Racial Disparities in Teacher Ratings of ADHD Symptoms and Behavior: A Systematic Review

Teacher ratings are fundamental to the assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) among students. However, teacher-reported ADHD symptoms and behavior differ across student and teacher characteristics, including race. Research has questioned the validity of teacher-reported ADHD symptoms across student race. However, prior studies are limited because they only report student race, not teacher race. This systematic review examines studies that report both teacher and student race to determine whether teacher–student racial congruence influences teachers’ ratings of ADHD symptoms and related behavior. A total of 3,029 studies were identified and 10 were included in the review. All studies utilized validated ADHD rating scales and reported teacher and student demographics. However, only four studies examined how student and teacher race influence ADHD ratings. Results indicated significant differences in ADHD ratings by race, but findings were inconsistent across studies. It is imperative educators and school psychologists involved in ADHD assessments and diagnoses consider the influence of implicit biases and racial identities when interpreting ADHD assessments. Impact Statement Teacher and student racial identities contribute to teachers’ assessments of student ADHD, leading to an over-identification of ADHD symptoms among students from historically marginalized backgrounds. ADHD rating scales should be interpreted with caution, and culturally and racially sensitive approaches to assessment should be utilized. Educators and mental health providers should increase awareness of how their implicit biases and racial identities influence their perceptions of behavior among students of color.