Black Boys and ADHD: Biology or Culture Clash?

African-American children are quickly catching up to white children in the rate of diagnoses for attention deficit/hyperactivity disorder.

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“After that it doesn’t count,” she said, meaning that you can’t qualify for extra time on the SAT. After high school, the medications are highly coveted on college campuses for students wanting to pull all-nighters. 

In my buppie parenting circles, we all seem to get the same not-so-subtle hints from school administrators about the deficiencies of our beautiful black sons. Is there something neurologically wrong with all of our boys? Or is something else in the culture at work? As one of the white Dalton administrators said, “There is a cultural disconnect between independent schools and African-American boys. The question is why.”

There are well-documented theories. Female-dominated classroom cultures punish boys. Toxic perceptions of black males in this country pollute the way schools interpret our boys’ behavior. There is pressure on teachers to maintain order in the classroom and produce results.

The ADHD drugs make boys more focused and compliant. But these medications can also potentially set them up for a lifetime of dependency and other side effects. Ryan Silver, a veteran public teacher in New York and New Jersey, thinks that teachers and parents sometimes use the diagnosis as a crutch. “Sometimes it’s just poor teaching,” he said.

As the first male teacher at one high-poverty school, Silver worried about the prevalence of disciplinary referrals and the diagnosis in his male students. The boys were lethargic and complained of headaches and dry mouth. “It was almost like a zombie in the classroom,” he said. “They were constantly asking for water. You knew why they were behaving this way, but they didn’t,” Silver said.

But when the boys behaved poorly, parents were summoned to school. Single mothers especially couldn’t afford to constantly leave work, so the medication seemed like a godsend. But Silver convinced a group of parents to let him work with a group of second-grade boys on alternatives to medication. He created a structured system of routines with plenty of activities and physical breaks.

Some of the boys needed the medication to function normally. But over two years, for a majority of the group, Silver saw dramatic improvement in both their behaviors and academic performance—with no medication. “They can avert the medication route,” Silver said. “They need to know the routine so they can get out their aggression in a healthy way. They need that release time to focus.”

The Brewster-Stephenson family came to a similar conclusion. Their son Idris used the medication for six months, and his academic performance soared, Brewster said in an interview with The Root. But Idris did not like the way the medication made him feel. So his parents took him off the prescription and used nonmedicinal interventions, including tutoring, rigidly scheduling his time and plenty of physical activity.

As a psychiatrist, Brewster is well aware of the resistance that black parents often have toward medicating their children and the highly subjective nature of how the disorder is diagnosed. “It is a highly personal and individual decision that families have to make,” he said.

If his son were at a public school, Brewster said, he probably would not feel the need to use medication. But they made the decision to put their son in the unforgiving academic environment and felt that they had to do whatever it took to help him succeed. They were very demanding of their firstborn son but made different choices for their younger son, who attends a more laid-back private school. “We also give him a lot more hugs,” Brewster said.