Lay and professional constructions of childhood ADHD (Attention Deficit Hyperactivity Disorder): a discourse analysis.
Gray, Carol A.
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Gray, C. (2008) Lay and professional constructions of childhood ADHD (Attention Deficit Hyperactivity Disorder): a discourse analysis., no. 285.
Childhood ADHD is a contested yet rising public health phenomenon, due to greateruse of inclusive American diagnostic classification. In the UK ADHD is considered to be 'incompletely medicalised' with rising incidences predicted. A critical approach was adopted in this thesis, based on a number of social constructionist assumptions in order to examine the emergence and increased use of the construct and to contribute to broader critical debate in the field. Parents and teachers are key adults in childhood ADHD as they may identify and care for diagnosed children yet they have been relatively neglected in the literature. How such adults account for children's difficulties was the focus of an empirical analysis. A 'critical discursive psychology' approach was adopted using Edley's (2001) framework in order to examine culturally available talk by parents and teachers about ADHD, from semistructured interviews in Scotland. Analysis highlighted how parents deployed contradictory interpretive repertoires in talk using a Biological repertoire as a genetic explanation and an Environmental repertoire in relation to various parenting issues. Such talk was organised to attend to the ideological dilemma of parental moral adequacy and accountability and which sought to accomplish the 'good parent'. Further analysis considered how parents accounted for competing versions of the difficulties and their positioning in relation to controversial medication talk. Teacher accounts of children's difficulties deployed an ADHD repertoire as a medical condition and a Not ADHD repertoire as due to temporal difficulties. Through the 'cases I know' device, teachers managed their own experiential knowledge and thereby negotiated agency and control for childhood behaviours. Analysis considered accounts of (mis)diagnosis and (mis)treatment as alternative explanations for ADHD. This innovative focus on how health policy for children's difficulties as ADHD were socially produced by lay parent and teachers accounts, highlighted the limitations for agency in ADHD diagnoses and implicated further critical debate about this topic. Parental talk which drew on current biopsychosocial models for ADHD was largely reductionistic and fragmentary. The reliance on discursive efforts about the 'good parent' identity meant that this was a temporal accomplishment in talk rather than achieved by a diagnosis. Analysis of teacher accounts originating from a Scottish context highlighted how they differed from a North American context and provided greater understanding of how teachers succeeded in offering robust alternative explanations to ADHD. The implications for health and education policy of ADHD efforts aimed at the 'education' of teachers may be limited in the face of the teacher talk. Finally, within methodological debate in discourse analysis, this work contributes to further arguments for an eclectic discourse analysis as applied to the field of ADHD.