Constructing an "other" citizen – the case of ADHD
University of Nottingham
Paper presented at the Nordic Educational Research Association Conference, University of Örebo, 9-11 March 2006
Draft only, please do not quote without permission
This paper represents a contribution to the Foucauldian literature in the study of early-years education. The main basis of the paper comes from a ten week ethnographic study conducted in a state run infant school in England’s East Midlands towards the end of 2005. Discussion will focus on the consequences of spatial segregation and regulation in terms of it’s interaction with reductionist psychiatric discourse and the contradiction which this fosters in terms of democratic ideals in education.
The Death of the Institution?
"There are many ways of being human, but each society makes a choice of the way it prefers or tolerates" (Bauman, 2005, p. 105)
Bauman’s study of the new order of consumerism from which the above quote is taken talks of a social order which demands above all the freedom to choose; this is the highest value for any consumer. Within this environment of free choice; drills and routines become counter-productive and normative regulation dysfunctional. Most importantly in this shift is the ‘disappearance’ of the panoptic institution. In society generally, there may well have been a decisive shift away from production towards consumerism, however, there is little doubt that there still exists – in our system of education – powerful, panoptic institutions, in which ‘production’ remains a principal, if partially concealed, function.
The freedom to choose is undoubtedly a value tied to consumerism, but also to the political ideals upon which western civilization bases itself, those of democracy. Whichever of the commonly theorized models of democracy one prefers, this element of choice is fundamental to the definition; "political rights, such as voting rights and free speech, have not only the same structure but also a similar meaning as civil rights that provide a space within which legal subjects are released from external compulsion" (Habermas, 1996, p. 22).
This so called ‘freedom to choose’ requires some qualification, however. Two different arguments which highlight free choice as a possible misnomer are these; firstly, that varying social, physical and economic circumstances can restrict or even completely remove one’s freedom to choose. So it is within Habermas’ highly influential deliberative model of democracy that rests on the ‘ideal speech’ situation (Habermas, 1981), dependent on "a network of fairly regulated bargaining processes" (Habermas, 1996, p. 25). However chances of achieving such equity stands obscured in the long shadow of our institutional practices, in which "the knowledge of dominant groups, the ways in which they see and experience the world, tends to be exclusively and positively valued…while that of marginalized groups is often allocated a negative value" (Gale & Densmore, 2000, p. 92).
The second argument, is that every choice must be measured by the opportunity cost of whatever is not chosen – thus choice is never free of the constraints of possible alternatives (Beck, 1992). This second argument gains importance if we then extend it to consider also the constraints provided by the consequences of choices made, and how some choices function to produce legitimacy while others may instigate exclusion. This second point brings us back to Bauman’s quote at the beginning of this section, and the implication that society makes certain choices on our behalf. For the liberal, the exercise of the right to vote safeguards this deferred decision making; for the republican, society’s choices are the product of a politically active autonomous praxis; while deliberative or communicative theorists attempt to find a ‘third way’ through a rationalization of political decision making by the influence of "communicative power" (Habermas, 1996, p. 28).
While these models may vary in the exact way in which they attempt to make power accountable and achieve consensus; the fundamental values such as accountability and consensus, and, implied by these, participation, autonomy, representation and choice, are present in all three. Thus when we discuss what it means to provide democracy, we are talking in terms of these elements, and where we are talking about undemocratic processes, we are talking about, the constraint of autonomy and choice and the mis-, under-, or non-participation of mis-, under-, or non-represented peoples. In short, when we talk about undemocratic conditions we are, in Young’s words, speaking of domination;
"Domination consists in institutional conditions which inhibit or prevent people from participating in determining their actions or the conditions of their actions. Persons live within structures of domination if other persons or groups can determine without reciprocation the conditions of their action, either directly or by virtue of the structural consequences of their actions. Thorough social and political democracy is the opposite of domination." (Young, 1990, p. 38)
In terms of children, one does not have to look far to see the wide ranging and pervasive controls that are placed on their choices. There are various social arenas where children of a certain age are not permitted, or have to be accompanied; various activities they cannot participate in, such as driving and voting; and, of course, for at least twelve out of their first sixteen years they are obliged to spend around six hours a day in school, for the most part sitting on chairs following other people’s instructions (Penn, 2000). This might seem like a moot point, but the obviousness of the situation perhaps works to obscure its far reaching implications in our attitudes towards children. If one could then also show that while children are in school, their almost every movement and moment is subject to an imposed order of regulation, segregation, discipline, in short, of domination; then one would have plenty of ammunition to mount a commanding critique of such a system.
The research study
Kilcott Infant School is situated in a small town in rural Nottinghamshire. The school and nursery house approximately 100 children from the age of about 3 until 7, where most go on to the larger primary school across the road. The town is one of many in the area which suffered from the collapse of the mining industry in the 1980s; unemployment is high and prospects are relatively low, though there is a mounting community effort towards regeneration.
