Dr John M Davis University of Edinburgh The Medicalisation Of Problem Behaviour john'davised'ac'uk

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Dr John M Davis University of EdinburghThe
Medicalisation Of Problem Behaviour
john.davis_at_ed.ac.uk
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Introduction

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

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Medical Modelling The Context

• Early Years Assessments - Physical Norms
• Base-Line Assessment - Educational Norms
• National Testing, Targets and League Tables
• Health Scare Mongering

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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/lea
  rningcentre/obesity/childhood/

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Health Scaremongering

• Obese children
• higher risk of serious adult illnesses
• become introverted, depressed and de-motivated.
• can be the subject of bullying

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Obesity Cause

• 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)

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ADHD Medical Model

• Dietary
• Genetic
• Neurological
• Psycho-social
• Environmental

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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."

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CHADD

• 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

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Disabled Children

• Defined as victims
• Concentrate on Negatives
• Not thought to be able to make choices
• Known as a Label - Wee Aspergers Boy
• Prevented from Meeting Other Children
• Experience Barriers To Transition

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Social 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)

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Socal Model

• In my English class, I was pleased that My Left
  Foot was included but the booklet introduced
  Christy Browns piece with Christy Brown was
  born a victim of cerebral palsy. Now I have
  cerebral palsy. I have often been the victim of
  other peoples 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 whove
  called me a freak, invalid, retarded and other
  fantastic words.

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Positive view of childhood and disability

• Ability not Inability
• Diversity of identities and contexts
• Participation and voice
• Change and power
• Inclusion not integration
• Reflexive practitioners

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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)

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Sociology of Childhood

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

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Education

• 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

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Complex 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.

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Complex 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

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Conclusion

• Your perspective of childhood/disability
  influences your practice.
• Childrens rights / participation requires you
  to ask children what they think
• Childrens rights does not exclude working in
  partnership with adults
• The causes of childhood behaviour are varied

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Conclusion

• What Do You Think?

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Resources

• Parents Group Funded by drug company
• http//www.chadd.org/
• Problems diagnosing childhood depression
  http//www.critpsynet.freeuk.com/ChildhoodDepressi
  on.htm
• Parents for Inclusion
• http//www.parentsforinclusion.org/pressrel.htm

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Resources

• 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 activity
• http//www.education.ed.ac.uk/cpd/courses/
• index.htmlPE-BasicMoves

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Resources

• Better Behaviour Scotland http//www.betterbehavio
  urscotland.gov.uk/
• Excellence and Enjoyment
• http//www.bandapilot.org.uk/pages/seal/docs.html
  
• Supporting Individual Learning Needs
• http//inclusion.ngfl.gov.uk/index.php?i1

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References

• Valentine, G. (1997a) "Oh Yes I Can." "Oh No You
  Cant" 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

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References

• 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
  Childrens Rights in Every Day Life
  Problematising Notions of Competency and
  Promoting Self-Empowerment, International Journal
  Of Childrens 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.

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References

• 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., 2004?Basic
  Moves Developing a Foundation for Lifelong
  Physical Activity?British 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.