Abnormal Child Psychology 7th Edition

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1. One of the first known published accounts of hyperactivity in children, published in 1845, referred to
a. a child named “Fidgety Phil.”
b. a boy from Chicago named Dusty.
c. a child who was often the symptom of ridicule at school.
d. a boy who was ostracized and had no friends
ANSWER: a

2. In an early study, Sir Alexander Crichton described a syndrome that included early onset, restlessness, inattention, and
poor school performance. Such individuals were described as having _______________.
a. attention deficit disorder (ADD)
b. the fidgets
c. ADHD
d. brain-injured child syndrome
ANSWER: b

3. The brain damage theory of ADHD, which arose in the 1940s and 1950s, was discarded because ____.
a. no evidence of brain damage could be found using x-ray
b. the psychological cause of ADHD was “found” in 1958
c. it could explain only a very small number of cases of ADHD
d. brain damage was thought to cause mental retardation, not ADHD
ANSWER: c

4. Which of the following statements about ADHD is false?

a. No single cause for the behavior patterns of children with ADHD has been identified.
b. ADHD is an umbrella term used to describe several different patterns of behavior that differ slightly.
c. Hyperactivity and inattention together are essential features of ADHD.
d. There are no distinct signs of ADHD that can be seen with an x-ray or a lab test.
ANSWER: c

5. Virginia Douglas (1972) made the argument that ____.

a. hyperactivity is the primary component of ADHD
b. in addition to hyperactivity, inattention and deficits in impulse control are the primary symptoms
c. ADHD is due to minimal brain damage
d. ADHD is psychological rather than biological in origin
ANSWER: b

6. Recently, the symptoms that have been emphasized as the central impairments of ADHD are ____.
a. inattention and difficulty regulating motor behavior
b. difficulty inhibiting behavior and poor self-regulation
c. inattention and poor moral control
d. hyperactivity and cognitive problems
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ANSWER: b

7. Jeremy cannot remember a phone number without jotting it down. He demonstrates a deficit in ____.
a. impulsivity
b. sustained attention
c. selective attention
d. attentional capacity
ANSWER: d

8. When Jessica sits down to do her homework and study, she is easily distracted by the television in another room.
Jessica demonstrates a deficit in ____.
a. attentional control
b. sustained attention
c. selective attention
d. attentional capacity
ANSWER: c

9. Bradley has particular difficulty paying attention when he is tired or uninterested in the task at hand. Bradley
demonstrates a deficit in ____.
a. sustained attention
b. distractibility
c. selective attention
d. attentional capacity
ANSWER: a

10. Which of the following is another term for a deficit in selective attention?
a. Distractibility
b. Impulsivity
c. Dual attention
d. Disorganization
ANSWER: a

11. The core attentional deficit in ADHD is believed by many to be ____.

a. selective attention
b. attentional capacity
c. sustained attention/vigilance
d. distractibility
ANSWER: c

12. What might be the most difficult task for a child with ADHD?
a. Learning a new video game

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b. Paying attention to the teacher when someone else in the class is talking
c. Remembering a friend’s phone number
d. Working for 45 minutes on a sheet of simple math problems
ANSWER: d

13. When is a child with ADHD likely to display more motor activity than other children?
a. When asked to sit still at his desk
b. In his sleep
c. While playing on the playground
d. All of these
ANSWER: a

14. What is an example of cognitive impulsivity?

a. Blurting out an answer in class
b. Touching a hot stove
c. Rushed thinking
d. Interrupting a parent on the telephone
ANSWER: c

15. Children with ADHD who are at increased risk for conduct or oppositional problems are those who exhibit ____.
a. behavioral impulsivity
b. cognitive impulsivity
c. selective inattention
d. diminished attentional capacity
ANSWER: a

16. Children who are at increased risk for problems in academic achievement are those who exhibit ____.
a. behavioral impulsivity
b. cognitive impulsivity
c. selective inattention
d. behavioral impulsivity and cognitive impulsivity
ANSWER: d