I spent one day a week at Kilcott throughout the Autumn term 2005, during this time I worked almost exclusively with the same Year One class, where I took on the role of a teaching assistant. The day when I was in Kilcott also happened to be the day when the teachers took their PPA time. During the summer 2005 I had conducted a small research project at Kilcott and so was on familiar terms with many of the teachers and children.
As an acting teaching assistant I was not able to take a structured approach to observation, but instead used any available time to keep a research journal. This journal became a mixture of recording tasks, activities, and conversations as well as providing a space to make an ongoing reflection of events and my own complicity in them. Below is presented not a holistic analysis of events in temporal succession, but rather the extraction of various moments which I believe to be significant in terms of the analytical concepts reviewed above.
My experiences at Kilcott suggest that the building of routines into the children’s day is the single most important requisite for ‘effective and enjoyable’ schooling (DfES, 2003). Routines are established through the setting up of infinite, normatively regulated, miniature orders, in which a certain activity should be performed by certain people, in a certain way. From the correct way to enter the class in the morning to the correct way to leave in the afternoon, via the correct way to wash hands before lunch and the correct way to line up for assembly; not forgetting the correct way to interact with other children, sit and listen to the teacher, speak in public, sit on chairs, use a pair of scissors, read a book, etc. As the following song, which was repeated through approximately twenty times, illustrates;
This discourse of routinization becomes highly infectious, such that I made the following diary entry;
Margaret, the head of Kilcott, uses this discourse to rationalize the integration of children into a new environment, or through a period of transition. She also suggests that one of the school’s responsibilities – given the troubled area in which it is situated – is to work on raising the children’s confidence and self-esteem; another function of this most versatile of theories. Indeed as Giddens states, "the discipline of routine helps to constitute a 'formed framework' for existence by cultivating a sense of 'being', and its separation from 'non-being', which is elemental to ontological security" (Giddens, 1991, p. 39).
Thus, within the school, a secure and consistent knowledge of "who I am" is contingent on a secure and consistent knowledge of "where I am", "what I am doing", and "how I am doing it". But routine does not just help one to constitute one’s own ‘formed framework’; routine is itself a ‘ready-formed framework’ in which as broader range of children – and teachers – must be ‘included’ as possible. In this way routine also functions for certain others to know "where I am", "what I am doing", and "how I am doing it", thus invoking the ‘order’. In fact these authoritative others are privileged indeed, they not only know "what I am doing" but are also in a position to say whether or not what I’m doing is satisfactory; thus invoking the ‘norm’.
Amongst its other worthy functions then, routine functions to create legitimacy – and thus illegitimacy also – in the times, places, movements, and utterances of the school day. Routinization emerges through this analysis as the overarching ‘strategy’, "designed to permit the possibility of certain things considered "natural" and "normal" to children" (Walkerdine, 1986). One of the ‘general forms of domination’ which create ‘subjected and practiced bodies, "docile" bodies’ (Foucault, 1979, p. 27).
In order to illustrate these themes, I have borrowed from the work of Jenny Gore, in her various studies of Foucault’s power relations in the classroom (Gore, 1993, 1995, 1998). Gore develops a set of categories, each capturing some feature of education’s disciplinary apparatus. Gore uses 12 categories, which are a mixture of spatial and temporal dimensions, strategic functions, tactical regulations and discursive positions. I have used only those I consider to be strategic functions. To these I have added "Examination" – which I have borrowed from Holligan (Holligan, 2000), and my own "Docility" and "Authorizing". The following table sets these definitions out:
Using these categories as interpretive frames, I present below a timetable, typical of a morning at Kilcott. Next to each activity’s description I have recorded my interpretation of the strategic function which it fulfills:
8.45 – 9.00
Hang up coat & store activity book
Write name on board
Sit on carpet with a book
9.00 – 9.30
Line up for ‘Omega 3’ and toast
Take water bottle and own seat
9.30 – 10.15
Receive instructions as a group
Individual work with teacher help
Re-group for progress report
10.15 – 10.45
Change shoes and take biscuit
Outdoor play – tyres & trees
Line up in playground
Door monitor for re-entry
Change shoes, sit with water bottle
10.45 – 11.45
Complete individual tasks
Those finished help others
Individual portfolio work with TA
Differentiation, Segregation, Examination
11.45 – 1.15
Group-at-a-time wash hands
Rest of group singing activity
‘Sandwiches’ and ‘School meals’ line up for Mrs. Dean
Eating, no noise or movement
Let out to play based on lunch ‘performance’
Distribution, Segregation, Distribution, Docility, Authorizing, Distribution, Segregation,
As well as Gore’s study, the above analysis takes it’s lead from Fielding’s analysis of teachers use of space for control and authority (Fielding, 2000) and borrows Meadmore & Symes, concept of uniformity, extending it into a more metaphorical space – for here it is the routine that defines what can be legitimately ‘worn’ at any one time.
