Linguistic Inequities in ADHD Diagnosis among School-age Children Screened for Attention Problems in Primary Care.

Abstract

Attention deficit/hyperactivity disorder (ADHD) remains underidentified among racial/ethnic minoritized populations. We examined whether parent reported screening questionnaires for attention problems in primary care mitigated these ADHD diagnostic inequities and identified contributing sociodemographic and clinical factors. We conducted a cross-sectional electronic medical record (EMR) study in an urban, hospital-based primary care pediatric clinic of school age children (N=2212) with a completed Pediatric Symptom Checklist (PSC-17). We examined differences between children with vs. without ADHD diagnoses, adjusting for positive PSC-17 attention score. Adjusting for positive PSC attention score, children had higher odds of an ADHD diagnosis if they were English-speaking and had a documented Vanderbilt ADHD Diagnostic Rating Scale in their medical record. Multilingual, parent-report screening for attention problems in pediatric primary care does not mitigate linguistic inequities in ADHD diagnosis.