17. Which of the following is an additional criterion for a diagnosis of ADHD?

a. Symptoms must appear prior to age 12.
b. Symptoms must be present for at least one year.
c. Symptoms must occur in at least one setting.
d. Symptoms must produce significant impairments in the child’s social or academic performance.
ANSWER: d

18. Which of the following is not an additional criterion for a diagnosis of ADHD?
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a. Symptoms must appear prior to age 12.
b. Symptoms must be present for at least 6 months.
c. Symptoms must occur in more than one setting.
d. Symptoms must produce significant impairments in the child’s social or academic performance.
ANSWER: a

19. In comparison to children with ADHD-HI, children with the subtype ADHD-PI are at greater risk of ____.
a. antisocial behavior
b. rejection by peers
c. anxiety/mood disorders
d. placement in a special education class
ANSWER: c

20. Which of the following is not true about ADHD-HI?

a. Children with ADHD-HI are often older than those with ADHD-C.
b. The ADHD-HI subtype is the rarest subtype of ADHD.
c. Children with ADHD-HI are more likely to display behavioral problems than those with ADHD-PI.
d. Children with ADHD-HI are more likely to be suspended from school than those with ADHD-PI.
ANSWER: a

21. Which of the following is not true about ADHD-PI?

a. Children with ADHD-PI are often described as daydreamy and drowsy.
b. Children with ADHD-PI have difficulties with speed of information processing.
c. Children with ADHD-PI are often described as aggressive and rude.
d. Research evidence suggests that children diagnosed with ADHD-PI may actually have a completely different
disorder than children with ADHD-HI and ADHD-C.
ANSWER: c

22. Diagnostic criteria for ADHD includes which symptom of inattention?

a. Often fidgets with or taps hands or feet or squirms in seat
b. Often has difficulty organizing tasks and activities
c. Often talks excessively
d. Often has difficulty waiting his/her turn
ANSWER: b

23. The mental processes underlying children’s capacity for self-regulation are called ____.
a. executive functions
b. metacognition
c. self-perceptions
d. thought tracking
ANSWER: a
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24. Which statement best describes the intelligence of a child with ADHD?
a. Over 50% of children with ADHD are below average in intelligence.
b. Over 50% of children with ADHD are above average in intelligence.
c. Brighter children tend to show more symptoms of impulsivity and hyperactivity.
d. Most children with ADHD are of average intelligence.
ANSWER: d

25. Which child would be more likely to display a positive illusory bias?
a. A child with ADHD-HI and conduct problems
b. A child with ADHD-HI and depression
c. A child with ADHD-PI and anxiety
d. A child with ADHD-PI and conduct problems
ANSWER: a

26. Which is a characteristic of the speech/language of a child with ADHD?

a. Mumbling that is difficult to distinguish
b. Consistent topic discussion
c. Quiet speech that is difficult to hear
d. Unclear links in conversation
ANSWER: d

27. Which of the following is NOT an area in which symptoms of accident-proneness and risk taking that are common in
individuals with ADHD are manifested?
a. Driving behaviors
b. Anxiety disorders
c. Incidence of STDs
d. Substance abuse
ANSWER: b

28. Mothers of children with ADHD are also more likely to have ____.
a. substance abuse problems
b. schizophrenia
c. depression
d. antisocial personality disorder
ANSWER: c

29. Which of the following is TRUE of children with ADHD?

a. They are deficient in social reasoning.
b. They have the same social agenda as their peers.
c. They report receiving high social support from peers.
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d. They are consistently rejected by peers
ANSWER: d

30. Children with ADHD display ____.

a. a decreased desire for peer relationships
b. a poor understanding of social reasoning
c. a strong ability to correctly recognize emotions in others
d. little give-and-take in relationships with peers
ANSWER: d

31. The most common comorbid psychological disorder(s) in children with ADHD is/are ____.
a. anxiety and depression
b. oppositional defiant disorder and depression
c. tic disorder
d. conduct disorder and oppositional defiant disorder
ANSWER: d

