Perceptions of Attention Deficit Hyperactivity Disorder in One African American Community

Abstract

The incidence of students being identified with Attention Deficit Hyperactivity Disorder (ADHD) is on the rise, yet few studies have examined the perceptions held by families of this special needs population. More specifically, what views do the parents and educators hold about the causes and treatment of ADHD? This ethnographic study took place in an urban school district. Forty-five hours of semi-structured interviews were conducted with 25 participants associated with four urban schools. The participants were African American parents and educators, and members of the medical community who work with African American parents and their children. Results of the interviews suggest that these participants have a socially constructed view of ADHD and are less likely to diagnose and use stimulant medication for the treatment of ADHD. According to the U.S. Drug Enforcement Agency (DEA), Attention Deficit Hyperactivity Disorder (ADHD) has become the most common psychopathology of children in the United States with a reported 600% increase in the use of stimulant medications to treat this disorder since 1990 (DEA, 2000). This growing phenomenon has prompted numerous studies. However, there are few studies specific to African American children. There have been studies examining the amount of knowledge and information about ADHD among African American parents (Bussing, Schoenberg, & Perwien, 1998) but few, if any specifically address the beliefs or perceptions of that population about ADHD. Furthermore, a review of the literature reveals that information about beliefs held by lower socioeconomic status (SES) African Americans is needed to enhance that body of knowledge (Ardila, 1995; Rostain, Power, & Afkins, 1993). In 1973, Draguns noted that an individual's behavior constitutes 'psychopa thology' was dependent upon the attitudes, expectations, and prevailing patterns of adaptation within the society in which the behavior occurs (see also Marsella, 1979). Therefore, a particular form of behavior may be considered deviant in one society or culture but quite acceptable in another. Because identical behavior may be perceived-and responded to-differently in different cultures, is important to make culturally influenced attitudes a focus of research on psychopathology. Culturally specific health beliefs determine whether one seeks medical care. However, very little research has been conducted that examines how influences perceptions and practices concerning ADHD (Bussing, 1998). Phinney (1996) concluded, it is necessary to unpack the packaged variable of ethnicity (p. 918). While race and SES are often strongly correlated, the terms are nevertheless not interchangeable. As noted earlier, the focus of this research is on ethnic, not class beliefs. For the purposes of this study, group refers to the African American population. Of course, within an ethnic group, whose members share a relatively precise ethnic label, there is a tremendous heterogeneity. That is, they differ in terms of social class, education, immigration history, geographical region, and family structure. Caution must be used as to not over generalize the entirety of the African American population. Bussing, Schoenberg, Rogers, Zima, and Angus (1998) suggest that African Americans have less knowledge about ADHD because ADHD has not become part of the collective consciousness of their communities and, thus, serves to undermine the medical label (Bussing, Schoenberg, Rogers, et al., 1998). Understandably, if no one in the social network is talking about medically recognized symptoms, a parent would be less likely to view a child's behavior as pathological. Subsequently, there would be no reason for a parent to actively seek information about a condition that few, if any, in his or her community believes is an actual medical condition. It is possible that what the medical community defines as either abnormal or as ADHD behaviors are perceived by African American parents as either normal or behaviors) that the child will outgrow. …