Dr John M Davis University of Edinburgh The Medicalisation Of Problem Behaviour [email protected].

Dr John M Davis University of Edinburgh

The Medicalisation Of Problem Behaviour

[email protected]

Dr John M Davis University of Edinburgh

The Medicalisation Of Problem Behaviour

[email protected]

IntroductionIntroduction

• Medical Model Context• Medical Model Example

• ADHD and Disabled Children• Social Model Context• Social Analysis of ADHD• Sociology of Childhood/Education• Complex Analysis• Conclusion

• Medical Model Context• Medical Model Example

• ADHD and Disabled Children• Social Model Context• Social Analysis of ADHD• Sociology of Childhood/Education• Complex Analysis• Conclusion

Medical Modelling The Context

Medical Modelling The Context

• Early Years Assessments - Physical Norms

• Base-Line Assessment - Educational Norms

• National Testing, Targets and League Tables

• Health Scare Mongering

• Early Years Assessments - Physical Norms

• Base-Line Assessment - Educational Norms

• National Testing, Targets and League Tables

• Health Scare Mongering

Health Scaremongering

Health Scaremongering

Solid research evidence to back practice is only beginning to emerge. For that reason, some of the guidance on helping children and young people to lose weight and develop healthier lifestyles is based on models from the United States, and will require some 'translation' for the Scottish cultural context. http://www.hebs.scot.nhs.uk/learningcentre/obesity/childhood/

Solid research evidence to back practice is only beginning to emerge. For that reason, some of the guidance on helping children and young people to lose weight and develop healthier lifestyles is based on models from the United States, and will require some 'translation' for the Scottish cultural context. http://www.hebs.scot.nhs.uk/learningcentre/obesity/childhood/

Health Scaremongering

Health Scaremongering

• Obese children :• higher risk of serious adult illnesses

• become introverted, depressed and de-motivated.

• can be the subject of bullying

• Obese children :• higher risk of serious adult illnesses

• become introverted, depressed and de-motivated.

• can be the subject of bullying

Obesity CauseObesity CauseReilly and Dorosty (1999) found the evidence implicating lower energy expenditure (in other words, reduced physical activity) as being the prime reason for weight increases was more convincing than the evidence on higher energy consumption (increased calorie intake)

Reilly and Dorosty (1999) found the evidence implicating lower energy expenditure (in other words, reduced physical activity) as being the prime reason for weight increases was more convincing than the evidence on higher energy consumption (increased calorie intake)

ADHD Medical ModelADHD Medical Model

•Dietary

•Genetic

•Neurological

•Psycho-social

•Environmental

•Dietary

•Genetic

•Neurological

•Psycho-social

•Environmental

CHILDREN WITH ATTENTION DEFICIT

DISORDERS

CHILDREN WITH ATTENTION DEFICIT

DISORDERS

"Frustrated, upset, and anxious parents do not cause their children to have ADD. On the contrary, ADD children usually cause their parents to be frustrated, upset, and anxious."

"Frustrated, upset, and anxious parents do not cause their children to have ADD. On the contrary, ADD children usually cause their parents to be frustrated, upset, and anxious."

CHADDCHADD

“Our kids have a neurological impairment that is pervasive and affects every area of their life, day and night”

http://www.breggin.com/methylphen.html

“Our kids have a neurological impairment that is pervasive and affects every area of their life, day and night”

http://www.breggin.com/methylphen.html

Disabled ChildrenDisabled Children

Defined as victimsConcentrate on NegativesNot thought to be able to make choicesKnown as a Label - ‘Wee Asperger’s Boy’Prevented from Meeting Other ChildrenExperience Barriers To Transition

Defined as victimsConcentrate on NegativesNot thought to be able to make choicesKnown as a Label - ‘Wee Asperger’s Boy’Prevented from Meeting Other ChildrenExperience Barriers To Transition

Social ModelSocial Model

• The Union of the Physically Impaired Against Segregation stated that disability is:

...the disadvantage or restriction of activity caused by a contemporary social organisation which takes little or no account of people who have...impairments and thus excludes them from participation in the mainstream of social activities. (UPIAS, 1976)

• The Union of the Physically Impaired Against Segregation stated that disability is:

...the disadvantage or restriction of activity caused by a contemporary social organisation which takes little or no account of people who have...impairments and thus excludes them from participation in the mainstream of social activities. (UPIAS, 1976)

Socal ModelSocal Model• In my English class, I was pleased that My Left Foot was

included but the booklet introduced Christy Brown’s piece with “Christy Brown was born a victim of cerebral palsy”. Now I have cerebral palsy. I have often been the victim of other people’s attitudes but I have never in my life felt myself to be a victim of cerebral palsy.When my English teacher found out how I felt about the word victim, the whole class had a discussion about it. This was good for the 30 teenagers in my class, but what about the other 1400 in my school – especially those who’ve called me a freak, invalid, retarded and other fantastic words.

