Understanding and Measuring Functional Impairment in Diverse Children With ADHD: Development of the ADHD-FX Scale With an At-Risk, Community Sample.

OBJECTIVE: The current study sought to develop a culturally appropriate measure of functional impairment related to ADHD for diverse families, as research suggests that functional impairment may be a more culturally universal construct than symptomatology. METHOD: Seventy-four low-acculturated Latino parents (49 mothers and 25 fathers) of school-aged children provided quantitative and qualitative responses about problem recognition after viewing a language-free video of a child displaying symptoms and behaviors consistent with ADHD. RESULTS: Thirty-two items were developed for the ADHD-FX scale based on most common responses given from participants. The scale is available in Spanish and English and instructs parents to consider how much each item affects their child in his or her everyday life (from 0 = not at all to 3 = a lot). CONCLUSIONS: The scale can provide an overall impairment score, as well as subscale scores in the theoretically derived domains of academic, peer, and familial impairment. (J. of Att. Dis. 2016; 20(6) 487-500).

Understanding parental locus of control in Latino parents: Examination of cultural influences and help-seeking intentions for childhood ADHD.

OBJECTIVE: To address the disparities that exist in utilization of mental health services for ADHD among Latino families and to further our understanding of factors that influence parents' decisions to seek treatment for ADHD, the goal of the current study was to examine parental locus of control (PLOC) in a community sample of Latino parents. Specifically, the current study investigated cultural influences on PLOC, as well as the influence of PLOC on help-seeking. METHOD: Seventy-four primarily Spanish-speaking, Latino parents of school-age children completed measures to assess their help-seeking intentions, PLOC, and cultural orientation. RESULTS: Results indicated that U.S. mainstream orientation was associated with increased feelings of parental control and decreased beliefs in fate/chance and several Latino cultural values were associated with increased beliefs in fate/chance, and decreased feelings of parental efficacy and parental control. In addition, 2 PLOC domains (e.g., parental efficacy and fate/chance) were associated with beliefs that the behaviors of a child with ADHD would go away on their own. CONCLUSIONS: Results highlight the need for interventions aimed at modifying parenting behavior to take parents' cultural beliefs and values into account in order to accommodate and engage Latino families more effectively.

Acculturation and Latino adolescent mental health: integration of individual, environmental, and family influences.

In order to address the mental health disparities that exist for Latino adolescents in the United States, psychologists must understand specific factors that contribute to the high risk of mental health problems in Latino youth. Given the significant percentage of Latino youth who are immigrants or the children of immigrants, acculturation is a key factor in understanding mental health among this population. However, limitations in the conceptualization and measurement of acculturation have led to conflicting findings in the literature. Thus, the goal of the current review is to examine and critique research linking acculturation and mental health outcomes for Latino youth, as well as to integrate individual, environmental, and family influences of this relationship. An integrated theoretical model is presented and implications for clinical practice and future directions are discussed.

Acculturation, cultural values, and Latino parental beliefs about the etiology of ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent mental health disorders of childhood. Despite the availability of several evidence-based interventions, Latino children are more likely than non-minority children to have an unmet need for services related to ADHD. Given that parental beliefs about the etiology of ADHD likely influence service utilization, research needs to focus on cultural factors that may influence parental beliefs about the etiology of child behavior problems. Thus, the goal of the current study was to investigate the role of acculturation and cultural values of familism, respect, spirituality, and traditional gender roles in explaining parental etiological beliefs about ADHD in a sample of Latino parents. Findings suggest that behavioral acculturation was not significantly correlated with biopsychosocial or sociological/spiritual etiological beliefs; however, the cultural values of familism and traditional gender roles were positively correlated with sociological/spiritual beliefs. Further, exploratory analyses suggested that after controlling for SES, familism and traditional gender roles accounted for 30.5 % of the total variance in sociological/spiritual beliefs about ADHD. Finally, post hoc analyses revealed that cultural values were associated with several individual belief categories within the sociological/spiritual domain, including beliefs about friends, spirituality, and nature disharmony. The current study supports the inclusion of etiological beliefs and cultural factors in research examining help-seeking and access to mental health services among Latino families and suggests that the incorporation of alternative etiological beliefs about child behavior may be an important factor in culturally-appropriate mental health services.

Latino parental help seeking for childhood ADHD.

To better understand the help seeking process that occurs within Latino families when a child is exhibiting behaviors consistent with attention-deficit/hyperactivity disorder (ADHD), qualitative and quantitative data from 73 Latino parents were examined. Findings suggest that most Latino parents in the current sample recognized ADHD symptoms as concerning and in need of professional help and reported being motivated to seek help. Unfortunately, they also appeared to lack knowledge about the etiology of and effective treatment for ADHD, and many identified barriers to seeking help. Future research must involve community collaborations aimed at increasing awareness and knowledge of ADHD and decreasing barriers to seeking help in targeted Latino communities.

Assessing ADHD in Latino families: evidence for moving beyond symptomatology.

OBJECTIVE: In an effort to combat the mental health disparities that exist among Latinos, the current study aimed to add to our knowledge related to culturally appropriate assessments for Latino children presenting with ADHD. METHOD: As part of a larger study, a community sample of 68 Spanish-speaking, Latino parents completed the Spanish translation of the Disruptive Behavior Disorders Rating Scale (DBD-S), a commonly used, parent-report measure of ADHD. RESULTS: Results suggest that although both the Inattentive and Hyperactive/Impulsive subscales of the DBD-S are psychometrically sound, the Hyperactive/Impulsive subscale may not be culturally appropriate with some Latino families, particularly those who are less acculturated. This was further supported by preliminary evidence suggesting that this subscale also was not diagnostically useful with the current, community sample. CONCLUSION: The potential problems associated with the overemphasis on symptomatology when working with Latino families, the importance of examining functional impairment as part of a culturally appropriate assessment, and the need to replicate the current findings with a clinical sample are discussed.