What Do Young People Diagnosed With ADHD Think About Life With ADHD?

Author(s):

Paulo Padilla-Petry(presenting / submitting)Carla Sòria-Albert(presenting)

Conference:

ECER 2015

Network:

04. Inclusive Education

Format:

Paper

Session Information

04 SES 06 A, Children and Young People's Perpectives on Inclusive Education

Paper Session

Time:

2015-09-09

15:30-17:00

Room:

205.Oktatóterem [C]

Chair:

Lenka Slepickova

Contribution

The DSM-V (APA, 2013) currently presents Attention-Deficit/Hyperactivity Disorder (ADHD) as a neurodevelopmental disorder characterised by hyperactivity, impulsivity and difficulty in paying attention that must be present in more than one setting. In the last years, ADHD has changed from a rather unknown childhood disorder to one of the most controversial psychiatric diagnosis ever given to children or young people. As the experts, families and teachers speak on behalf of the potential or actual ADHD patients, their silence is quite disturbing. The lack of studies about what do children and young people diagnosed with ADHD think about their lives and their diagnoses called our attention and made us start this research.

In dealing with such a controversial subject, we could not pretend to have a sort of neutral or independent approach. We decided to investigate about the young people’s discourse on ADHD from a constructionist approach (Atkinson and Gregory, 2008). Therefore, we considered ADHD as a reality that has been socially and discursive constructed. So, our research is not about denying or confirming the very ADHD existence, but rather studying how it is constructed and legitimised through discourse (Bailey, 2014).

Foucault’s works on mental health present the disorders as a cultural production that starts with a social uneasiness towards some people’s behaviour and ends up with a categorisation through diagnoses. Through sharing the status of the medical diseases, mental disorders completely lose their questioning power. The children and young people diagnosed with ADHD most of the time represent a challenge to their schools, parents and teachers (Bailey, 2014). Moreover, ADHD prevalence rates increase has raised questions about the role of the school in this trend (Bailey, 2010). As many parents search for an ADHD diagnosis after being advised by school and as children are often set free of medication during weekends (Martins, Tramontina, Polanczyk, Eizirik, Swanson and Rohde, 2004) and hollidays, ADHD may be considered as a school disorder, one that is much more evident in formal education contexts than other environments.

Nevertheless, the current scientific discourse about the biological causes of ADHD may contribute to a social attitude towards ADHD that does not blame anyone, school, parents or kids (Lakoff, 2000) and lay all the responsibility in its biological causes and medical treatment. Foucault’s work on the medicalization of society (Foucault, 1984, 1996, 2000, 2005) analyses the medical discourse as a power discourse that is part of the normalisation and control of the individual and social bodies. Following Foucault’s critical point of view, authors such as Timimi (2010) talk today about the pathologization of childhood. Thus, the medical discourse and practice are colonising and incorporating social life’s problems that were regulated by families, schools and other institutions in the past (Illich, 1975, Conrad, 1982; Foucault, 1984, 1996).

In this context, the children and young people diagnosed with ADHD grow up listening to the established medical discourse about ADHD, its symptoms and ultimately, about themselves. Harwood (2009) says that the children and young people construct their own discourse and may see themselves as “sick” or “problematical” since there is an interrelation among the truth, the power relations and the self. Foucault (1996) reminds us that although the subject constitutes him or herself in an active way through his or her practices, they are not made up by the subject, they are models found in his culture, his society and social group. They are proposed, suggested and imposed by them to him or her. Thus, a child or young person would build his or her own discourse through the group’s expectations and descriptions.

Method

The purpose of our research was to explore how young people diagnosed with ADHD think, feel and construct their discourses about it. Since our research followed a constructionist approach, ADHD was considered as a cultural construction about children and young people that present a disruptive conduct at school (Holstein and Gubrium, 2008). As a qualitative exploratory research, it did not have any pretension of having results that would be fully generalizable to all young people diagnosed with ADHD. The participants were ten kids (six boys and four girls) between 12 and 18 years old. They were interviewed in environments that were well known to them: their school (6), a recreational area to where they went after school (2) and the meeting room of a psychologist’s office (2). The interviewer was someone outside from these spaces and presented herself as somebody that was doing a research for the university. The criteria for composing the sample of participants were: young people, boys and girls, diagnosed with ADHD by a doctor or recognised by their teachers and parents as having ADHD and only ADHD, to be informed about his or her diagnosis. They were from 3 different Catalan cities, although half of them studied in the same secondary school. All the participants were interviewed within full knowledge and allowance from their families. All ten participants went through an interview about their views on ADHD and four of them were interviewed a second time. Considering the answers given in the first interview, we tried to have boys and girls with different views about ADHD in the second interview. In the first interview, we asked questions about the definition of ADHD and how it affected their lives. The second interview was longer than the first one and focused on their experiences with ADHD: consequences of being diagnosed with ADHD, the help received and the feelings towards it, how ADHD affected their relationships, what is expected from the future and what would be recommended to kids that just found out they have ADHD. All the interviews were semi-structured, the first one was approximately 20 minutes long and the second was about 40 minutes long. The interviews were analysed through constructing categories around the central point of each question. Also, the analysis of the participants’ discourse searched both for ideas repeated by all or almost all of them and ideas that were unique.