The frequent appearance of "distribution" in my analysis, suggests that it is an important category. Considering the definition above, perhaps the reason why distribution appears so often is because it functions to act on a number of other functions, such as surveillance and docility. By creating legitimate and illegitimate spaces, distributing allows one to monitor children’s use of, or ability to keep within, their own space, thus, allowing the entry of another frequently appearing function; differentiation. Differentiating ability to follow one’s distributed order, would seem frequently to be related directly to protecting the routine itself; if one is sitting well, then one’s reward for sitting well is often to be the instigator or ‘leader’ of the next routinized stage – the first in line, the door monitor, etc. There would certainly seem to be nothing inherently productive about the ability to sit still, it would seem an odd skill for teachers to reward for itself; thus I would suggest that what is really being looked for is the ability to accept the order and it’s rationale. Taking on this self-referential character would seem to detract from the routine’s ability to foster self-regulation – for the only rationale for well ‘tempered’ subjectivity (Miller, 1993) is tied to the immediate ends of the routine itself. Put another way, the self-referential routine acts to separate and mark as ‘risky’ those whom, for whatever reason, do not ‘fit’ the prescribed order.
If routine comprises the strategy, imposes the order and creates the normative space, then regulation is responsible for communicating, or ‘translating’ the strategy into the everyday language of human action and choice; a responsibility, in short, to enforce.
I observed this tactical responsibility in action at a number of different ‘levels’, which I have developed into a ‘typology of regulation’. This is not intended as an exhaustive list, nor is it to say that these categories are necessarily independent or distinct. I merely wish to draw attention to the various levels of structure and agency(1) at which these forces can operate.
Structural regulation concerns measures of control as administered by macro structures, usually a government or policy measure. By this analysis changes in macro level regulation affect changes in the "political technology of the subject" (Miller, 1993, p. ix). The following excerpt provides an example:
The Life Education Centre (LEC) is part of a nationwide government initiative, particularly concerned with children, and parents, in deprived areas. Into these ‘troubled places’ (Thomson, 2002), the government wish to impose various medical, social, environmental and economic norms – the correct way to behave in public, eat healthily, look after your body, treat your friends, attain economic stability, etc.
Situational regulation involves the ordering of groups of people through the use of rules, space, buildings etc, and is applied with some autonomy within the school, as these separate examples illustrate;
Spatial regulation is directed at individuals and applied often reactively by an authoritative person such as the teacher – though of course teachers, or assistants, can also be subject to it;
The use of computers is used in the second of the three excerpts to illustrate spatial regulation – each child’s movement is controlled by having their own seat and the focus of the computer screen. In this particular example, one of numerous such occasions, Sarah would use the computer room to apply some situational regulation as well – by using me to remove four or five pupils from the main class; this example is particularly pertinent as I have been given several of the most ‘disruptive influences’.
Spiritual regulation is a kind of ‘micro-physics’ (Foucault, 1979) involving the use of fine motor tasks to make essentialist evaluations concerning the abilities, skills and circumstances of the performer; allowing the authoritative other to "gaze into ‘the soul’ of the learner" (Holligan, 2000, p. 143);
In the excerpt above Sarah has asked me to differentiate children’s fine motor coordination, here exemplified by ‘mouse control’. At the time I did not really understand what purpose this served, but despite this I, almost automatically, started to differentiate the children according to other skills, such as their ability with the keyboard and spelling their names.
Spiritual regulation often occurs in tandem with what has been called a ‘discourse of derision’ (Ball, 1995, Holligan, 2000), where a child’s ability or inability in a given task, or simply an observed characteristic, may be seen as reflecting some private or domestic deviance;
Both excerpts here illustrate the importance attached to the family environment in the teacher’s discourse. Here there are a number of different derisions going on. Throughout there is the implication that the family is not providing an appropriate environment for the nurturing of the ‘school child’ – this is the implicit notion of policy directives such as Every Child Matters (DfES, 2004)(2). Interacting with this family derision is that of age and gender. Given school’s decision to segregate by the September birthday, there will always be those who are young for their year, and these children are often concerns for teachers – in the second excerpt, ‘inappropriate mothering’ combines with the ‘youngest in year’ to produce a ‘spoilt child’. In the first excerpt gender is used to rationalize the child’s disruptive behaviour, both in the description of the aggression amongst the men in the family; and, my ability, as a man, to relate to the situation.
