Linguistic Inequities in ADHD Diagnosis among School-age Children Screened for Attention Problems in Primary Care

Introduction. Attention deficit/hyperactivity disorder (ADHD) remains under-identified among racial/ethnic minoritized populations. We examined whether parent reported screening questionnaires for attention problems in primary care mitigated these ADHD diagnostic inequities and identified contributing sociodemographic and clinical factors. Methods. We conducted a cross-sectional electronic medical record (EMR) study in an urban, hospital-based primary care pediatric clinic of school age children (N=2212) with a completed Pediatric Symptom Checklist (PSC-17). We examined differences between children with vs. without ADHD diagnoses, adjusting for positive PSC-17 attention score. Results. Adjusting for positive PSC attention score, children had higher odds of an ADHD diagnosis if they were English-speaking and had a documented Vanderbilt ADHD Diagnostic Rating Scale in their medical record. Conclusion. Multilingual, parent-report screening for attention problems in pediatric primary care does not mitigate linguistic inequities in ADHD diagnosis.