Expected Outcomes

Most of the participants defined ADHD as a sickness or a trouble that affected them whenever they tried to concentrate on a task or to control their impulses and nervous state. None of the participants questioned their diagnosis, but some do expect to be free of ADHD in the future. All the definitions were related to the main symptoms of ADHD: lack of attention, excess of activity and impulsivity. However, ADHD was also related to “bad behaviour” and lower grades. Actually, the most important impairment caused by ADHD seems to be the school results. ADHD stands as the main reason for the lack of concentration and need to move when they get bored. Almost all participants characterised themselves as “nervous people”. Nevertheless, two of the girls defended ADHD as a part of them that should be accepted. ADHD was also referred to as an advantage when practising sports and one of the girls said it gave her mental agility. Most of the participants’ information about ADHD came from psychologists, pedagogues and school professionals. All but one of the participants were diagnosed with ADHD after the schools’ complaints about their behaviour, As parents looked for professional help, one of the reasons for looking for a second opinion was the lack of a positive identification of ADHD. When a professional would not confirm the diagnosis claimed by school, the parents looked for another one that would do it. Considering the attributional effects (Whalen and Henker, 1997) of being diagnosed with ADHD, two participants told us about how their parents started blaming ADHD for everything they did, although such effect was less noticeable on teachers as they kept punishing them just like before. The lack of teacher’s support was a common complaint of the participants.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders – fifth edition. Washington: American Psychiatric Publishing. Atkinson, P., Gregory, M. (2008). Constructions of Medical Knowledge. In Holstein, J. A. & Gubrium, J. F. (Eds.) Handbook of constructionist research (p.593-604). New York: The Guilford Press. Bailey, S. (2010). The DSM and the dangerous child. International Journal of Inclusive Education, 14:6, 581-592. Bailey, S. (2014). Exploring ADHD: an ethnography of disorder in early childhood. New York: Routledge. Conrad, P. (1982). Sobre la medicalización de la anormalidad y el control social. In Ingleby, D. (Ed.) Psiquiatría crítica: la política de la salud mental (p.129-159). Barcelona: Crítica-Grijalbo. Faraone, S., Barcala, A., Torricelli, F., Bianchi, E,. Tamburino, M. C. (2010). Discurso médico y estrategias de marketing de la industria farmacéutica en los procesos de medicación de la infancia en Argentina. Interface -Comunic., Saude, Educ., v.14, n.34, p.485-97. Foucault, M. (1984). Enfermedad mental y personalidad. Barcelona: Paidós. Foucault, M. (1996). La vida de los hombres infames. Buenos Aires: Altamira. Foucault, M. (2000). Los anormales - curso del Collège de France 1974-1975. Mexico: Fondo de Cultura Económica. Foucault, M. (2005). El poder psiquiátrico - curso del Collège de France 1973-1974. Madrid: Akal. Harwood, V. (2009). El diagnóstico de los niños y adolescentes" problémáticos": una crítica a los discursos sobre los trastornos de la conducta. Madrid: Ediciones Morata.   Holstein, J. A. & Gubrium, J. F. (2008). Handbook of constructionist research. New York: The Guilford Press. Illich, I. (1975). Némesis médica: la expropiación de la salud. Barcelona: Barral Editores. Lakoff, A. (2000). Adaptative will: The evolution of attention deficit disorder. Journal of the History of the Behavioral Sciences, 36(2), p.149–169. Martins, S., Tramontina, S., Polanczyk, G., Eizirik, M., Swanson, J. & Rohde, L. A. (2004). Weekend holidays during methylphenidate use in ADHD children: a randomized clinical trial. Journal of Child and Adolescent Psychopharmacology, 14, 2, p.195-204. Timimi, S. (2010). The mcdonaldization of childhood: children’s mental health in neo-liberal market cultures. Transcultural Psychiatry, 47(5), p.686-706. - Whalen, C. K. & Henker, B. (1997). Stimulant pharmacotherapy for attention-deficit hyperactivity disorders: an analysis of progress, problems, and prospects. In Fisher, S. & Greenberg, R. P. (eds.), From placebo to panacea, putting psychiatric drugs to the test (New York: Wiley & sons), p.323-356.

Author Information

Paulo Padilla-Petry (presenting / submitting)

University of Barcelona

Sant Cugat del Vallès

Carla Sòria-Albert (presenting)

University of Barcelona, Spain

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