32. A common condition among children with ADHD, a ______________ is characterized by marked motor
incoordination and delays in achieving motor milestones.
a. mood dysregulation disorder
b. tic disorder
c. developmental coordination disorder (DCD)
d. developmental learning disorder (DLD)
ANSWER: c

33. The relationship between ADHD and depression appears to be a function of ____.
a. the bullying and isolation that a child experiences
b. family risk for one disorder increasing the risk for the other
c. general family stress
d. the parallel impact of school achievement
ANSWER: b

34. The best prevalence estimate for ADHD in school-age children in North America is ____.
a. 1% to 2%
b. 5% to 9%
c. 12% to 14%
d. 15% to 20%
ANSWER: b

35. The higher incidence of ADHD in boys versus girls is most likely due to ____.
a. girls age out of ADHD in childhood
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b. societal expectations and acceptance
c. more aggression in girls
d. greater attention span in females
ANSWER: b

36. In comparison to boys, girls with ADHD are more likely to display ____.
a. higher levels of hyperactivity
b. greater impairment in executive functions
c. higher levels of aggression
d. inattentive/disorganized symptoms
ANSWER: d

37. Girls with ADHD are more likely than girls without ADHD to have ____.
a. conduct, mood, and anxiety disorders
b. lower rates of verbal aggression
c. higher IQ and school achievement scores
d. a large social network
ANSWER: a

38. The higher rates of ADHD in lower SES groups are best accounted for by ____.
a. the presence of co-occurring depression
b. the presence of co-occurring parental psychopathology
c. the presence of co-occurring conduct problems
d. the presence of co-occurring learning problems
ANSWER: c

39. Which is true regarding ADHD and culture?

a. ADHD has been found to occur more in higher SES groups than lower ones.
b. ADHD has been identified in only one or two countries around the world in which it has been studied.
c. Differences in the prevalence of ADHD across cultures may reflect cultural norms.
d. ADHD presents the same in each country.
ANSWER: c

40. Children from which racial/ethnic group are teachers most likely to rate as ADHD?
a. Caucasian
b. African American
c. Asian
d. Hispanic
ANSWER: b

41. Mothers of children with ADHD often describe their children as being ____ as infants.
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a. difficult
b. easy
c. indistinguishable from their siblings
d. overly anxious and depressed
ANSWER: a

42. With regard to the onset of symptoms of ADHD, ____.

a. symptoms of hyperactivity–impulsivity and inattention tend to emerge at about the same time, usually in the
preschool years
b. symptoms of hyperactivity–impulsivity and inattention tend to emerge at about the same time, usually in the
early primary school years
c. symptoms of inattention usually emerge before symptoms of hyperactivity–impulsivity
d. symptoms of hyperactivity–impulsivity usually decline by adolescence
ANSWER: d

43. Which is true of the course of ADHD?

a. ADHD does not develop until school age.
b. The majority of children with ADHD outgrow their problems before adolescence.
c. Many adults have ADHD but were never been diagnosed in childhood.
d. Signs of ADHD are unlikely to be present before the age of two.
ANSWER: c

44. Individuals with ADHD are typically identified as ADHD and referred for special assistance during the __________.
a. preschool
b. elementary school
c. adolescence
d. adulthood
ANSWER: b

45. Which of the following is most likely to cause ADHD?

a. Too much sugar
b. Fluorescent lighting
c. Poor school environment
d. No single theory has been able to identify a cause
ANSWER: d

46. Children with ADHD display deficits in ____.

a. intelligence
b. motor activity
c. self-regulation
d. arousal
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ANSWER: d

47. Research into causal factors provides strong evidence for ADHD as a disorder with ____ determinants.
a. biological
b. neurobiological
c. socioenvironmental
d. familial
ANSWER: b

48. Twin studies suggest that ____ factors play the largest role in accounting for ADHD.
a. shared environmental
b. nonshared environmental
c. heritable
d. cultural
ANSWER: c

