The Use of Neuropsychological Assessments in the Diagnosis of ADHD among Racial and Ethnic Minorities in the US

Objectives
Neuropsychological evaluations provide information that can potentially minimize the risk of poor outcomes and enhance the quality of life for children with attention deficit hyperactivity disorder (ADHD). Black and Brown students have higher incidences of misdiagnosis of Oppositional Defiant Disorder (ODD) and being funneled into Emotional and behavioral disorders (EBD) classrooms. There is support for the incremental efficacy of neuropsychological evaluation compared to routine care in the diagnosis and management of ADHD. This study analyzes neuropsychological assessment practices and diagnosis trends by race, ethnicity, and gender, incorporating teacher and parent perceptions through behavioral rating scales.

Data Selection
The following selection criteria were utilized: -published in peer-reviewed journals focusing on neuropsychological evaluations for ADHD among black and brown clients -employed a variety of assessment tools and methodologies - reporting on cultural considerations, validity, and reliability of neuropsychological assessments in black and brown populations.

Data Synthesis
Gender and racial differences in the timing and rate of diagnosis have delayed the onset of treatment. Additionally, there has been a difference in how parents and teachers endorse symptoms of ADHD by race on rating scales included in comprehensive neuropsychological evaluations.

Conclusions
Early intervention is associated with improved outcomes for individuals diagnosed with ADHD. However, there is a significant imbalance between the growing numbers of ethnic/racial and linguistic minority children in the United States who need neuropsychological services and the limited number of neuropsychologists trained to handle the cultural complexities. Accurate, culturally informed neuropsychological assessments are needed to ensure equitable behavioral health services are provided.