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Functional Impairment in Latino Children with ADHD: Implications for Culturally Appropriate Conceptualization and Measurement

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Abstract

Conceptualizing and measuring functional impairment related to childhood ADHD, particularly within the rapidly growing, yet underserved, Latino population, is an important area of research that is in its infancy in the field of psychology. The functional impairments related to academic achievement, social competence, and familial relations experienced by children with ADHD lead to long-lasting and debilitating difficulties that adversely affect the individuals themselves, their families, and society. In addition, limited available research suggests that Latino children are at a great or greater risk for developing ADHD, although they are much less likely to be identified by their parents as displaying problematic behavior and subsequently are less likely to receive proper assessment and treatment due to several practical and cultural factors. Fortunately, initial evidence suggests that the construct of functional impairment may be a more universal notion than the potentially culturally biased measurement of symptomatology. Therefore, in order to provide the best possible outcomes for all children with ADHD, research needs to be expanded to include examination of functional impairment related to ADHD, particularly when working with Latino children and their families. Thus, the primary aim of the current review is to examine and critique how the field of psychology has understood and measured functional impairment in school-aged Latino children with ADHD to date. Based on information reviewed, suggestions for moving toward a culturally modified assessment of functional impairment related to ADHD in Latino children will be proposed. This work is a necessary step toward providing culturally appropriate services for a currently underserved, yet rapidly growing, Latino population in our country.

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References

  • Abidin, R. R. (1982). Parenting stress and the utilization of pediatric services. Children’s Health Care, 2, 70–73.

    Google Scholar 

  • Abidin, R. R. (1995). Parenting stress index (3rd ed.). Lutz, FL: Psychological Assessment Resources, Inc.

    Google Scholar 

  • Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.

    Google Scholar 

  • Alegría, M., Mulvaney-Day, N., Woo, M., Torres, M., Gao, S., & Oddo, V. (2007). Correlates of past-year mental health service use among Latinos: Results from the National Latino and Asian American Study. American Journal of Public Health, 97(1), 76–83.

    Article  PubMed  Google Scholar 

  • Anesko, K. M., Shoiock, G., Ramirez, R., & Levine, F. M. (1987). The Homework Problem Checklist: Assessing children’s homework difficulties. Behavioral Assessment, 9, 179–185.

    Google Scholar 

  • Arcia, E., & Fernández, M. C. (2003a). From awareness to acknowledgement: The development of concern among Latina mothers of children with disruptive behaviors. Journal of Attention Disorders, 6, 163–175.

    Article  PubMed  Google Scholar 

  • Arcia, E., & Fernández, M. C. (2003b). Presenting problems and assigned diagnoses among young Latino children with disruptive behavior. Journal of Attention Disorders, 6, 177–185.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, text revision (DSM-IV-TR) (4th ed.). Washington, DC: American Psychiatric Association.

    Book  Google Scholar 

  • American Psychological Association. (2003). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. American Psychologist, 58, 377–402.

    Google Scholar 

  • Barkley, R. A. (1997). Attention-deficit/hyperactivity disorder. In E. J. Mash & L. F. Terdal (Eds.), Assessment of childhood disorders (3rd ed.). New York: The Guilford Press.

  • Bauermeister, J. J., Matos, M., Reina, G., Salas, C. C., Martınez, J. V., Cumba, E., et al. (2005). Comparison of the DSM-IV combined and inattentive types of ADHD in a school-based sample of Latino/Hispanic children. Journal of Child Psychology and Psychiatry, 46, 166–179.

    Article  PubMed  Google Scholar 

  • Bird, H. R., Andrews, H., Schwab-Stone, M., Goodman, S., Dulcan, M., Richters, I., et al. (1996). Global measures of impairment for epidemiological and clinical use with children and adolescents. International Journal of Methods in Psychiatric Research, 6, 295–307.

    Article  Google Scholar 

  • Brislin, R. W. (1970). Back-translation for cross-cultural research. Journal of Cross-Cultural Psychology, 1(3), 185–216.

    Article  Google Scholar 

  • Brislin, R., Lonner, W., & Thorndike, R. (1973). Cross-cultural research methods. New York: Wiley.