49. DRD4, the dopamine receptor gene, has been linked to ____.
a. inhibition
b. attention
c. impulsivity
d. cognition
ANSWER: c

50. Minor physical anomalies and other risk factors before, during, and after birth are specific risk factors for ____.
a. ADHD, but not other forms of psychopathology
b. many forms of psychopathology
c. ADHD and conduct disorder alone
d. anxiety and depression alone
ANSWER: b

51. Neurobiological research on the causes of ADHD has shown consistent support for the implication of the
a. limbic system.
b. hippocampus.
c. reticular activating system.
d. frontostriatal circuitry.
ANSWER: d

52. In Hoover and Milich’s study (1994), mothers who (erroneously) believed that their children had ingested sugar ____.
a. described them as “sweeter” than did mothers of children in the control condition
b. rated them as happier and calmer than did mothers of children in the control condition
c. were more critical of their children and rated them as more hyperactive than did mothers of children in the
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control condition
d. did not notice any change in their children’s behavior
ANSWER: c

53. What does research into the negative influence of family on ADHD symptomatology indicate?
a. Familial factors account for a significant degree of variance in ADHD symptoms.
b. Familial factors account for only a small degree of variance in ADHD symptoms.
c. Familial factors may increase the severity of certain ADHD symptoms.
d. Familial factors account for only a small degree of variance in ADHD symptoms, although they may increase
the severity of certain symptoms.
ANSWER: d

54. One focus of educational intervention treatments is to

a. provide a supportive relationship in which the youth can discuss personal concerns and feelings.
b. combine other treatments in an intensive treatment program.
c. reduce conflicts at home.
d. teach prosocial and self-regulating behaviors.
ANSWER: d

55. Stimulant medications work by ____.

a. paradoxically slowing kids down
b. altering neurotransmitter activity in the frontostriatal region of the brain (stimulating areas that are
underaroused)
c. enhancing mood, which in turn enhances self-esteem and behavioral control
d. “convincing” parents and teachers that the medications are working, even when they’re not (placebo effect)
ANSWER: b

56. An educational intervention for ADHD may include ____.

a. positive punishment procedures in the classroom
b. use of workbooks in the classroom
c. giving written and oral instructions in the classroom
d. residential care
ANSWER: c

57. What were the results of the Multimodal Treatment Study of Children with ADHD (MTA Study)?
a. In general, behavioral treatment was superior to medication management.
b. Adding behavioral treatments to medication resulted in benefits over and above medications in terms of
alleviating core symptoms.
c. Three years after the conclusion of the treatment, only the medication management group continued to benefit
from treatment.
d. There were no variations in the amount of change between groups.
ANSWER: c
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58. When utilizing educational interventions, disruptive or off-task classroom behaviors may be punished with ____ that
involve the loss of privileges, activities, points, or tokens following inappropriate behavior.
a. partial-response procedures
b. all-or-nothing procedures
c. response-cost procedures
d. delayed-cost procedures
ANSWER: c

59. Causes for the controversy over Ritalin and other stimulants include all of the following EXCEPT
a. questions about whether parents are being coerced into administering stimulants so that their children can
attend school.
b. a large and growing number of children and adolescents in the US are taking stimulants for ADHD.
c. research on the benefits of stimulants is contradictory; some studies suggest substantial benefits while others
suggest that their usage is harmful.
d. wide varieties in diagnostic practices, treatment decisions, and rates of use contribute to inconsistent practices
and conclusions about results.
ANSWER: c

60. One exemplary intensive intervention for ADHD, developed by Dr. William Pelham, is known as the
a. parent management training (PMT).
b. school-based intervention program.
c. summer treatment program.
d. stimulant medications intensive treatment program.
ANSWER: c

