Racial differences in parental reports of attention-deficit/hyperactivity disorder behaviors.
OBJECTIVE
Accurate assessment of racial disparities in attention-deficit/hyperactivity disorder (ADHD) depends on measurement that is equally valid for all groups. This study examines differences among African American and white children in ADHD measurement with a widely used parental report instrument, the Diagnostic Interview Schedule for Children (DISC).


METHODS
Data come from 1070 children in the Fast Track Project, a longitudinal study of predominantly low-income children at risk of emotional and/or behavioral problems. Item Response Theory (IRT) methodology is used to determine whether ADHD screening items provide comparable information for African American and white children or whether differential item function (DIF) exists. IRT scores and race/ethnicity are entered in logistic regression models predicting use of ADHD medication.


RESULTS
Seven of 39 DISC items performed differently among African Americans and whites. In most cases, parents of white children were more likely to endorse these items than were parents of African American children at comparable underlying levels of children's hyperactivity. When items exhibiting differential functioning were deleted, race disparities predicting underlying need as indicated by ADHD medication use decreased and were no longer statistically significant.


CONCLUSIONS
Perceptions of ADHD-related symptoms among parents of African American children appear to differ in important ways from those of parents of white children, and screening instruments relying on parent report may yield different results for African American and white children with similar underlying treatment needs. Gathering information from additional sources including teachers and school counselors can provide a more complete picture of the behavioral functioning and therapeutic needs of children in all race/ethnic groups.
Department of Health Policy and Administration, Prevention Center, Pennsylvania State University, University Park, PA 16802, USA. mmh18@psu.edu
Marianne M
MM
Hillemeier
E Michael
EM
Foster
Brenda
B
Heinrichs
Brigitt
B
Heier
D000342:Affective Symptoms / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology / Q000628:therapy; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D044383:Black People / Q000523:psychology*; D002648:Child; D015331:Cohort Studies; D019955:Conduct Disorder / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology / Q000628:therapy; D003431:Cross-Cultural Comparison; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015588:Observer Variation; D010290:Parents / Q000523:psychology*; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012307:Risk Factors; D014481:United States; D044465:White People / Q000523:psychology*; D001741:Black or African American