    Google Scholar 

  • Canino, I. A., & Spurlock, J. (2000). Culturally diverse children and adolescents (2nd ed.). New York: The Guilford Press.

    Google Scholar 

  • Conners, C. K. (2008). Conners comprehensive behavior rating scale manual. Toronto, ON: Multi-Health Systems (MHS).

    Google Scholar 

  • Corbin, J., & Strauss, A. (1990). Grounded theory research: Procedures, canons, and evaluative criteria. Qualitative Sociology, 13, 3–21.

    Article  Google Scholar 

  • Cortina, J. M. (1993). What is coefficient alpha? An examination of theory and applications. Journal of Applied Psychology, 78, 98–104.

    Article  Google Scholar 

  • Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.

    Article  Google Scholar 

  • Cronbach, L. J., & Meehl, P. E. (1955). Construct validity in psychological tests. Psychological Bulletin, 52, 281–302.

    Article  PubMed  Google Scholar 

  • Dupaul, G. J. (2007). School-based interventions for students with attention-deficit hyperactivity disorder: Current status and future directions. School Psychology Review, 36, 183–194.

    Google Scholar 

  • Eraldi, R. B., Mazzuca, L. B., Clarke, A. T., & Power, T. J. (2006). Service utilization among ethnic minority children with ADHD: A model of help-seeking behavior. Administration and Policy in Mental Health and Mental Health Services Research, 33, 607–622.

    Article  Google Scholar 

  • Fabiano, G. A., Pelham, W. E., Coles, E. K., Chronis-Tuscano, A., & O’Connor, B. C. (2009). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29, 129–140.

    Article  PubMed  Google Scholar 

  • Fabiano, G. A., Pelham, W. E., Gnagy, E. M., Waschbusch, D. A., Lahey, B. B., Chronis, A. M., et al. (2006). A practical measure of impairment: Psychometric properties of the Impairment Rating Scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. Journal of Clinical Child and Adolescent Psychology, 35, 369–385.

    Article  PubMed  Google Scholar 

  • Flores, G., Guentes-Afflick, E., Barbot, O., Carter-Pokras, O., Claudio, L., Lara, M., et al. (2002). The health of Latino children: Urgent priorities, unanswered questions, and a research agenda. American Medical Association, 288, 82–90.

    Article  Google Scholar 

  • Flory, K., Molina, B. S. G., Pelham, W. E., Gnagy, E., & Smith, B. (2006). Childhood ADHD predicts risky sexual behavior in young adulthood. Journal of Clinical Child and Adolescent Psychology, 35, 571–577.

    Article  PubMed  Google Scholar 

  • Garland, A. F., Lau, A. S., Yeh, M., McCabe, K. M., Hough, R. L., & Landsverk, J. A. (2005). Racial and ethnic differences in utilization of mental health services among high-risk youths. American Journal of Psychiatry, 162, 1336–1343.

    Article  PubMed  Google Scholar 

  • Gerdes, A. C., Lawton, K. E., Haack, L. M., & Dieguez, G. M. (under review). Assessing ADHD in Latino families: Evidence for moving beyond symptomatology.

  • Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine Publishing Company.

    Google Scholar 

  • Gordon, M., Antshel, K., Faraone, S., Barkley, R., Lewandowski, L., Hudziak, J. J., et al. (2006). Symptom versus impairment: The case for respecting DSM-IV’s Criterion D. Journal of Attention Disorders, 9, 465–475.

    Article  PubMed  Google Scholar 

  • Green, D. O., Cresswell, J. W., Shope, R. J., & Clark, V. P. (2007). Grounded theory and racial/ethnic diversity. In A. Bryant & K. Charmaz (Eds.), The SAGE handbook of grounded theory (pp. 472–492). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Gresham, F. M., & Elliott, S. N. (1989). Social skills rating system—parent, teacher, and child forms. Circle Pines, MN: American Guidance Systems.