While much of the above regulation could be described as physical, in the sense that it seeks to act on the body, I wish to posit a distinct category, which involves dietary control or supplement, or the use of chemical agents;
This quote betrays implicit ‘deficit thinking’ (Valencia, 1997) in Sarah’s speech; for her it is not possible that being seen as a ‘good’, ‘bad’ or ‘wonderful’ pupil are just three subjectivities which James could portray; instead, he is essentially a troublemaker, who requires supplements such as Omega 3 to temper his behaviour. Not only is the medicalised ‘desire’ for physical supplement present here, but also a kind of essentialism – that which seeks to fix in one place some supposedly fundamental aspect of subjectivity. Such essentialism is reflected in the psychiatric gaze, which seeks to pin a fixed subjectivity onto what may be a highly fluid and plural identity. Thus in this example, we could say that the essentialism underlying the teacher’s discourse opens up spaces into which psychiatric ‘expertise’ can assert itself. This is an argument I shall return to later.
Like physical regulation, this category could be said to operate throughout all the other categories, for implicit in the notion of power and domination is the existence of an imbalanced relation between people or groups of people. Here I provide some examples of the way in which those in authority can make use of the control which the students can exert on each other;
The second excerpt provides an example of a much used template for classroom practice at Kilcott. Bringing the children back together on the carpet to discuss what they have done introduces processes of checking, observation and examination as well aiding self-regulation (see table above). The third excerpt was taken from a year two drama class, in this case the relational regulation aids several functions; the drama class is held during PPA time, when part-time staff are brought in to cover for the usual teachers; Ben has a history of troublemaking, and has a diagnosis of ADHD, so he is a ‘cause for concern’, especially during PPA time; Ben chooses to sit and enjoys working in this group, thus it is also self-regulational.
The paragraph above on PPA, has brought me onto this section, which concerns instances when the routinized order is cracked or broken – instances I have termed ruptures. PPA time provided the most consistently noticeable instances of rupture during my time at Kilcott, and below I will detail the increased threats which the order perceives and some of the structures it imposes to try and counter this threat. In fact PPA time is interesting on a number of levels; it is structural regulation placed on teachers by government; it involves situational and relational regulation on the staff, who are all required to be in the staff room, group planning – however this same congress also has the potential to increase teacher’s ability to regulate classes. The most interesting aspect for me, though, is the potential spaces of disruption and indiscipline it opens up, and the strategies developed to counter this.
The first two weeks I was at Kilcott were the first two weeks they were holding PPA time. It involved all full-time, main school teachers(3), and the headmistress, once-a-week, being in the staff room for the large majority of the afternoon. So, after lunch the children would come back in and have some ‘cooling off’ time on the carpet, when they would have their ‘PPA badges’ given to them – a regulating strategy in itself. Two extra staff were brought in to take on the teaching; for Year One, a French teacher, Mrs Milton and for Year Two, a drama teacher, Mrs Reed. Year one and two would each split into two groups, one group getting the extra teacher, the other group taken for ‘speaking and listening’ with Melissa, a teaching assistant, and myself; there were also TAs on hand to aid the extra staff. Below is my diary entry concerning Kilcott’s first experience of trying to organise PPA time;
This entry raises several interesting issues, which I will expand on briefly. Firstly, the general effect of there being a lack of routine – which appeared clear enough for me to record it ‘live’. This adds weight to the reasoning that reliance on the self-referential routine means that when it is taken away, the children are left with no rationale to behave well – as though when it is taken away, the legitimacy which it defines is suddenly up for negotiation again.
The second point, almost the reverse of the children’s new found powers of resistance is both my own and Melissa’s discomfort with the situation. In my own case, this was a new and unexpected position to be put into, I had not expected to be given this amount of responsibility so early on in the project. This manifested itself clearly in my inability to discipline the children to the level that was expected.
The third issue this raises, is the urgency and rationale of the alternative strategy which was developed to tackle this insurgency. The main element of this strategy was to load most of the responsibility onto the supply teachers and ‘divide and rule’ the remaining mob. The likely success of this strategy was contingent on certain regulations – such as Mrs Milton’s insistence that she didn’t mind doubling the size of the group she took, as long as they remained sat on their own seats throughout – thus imposing a coercive new routine in which distribution, segregation, docility and surveillance can all be seen to operate.
My own ‘failure’ within this first experiment gone wrong meant that during future PPA time I was not relied on with any responsible role – with one notable exception, see below – so I could really do as I pleased, and so I chose to observe the other supply teacher – Mrs Reed, in drama. Mrs Reed had an interesting teaching routine of her own which she generally put to good effect in class.
Drama seemed to be something that the children looked forward to, unsurprisingly perhaps, given the rare chance for freedom and creativity of movement and mind which it offers. This freedom of course also provided more scope for disruption. For the first couple of weeks, Mrs Reed would begin each drama class by carefully explaining the rules which would ensure that ‘the drama’ would not be stopped, disrupted or spoilt. These included various signals which would denote when everyone should be sitting in a circle; freezing on the spot; instantly silent etc. There were positive incentives for good behaviour in gold stars, and the chance to hit the big metal gong which Mrs Reed brought in every week at the end of the class. Bad behaviour was sanctioned first through two warnings – which were pictorially represented by a sad face (first warning) and then a sad face with a cloud over it (second warning), a third warning would mean a trip to the ‘sad chair’ from where one was excluded from activities until they were ‘ready to continue with the drama’. Added to this elaborate ‘technology’ of regulation, Mrs Reed had a subtle tactic which she used frequently – usually when giving out whole group instructions (such as the one’s detailed here), or actually performing the drama – and that was to speak in a voice so quiet that, were there anyone talking or otherwise not paying attention, would not be heard by the majority of the class.
