children were labeled with ADHD because of poor educational environments that were unresponsive to the needs of AA children.
Conclusions
These focus groups identified important community perceptions about ADHD and its medical treatment. Understanding how these perceptions contribute to racial disparities in ADHD diagnosis and treatment can help inform culturally sensitive interventions to improve the management of ADHD among AA children.
1Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University, Baltimore, Md
2Division of Child and Adolescent Psychiatry, Johns Hopkins University, Baltimore, Md
3School of Medicine, and Robert Wood Johnson Clinical Scholars Program, Johns Hopkins University, Baltimore, Md
4Children’s National Medical Center, George Washington School of Medicine, Washington, DC.
Address correspondence to Tina L. Cheng, MD, MPH, Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University, 200 N Wolfe St, Room 2055, Baltimore, MD 21287.
ABSTRACT