    Google Scholar 

  • Haack, L. M., Gerdes, A. C., Cruz, B., & Schneider, B. W. (2011). Culturally-modified recruitment strategies for Latino families in clinical child research: A critical first step. Journal of Child and Family Studies. Advance online publication at doi:10.1007/s10826-011-9460-5.

  • Haack, L. M., Gerdes, A. C., Schneider, B. W., & Dieguez, G. M. (2010). Advancing our knowledge of ADHD in Latino children: Psychometric and cultural properties of Spanish-versions of parental/family functioning measures. Journal of Abnormal Child Psychology, 39, 33–43. doi:10.1007/s10802-010-9441-y.

    Article  Google Scholar 

  • Halgunseth, L. C., Ispa, J., & Ruddy, D. D. (2006). Parental control in Latino families: An integrative review. Child Development, 77, 1282–1297.

    Article  PubMed  Google Scholar 

  • Harter, S. (1982). The perceived competence scale for children. Child Development, 53, 87–97.

    Article  Google Scholar 

  • Hodges, K. (1994). The child and adolescent functional assessment scale. Ypsilanti: Eastern Michigan University, Department of Psychology.

    Google Scholar 

  • Hoza, B. (2007). Peer functioning in children with ADHD. Ambulatory Pediatrics, 7, 101–106.

    Article  PubMed  Google Scholar 

  • Huey, S. J., & Polo, A. J. (2008). Evidence-based psychosocial treatments for ethnic minority youth. Journal of Clinical Child and Adolescent Psychology, 37, 262–301.

    Article  PubMed  Google Scholar 

  • Israel, B. A., Coombe, C. M., Cheezum, R. R., Schulz, A. J., McGranaghan, R. J., Lichtenstein, R., et al. (2010). Community-based participatory research: A capacity-building approach for policy advocacy aimed at eliminating health disparities. American Journal of Public Health, 100, 2094–2102.

    Article  PubMed  Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.

    Article  PubMed  Google Scholar 

  • Jenson, P. S., & Hoagwood, K. (1997). The book of names: DSM-IV in context. Development and Psychopathology, 9, 231–249.

    Google Scholar 

  • Johnson, C., & Mash, E. J. (2001). Families of children with attention-deficit/hyperactivity disorder: Review and recommendations for future research. Clinical Child and Family Psychology Review, 4(3), 183–207.

    Article  Google Scholar 

  • Johnston, C., & Mash, E. (1989). A Measure of parenting satisfaction and efficacy. Journal of Clinical Child Psychology, 18, 167–175.

    Article  Google Scholar 

  • Kataoka, S. H., Zhang, L., & Wells, K. B. (2002). Unmet need for mental health care among US children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159, 1548–1555.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E. (1999). The meanings and measurement of clinical significance. Journal of Consulting and Clinical Psychology, 67, 332–339.

    Article  PubMed  Google Scholar 

  • Lambert, M. J., & Ogles, B. M. (2009). Using clinical significance in psychotherapy outcome research: The need for a common procedure and validity data. Psychotherapy Research, 19, 493–501.

    Article  PubMed  Google Scholar 

  • Lujan, J., & Campbell, H. B. (2006). The role of religion on the health practices of Mexican Americans. Journal of Religion and Health, 45, 183–195.

    Article  Google Scholar 

  • Martinez, C. (1993). Psychiatric care of Mexican Americans. In A. C. Graw (Ed.), Culture, ethnicity, and mental illness (pp. 431–466). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Matheny, A. P., Wachs, T. D., Ludwig, J. L., & Phillips, K. (1995). Bringing order out of chaos: Psychometric characteristics of the Confusion, Hubbub, and Order Scale. Journal of Applied Developmental Psychology, 16, 429–444.

    Article  Google Scholar 

  • Messick, S. (1995). Validity of psychological assessment: Validation of inferences from persons’ responses and performances as scientific inquiry into score meaning. American Psychologist, 50, 741–749.

    Article  Google Scholar 

  • Miranda, A. O., Bilot, J. M., Peluso, P. R., Berman, K., & Van Meek, L. G. (2006). Latino families: The relevance of the connection among acculturation, family dynamics and health for family counseling research and practice. The Family Journal: Counseling and Therapy for Couples and Families, 14, 268–273.

