Racial-Ethnic Heterogeneity in the Relationship Between an Early Elementary School ADHD Diagnosis and Later Child Well-Being

Attention-deficit/hyperactivity disorder (ADHD) is America’s most common childhood disorder. Although an ADHD diagnosis can bring positives, recent research uncovers potential negatives associated with diagnosis. This study examines understudied racial-ethnic heterogeneity in the relationships between an early elementary school ADHD diagnosis—with or without medication treatment—and children’s future perceived self-competence, teacher-rated school behaviors, and parent-rated educational expectations. Findings are consistent with the notion that diagnosis can trigger racialized patterns of stigma. That is, relative to undiagnosed matches of the same social class and regardless of medication use, diagnosed Black children demonstrate worse teacher-rated school behaviors, diagnosed White children report poorer perceived self-competence, and parents of diagnosed Hispanic children report poorer educational expectations. Racialized patterns of stigma might amplify the consequences of negative-ability stereotyping on Black children, academic pressure on White children, and mental health stigma on Hispanic children. Findings also highlight the challenges of identification posed by differential unobserved selection into diagnosis.