Socioeconomic Barriers to Diagnosis and Accommodation of ADHD in Public Education

This thesis explores socioeconomic barriers in the diagnosis and accommodation of Attention- Deficit Hyperactivity Disorder (ADHD) in secondary public education. First, it examines the definition of ADHD, including diagnostic criteria over time, increasing prevalence amongst adolescents, factors impacting prevalence changes, and arguments for potential overdiagnosis and misdiagnosis of ADHD in the United States. Next, this thesis reviews the history of accommodations for ADHD in schools, such as federal disability legislation and current public spending on disability services in education. Then, it investigates the processes involved in securing diagnostic testing and special education (504) plans through public and private schools, including burdens on families and institutions. From there, this thesis dives into socioeconomic differences in disability designation, exploring existing research on wealth-related accommodation disparities and presents unique analysis of ADHD designation across three states (California, Arizona, and New Jersey). Finally, this thesis surveys existing research of additional socioeconomic barriers to diagnosis and accommodation, including cultural stigmas, ethnic/racial homogeneity in the medical field, and access to healthcare. The exploration of existing data supports the notion that disability accommodation is an incredibly complex topic. However, common socioeconomic barriers to 504 designation include difficult processes to attain testing through public schools, lack of access to private diagnosis, medical professional stigma/ homogeneity, and cultural differences in the perception of ADHD. The unique analysis resulted in a very weak but statistically significant negative correlation between the percent of students with Other Health Impairment (the category that includes ADHD) 504 plans, and the percent of students receiving Free or Reduced Priced Meals (FRPM) (a measurement of wealth/poverty) across all three states. However, the percentages of students with any 504 plan were not negatively correlated, and in some cases weakly positively correlated, with the percent receiving FRPM. Additionally, the strength of correlation (R2 value) was 5 times stronger (larger) when analyzing a single school district (Los Angeles Unified) than when analyzing California as a whole, suggesting that many confounding variables impact 504 disability designation. Overall, this thesis presents a broad picture of the socioeconomic barriers that exist in public education and disability services, and calls for future research to more closely examine disability designation disparities on a local, state, and federal level as well as explore other factors that account for the vast variance in how disability services serve students in secondary public education