The Stigma of ADHD

In the past 15 years, the number of children who’ve been prescribed medications to treat Attention Deficit Hyperactivity Disorder—better known as ADHD—has risen dramatically.

But as Daniel Eisenberg, an assistant professor of health management and policy, notes, there is enormous variation, both geographically and demographically, in ADHD diagnosis and treatment rates across the United States.

“We see the highest rates among white children, medium rates among black children, and very low rates among Asian children,” says Eisenberg. “In some geographic areas the rates are as high as one in five boys being medicated, while in other areas virtually nobody is medicated. How do we explain the variation?”

Eisenberg wants to know more about the social implications of an ADHD, such as whether teachers and parents perceive their children differently, or whether the children change their self perception. Is there an ADHD “bias”?

The peak age for ADHD diagnosis is 10 years old, although growing numbers of preschoolers are now being diagnosed with the disorder. “Because children are especially vulnerable to perceptions, we may need to do more to address the stigma that often comes with diagnosis,” says Eisenberg, who is currently studying the issue with an eye toward health care policy.

“Our research question is, essentially, if you have two kids with the same standard test scores and the same demographics, but one has ADHD, are the math and reading abilities of the ADHD kid perceived to be less?” says Eisenberg.

With Helen Schneider, a health economist with the Los Alamos National Laboratory, Eisenberg is examining ADHD perceptions from the point of view of parents, teachers, and children themselves. The two researchers are using survey panel data from the U.S. Department of Education’s Early Childhood Longitudinal Survey, a study following 15,000 children nationwide from kindergarten through fifth grade. The survey includes individual responses from parents, teachers, and children to such questions as how a given child compares to other children in his or her class when it comes to reading skills.

By comparing these responses to children’s test scores and data indicating which children in the survey have been diagnosed with ADHD, Eisenberg and Schneider hope to better understand ADHD bias. They are also studying medication and behavior counseling in order to gain a clearer sense of the effectiveness of particular treatments and to identify those factors that may make children more likely than not to get treatments.

Eventually Eisenberg hopes to supplement this work by studying the academic development of children with ADHD. “One of the controversial policy issues for ADHD,” he says, “is the extent to which teachers or other school personnel can raise the issue of medication.”