Dr Pek Ru Loh
Aboriginal Perspective on Attention Deficit Hyperactivity disorder
Attention Deficit/Hyperactivity Disorder (ADHD) is a childhood disorder with a worldwide prevalence rate of 5.29%. This disorder impacts adversely on the child's academic and social development and is associated with a broad range of negative outcomes in life, resulting in a massive financial burden to families and society. It also has a high comorbidity rate with Oppositional Defiance Disorder, Conduct Disorder, Depression and Anxiety Disorder. Nevertheless, early identification of ADHD allows intervention to be rendered which may improve the long term prognosis and minimises the economic and social cost otherwise incurred. Although ADHD has been reported in different countries and cultures, data are lacking for the Australian Indigenous population. Using a diagnostic system solely based on the western health model, however, raises the issue of cultural sensitivity and appropriateness in identifying ADHD in the Indigenous culture. In fact, it is still unclear if cultural variations will influence the validity of the ADHD construct (Rohde, 2002). The high attrition rate among Indigenous people in the mental health system in general has also brought to question the acceptance of a psychiatric diagnosis, and whether cultural health beliefs influence early detection and help seeking behaviour in the Indigenous communities. As "cultural explanation for causation must be assessed before diagnosis and treatment may be successful" (Cawte, 1974), the current study seeks to examine the Aboriginal concept of ADHD, cultural beliefs of the ADHD symptomatology, and approach to managing the disorder/symptoms. This study adopts a qualitative approach using a reiterative process of data collection. An Aboriginal steering group will be formed to help identify members for the focus groups which will include representatives from the Aboriginal communities and Indigenous parents with ADHD children. Cultural consultants will be utilised to ensure cultural appropriateness of the research and help with the cultural validation processes.