ORCID

0009-0009-7453-1705

Date of Award

Summer 2026

Language

Englishh

Embargo Period

5-8-2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College/School/Department

Department of Psychology

Program

Clinical Psychology

First Advisor

Elana Gordis

Committee Members

James Boswell, Drew Anderson

Keywords

ADHD, racial bias, collateral report, neuropsychological evaluation

Subject Categories

Child Psychology | Clinical Psychology | Mental Disorders | Psychiatric and Mental Health

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed mental health condition among children in the United States. However, prevalence rates in the diagnosis and treatment of ADHD are unequal across populations. Specifically, the literature has demonstrated consistent variability in symptom endorsements and diagnosis dependent on a child’s demographic factors (i.e., race, gender, age). A diagnosis of ADHD requires that the diagnostic criteria be met in at least two aspects of a child's life, usually the school and home environments. As such, teacher reports are commonly used in the assessment of ADHD for children and adolescents. Given the challenges in obtaining a precise measure of ADHD through neuropsychological or cognitive testing, teacher collateral reports play a key role in diagnosis. Discrepancies in symptom reports based on a child’s race rather than the objective presence or absence of symptoms can have devasting implications. Examining racial bias as a potential factor influencing symptom endorsement among collateral reports is critical. This project examined whether a child's race impacts endorsement of ADHD symptoms, perceived severity, and clinical predictions across three sample groups. The sample groups were made up from pilot study undergraduates, undergraduate pre-service educators, and active K-12 teachers. Results demonstrated variability in both the presence and absence of racial bias dependent on the group sample. Study 1 demonstrated bias in ADHD symptom endorsement (reporting the presence of ADHD symptoms), perceived severity, and clinical predictions, with the White child receiving greater endorsements (higher reports of ADHD symptoms) and more favorable clinical outcomes. Study 2 demonstrated largely null findings on all primary, secondary, and exploratory findings. Study 3 yielded significant racial bias with greater clinical predictions for the White child, while ADHD symptom endorsement and perceived severity were null. This study underscores the need for continued scholarship in how a child’s race may impact collateral reports and clinical predictions towards children and adolescents. This scholarship may drive better understanding of how we may mitigate bias in the psychodiagnostic and neuropsychological evaluation of ADHD across racial groups.

License

This work is licensed under the University at Albany Standard Author Agreement.

Download

Share

COinS