What children and young people learn about ADHD from youth information books: A text analysis of nine books on ADHD available in Dutch

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is not a singular concept. For the purposes of this study, understandings of ADHD are assumed also to spread along a conceptual dimension that includes some combination of biomedical and psychosocial knowledge. Biomedically, ADHD may be considered a somatic affliction causing inattention and hyperactivity, amenable to pharmaceutical treatment. Psychosocially, ADHD ranks among adverse behaviour patterns that are amenable to psychosocial and pedagogical intervention. Considering both biomedical and psychosocial factors are associated with the ADHD construct, it seems self-evident that young people should be offered information that gives equal consideration to both ways of addressing ADHD, but the question is just how balanced the information available to young people is. This study investigated nine information books on ADHD available in the Netherlands in Dutch, aimed at children and young people up to age 17. Thirteen perspective-dependent text elements were identified in qualitative content analysis. Eight attributes associate with a biomedical view: ADHD as cause, biological factors, clinical diagnosis, brain abnormality, medication, neurofeedback, heritability and persistence. Five text elements associate with a psychosocial view: ADHD as perceived behaviour, environmental factors, descriptive diagnosis, behavioural intervention and normalisation. The most frequent text passages encountered describe ADHD as a brain abnormality, along with medical and behavioural treatment. Providing the main focus for information in eight out of nine books, biomedical information about ADHD predominates in the available youth information books, while psychosocial information about ADHD is far less well covered.

Lost in explanation: internal conflicts in the discourse of ADHD psychoeducation

“…According to this model the interplay between biological, psychological and social factors underlies behavioral and emotional problems [ 15 , 51 ]. Within the context of this biopsychosocial model, there seems to be a covert preference for biology [ 13 , 14 , 20 , 25 , 26 , 52 ]. In the materials we analyzed, neurobiological and genetic factors were prioritized: they were discussed ahead of environmental factors, received more attention and were assigned more definitive terminology.…”

“…The biomedical perspective considers ADHD to have a biological cause, and understands it as a heritable, persistent neurodevelopmental disorder [16][17][18][19]. The psychosocial perspective understands ADHD as a dynamic outcome of how an individual interacts with his or her individual circumstances, including at home and school or work on a day-to-day basis [20,21]. These perspectives are not mutually exclusive.…”

“…Previous studies have often found the biomedical perspective to be overrepresented. In Dutch youth information books on ADHD, text on both psychosocial and biomedical perspectives was included [ 20 ]. However, biomedical text elements were overrepresented in two ways, with greater variety in the information offered (eight biomedical versus five psychosocial categories) and more instances of it being offered (207 biomedical versus 91 psychosocial text elements) [ 20 ].…”

“…In Dutch youth information books on ADHD, text on both psychosocial and biomedical perspectives was included [ 20 ]. However, biomedical text elements were overrepresented in two ways, with greater variety in the information offered (eight biomedical versus five psychosocial categories) and more instances of it being offered (207 biomedical versus 91 psychosocial text elements) [ 20 ]. A similar discrepancy was reported for English language websites on ADHD: 96,5% of websites were found to emphasize bio-genetic over psychosocial causes [ 14 ].…”

ADHD and reification: Four ways a psychiatric construct is portrayed as a disease

“…The effects of the reifying discourse surrounding ADHD go far beyond children’s own perception as suffering from a ‘disease.’ How social institutions, such as schools, understand and respond to children rests upon ADHD being constructed, or reified in discourse, as a disorder that some children have and others do not. Through literature such as research articles, textbooks, websites, TV-Programs, and even books for children [see for e.g., ( 18 , 71 , 72 )] ADHD is reified as an attribute shared across individuals who have harmful brain characteristics. Based on such false assumptions, an institutional world is created that provides medical and school-based interventions and perpetuates the reifying narrative.…”