Understanding ADHD in Low-Income Latino Children.

描述（由申请人提供）：大多数关于注意力缺陷/多动障碍（ADHD）的研究都是在生活在郊区的白人中产阶级男孩的样本组中进行的。尽管拉丁裔儿童很快将成为这个国家最大的少数民族，但很少有关于多动症的研究是针对拉丁裔儿童进行的。需要进行研究，以确定具有文化敏感性的、有效的和临床有用的方法来诊断多动症，并评估拉美裔儿童的临床特征，如损伤水平和合并症模式。专门开发的理论框架考虑到这个国家大多数拉美裔人独特的文化、历史和社会经济特征，将极大地促进对拉美裔多动症儿童的研究。本项目的研究目的是：(1)确定生活在低收入城市环境中的拉丁裔和白人儿童样本中诊断ADHD所需的DSM-IV（美国精神病学协会，1994）症状的最佳数量；(2)确定拉丁裔和白人儿童ADHD评定量表IV的最佳分界点；(3)确定低收入城市拉美裔和白人儿童ADHD合并型（ADHD/COM）的共病模式是否存在差异；(4)探讨拉丁裔儿童的家庭主义（一种文化价值观，涉及对核心家庭和大家庭成员的强烈认同和依恋）、文化适应与障碍和合并症水平之间的关系。为了测试目标(1)到(4)，100名教师推荐的拉丁裔儿童和100名教师推荐的6至13岁的白人儿童将被评估，这些儿童就读于以拉丁裔和白人学生为主的低收入地区的7所公立学校。我未来五年的目标是进行独立研究，调查拉丁裔儿童和家庭应对多动症的诊断和临床问题。为了让我在这些领域变得精通，我和我的导师制定了一个教育计划，有四个具体目标：1。熟练理解拉丁裔家庭应对多动症的独特需求；2. 发展拉丁裔儿童ADHD评估的知识和实践技能；3. 了解拉丁裔ADHD儿童的共病障碍；4. 在研究设计和统计方面更加熟练。此外，我将接受负责任的研究培训。为了确保这个研究项目的所有方面都符合拉丁裔家庭的价值观和需求，我将召集一个由拉丁裔父母、专业人士和来自当地拉丁裔社区的辅助专业人士组成的利益相关者小组。完成拟议的研究和教育计划将使我成为一名熟练的独立研究人员，并为目前服务不足的儿童和家庭应对ADHD开发基于经验的、文化敏感的评估和干预程序。

DESCRIPTION (provided by applicant): Most research on attention-deficit/hyperactivity disorder (ADHD) has been conducted with sample groups of white, middle class boys living in suburban settings. Very few studies related to ADHD have been conducted with Latino children despite the fact that Latinos will soon be the largest ethnic minority group in this country. Research is needed to identify culturally sensitive, valid, and clinically useful methods for diagnosing ADHD and for assessing clinical characteristics such as impairment level and comorbidity patterns among Latino children. Theoretical frameworks specifically developed to take into account the unique cultural, historical, and socio-economic characteristics of most Latinos in this country would greatly facilitate research on Latino children with ADHD. The research aims of this project are (1) to determine the optimum number of symptoms from the DSM-IV (American Psychiatric Association, 1994) needed for the diagnosis of ADHD in a sample of Latino and White children living in low income urban settings; (2) to determine the optimal cut off scores for Latino and White children with ADHD on the ADHD Rating Scale IV; (3) to determine whether Latino and White children living in low-income urban settings differ in comorbidity patterns for ADHD, Combined Type (ADHD/COM); (4) to explore the relationship between familism (a cultural value that involves strong identification with and attachment to members of nuclear and extended families), acculturation and level of impairment and comorbidity among Latino children. To test Aims (1) through (4), 100 teacher-referred Latino children, and 100 teacher-referred White children between the ages of 6 and 13 attending seven public schools in a low income area with predominantly Latino and White student population will be assessed. My goal for the next five years is to conduct independent research to investigate diagnostic and clinical issues arising in Latino children and families coping with ADHD. In order for me to become proficient in these areas, my mentors and I have developed an educational plan with four specific aims: 1. To become proficient in understanding the unique needs of Latino families coping with ADHD; 2. To develop knowledge and practical skills in the assessment of ADHD among Latino children; 3. To become knowledgeable about comorbid disorders among Latino children with ADHD; 4. To become more proficient in research design and statistics. In addition, I will receive training in the responsible conduct of research. In order to insure that all aspects of this research project are responsive to the values and needs of Latino families, I will assemble a stakeholder group composed of Latino parents, professionals, and paraprofessionals from the local Latino community. The completion of the proposed research and educational plans will enable me to become a skilled independent researcher and to develop empirically based, culturally sensitive assessment and intervention procedures for what is currently an under-served segment of children and families coping with ADHD.