61. Describe three types of attention deficits seen in children with ADHD, and provide an example of each.
ANSWER: Inattention refers to an inability to sustain attention or stick to tasks or play activities, to and follow through
on instructions or rules, and to resist distractions. It also involves difficulties in planning and organization and
in timeliness and problems in staying alert. With hyperactivity, recordings of body movements indicate that
even when they sleep, children with ADHD display more motor activity than other children (Teicher et al.,
1996). However, the largest differences are found in situations requiring the child to inhibit motor activity—
to slow down or sit still in response to the structured task demands of the classroom. Children who are
impulsive seem unable to bridle their immediate reactions or think before they act. They may take apart an
expensive clock with little thought about how to put it back together. It’s very hard for them to stop an
ongoing behavior or to regulate their behavior in accordance with the demands of the situation or the wishes
of others.

62. What are some of the limitations of the DSM-5 as a means of diagnosing ADHD? What changes have been suggested
to address these limitations?
ANSWER: Although DSM states that clinical judgment may be used to assess whether symptoms are “inconsistent with
developmental level,” it applies the same symptoms to individuals of all ages, even though some symptoms,
particularly for hyperactive–impulsive behaviors (running and climbing), apply more to young children.
According to DSM, ADHD is a disorder that a child either has or doesn’t have. However, because the
number and severity of symptoms are also calculated on a scale, children who fall just below the cutoff for
ADHD are not necessarily different from children just above the cutoff. These limitations highlight the fact
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that DSM criteria are designed to classify and diagnose. They help shape our understanding of ADHD but are
also shaped by—and in some instances lag behind—new research findings.

63. Executive functions include cognitive, language, motor, and emotional processes. Give an example of each, and
explain how executive functions relate to ADHD.
ANSWER: Executive functions (EFs) are cognitive processes in the brain that activate, integrate, and manage other brain
functions. Cognitive processes, such as working memory (holding facts in mind while manipulating
information), mental computation, planning and anticipation, flexibility of thinking, and the use of
organizational strategies. Language processes, such as verbal fluency and the use of self-directed speech.
Motor processes, such as allocation of effort, following prohibitive instructions, response inhibition, and
motor coordination and sequencing. Emotional processes, such as self-regulation of arousal level and
tolerating frustration.

64. Identify and describe symptoms of ADHD related to accident-proneness and risk taking.
ANSWER: Children with ADHD are significantly more likely to experience serious accidental injuries. They are at
higher risk for traffic accidents and deviant peer associations that could also encourage risky behaviors,
especially among adolescents. One study of boys with ADHD found that they had more risky driving
behaviors, STDs, head injuries, and ER admissions, compared to a control group. A Danish study found that
ADHD associated with excess mortality, notably driven by deaths from unnatural causes. Finally, ADHD
prevalence is negatively associated with health-promoting behaviors, such as exercise, proper diet, safe sex,
and avoidance of tobacco, alcohol, and caffeine use.

65. The co-occurrence of ADHD and conduct disorder has led some researchers to suggest a subgroup of children with
ADHD at increased risk for conduct problems. What support is there for such a subtype?
ANSWER: Longitudinal studies have found that ADHD leads to ODD and CD rather than vice versa (Thapar et al.,
2006). Interestingly, persistent and severe ODD and CD outcomes among children with ADHD are related to
variations in a specific gene (COMT) known to be associated with the regulation of neurotransmitters in the
areas of the brain implicated in ADHD. These findings suggest the existence of a subgroup of children with
ADHD who are at biological risk for later developing conduct problems (Caspi et al., 2008). Finally, ADHD
is also a risk factor for the later development of antisocial personality disorder (APD) (Storebø & Simonsen,
2013), a pervasive pattern of disregard for, and violation of, the rights of others, as well as involvement in
multiple illegal behaviors.

