Why another discourse on adhd

372 Pages·2016·2.79 MB·English

Producing ADHD: An ethnographic study of
behavioural discourses of early childhood

Simon Bailey, MA, BSc.

Thesis submitted to the University of Nottingham for the
degree of Doctor of Philosophy

April 2009

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Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is the most
commonly diagnosed mental disorder of childhood. Most of the
deficits it describes are situated examples of classroom
misdemeanour, and yet the school‟s complicity in rising diagnostic
trends has not been extensively questioned. This study aims to
provide this through an ethnographic account of ADHD in the infant
classroom. Underscored by Foucault‟s analysis of power and
discourse, this study aims to describe some of the conditions of
school and home which make the application of a diagnosis possible.
The project firstly presents textual critique of the dichotomous and
categorical channels through which ADHD is currently known.
Following this the ethnographic account is presented, the data for
which derives mainly from observational work in two schools and
interviews with two families. The data explores four problematics in
early education and social care; routinisation, gendering,
responsibilisation and emotional governance. Together these
relations produce binds in the conceptualisation of childhood,
schooling and family, through which therapeutic discourse is able to
form objects, producing the classroom subject „ADHD‟. Through this
argument I offer the means to re-insert the social and cultural into
naturalised and individualised therapeutic narratives. In conclusion I
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argue for a re-imagination of the manner in which we interrogate
choice, and state the case for a more reflexive pedagogical
encounter with the construction of others.

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Acknowledgements

I would firstly like to thank my supervisor at the University of Nottingham, Pat
Thomson. Pat has always seemed to have an instinctive sense of the kind of
encouragement I respond to and she has never held back in sharing whatever she
can to better aid me and the project. At different times I have called on her
expertise, her encouragement, her understanding and support, and, on more than
one occasion, her spare bedroom. Her value as a supervisor is attested to by the
fact that if I was ever unsure or uncertain, disconsolate or demotivated, then she
would be my first port of call, and in this and all possible capacities she has
always been there for me.

I would also like to extend thanks to several other colleagues at the university.
Firstly, Bob Curtis, whose company has made many conferences less daunting
experiences and without whom my fieldwork may have looked very different.
Secondly, to Joanne Raven, for her friendship and support and, with Pete and
Cassie, a welcoming roof over my head. Also in the School of Education, Chris
Hall, Kathryn Ecclestone, Jackie Stevenson, Jo McIntyre, Kerry Vincent, Tina
Byrom and Andy Townsend, for their advice, support, comment and friendship.

To everyone who made my fieldwork possible, but particularly, Mary, David &
Rachel, Sally, Pam, Suzanne, Linda, Helen, James & Jane, Glynis, Lorraine, Simon
& Michelle, Alison, and Sally.

To my newer colleagues in the School of Sociology & Social Policy, particularly,
Justine Schneider, Kezia Scales and Joanne Lloyd, thank you all for encouraging
me to complete the project and for having the patience to allow me to do so, also
to Deirdre Duffy for her enthusiastic support towards the end. To colleagues at
other universities, firstly, Gwynedd Lloyd, for always providing me with a
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challenging perspective, for making me so welcome in Edinburgh and surrounding
me there with such influential and inspirational company. Also to Liz Jones,
Christina Rae, Terry Wrigley, Valerie Harwood, Jill Blackmore, John Pryor, Ilina
Singh, Dennis Beach, Alice Paige-Smith, and Linda Graham for advice,
encouragement, support and critique.

Outside of work the first person I would like to thank is my partner, Sarah, for her
love, encouragement and patience. Also to my family, for whose care and support
I have and will always feel very fortunate. I would like to give particular mention
to Joan and Doreen, who both passed away in 2005, and to Besty, for doing her
best to replace them. Also to Lucy, Daniel and Emily, to whom I am sorry for not
having always been the most attentive uncle so far. Of the many friends who
have helped me along the way, I would like to give specific mention to Robin, for
keeping me sane towards the end, and to Nick and Ben for their critical eye and
excellent grasp of the English language.

I would like to dedicate this to my eldest sister, Jules,
for remaining alive and healthy, against all the odds.