I found these strategic manoeuvres fascinating – intricate theatricals in themselves – ‘the drama’, or the prevention there of, was the ultimate rationale for good behaviour, and given the enjoyment which the children would generally get out of a session, this was rationale was probably quite a strong one. Interestingly, to begin with, the insertion of this apparatus probably caused as many problems as it resolved – as about the first ten minutes of each lesson would be spent going though the explanation of them – all the while fostering the fidgety, frustrated child who once let loose on the drama would run amok, and restricting Mrs Reed’s ability to finish ‘the drama’ on time. However, in the long run this strategy paid off – by the third and fourth week it was enough to hold up a couple of the signs to remind the children what was what, and by the fifth week a mere point at the sad chair was deemed enough revision for the whole rule book – at this point the class could be said to have been fully routinized into the ‘new order’ of PPA time.
More often than not, however, there was not enough ‘order’ to PPA afternoons for Kilcott to maintain it’s usual efficiently monitored regime. The following excerpt is taken from the afternoon when the Learning Education Centre (LEC) was visiting the school. I’m sure the fact that this visit coincided with PPA time was no fluke – Margaret’s planning was generally too astute for this. Thus not only is the LEC here providing an example of structural regulation (see above) but also an example of situational regulation; as autonomously planned and practiced by the school to coincide with those ‘difficult’ Wednesday afternoons. However, as the excerpt shows, things did not quite work out to plan.
It hardly seems necessary to say that I got nowhere near being able to manage this over excited, over stimulated group of about 25 children through an ‘empty space’ activity like waiting to be picked up. What this excerpt illustrates again is the precariousness of the self-referential routine. When the routine itself is disrupted – as in PPA time generally, or with an unusual visit like the LEC, or in the empty spaces of transitional periods such as waiting to be picked up, or when the principle representatives of the routine, i.e. teachers, are not present then the good order breaks down (in the above excerpt all four of these breakages had occurred simultaneously).
What this excerpt therefore provides is an example of what Gore calls an ‘actualisation’ or power relations (Gore, 1995, p. 100). This particular example is relatively rare in that it is the children who benefit from these movements of power – and it was me who felt the direct force of them in my total inability to manage the situation. However, this should not obscure the fact that the situation only arose because of the schools power constraint in having to administrate PPA time with insufficient funds to provide adequate cover.
‘Othering’ – or, the construction of subjectivities
If there exists a term which unifies everything that I have so far referred to in the routinization and regulation of school children it is, perhaps, ‘othering’ or to borrow Foucault’s term ‘subjectivisation’94):
"I would call subjectivisation the process through which results the constitution of the subject, or more exactly, of a subjectivity which is obviously only one of the given possibilities of organizing a consciousness of the self" (Foucault, 1996, p. 472).
I shall follow Harwood’s interpretation, using;
"…the term ‘subject’ to describe the focus of subjectivisation and consider subjectivity to be one of the many products of this process of subjectivisation" (Harwood, 2005, p. 6).
Instances and processes of subjectivisation occur everywhere and at all times in the school – indeed they follow naturally the pervasive processes of distribution and differentiation. Presented below are, taken from my research journal, just some of the examples of the different subjectivities which course through the lifeblood of the school, like so many ‘capillaries’ of power (Foucault, 1980, p. 96).
The important element to recognise within these different subjectivities is the powerful effects which they cause to be registered on human action – "an action upon an action, on existing actions or on those which may arise in the present or the future" (Foucault, 1982, p. 220). It is through these subjectivities that people become known to one another in a certain context – in this case, the school. When we think of the ‘authoritarian teacher’, ‘straight-A student’, ‘spoiled brat’ or ‘disorderly child’ then this subjectivisation converts the totality of a pluralized, fragmented and ‘diasporic’ identity (Hall, 1994), into a unified and instantly knowable image, by which all subsequent actions will be rationalized, objectified and known. It is in what Harwood calls this ‘truth telling’ function of subjectivisation that its power is contained – for the power to know something or someone is also the power to dominate it (Harwood, 2005).