    Google Scholar 

  • Molina, B. S. G., Hinshaw, S. P., Swanson, J. M., Arnold, L. E., Vitiello, B., Jensen, P. S., et al. (2008). MTA at 8 years: Prospective follow-up of children treated for combined-type ADHD in a multisite study. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 484–500.

    Article  Google Scholar 

  • National Institutes of Health. (2002). Outreach notebook for the inclusion, recruitment and retention of women and minority subjects in clinical research. Retrieved June 1, 2009, from http://orwh.od.nih.gov/pubs/outreach.pdf.

  • Nickerson, R. S. (2000). Null hypothesis significance testing: A review of an old and continuing controversy. Psychological Methods, 5, 241–301.

    Article  PubMed  Google Scholar 

  • Ogles, B. M., Lunnen, K. M., & Bonesteel, K. (2001). Clinical significance: History, application, and current practice. Clinical Psychology Review, 21(3), 421–446.

    Article  PubMed  Google Scholar 

  • Ojeda, L., Flores, L. Y., Meza, R. R., & Morales, A. (2010). Culturally competent qualitative research with Latino immigrants. Hispanic Journal of Behavioral Sciences, 33, 184–203.

    Article  Google Scholar 

  • Padilla, A. M., & Medina, A. (2001). Issues in culturally appropriate assessment. In L. A. Suzuki, J. G. Ponterotto, & P. C. Miller (Eds.), Handbook of multicultural assessment: Clinical, psychological, & educational applications (2nd ed., pp. 29–45). San Franscisco: Jossey-Bass Inc.

    Google Scholar 

  • Paniagua, F. A. (1994). Assessing and treating culturally diverse clients: A practical guide. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Pelham, W. E. (2002). Attention deficit hyperactivity disorder: Diagnosis, assessment, nature, etiology, and treatment. Unpublished manuscript, State University of New York at Buffalo.

  • Pelham, W. E., & Fabiano, G. A. (2001). Comorbidity in child mental health disorders and treatment strategy. Clinical Psychology and Psychotherapy, 8, 315–329.

    Article  Google Scholar 

  • Pelham, W. E., Fabiano, G. A., & Massetti, G. M. (2005). Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 449–476.

    Article  PubMed  Google Scholar 

  • Pelham, W. E., Gnagy, E. M., Greiner, A. R., Waschbusch, D. A., Fabiano, G. A., & Burrows-MacLean, L. (2010). Summer treatment programs for attention-deficit/hyperactivity disorder. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (2nd ed.). New York: The Guilford Press.

    Google Scholar 

  • Perczek, R., Carver, C. S., Price, A. A., & Pozo-Kaderman, C. (2000). Coping, mood, and aspects of personality in Spanish translation and evidence of convergence with English versions. Journal of Personality Assessment, 74(1), 63–87.

    Article  PubMed  Google Scholar 

  • Raggi, V. L., & Chronis, A. M. (2006). Interventions to address the academic impairment of children and adolescents with ADHD. Clinical Child and Family Psychology Review, 9, 85–111.

    Article  PubMed  Google Scholar 

  • Reddy, L. A., & de Thomas, C. A. (2007). Assessment of attention-deficit/hyperactivity disorder with children. In S. R. Smith & L. Handler (Eds.), The clinical assessment of children and adolescents: A practitioner’s handbook. New Jersey: Lawrence Erlbaum Associates.

    Google Scholar 

  • Rothe, E. M. (2005). Considering cultural diversity in the management of ADHD in Hispanic patients. Journal of the National Medical Association, 97, 175–235.

    Google Scholar 

  • Rubio-Stipec, M., Bird, H., Canino, G., & Gould, M. (1990). The Internal consistency and concurrent validity of a Spanish translation of the Child Behavior Checklist. Journal of Abnormal Child Psychology, 18, 393–396.

    Article  PubMed  Google Scholar 

  • Sattler, J. M. (2001). Assessment of children: Cognitive applications (4th ed.). San Diego: Jerome M. Sattler, Publisher, Inc.

