America's Melting Pot and Treatment of ADHD
The next patient described is a 9-year-old boy who attended a Jewish private school with a demanding schedule and curriculum. He was taking his ADHD medicine at breakfast and lunch but his symptoms would return within a few hours. When his medication schedule was adjusted to accommodate his 8-and-1/2-hour school day, and his teachers were persuaded to modify his homework assignments, he improved markedly. Jaksa says that he often recommends that a child change teachers or even schools if his or her needs can be better met elsewhere.
Another patient Livingston describes is a 14-year-old girl, the daughter of Cuban parents who interpreted her impulsive comments as a sign of disrespect. Through medication and counseling she learned to control her speech, and her parents and grandparents gained a better understanding of her condition.
Issues of trust and communication between cultural groups also play a role in diagnosis. The last patient Livingston describes is a black third-grader whose mother attributed his problems to "'an inexperienced white teacher who wants to drug children into compliance.'" She observed her son at school and met with the teacher he had had in second grade. That teacher, who was black, explained that third grade is more demanding than second grade. The mother came to appreciate the importance of treatment for her child and even helped the local clinic start special support groups for Latino and black families with children with ADHD.
Livingston concludes that enhanced understanding of ethnic and cultural factors can lead to more effective treatment for patients and their families.