‘Othering’ – or, the domination of subjectivity
I do not believe, however, that it is enough to speak of the ways in which routine functions to create docility, legitimacy and regulation functions to enforce it. Nor is it enough to observe the fact that infinite ‘others’ – routinized others, regulated others, resistant others – are constructed, distributed and known minute-by-minute in every school day. For me it would be to display are rather idealistic neutrality to suggest that it is some happy coincidence that strategies such as routinization open up spaces into which the medicalised gaze of psychiatry can seek and destroy. Instead I believe that such strategies have been developed within the professional discourses of the ‘sciences of the mind’ as part of the inter-relation between discourses of therapy and education – an inter-relation which may have more of a history than is often acknowledged and has grown to such proportions as to render the present landscape all too ‘familiar and poorly known’(Foucault, 1997).
To begin in a relatively general manner, consider the earliest introduction of what became known as the IQ test. Introduced in France in the late 19th century by a psychologist, Binet, with the express objective of identifying difference – and now reflected in form, content and objective across the entire educational spectrum, in ‘the examination’. Foucault chose this term – ‘the examination’ – not only to describe the point at which the mechanisms of hierarchical observation and normalizing judgement found their dominating actualisation, but as a symbol of the power-knowledge relation which resides within every subjectifying strategy and tactic. Yet, it’s place within education is so central to contemporary policy across so many nations that its presence is simply assumed.
To move to a less general level; the following claim is taken from one of the many histories of psychiatry which have followed Foucault’s own (Foucault, 1967). Consider it in relation to the discussion so far about the function of routinization in the school day;
"More and more psychiatrists confessed their doubts that the bulk of their patients could be cured with either individualized moral treatment or standard physicalist remedies. Instead they argued that the asylum psychiatrist’s duty was to manage the hospitalized population by organizing the lives of the inmates down to the smallest detail" (Goodson & Dowbiggin, 1990, p. 109)
These authors go on to talk of a ‘culture of concern’ which developed in relation to what was seen as a declining biological fitness and the effects of ‘pathogenic environmental conditions’ (Goodson & Dowbiggin, 1990, p. 113). Is it merely chance that these same concerns propel schooling strategies into ‘deprived areas’ and ‘ex-coalfield communities’ where ‘less gifted’ children with ‘low self-esteem’ can nevertheless be taught to ‘use their hands’, or ‘find their creative potential’ through sports and outdoor activities, or at the very least learn how not to be a social menace and their parents taught how to be economically productive. Small wonder such derisive discourse arises in schools that find themselves within such ‘pathogenic’ communities; a cancer/cure relationship, constructed, maintained and perpetuated through accepted wisdoms of the supposedly "vanquished presence" (Foucault, 1967, p. 16) of those who over 150 years ago spoke of ‘pauper’ classes and their ‘immoral’ lifestyles (Goodson & Dowbiggin, 1990, p. 112).
The formulas of exclusion
"Often, in these same places, the formulas of exclusion would be repeated, strangely familiar two or three centuries later. Poor vagabonds, criminals, and "deranged minds" would take the part played by the leper…With an altogether new meaning and in a very different culture, the forms would remain" (Foucault, 1967, p. 7, italics added).
Thus the mechanisms of schooling separate and make visible those ‘at risk’ of a "barbaric future" (Popkewitz & Lindblad, 2004, p. 232), and the sciences of the mind then enter with their "book of names" (Jensen & Hoagwood, 1997), and assign to every "other" child a glass jar – a categorical painting by numbers which obscures all but two figures – zero and one. Furthermore, the processes by which the school separates and makes visible have been fine tuned through a historical interaction between those that sought to know ‘the madman’, ‘the criminal’, ‘the deviant’ and ‘the child’, an interaction by which these institutions have learnt to serve one another in their common objective of control (Foucault, 1979). In this section I shall use the literature surrounding ADHD; the Diagnostic and Statistical Manual for Mental Disorder (DSM-IV-TR); and further excerpts from my research diary to expand on these arguments.
ADHD – Everybody knows
"Attention Deficit/Hyperactivity Disorder (ADHD) is a developmental disorder characterized by age-inappropriate levels of inattention, and/or hyperactivity and impulsivity that arise prior to 7 years of age. The disorder is estimated to be present in 3-7% of school-aged children, and preferentially affects boys with an approximate 3:1 male-to-female ratio" (Berwid et al., 2005, p. 1219)
The above quote, which is taken from the opening paragraph of a recent paper chosen at random from the many which, while representing differing perspectives on ‘the ADHD industry’ – some even attempting to subvert aspects of it – all reflect, accept, implicate, reproduce and reinforce this same wisdom (From the last year alone, see Bauermeister et al., 2005, Berwid et al., 2005, Blackman et al., 2005, Faraone et al., 2005, Johnston et al., 2005, Rappley, 2005, Remschmidt, 2005, Rhodes et al., 2005, Rodriguez & Bohlin, 2005).
