\n\tClaire Sibonney<\/span><\/p>\n

As a kid, Wesley Jackson Wade should have been set up to succeed. His father was a novelist and corporate sales director and his mother was a special education teacher. But Wade said he struggled through school even though he was an exceptional writer and communicator. He played the class clown when he wasn\u2019t feeling challenged. He got in trouble for talking back to teachers. And, the now 40-year-old said, he often felt anger that he couldn\u2019t bottle up.<\/p>\n

As one of the only Black kids in predominantly white schools in upper-middle-class communities \u2014 including the university enclaves of Palo Alto, California, and Chapel Hill, North Carolina \u2014 he often got detention for chatting with his white friends during class, while they got only warnings. He chalked it up to his being Black. Ditto, he said, when he was wrongly arrested as an eighth grader for a bomb threat at his school while evacuating with his white friends. So he wasn\u2019t surprised that his behavioral issues drew punishment, even as some of his white friends with similar symptoms instead started getting treatment for attention-deficit\/hyperactivity disorder.<\/p>\n

\u201cBlack kids at a very young age, we start dealing with race, we have a lot of racial stamina,\u201d said Wade, who now lives outside of Durham, North Carolina. \u201cBut I didn\u2019t understand until later on that there was probably something else going on.\u201d<\/p>\n

After spending years grappling with self-doubt and difficult relationships \u2014 and smoking what he called \u201cSnoop Dogg volumes of weed\u201d from middle school until his 20s \u2014 he learned he had ADHD and dyslexia, two diagnoses that often overlap. He was 37.<\/p>\n

It\u2019s long been known that Black children are underdiagnosed for ADHD<\/a> compared with white peers. A Penn State report<\/a> published in Psychiatry Research in September studied the extent of the gap by following more than 10,000 elementary students nationwide from kindergarten to fifth grade through student assessments and parent and teacher surveys. The researchers estimated the odds that Black students<\/a> got diagnosed with the neurological condition were 40% lower than for white students, with all else being equal \u2014 including controlling for economic status, student achievement, behavior, and executive functioning.<\/p>\n

For young Black males, the odds of being diagnosed with ADHD were especially stark: almost 60% lower than for white boys in similar circumstances, even though research suggests<\/a> the prevalence of the condition is likely the same.<\/p>\n

The racial ADHD divide isn\u2019t merely a health concern. It\u2019s deepening inequity for Black children, and especially Black males, said the study\u2019s lead author, Paul Morgan<\/a>, the former director of the Center for Educational Disparities Research at Penn State. He now leads the Institute for Social and Health Equity<\/a> at the University of Albany.<\/p>\n

ADHD has been diagnosed in nearly 1 in 10 children<\/a> in the United States, according to a Centers for Disease Control and Prevention study published in 2022, with rates surging nearly 70%<\/a> in the past two decades. It is often a lifetime condition that can be managed with treatments including therapy and medication. Untreated, children with ADHD face much greater health risks, including drug addiction, self-harm, suicidal behavior, accidents, and untimely death. By adulthood, many people with undiagnosed ADHD have spent years feeling isolated and hopeless, just as Wade did.<\/p>\n

Even before Wade\u2019s diagnosis, he was helping similar college students in a career counseling role at North Carolina State University. Today, he\u2019s a licensed mental health and addiction counselor and doctoral student, but he said it\u2019s been hard to see his successes.<\/p>\n

\u201cTo the rest of the world, this is a Black man with two master\u2019s degrees, and he\u2019s a PhD candidate, and he has two licenses and certifications,\u201d he said. \u201cBut to me, I\u2019m a brother who\u2019s had a lot of bad luck with people and jobs I\u2019ve gotten fired from. I\u2019ve never been promoted, ever, in my professional life.\u201d<\/p>\n

Wade\u2019s experiences of race and ADHD are intertwined. \u201cADHD is an accelerant to my Black experience,\u201d he said. \u201cI can\u2019t separate my experiences as a Black boy and Black man from my experiences of understanding my neurodivergent identity.\u201d<\/p>\n

People who study and treat ADHD cite several reasons why young Black males fall under the radar, including teachers who are racially biased or have lower expectations of Black students and don\u2019t recognize an underlying disability, and Black parents who are distrustful of teachers and doctors, fearing they\u2019ll label and stigmatize their children.<\/p>\n

\u201cWe\u2019ve known for a long time that ADHD diagnoses are not made in a vacuum. They\u2019re made in a geographic context, cultural context, racial context,\u201d said George DuPaul<\/a>, a psychology professor at Lehigh University who studies nonmedication interventions for ADHD.<\/p>\n

Studies have shown that ADHD underdiagnosis contributes to harsher school discipline and to the \u201c school-to-prison pipeline<\/a>.\u201d Black kids routinely face punishment, including criminal prosecution, for problem behavior and mental health conditions such as ADHD, while white kids are more likely to be diagnosed with behavioral conditions and receive medical treatment and support. There\u2019s a common saying: \u201cBlack kids get cops, white kids get docs.\u201d <\/p>\n

Courtney Zulauf-McCurdy<\/a>, a researcher and clinician at the University of Washington School of Medicine, focuses on decreasing mental health disparities in early childhood. By preschool, she said, Black children with ADHD symptoms are more likely to be expelled<\/a> and less likely to receive appropriate treatment than their white peers.<\/p>\n

Her research has found<\/a> that teachers\u2019 judgments of children are heavily influenced by their opinions of the kids\u2019 parents, and that often determines whether those children are evaluated for behavioral conditions and given appropriate support \u2014 or simply kicked out of class. She said the Penn State findings confirm what she\u2019s seen in clinics and heard from parents.<\/p>\n