Same Presentation, Different Code: Race and the ADHD Workup. (For HCPs)
ADHD is not a different condition across racial groups, but the route to the diagnosis is. Black children are markedly less likely to be diagnosed with ADHD and markedly more likely to be coded with a disruptive behavior disorder on comparable presentations, and the recent national rise in diagnosis has not reached them. Much of the divergence is built into the informant data before the clinician sees the patient: parent and teacher ratings differ in a race-patterned way, so treating rater agreement as confirmation inherits the gap. The corrective is already in the AAP guideline. Six changes in reading, sequence, and attention are described, five of which cost no added visit time, along with one dermatologic caution specific to the methylphenidate patch.