Dr. Wilfred H. Farquharson on improving ADHD treatment for marginalized communities
1-minute summary: Studies have indicated that Black, Latinx and Asian children are less likely to receive diagnoses and treatment for their ADHD. Dr Wilfred H. Farquharson discusses the impact of disparate care in marginalized communities, ADHD treatment, the use of QbTest in his clinic, and strategies for giving every patient and their families the highest level of support.
Marginalized communities have long faced challenges in receiving access to adequate medical treatment. Studies from the US have shown that Black and Latinx children are less likely to receive diagnoses and treatment for their ADHD, while a 2021 study suggested Asian children had an ADHD diagnosis rate of just 1.1%. With the overall rate of ADHD in children estimated at 9.8%, it’s clear that more work must be done to bridge the gaps in youth treatment.
Yet making a diagnosis is just one part of the overall support process. As the authors of a literature review in Transcultural Psychiatry wrote: “Paradoxically, cultural, racial, and language bias may also lead to the overidentification of ethnic minority children as disabled and to higher ratings of ADHD symptoms.” Balancing the real needs of children with ADHD in racially marginalized communities, while avoiding the biases and presumptions that undermine care, creates a fine line for clinicians and researchers to walk.
Few individuals understand this reality better than Dr. Wilfred H. Farquharson, Director of Outpatient Behavioral Health at Stony Brook Children’s Hospital. With over a decade of experience as a clinical psychologist, Dr. Farquharson’s work dives directly into the impact of disparate care in marginalized communities. We caught up with Dr. Farquharson to learn more about ADHD treatment, the use of QbTest in his clinic, and strategies for giving every patient and their families the highest level of support.
On ADHD treatment
Dr. Farquharson’s passion for helping children with ADHD goes back to his youth: “I’ve always been interested in helping people and wanted to get into the field of psychology. I also always loved working with children, and we know ADHD is a thing many children continue to struggle with.”
Providing the right treatment for patients means creating a supportive environment. Dr. Farquharson has noted that shorter assessments are more enjoyable for patients, which certainly helps when assessing for potential ADHD symptoms.
As in many practices, some of the data comes from outside the clinic, in the form of subjective assessments from parents and teachers. Utilizing QbTest alongside these results has helped them make accurate diagnoses. “The addition of objective testing is helpful to providers looking for more information to assess diagnostically what is happening with their patient,” he notes. And with a QbTest lasting less than thirty minutes, there’s little risk of testing a patient’s patience.
Working with marginalized communities
Dr. Farquharson’s work has provided him and his team with an in-depth understanding of the challenges facing marginalized communities. “There have been reports that marginalized identities have higher rates of ADHD diagnosis. I have different suspicions as to why that may be, but something we need to pay particular attention to is how we evaluate behavior. There may be cultural nuances or implicit biases that impact the assessment.
For example, there is data that suggest black children are perceived older than they are – what does this mean for behavioral expectations and how their ratings in traditional testing may come back? This is a topic we need to continue analyzing in behavioral medicine and treatment.”
These biases that affect every aspect of medical care can impact ADHD treatment, diagnosis, and support as well. The way we talk about ADHD can have a notable impact on outcomes, as Dr. Farquharson has witnessed firsthand.
“My main goal is to continue having conversations around how the medical community and behavioral medicine talk to those people who are different than us. We need to be clear about healthcare literacy and explain reports from testing for these disorders in a way that the patient and family can understand.
Language access is part of this, and we need to be able to address and explain diagnostic criteria and treatment planning in multiple languages when we speak to families. It is also important to consider their experience as a marginalized group. We can hand folks a report, but it doesn’t mean anything unless they understand the information they are given.”
Better assessment with objective measures
Psychiatrists and nurse practitioners across the globe use QbTest and QbCheck to deliver diagnostic results to their ADHD patients. With objective reports in-hand, clinicians are better able to help patients and their families understand the diagnostic decision (no matter whether ADHD has been ruled in or ruled out), as well as options for treatment and further evaluation. Learn more about our ADHD tests or contact us today to see how our award-winning tests can help your practice.