Also reflecting this wisdom on ADHD, but taking it one stage further are the geneticists (Blair et al., 2005, Dick et al., 2005, Kuntsi et al., 2005, Meulen et al., 2005, Plomin, 2005, Price et al., 2005, Stevenson et al., 2005, Todd et al., 2005), for whom the state of the art is represented by claims such as;
"Twin and adoption studies have shown that attention-deficit hyperactivity disorder (ADHD) is highly genetic with an estimated heritability of .75-.91. Recent meta analyses have shown that three genes that code for key proteins in the dopaminergic system, the Dopamine D4 receptor gene (DRD4), the Dopamine Transporter gene (DAT1) and the Dopamine D5 receptor gene (DRD5), are associated with increased risk for the disorder" (Meulen et al., 2005, p. 1074)
Thus, a very clear picture of ADHD emerges, in which biologically deficient children find themselves bound by their degenerate genes – but this is ok of course, at least they’re not just ‘bad’ (Conrad & Schneider, 1980, Singh, 2002). Then, biomedical psychiatry enters with the ‘miracle drug’ Ritalin (Livingston, 1997) – effective in around 80% of cases (Buitelaar et al., 1995) – and makes everything ok; expunges blame from parent, child and teacher and increases further the discursive power of psychiatric and pharmaceutical methods of control.
ADHD – Nobody knows
The first problem with these broad strokes; painted like undisputed facts upon the blank canvas of the child’s self, is that even within the ‘scientific’ community, there is no consensus over the numbers involved. Take the following example;
"According to epidemiological studies, the prevalence range of ADHD among children is 2.3-19.8%…The best estimate of prevalence is probably 3-7%" (Yeh et al., 2004, p. 10)
That this statement is made without a hint of concern regarding its implications, should come as no surprise given the other issues which the hegemonic discourse on ADHD generally glosses over. Issues such as the stigmatization of mental illness (Goffman, 1968, Harwood, 2005, Hinshaw, 2005, Jahnukainen, 2001, Scheff, 1975, Slee, 1997, Szasz, 1961, 1994, Walsh, 1993, Watling, 2004); the political and ethical implications of genetic research and pharmaceutical treatment for children (Baker, 2002, Breggin, 2002, Livingston, 1997, Miller & Leger, 2003, Singh, 2002, Stein, 2002, Yeh et al., 2004); the mixed understanding and perception of this ‘illness’ and their gate keeping responsibilities within its discourse (Bekle, 2004, Bibou-Nakou et al., 2000, Bradshaw & Mundia, 2005, Daley et al., 2005, Gomez et al., 1999, Nolan et al., 2001, Poulou, 2005, Sciutto et al., 2000, Wolraich et al., 2003); and, the implications of a gender ratio, which could be as high as 6:1, boys to girls – and the similar skews which emerge through analysis by class and ethnicity (Abikoff et al., 2002, Garb, 1997, Newcorn et al., 2001, Singh, 2002, Timimi & Taylor, 2004). By its mere presence and numbers this growing body of research presents a worrying issue in itself – namely that the hegemonic discourse as described above rolls on seemingly oblivious. As Harwood remarks; "So pervasive are the discourses of psychiatric disorder that it is difficult to imagine how behaviour problems can be conceived without its influence" (Harwood, 2005, p. 19) This is certainly true with the issue I wish to focus on today, which is the diagnostic process for ADHD, the DSM, and classroom discourse – "practices that systematically form the objects of which they speak" (Foucault, 1972, p. 49).
Taming the wild profusion
"In the wonderment of this taxonomy, the thing we apprehend in one great leap, the thing that, by means of the fable, is demonstrated as the exotic charm of another system of thought, is the limitation of our own, the stark impossibility of thinking that" (Foucault, 1974, p. xvi, emphasis in original)
I want to try and reverse this exoticism, turn things around so that taxonomies such as the DSM can be viewed from our own system of thought as a fable on which we can look with mirth, and muse on the impossibility of thinking so. To do so would require our system of thought to be somewhat more malleable; further liberated from modernist rationality; less repressed by fear of the other; and, more responsive to change than is suggested by the dominance that such an absurd classificatory system could bring to bear over the lives of so many.
The history of psychiatry is the history of a discourse always attempting to shed a debilitating inferiority complex; always looking to find favour with the more established profession’s, first medicine then education; always looking for ways in which it could appear ‘scientific’; always appealing to that questionable medical ethic that the proof of the pudding really is in the eating. This same pattern has been repeated over and over; through Pinel’s promise to de-pauperise the world and the birth of the asylum (Foucault, 1967), through the entry of the discipline of psychiatry into the university in the mid-19th Century (Goodson & Dowbiggin, 1990); to the turn of the twentieth century and the first entry of this ‘pseudo-science’ and its dividing practices into the school system (Copeland, 1997); to the last fifty years and the rise of the DSM and psychopharmacology into the everyday consciousness of the depressed and disorderly (Kirk & Kutchins, 1992).