• In my English class, I was pleased that My Left Foot was included but the booklet introduced Christy Brown’s piece with “Christy Brown was born a victim of cerebral palsy”. Now I have cerebral palsy. I have often been the victim of other people’s attitudes but I have never in my life felt myself to be a victim of cerebral palsy.When my English teacher found out how I felt about the word victim, the whole class had a discussion about it. This was good for the 30 teenagers in my class, but what about the other 1400 in my school – especially those who’ve called me a freak, invalid, retarded and other fantastic words.

Positive view of childhood and

disability

Positive view of childhood and

disabilityAbility not InabilityDiversity of identities and contextsParticipation and voiceChange and powerInclusion not integrationReflexive practitioners

Ability not InabilityDiversity of identities and contextsParticipation and voiceChange and powerInclusion not integrationReflexive practitioners

Social Analysis of ADHD

Social Analysis of ADHD

• Lacks a clear medical cause (e.g. diagnosis of symptoms).

• Lacks a medical diagnostic criteria (e.g. ‘swinging on chairs’)

• Questions who benefits (e.g. drug companies, professionals intolerant of children, parents, teachers, etc)

• Questions rapid increase and highlights side effects of drugs (e.g. methylphenidate)

• Lacks a clear medical cause (e.g. diagnosis of symptoms).

• Lacks a medical diagnostic criteria (e.g. ‘swinging on chairs’)

• Questions who benefits (e.g. drug companies, professionals intolerant of children, parents, teachers, etc)

• Questions rapid increase and highlights side effects of drugs (e.g. methylphenidate)

Sociology of Childhood

Sociology of Childhood

• Pressure on the role of mothers of children who do not academically achieve

• Pressure on children’s time and space• Pressure caused by new forms of

technology (IT/TV) and independence• Pressures caused by a lack of social capital• Pressures caused by the legal/justice

system• Tension between inclusion and attainment

in schools

• Pressure on the role of mothers of children who do not academically achieve

• Pressure on children’s time and space• Pressure caused by new forms of

technology (IT/TV) and independence• Pressures caused by a lack of social capital• Pressures caused by the legal/justice

system• Tension between inclusion and attainment

in schools

EducationEducation

• Literacy hours• Full curriculum• Lack of active time• Focus on children with learning

disabilities and other impairments

• Bullying of disabled children• Lack of access to the curriculum• Cultural imperialism of phonics

• Literacy hours• Full curriculum• Lack of active time• Focus on children with learning

disabilities and other impairments

• Bullying of disabled children• Lack of access to the curriculum• Cultural imperialism of phonics

Complex AnalysisComplex Analysis

• Pribilsky (2001)

• Illness - young people - Equadorian Andes • young peoples perceptions of self,

• economic migration by fathers,

• emotional and physical exhaustion,

• parenting styles• changes in community relationships.

• Pribilsky (2001)

• Illness - young people - Equadorian Andes • young peoples perceptions of self,

• economic migration by fathers,

• emotional and physical exhaustion,

• parenting styles• changes in community relationships.

Complex AnalysisComplex Analysis

• Robinson and Delahooke (2001) Medication involves social performance e.g.

• The performance of using of an inhaler for asthma

• Play full linking of coloured inhalers and coloured belts in Karate

• Peer relational issues caused by an inhaler being stolen

• Robinson and Delahooke (2001) Medication involves social performance e.g.

• The performance of using of an inhaler for asthma

• Play full linking of coloured inhalers and coloured belts in Karate

• Peer relational issues caused by an inhaler being stolen

ConclusionConclusion

Your perspective of childhood/disability influences your practice.Children’s rights / participation requires you to ask children what they thinkChildren’s rights does not exclude working in partnership with adultsThe causes of childhood behaviour are varied

Your perspective of childhood/disability influences your practice.Children’s rights / participation requires you to ask children what they thinkChildren’s rights does not exclude working in partnership with adultsThe causes of childhood behaviour are varied

ConclusionConclusion

What Do You Think?What Do You Think?

ResourcesResourcesParents Group Funded by drug

company:http://www.chadd.org/

Problems diagnosing childhood depression: http://www.critpsynet.freeuk.com/ChildhoodDepression.htm

Parents for Inclusion:http://www.parentsforinclusion.org/pressrel.htm

Parents Group Funded by drug company:http://www.chadd.org/

Problems diagnosing childhood depression: http://www.critpsynet.freeuk.com/ChildhoodDepression.htm

Parents for Inclusion:http://www.parentsforinclusion.org/pressrel.htm

ResourcesResourcesHealth Promoting Schools Website http://

www.healthpromotingschools.co.uk/index.asp

Travelling to school a good practice guide:www.dft.gov.uk/stellent/groups/dft_susttravel/ documents/page/dft_susttravel_023992.pdf

