Racial and Ethnic Considerations Across Child and Adolescent Development
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COMMENTARY
Racial and Ethnic Considerations Across Child and Adolescent Development Shireen F. Cama 1
&
Priya Sehgal 1
Received: 15 February 2020 / Accepted: 20 October 2020 # Academic Psychiatry 2020
The US Census Bureau estimates that currently over 50% of youth under the age of 18 belong to at least one racial or ethnic minority group. It is projected that ethnic and racial minorities will make up more than half of the total US population by the year 2060 [1], yet the pool of mental health professionals has been slower to diversify [2]. All child and adolescent psychiatrists must be able to consider how the intersectionality of social class, culture, ethnicity, race, and position of power within systems of care contributes to a child’s developmental trajectory and presenting symptoms. Additionally, the emphasis on intersecting social identities must be integrated with traditional core models of child development, theoretical formulations, and teaching [3]. Many of the conventionally taught theories in child and adolescent psychiatry have been studied in diverse populations. These theories, however, do not explicitly address how experiences of microaggressions, bias, and discrimination faced by racial and ethnic minority youth and families impact typical child development and how it should be assessed. This commentary highlights some of the relevant factors that child and adolescent psychiatrists should consider when conceptualizing typical child development among racial and ethnic minority youth and families.
Infancy and Early Childhood The predominant theory of development during infancy and early childhood, attachment theory, emphasizes the quality of attunement in the parent (typically mother)-infant dyad. However, in communities where it is the norm for a child to have multiple prominent caregivers and the typical relational * Shireen F. Cama [email protected] 1
Cambridge Health Alliance, Cambridge, MA, USA
overtures and responses may differ from those found in what is commonly accepted as a “securely attached” relationship, application of this paradigm risks mischaracterizing and overpathologizing relationships that are thought to be acceptable and normative in the child’s culture of origin [4]. Unfortunately, when the sociocultural context of parenting styles and familial interactions has not been taken into account with regard to assessment and intervention, children and families have unnecessarily suffered the consequences of involvement with child protective services and foster care, despite the best intentions of those involved [4, 5]. Cultural factors can also influence whether or not a child gets diagnosed with autism spectrum disorder (ASD) at a young age [6]. Studies have demonstrated that Latino and African-American children are less likely than children from other racial and ethnic groups to be diagnosed with ASD at a young age and are more likely to receive the diagnosis at older ages when symptoms have increased in severity [7]. The reasons for this are certainly complex and includ
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