66. How do the symptoms of inattention and hyperactivity–impulsivity change over the lifespan?
ANSWER: Symptoms of inattention become especially evident when the child starts school. Classroom demands for
sustained attention and goal-directed persistence are formidable challenges for these children (Kofler,
Rapport, & Alderson, 2008). Not surprisingly, this is when children are usually identified as having ADHD
and referred for special assistance. Symptoms of inattention continue through grade school, resulting in low
academic productivity, distractibility, poor organization, trouble meeting deadlines, and an inability to follow
through on social promises or commitments to peers. The hyperactive–impulsive behaviors that were present
in preschool continue, with some decline, from 6 to 12 years of age (Barkley, 2006a). Although hyperactive–
impulsive behaviors decline significantly by adolescence, they still occur at a higher level than in 95% of
same-age peers who do not have ADHD. The disorder continues into adolescence for at least 50% or more of
clinic-referred elementary school children. Childhood symptoms of hyperactivity–impulsivity (more so than
symptoms of inattention) are generally related to poor adolescent outcomes (Barkley, 2006b). Unfortunately,
most children with ADHD will continue to experience problems, leading to a lifelong pattern of suffering and
disappointment (Barkley, 2014a, b). Once thought of primarily as a disorder of childhood, ADHD is now
well established as an adult disorder. Adults with ADHD are restless, easily bored, and constantly seeking
novelty and excitement; they may experience work difficulties, impaired social relations, and suffer from
depression, low self-concept, substance abuse, and personality disorder
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67. Distinguish between the different subtypes of ADHD.

ANSWER: Predominantly inattentive presentation (ADHD-PI) describes children who meet symptom criteria for
inattention but not hyperactivity–impulsivity. Predominantly hyperactive–impulsive presentation (ADHD-HI)
describes children who meet symptom criteria for hyperactivity-impulsivity but not inattention. Combined
presentation (ADHD-C) describes children who meet symptom criteria for both inattention and
hyperactivity–impulsivity.

68. List and describe impaired executive functions in ADHD as well as resulting impairments.
ANSWER: Six impaired executive functions in individuals with ADHD have been identified. Along with their resulting
impairments, they are as follows: (1) Organize, prioritize, and activate: trouble getting started; difficulty
organizing work; misunderstanding directions; (2) Focus, shift, and sustain attention: lose focus when trying
to listen; forget what has been read and need to reread; easily distracted; (3) Regulate alertness, effort, and
processing speed: excessive daytime drowsiness; difficulty completing a task on time; slow processing speed;
(4) Manage frustration and modulate emotion: very easily irritated; feelings hurt easily; overly sensitive to
criticism; (5) Working memory and accessing recall: forget to do a planned task; difficulty following
sequential directions; quickly lose thoughts that were put on hold; (6) Monitor and regulate action: find it
hard to sit still or be quiet; rush things or slapdash; often interrupt, blurt things out.

69. Describe the difficulties children experience that have co-occurring ADHD and anxiety.
ANSWER: These children worry about being separated from their parents, trying something new, taking tests, making
social contacts, or visiting the doctor. They may feel tense or uneasy and constantly seek reassurance that
they are safe and protected. Because these anxieties are unrealistic, more frequent, and more intense than
normal, they have a negative impact on the child’s thinking and behavior.

70. Describe the influence that dietary factors, notably sugar consumption, contribute to hyperactivity.
ANSWER: Despite popular perception, multiple studies have conclusively shown that sugar is not a cause of
hyperactivity. Popular perception, contrary to these findings, are long-standing and have been scientifically
verified as related to the power of suggestion in studies showing parents’ reactions and behavior with regard
to perceived sugar consumption. This relates to ADHD because what parents believe about the causes of their
children’s ADHD can affect their views of their children, how they treat them, as well as treatment options
pursued.

