Bad Kid or ADHD?

The child can't be still, his grades are decreasing, and he won't listen in class. While some family members, friends, and teachers might consider him a menace, modern science may diagnose him with having ADHD (Attention Deficit Hyperactive Disorder).

According to Psych Central, 3 percent to 5 percent of U.S. children (approximately 2.5 million) have ADHD. The number of African American children with ADHD is guesstimated to be the same amount in white children, but with the lack of healthcare, skepticism of Ritalin and other medicine, lack of diagnosis and scientific research for Black children with ADHD, and the belief that a "good whooping" will solve everything, some African American children with ADHD are suffering while others have improved conduct after being treated.

Gwendolyn Young, 49 and grandmother of two boys with ADHD, said, "My grandsons are a lot calmer when they're on medication, especially one who is not as mean-spirited and less antsy. You can talk to him, and he doesn't get flustered as easily. But both of them are really quiet and kinda despondent when they first take the medicine. But if I had to choose between them being quiet or being evil, I'll choose quiet. Trying to deal with a child with ADHD is...when they're in rare form, it's a challenge."

The challenge of ADHD, formerly known as Attention Deficit Disorder (ADD) until 1994, involves hyperactivity-impulsivity type, inattention type and combined type. Hyperactivity type involves fidgeting and squirming, leaving one's seat, running or climbing. Inattention type is having a short attention span, unable to listen well or comprehend small details, being forgetful, or poor organizational skills and study skills for the child's age group. Impulsivity type is interrupting others when they're talking, blurts out answers before they're called or acts sporadically.

Several studies show that boys are three times more likely to be diagnosed with ADHD. Even with grandsons like Ms. Young's who are being treated for ADHD, there are still rumors circulating that ADHD medicine (like Ritalin) is social genocide in the African American community. "As a Black physician who went to a Black medical school with Black physicians who were training Black people, it's offensive to me when Black people listen to anti-psychiatrists lying and saying ADHD medicine is genocide on the Black community," said Carl C. Bell, M.D., President and CEO of Community Mental Health Council, Inc. and Professor of Psychiatry and Public Health, University of Illinois in Chicago.

Dr. Bell continued, "In one study done in Maryland, there were three times as many White children on Ritalin as Black children. So if psychiatrists are supposedly trying to kill Black people with medicine, are white psychiatrists trying to kill white children too? Medication for ADHD helps those children."

However, not every child who acts up has ADHD. Other factors could include violence and trauma, irresponsible parents, and neglect, but if a doctor is testing this child for ADHD, her background will be explored. Without treatment for kids with ADHD, a study completed by the Journal of the National Medical Association states that there are higher rates of delinquency, incarceration, teen pregnancy and sexually transmitted diseases.

Disruption in school is still common grounds in the African American community for a whooping. "Beating kids is not the answer," said Dr. Bell. "That is how bullies lead, not how true leaders lead. Of course, hitting someone and being a bully is easy, and it relieves a lot of stress in the parent because their frustrations get released, but you can always hit someone. Mostly, kids try to make their parents proud. They are not bad on purpose, plus, although they are clear about right and wrong, they don't really understand morality-so they are at a disadvantage regarding good judgment, planning, self-control. The main thing is to try to keep a good relationship with your children."

"What I find in my own clinical practice is that parents will talk about spanking and whooping as a punishment but don't always resort to it. African American parents who do use spanking, sometimes they are very consistent in using other methods of punishment beforehand. It's a consistent hierarchy," said Karen Taylor-Crawford, M.D., former member of the CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) of Chicago professional advisory board and a doctor at the University of Illinois.

Other methods include taking away something the child enjoys, timeouts, or talking to the child about why this behavior is wrong. But how would a parent who believes in physical punishment when necessary discipline a child with ADHD?

A board member of CHADD, U. Diane Buckingham, M.D., an active member of the National Medical Association backpacks on this statement by saying, "I work with those parents...about other alternatives for this child. When you look at juvenile services and look at jail and prison services, the number of people that have been abused or physical aggressive [sic] and exposed to physical aggressive [sic], they become perpetrators and are physically aggressive toward others, so my goal is cutting that out. People have risks to go to adult prison services. They have a risk of being kinda depressed. They have a risk of anxiety disorders. There are other better alternatives."

Dr. Taylor-Crawford responded, "We don't tell parents don't spank. We talk to parents about being consistent and setting clear expectations. Discipline is learning how to control your behavior and understanding that there are going to be certain consequences for infractions of this behavior. Now, what parents are able to see is even when putting these things in place, a child is still having trouble conforming their behavior...what would be the thing that you as a parent would be afraid of in terms of medication for these children that have attention deficit disorder? Because most of the time parents are very comfortable with the use of behavioral intervention. But they're less comfortable with using the medication, and so I start low with the medication."

Although boys tend to be diagnosed with ADHD far more times than girls, females should not be excluded from the potential for ADHD. "Boys tend to be socialized to be more active, and so you do see more hyperactivity in boys than you do in girls. But now that we have better studies and better parameters to look at ADHD, it doesn't seem to be quite the discrepancy between boys and girls. Girls tend to have inattentive ADHD. In terms of the subtypes and socializations, girls do tend to conform more to the school expectations, but they may have just as much difficulty with impulsivity and being able to focus and work consistently, but they may not be as likely to have the hyperactivity," said Dr. Taylor-Crawford.

With any medication, there are side effects. For ADHD medicine, side effects include a decreased appetite, stomachache, headache, moodiness, chest pain, vomiting, and being uncharacteristically antisocial.

"We give parents and kids the chance to understand what the possible side effects are, and then you bring them in fairly frequently, like every two three weeks, to see how they're doing with the medication, monitoring the side effects to see if things have really improved," said Dr. Taylor-Crawford. "The improvements are in consistent academic performance. They often will socialize better."