    Google Scholar 

  • Schmitz, M. F., & Velez, M. (2003). Latino cultural differences in maternal assessments of attention deficit/hyperactivity symptoms in children. Hispanic Journal of Behavioral Sciences, 25, 110–122.

    Article  Google Scholar 

  • Shelton, K. K., Frick, P. J., & Wootton, J. (1996). Assessment of parenting practices in families of elementary school-age children. Journal of Clinical Child Psychology, 25, 317–329.

    Article  Google Scholar 

  • Skinner, D. G., Correa, V., Bailey, D. B., & Skinner, M. (2001). Role of religion in the lives of children with developmental delays. American Journal of Mental Retardation, 106, 297–313.

    Article  PubMed  Google Scholar 

  • Smith, B. H., Barkley, R. A., & Shapiro, C. J. (2006). Attention-deficit/hyperactivity disorder. In E. J. Mash & R. A. Barkley (Eds.), Treatment of childhood disorders (3rd ed., pp. 65–136). New York: The Guilford Press.

    Google Scholar 

  • Solis, M. L., & Abidin, R. R. (1991). The Spanish version Parenting Stress Index: A psychometric study. Journal of Clinical Child Psychology, 20, 373–378.

    Google Scholar 

  • Suarez-Balcazar, Y., Davis, M. I., Ferrari, J., Nyden, P., Olson, B., Alvarez, J., et al. (2004). University-community partnerships: A framework and an exemplar. In L. Jason, C. B. Keys, Y. Suarez-Balcazar, R. R. Taylor, & M. I. Davis (Eds.), Participatory community research: Theories and methods in action (pp. 105–120). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • US Census Bureau. (2000). Retrieved March 23, 2007 from http://www.factfinder.census.gov.

  • US Census Bureau. (2003). Poverty: Census 2000 brief. Retrieved July 28, 2009 from http://www.census.gov/prod/2003pubs/c2kbr-19.pdf.

  • Van Widenfelt, B. M., Treffers, D. A., de Beurs, E., Siebelink, B. M., & Koudijs, E. (2005). Translation and cross-cultural adaptation of assessment instruments used in psychological research with children and families. Clinical Child and Family Psychology Review, 8(2), 135–147.

    Article  PubMed  Google Scholar 

  • Weeks, A., Swerissen, H., & Belfrage, J. (2007). Issues, challenges, and solutions in translating study instruments. Evaluation Review, 31, 153–165.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., & Kazdin, A. E. (2010). Evidence-based psychotherapies for children and adolescents (2nd ed.). New York: The Guilford Press.

    Google Scholar 

  • Werner, O., & Campbell, D. T. (1970). Translating, working through interpreters, and the problem of decentering. In R. Naroll & R. Cohen (Eds.), A handbook of cultural anthropology (pp. 398–419). New York: American Museum of Natural History.

    Google Scholar 

  • Wideger, T., & Mullins-Sweatt, S. (2007). Mental disorders as discrete clinical conditions: Dimensional versus categorical classification. In M. Hersen, S. M. Turner, & D. C. Beidel (Eds.), Adult psychopathology and diagnosis (5th ed., pp. 3–33). New Jersey: Wiley.

    Google Scholar 

  • Yeh, M., Hough, R. L., McCabe, K., Lau, A., & Garland, A. (2004). Parental beliefs about the causes of child problems: Exploring racial/ethnic patterns. Journal of the Academy of Child & Adolescent Psychiatry, 43, 605–807.

    Article  Google Scholar 

  • Yeh, M., McCabe, K., Hough, R. L., Lau, A., Fakhry, F., & Garland, A. (2005). Why bother with beliefs? Examining relationships between race/ethnicity, parental beliefs about causes of child problems, and mental health service use. Journal of Consulting and Clinical Psychology, 73, 800–807.

    Article  PubMed  Google Scholar 

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Haack, L.M., Gerdes, A.C. Functional Impairment in Latino Children with ADHD: Implications for Culturally Appropriate Conceptualization and Measurement. Clin Child Fam Psychol Rev 14, 318–328 (2011). https://doi.org/10.1007/s10567-011-0098-z

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