71. Discuss the behavioral differences in boys and girls with ADHD that have been found in clinical samples.
ANSWER: In the past, girls with ADHD were a highly understudied group (Hinshaw & Blachman, 2005). Although girls
with ADHD tend to display inattentive/ disorganized symptoms, some research shows more similarity
between girls and boys with ADHD than was previously thought to exist. Some studies have found that
among clinic-referred school-age children with ADHD, boys and girls are quite similar with respect to their
expression and severity of symptoms, brain abnormalities, deficits in response inhibition and executive
functions, level of impairment, family correlates, response to and young adulthood, including anxiety;
depression; romantic relationship difficulties; conflict with mothers; significant peer rejection and conduct
problems; large deficits in academic achievement; continuing deficits in attention, executive functions, and
language; impaired decision making; and high rates of service utilization (Babinski et al., 2010; Biederman et
al., 2010; Mick et al., 2011; Miller et al., 2013; Owens et al., 2014).

72. Discuss the nature of relationships in adolescence.

ANSWER: Despite their many social problems with peers, some adolescents with ADHD may meet their social needs by
maintaining one or two positive close friendships (Glass, Flory, & Hankin, 2012). The social premise for
such relationships may differ from those of other teens, possibly with a mutual focus on “having fun” rather
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than on seeking emotional support. Positive friendships may buffer the negative outcomes of peer rejection
commonly seen in children with ADHD.

73. What is the role of the family in etiology and development of ADHD symptoms?
ANSWER: Family influences may lead to ADHD symptoms or to a greater severity of symptoms. In some cases, ADHD
symptoms may be the result of interfering and insensitive early caregiving practices (Carlson, Jacobvitz, &
Sroufe, 1995), especially in children with a specific genetic risk for ADHD (Martel et al., 2011). Thus,
parenting practices may interact with the child’s genetic makeup to moderate risk for ADHD. In addition, for
children at risk for ADHD, family conflict may raise the severity of their hyperactive–impulsive symptoms to
a clinical level. Family problems may result from interacting with a child who is impulsive and difficult to
manage (Mash & Johnston, 1990). The clearest support for this child-to-parent direction of effect comes from
double-blind placebo-controlled drug studies in which children with ADHD who received stimulant
medications showed a decrease in their symptoms. Family conflict is likely related to the presence,
persistence, or later emergence of associated oppositional and conduct disorder symptoms. In children with
an inherited biological risk for ADHD, family conflict may heighten the emergence of early ODD and later
comorbid ADHD and CD (Beauchaine et al., 2010). For example, children with ADHD report observing
more interparental conflict than do children without ADHD, which may worsen ADHD and related ODD and
CD symptoms in those who have a genotype that makes them particularly vulnerable to the effects of the
emotional stress and self-blame associated with interparental conflict.

74. Discuss the relationship between ADHD and race and ethnicity. What racial/ethnic groups are teachers most and least
likely to rate as ADHD.
ANSWER: Research on the relationships among ADHD, race, and ethnicity has been inconsistent, and it remains unclear
whether current tools for assessing ADHD adequately capture the expression of ADHD in minority groups.
By kindergarten entry, children in the United States who are black are 70% less likely to be diagnosed with
ADHD than otherwise similar white children—even though they are equally likely to display ADHD-related
behaviors in the classroom (Morgan et al., 2014). However, for older children, teacher-rated ADHD and
observed rates of ADHD behavior are higher for black than for white children, which are not explained by
rater bias or SES (Miller, Nigg, & Miller, 2009). Slightly lower rates of ADHD have been reported for
Hispanic, Asian, American Indian, and Pacific Islander children (Cuffe, Moore, & McKeown, 2005).
Knowledge about ADHD and access to treatment seem to be greater among Caucasian, non-Hispanic, and
more highly educated families (McLeod et al., 2007; Miller et al., 2009).However, some research suggests
that when families from different ethnic groups do receive treatment, they do not differ in the benefits derived
(Jones et al., 2010).

75. Discuss the factors that can influence more positive outcomes for children with ADHD.
ANSWER: Some children with ADHD either outgrow their disorder or learn to cope with it, particularly those with mild
ADHD and without conduct or oppositional problems. Better outcomes are more likely for children whose
symptoms are less severe and who receive good care, supervision, and support from their parents and
teachers and who have access to economic and community resources, including educational, health, and
mental health services (Kessler et al., 2005).

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