dr john m davis university of edinburgh the medicalisation of problem behaviour [email protected]
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Dr John M Davis University of Edinburgh
The Medicalisation Of Problem Behaviour
Dr John M Davis University of Edinburgh
The Medicalisation Of Problem Behaviour
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.