Relational Troubles and Semiofficial Suspicion: Educators and the Medicalization of “Unruly” Children

Abstract

Using an interview‐based analysis of the accounts of interactions between educators, parents, and clinicians, this study explores educators' roles in interpreting childhood troubles as the medical phenomenon of attention deficit‐hyperactivity disorder (ADHD). The analysis of interviews shows how children's “personal” troubles become understood as “relational” ones, prompting increasingly sophisticated social responses. I argue that the institution of education, operating in a clinical capacity but lacking the legitimate authority to assign ADHD diagnoses, plays a hybridized, semiofficial role in the medicalization process. This assertion informs a critique of the “informal/official” dichotomy found in the sociology of deviance lexicon, and furthers previous positions in the sociology of mental health that have implicated school representatives in the social construction of behavior disorders.

Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research

“…347 This description of heightened irritability, often resulting in emotional outbursts, is in line with the experiences pupils describe themselves (e.g. see p. 260), as well as the findings from Shea and Wiener 392 and Hands 293 (see Impact of a disconnect between pupils diagnosed with attention-deficit/hyperactivity disorder and peers: shunning and bullying, above).…”

“…Edwards 290 and Shea and Wiener 392 discuss findings from a case study that describes the potential for different classroom contexts to impact on learning behaviour, 293 and then conclude with findings from a study exploring the role of teacher expectations and perceptions in the shift from understanding problematic behaviour as normal to formally identifying it as deviant. 347 These findings provide examples of both fit and disconnection, demonstrating that in certain classroom contexts pupils diagnosed with ADHD are able to cope in a manner acceptable to teachers and pupils. However, experiences of disconnection are prominent.…”

Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research

“…347 This description of heightened irritability, often resulting in emotional outbursts, is in line with the experiences pupils describe themselves (e.g. see p. 260), as well as the findings from Shea and Wiener 392 and Hands 293 (see Impact of a disconnect between pupils diagnosed with attention-deficit/hyperactivity disorder and peers: shunning and bullying, above).…”

“…Edwards 290 and Shea and Wiener 392 discuss findings from a case study that describes the potential for different classroom contexts to impact on learning behaviour, 293 and then conclude with findings from a study exploring the role of teacher expectations and perceptions in the shift from understanding problematic behaviour as normal to formally identifying it as deviant. 347 These findings provide examples of both fit and disconnection, demonstrating that in certain classroom contexts pupils diagnosed with ADHD are able to cope in a manner acceptable to teachers and pupils. However, experiences of disconnection are prominent.…”

Teachers as disorder-spotters: (in)decisiveness in assigning a child’s hyperactivity, impulsivity and/or inattention to ADHD as the underlying cause

“…We recommend that teachers are made aware of and reflect on the mechanisms behind their practices as disorder-spotters that were revealed in this study, and their personal involvement in relation to the academic and social problems in children who exhibit hyperactivity, impulsivity and/or inattention (Rafalovich 2005). Future research should further assess the association between teachers' decisiveness in assigning a child's hyperactivity, impulsivity and/or inattention to ADHD and the actual numbers of medical diagnoses.…”

A systematic review and synthesis of qualitative research: the influence of school context on symptoms of attention deficit hyperactivity disorder

“…Nonetheless, the child was referred to a clinician and diagnosed with ADHD, and prescribed Ritalin. Rafalovich's (2005) study therefore demonstrates from another angle that ADHD is an interaction between the child and expectations of educational staff in a specific context.…”

Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research

“…347 This description of heightened irritability, often resulting in emotional outbursts, is in line with the experiences pupils describe themselves (e.g. see p. 260), as well as the findings from Shea and Wiener 392 and Hands 293 (see Impact of a disconnect between pupils diagnosed with attention-deficit/hyperactivity disorder and peers: shunning and bullying, above).…”

“…Edwards 290 and Shea and Wiener 392 discuss findings from a case study that describes the potential for different classroom contexts to impact on learning behaviour, 293 and then conclude with findings from a study exploring the role of teacher expectations and perceptions in the shift from understanding problematic behaviour as normal to formally identifying it as deviant. 347 These findings provide examples of both fit and disconnection, demonstrating that in certain classroom contexts pupils diagnosed with ADHD are able to cope in a manner acceptable to teachers and pupils. However, experiences of disconnection are prominent.…”

Teachers as disorder-spotters: (in)decisiveness in assigning a child’s hyperactivity, impulsivity and/or inattention to ADHD as the underlying cause

“…We recommend that teachers are made aware of and reflect on the mechanisms behind their practices as disorder-spotters that were revealed in this study, and their personal involvement in relation to the academic and social problems in children who exhibit hyperactivity, impulsivity and/or inattention (Rafalovich 2005). Future research should further assess the association between teachers' decisiveness in assigning a child's hyperactivity, impulsivity and/or inattention to ADHD and the actual numbers of medical diagnoses.…”

A systematic review and synthesis of qualitative research: the influence of school context on symptoms of attention deficit hyperactivity disorder

“…Nonetheless, the child was referred to a clinician and diagnosed with ADHD, and prescribed Ritalin. Rafalovich's (2005) study therefore demonstrates from another angle that ADHD is an interaction between the child and expectations of educational staff in a specific context.…”

Non-pharmacological interventions for attention-deficit/hyperactivity disorder (ADHD) delivered in school settings: systematic reviews of quantitative and qualitative research

“…347 This description of heightened irritability, often resulting in emotional outbursts, is in line with the experiences pupils describe themselves (e.g. see p. 260), as well as the findings from Shea and Wiener 392 and Hands 293 (see Impact of a disconnect between pupils diagnosed with attention-deficit/hyperactivity disorder and peers: shunning and bullying, above).…”

“…Edwards 290 and Shea and Wiener 392 discuss findings from a case study that describes the potential for different classroom contexts to impact on learning behaviour, 293 and then conclude with findings from a study exploring the role of teacher expectations and perceptions in the shift from understanding problematic behaviour as normal to formally identifying it as deviant. 347 These findings provide examples of both fit and disconnection, demonstrating that in certain classroom contexts pupils diagnosed with ADHD are able to cope in a manner acceptable to teachers and pupils. However, experiences of disconnection are prominent.…”

Teachers as disorder-spotters: (in)decisiveness in assigning a child’s hyperactivity, impulsivity and/or inattention to ADHD as the underlying cause

“…We recommend that teachers are made aware of and reflect on the mechanisms behind their practices as disorder-spotters that were revealed in this study, and their personal involvement in relation to the academic and social problems in children who exhibit hyperactivity, impulsivity and/or inattention (Rafalovich 2005). Future research should further assess the association between teachers' decisiveness in assigning a child's hyperactivity, impulsivity and/or inattention to ADHD and the actual numbers of medical diagnoses.…”

A systematic review and synthesis of qualitative research: the influence of school context on symptoms of attention deficit hyperactivity disorder

“…Nonetheless, the child was referred to a clinician and diagnosed with ADHD, and prescribed Ritalin. Rafalovich's (2005) study therefore demonstrates from another angle that ADHD is an interaction between the child and expectations of educational staff in a specific context.…”