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CHAPTER 1: INTRODUCING ADHD .......................................................... 12
POPULARISING ADHD ................................................................................. 13
PERSONALISING ADHD ............................................................................... 16
STUDYING ADHD ....................................................................................... 20
CHAPTER 2: TEXT & FIELD ..................................................................... 29
TEXTWORK ................................................................................................ 29
POWER & SUBJECTIVITY .............................................................................. 35
CONNECTING TEXTWORK TO FIELDWORK .......................................................... 41
ETHNOGRAPHY ........................................................................................... 46
AUTHORITY AND AUTHORISATION ................................................................... 53
CONDITIONING THE POSSIBLE ....................................................................... 60
CHAPTER 3: ADHD MYTHOLOGY ............................................................. 62
THE MYTHOLOGICAL ADHD CHILD .................................................................. 62
ONE CHILD IN FIVE ‘MENTALLY ILL’ ................................................................. 68
ALL THE REST IS MYTH ................................................................................. 70
NOW YOU SEE IT, NOW YOU DON’T .................................................................. 74
THE PERPETUATION OF MYTH AND MISINFORMATION .......................................... 78
THE DEATH OF RADICAL CRITIQUE .................................................................. 81
REALITY AS A REGIME OF TRUTH ..................................................................... 87
INHABITING MYTHOLOGY .............................................................................. 95
THE CENTRAL MYTH ................................................................................... 103
THE LIMITS OF EITHER/OR .......................................................................... 105
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CHAPTER 4: THE DSM AND THE DANGEROUS SCHOOL CHILD ............... 107
SITUATING THE SCHOOL ............................................................................. 108
THE DSM ............................................................................................... 110
DANGEROUS DEVELOPMENT ......................................................................... 118
RISKY CHOICES ........................................................................................ 121
BECOMING SOMETHING .............................................................................. 126
CHAPTER 5: ROUTINE CONDUCT .......................................................... 128
ADHD & EDUCATION ................................................................................ 128
BRINGING FOUCAULT TO THE CLASSROOM ...................................................... 129
KILCOTT INFANTS ..................................................................................... 132
NORMATIVE ROUTINES ............................................................................... 146
TIME/SPACE ROUTINISATION ...................................................................... 165
PRODUCING THE CLASSROOM SUBJECT ‘ADHD’ ............................................... 168
CHAPTER 6: BOYS, BOYS, BOYS ........................................................... 171
ADHD AND GENDER .................................................................................. 172
BAD, SAD, STUPID AND MAD ........................................................................ 175
THE FEMINISATION OF SCHOOLING? ............................................................. 179
THE ‘RE-MASCULINISING’ OF PRIMARY SCHOOL ............................................... 181
ALDERLEY PRIMARY .................................................................................. 182
OBSERVING GENDERED POSITIONING ............................................................ 208
THE NORMALISED DOMINANCE OF BOYS ......................................................... 209
THE ALLOCATION OF RISK AND RESOURCES ..................................................... 214
PATHOLOGY AND THE REPRODUCTION OF DOMINANCE ....................................... 220
DOMINANCE AND DIVIDEND?....................................................................... 232
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CHAPTER 7: LOST IN TRANSLATION .................................................... 235
SITUATING THE FAMILY .............................................................................. 235
PSYCHO-MEDICAL PERSPECTIVES.................................................................. 236
IMAGES OF BLAME ..................................................................................... 240
CULTURES OF BLAME .................................................................................. 242
INVISIBLE PARENTWORK ............................................................................ 244
ACCESSING FAMILIES ................................................................................ 245
SETTINGS ............................................................................................... 248
ACTIVE PARENTING ................................................................................... 257
STRUGGLING FOR AGENCY ........................................................................... 261
ENACTING BLAME ...................................................................................... 269
TAKING RESPONSIBILITY FOR THEIR CHILDREN ............................................... 271
CHAPTER 8: SAFE AS MILK? ................................................................. 273
THE NURTURING FORMULA .......................................................................... 274
THE NURTURE GROUP AT ALDERLEY ............................................................... 276
THE NURTURING SCHOOL ............................................................................ 280
FROM ROUTINE TO RITUAL .......................................................................... 294
NURTURE NATURE NORMAL ......................................................................... 298
CHAPTER 9: PRODUCING ADHD ........................................................... 300
CONDITIONING ADHD .............................................................................. 300
EVALUATION ............................................................................................ 314
REFERENCES ........................................................................................ 319
APPENDIX 1: INFORMATION FOR PARTICIPANTS AND PARENTS -
KILCOTT INFANT SCHOOL .................................................................... 358
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APPENDIX 2 INFORMATION FOR PARTICIPANTS AND PARENTS –
ALDERLEY PRIMARY SCHOOL ............................................................... 361
APPENDIX 3: INFORMATION FOR PARTICIPANTS - PARENTAL
INTERVIEWS ........................................................................................ 364
APPENDIX 4: SAMPLE OF FIELDNOTES FROM KILCOTT INFANTS ......... 366
APPENDIX 5: SAMPLE OF FIELDNOTES FROM ALDERLEY PRIMARY ...... 369

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Abbreviations

ADHD Attention Deficit Hyperactivity Disorder. Described by the American
Psychiatric Association, replaced previous nomenclature in 1994.
ADHD refers to the „combined‟ diagnosis of hyperactivity and
attention deficit, also available are diagnoses of predominantly
inattentive (ADHD-I) or hyperactive/impulsive (ADHD-H).
ADD Attention Deficit Disorder. An older term for ADHD, before
hyperactivity became part of the core diagnosis, those with
hyperactivity were sometimes labelled ADD-H.
APA American Psychiatric Association.
CD Conduct Disorder. Another of the DBDs, has large overlap with ADHD
and ODD
DBD Disruptive Behaviour Disorders. Defined by the APA, the group of
disorders to which ADHD belongs
DSM The Diagnostic and Statistical Manual for Mental Disorders.
Diagnostic criteria published by the APA, current version is DSM-IV-
TR, plans to publish DSM-V by 2011
EBD Emotional and Behavioural Difficulties. Umbrella term for a range of
socio-psychological difficulties.
HKD Hyperkinetic Disorder. Alternative conception of similar problems to
ADHD, this described by the World Health Organisation. Thought to
represent particularly severe form of ADHD.
ICD International Classification of Diseases. Diagnostic criteria published
by the World Health Organisation, includes HKD.
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