Basic Moves - encourage activityhttp://www.education.ed.ac.uk/cpd/courses/

index.html#PE-BasicMoves

Health Promoting Schools Website http://www.healthpromotingschools.co.uk/index.asp

Travelling to school a good practice guide:www.dft.gov.uk/stellent/groups/dft_susttravel/ documents/page/dft_susttravel_023992.pdf

Basic Moves - encourage activityhttp://www.education.ed.ac.uk/cpd/courses/

index.html#PE-BasicMoves

ResourcesResources

Better Behaviour Scotland http://www.betterbehaviourscotland.gov.uk/

Excellence and Enjoyment: http://www.bandapilot.org.uk/pages/seal/docs.html

Supporting Individual Learning Needshttp://inclusion.ngfl.gov.uk/index.php?i=1

Better Behaviour Scotland http://www.betterbehaviourscotland.gov.uk/

Excellence and Enjoyment: http://www.bandapilot.org.uk/pages/seal/docs.html

Supporting Individual Learning Needshttp://inclusion.ngfl.gov.uk/index.php?i=1

ReferencesReferencesValentine, G. (1997a) "Oh Yes I Can." "Oh No You Can’t": Children and Parents’ Understandings of Kids’ Competence to Negotiate Public Space Safely , Antipode 29: 165-189 .Shakespeare, T. & Watson, N. (1998) Theoretical principles in disabled childhood, in K.Stalker & C.Robinson, Growing Up with Disability, Jessica Kingsley, London.Norris,C & Lloyd,G (2000) Parents, Professionals and ADHD - What the Papers Say. European Journal of Special Needs Education 15, 2 pp 123 –137

Valentine, G. (1997a) "Oh Yes I Can." "Oh No You Can’t": Children and Parents’ Understandings of Kids’ Competence to Negotiate Public Space Safely , Antipode 29: 165-189 .Shakespeare, T. & Watson, N. (1998) Theoretical principles in disabled childhood, in K.Stalker & C.Robinson, Growing Up with Disability, Jessica Kingsley, London.Norris,C & Lloyd,G (2000) Parents, Professionals and ADHD - What the Papers Say. European Journal of Special Needs Education 15, 2 pp 123 –137

ReferencesReferencesCorker, M. & Davis, J.M. (2000) ‘Disabled children – (Still) invisible under the law’, Cooper, J (ed) Law, Rights and Disability (London: Jessica Kingsley).Davis, J M & Watson N, (2000) Disabled Children’s Rights in Every Day Life: Problematising Notions of Competency and Promoting Self-Empowerment, International Journal Of Children’s Rights 8: 211-228.Davis J M (2006) Disability, Childhood Studies and The Construction of Medical Discourses: Questioning Attention Deficit Hyperactivity Disorder; A Theoretical Perspective. In Lloyd, G, Stead, J and Cohen, D (eds) Critical New Perspectives on ADHD. Taylor and Francis Publishing, London.

Corker, M. & Davis, J.M. (2000) ‘Disabled children – (Still) invisible under the law’, Cooper, J (ed) Law, Rights and Disability (London: Jessica Kingsley).Davis, J M & Watson N, (2000) Disabled Children’s Rights in Every Day Life: Problematising Notions of Competency and Promoting Self-Empowerment, International Journal Of Children’s Rights 8: 211-228.Davis J M (2006) Disability, Childhood Studies and The Construction of Medical Discourses: Questioning Attention Deficit Hyperactivity Disorder; A Theoretical Perspective. In Lloyd, G, Stead, J and Cohen, D (eds) Critical New Perspectives on ADHD. Taylor and Francis Publishing, London.

ReferencesReferencesDavis, J M (2004) Disability and Childhood: Deconstructing The Stereotypes In Swain, J, Finkelstein, V, French, S and Oliver, M (eds) Disabling Barriers – Enabling Environments. Sage, London. Jess, M., Dewar, K. and Fraser, G., 2004Basic Moves: Developing a Foundation for Lifelong Physical ActivityBritish Journal of Teaching in Physical Education, Vol. 35(2), pp. 23-27.Reilly JJ. Dorosty AR. Epidemic of obesity in UK children. The Lancet. 354(9193):1874-5, 1999.

Davis, J M (2004) Disability and Childhood: Deconstructing The Stereotypes In Swain, J, Finkelstein, V, French, S and Oliver, M (eds) Disabling Barriers – Enabling Environments. Sage, London. Jess, M., Dewar, K. and Fraser, G., 2004Basic Moves: Developing a Foundation for Lifelong Physical ActivityBritish Journal of Teaching in Physical Education, Vol. 35(2), pp. 23-27.Reilly JJ. Dorosty AR. Epidemic of obesity in UK children. The Lancet. 354(9193):1874-5, 1999.