The premise, promise and disillusion of the ADHD categorisation – family narrative about the child’s broken school trajectory

Abstract

This study presents co-narrated school experiences of a young Finnish girl diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and those of her parents. The discourse analysis of the family interview focused on the discrepant ways family members gave meanings to and mobilized the ADHD categorization while narrating their broken school trajectory. The results showed that the ADHD diagnosis was laden with the promise of the whole family being recognized differently by the school. However, this cultural promise proved disillusioning as daughter's support needs and parents' expertise were not recognized nor did the diagnostic category emancipate from stigmatizing identities and blame. Interestingly, the parents leaned more on the diagnostic categorization while accounting for the disillusion of these promises, whereas the daughter aimed at distancing herself from the ADHD category and behaviour characteristics related to it. The discussion concludes by comparing the viewpoints of cure and care when catering to children's needs.

The (Un)real Existence of ADHD—Criteria, Functions, and Forms of the Diagnostic Entity

“…To better understand how these processes work, we will next focus on meanings given to the ADHD diagnostic entity and their functions deployed through cultivating psycho-medical discourse of ADHD in institutional and social practices. Drawing from our previous research on how identities, agencies, and moral responsibility are negotiated in relation to the ideas about ADHD (Honkasilta et al, 2015 , 2016 ; Honkasilta and Vehkakoski, 2019 ) and medication use (see Honkasilta and Vehkakoski, 2017 ) as well as how the diagnosis impacts social and educational practices (see, Koutsoklenis and Gaitanidis, 2017 ; Koutsoklenis, 2020 ; Koutsoklenis et al, 2020 ), we have identified four functions and nine specific forms of the ADHD diagnosis as a semiotic mediator in the literature. Below, we present and analyze each of them and provide examples drawn from empirical studies (see Table 2 for a summary).…”

“…For parents, a child's diagnosis absolves the culture of blame of what may be seen as poor parenting, since asserting that a child “suffers” from a neurobiological disorder is not as delicate a matter as asserting that the child manifests unwanted ADHD-like symptoms in response to an unsteady home life (e.g., Frigerio and Montali, 2016 ; Wong et al, 2018 ). The diagnosis eases parents from self-blame or guilt against conventional beliefs of good or bad parenting (e.g., Frigerio et al, 2013 ; Dauman et al, 2019 ) as well as protecting them from being blamed, shamed and held accountable for their child's doings in interaction between home and education institutions (e.g., Carpenter and Emerald, 2009 ; Honkasilta et al, 2015 ; Honkasilta and Vehkakoski, 2019 ). The diagnosis thus functions as a disclaimer for both parents and their diagnosed children: child is not the problem nor does the child have a problem, the problem lays within the child.…”

“…Parents seek a diagnosis for their children not only to advocate for their children's so-called remedial or special needs being recognized and pedagogically supported at schools, but also as a response to perceiving their children as being misjudged and inadequately socioemotionally supported (Carpenter and Emerald, 2009 ; Bailey, 2014 ; Honkasilta et al, 2015 ). Furthermore, the humanizing function and how it interplays with that of moral emancipation from blame or guilt also extends to parents' negotiating an alternative form of recognition for themselves, as demonstrated in the excerpt (below) from a study conducted by the first author on meanings given to the ADHD diagnosis in a family narrative of a young person diagnosed as “having” ADHD (Honkasilta and Vehkakoski, 2019 , p. 9):…”

“…Diagnosis is expected to reframe and change the way child and parents are viewed, regarded and treated by others, and translate psycho-medical discourse into pedagogies that promote learning and positive self-image; to direct the focus from behaviors and performance that may be of concern to an individual characterized by neurodiversity. With this new interpretation frame then, an ADHD diagnosis functions as a means to normalize the parents as well as the child, who can now establish their moral status as competent educators and caregivers through received/internalized emotional reprieve from guilt and blame (Schubert et al, 2009 ; Singh, 2011 ; Frigerio and Montali, 2016 ; Wong et al, 2018 ; Honkasilta and Vehkakoski, 2019 ).…”

“…It is noteworthy that this function is not limited to subjectivities of those diagnosed. Instead, for parents of a diagnosed child the empowering nature of the diagnosis may materialize in a form of claiming strong advocacy and expertise in the diagnosed child's schooling, after having gained a more in-depth understanding of the claimed condition, the manifestation of its so-called symptoms, and means of support (e.g., Frigerio et al, 2013 ; Honkasilta et al, 2015 ; Honkasilta and Vehkakoski, 2019 ). Internalization of psycho-medical discourse of ADHD can thus make acknowledging and welcoming parents' knowledge, expertise, and agency possible in multisectoral collaboration with professionals and equalize the power relations (Honkasilta and Vehkakoski, 2019 ).…”