There are numerous studies already which critique the history of the DSM and the validity of its categories (Cooksey & Brown, 1998, Harwood, 2005, Jensen & Hoagwood, 1997, Kirk & Kutchins, 1992, Rafalovich, 2005). In brief these studies suggest that the models in the DSM are "descriptively static, unidimensional and provide little context for emergent properties within the child’s broader surround" (Jensen & Hoagwood, 1997, p. 231). They accuse organized psychiatry of an "over-reliance on drugs, abusive treatment such as psychosurgery, conscious and unconscious social control, and replication and support of race, sex, and class bias" (Cooksey & Brown, 1998, p. 528). And to the process by which this dominant model is written it is claimed that; "in practice, decisions about who is normal begin with at most a few dozen people – mostly male, mostly white, mostly wealthy, mostly American psychiatrists" (Caplan, 1995, p. 31). Valerie Harwood is quite right when she states that "it is remarkable that a classification scheme like the DSM-IV-TR is successful at speaking the truth of mental disorder and plays such a fundamental role in the diagnosing of disorderly children" (Harwood, 2005, p. 47). To ‘remarkable’ one could offer endless alternative adjectives – concerning, frustrating, depressing and sickening, to name but a few.
The list of manifestations
So, according to the DSM, what does ADHD look like? Below is given the diagnostic criteria;
There are a couple of things that one can immediately critique with this criteria. Firstly, the language is loose and ill defined; for example, the first paragraph equates the "child’s current developmental level" with the significance of it when compared to peers. These two things are not the same – the first part implies an individualized approach to diagnosis, where a child’s developmental level is measured by some abstract criteria, the second part is entirely contingent on the child’s immediate environment.
The second paragraph reinforces the environmental contingency on which this diagnosis is based – "maladaptive" and "immature" are both descriptions that imply comparative judgment. Odd, one may think that the criteria rely so heavily on the child’s environment and yet treatment so rarely looks to environmental change, generally opting instead for drugs.
Thirdly, some of the wording in this criteria represents a tactical shift on the part of the APA. In the DSM-IV, for a combined-type diagnosis it stated that at least six from each section must be present – the language now is the much softer, more discretionary often. Of course the psychiatrist would defend this as a reaction to the "pigeon-holing" criticism that is often leveled at their practice – what they may not acknowledge so quickly is the clear fact that this change of terminology potentially broadens the net over those previously "borderline" cases, while simultaneously empowering the "expert" opinion, upon who’s judgment the diagnosis is now even more contingent.
Civilization and its malcontents
Lastly, and crucially, the school and the classroom are implicated everywhere in the criteria. The first seven criteria under "inattention" (a wholly inadequate term for the breadth of behaviour here characterised under it) all directly implicate the child’s ability to cope with various tasks with which they will be faced in the school. Where else would it matter if a child of five or six could not "organize activities or tasks"; or disliked "sustained mental effort"; or, failed to "pay close attention to details". The diagnostic criteria also states that the child must display these "deficiencies" across more than one environment; but only in the school could the ability to do these things ever be rated upon such scales as "maladaptive" and "immature". Turn your attention now to the criteria for "hyperactivity" and ask yourself; firstly, whether a child who "squirms in their seat" or even "inappropriately leaves" it, should be considered at risk of mental illness, and secondly whether the "illness" might not disappear if the requirement for such exacting physical control was not present in the first place.
This now brings us back to the routine – the self-referential and coercive regime by which the school day is organized – it’s rationale now becomes somewhat clearer. It separates and makes visible those who fail or resist routinization, for if they fail this first test then they are surely "dangerous individuals" (McCallum, 1998), "barbarians" (Popkewitz & Lindblad, 2004) and "fledgling psychopaths" (Harwood, 2005). Thus identifying and intervening to regulate these un-routinizable, unteachable, anti-social, untempered savages is a matter of the most immediate importance. The earlier they are ‘caught’ the earlier they and there peers can benefit from the gentle hand of the psychiatrist and the chemical embrace of the pharmaceutical.
The ADHD child – impulsive, unthoughtful, disorganized, disruptive, in short non-docile. The ADHD child emerges through this analysis as the absolute anti-thesis of the routinized good order of the school, and as such recourse to expert discourses, essentialising labels, invasive procedures, and coercive physical regimes – is easily justifiable. Such an individualization of deficiency betrays the unquestioned faith in the order of the school – a blind faith one could claim, if one were feeling generous enough to suggest that such processes happen beneath ‘ordinary’ consciousness. Whichever we choose, the result remains that the child questioning the austere monarchy of the routinized order shall be hung for treason by those civilized "others", in whom such power is invested.
Let us not forget however, that power is fickle, that resistance threatens order and that representation strengthens resistance. Our ongoing challenge is to provide such representation, for those who every day feel these totalizing effects of dominance, which once again brings us back to the democratic ideal. As such I finish with Nancy Fraser’s conception of our duty to;
"expose the limits of the specific form of democracy we enjoy in late-capitalist societies. Perhaps it can thereby help inspire us to try to push back those limits" (Fraser, 1997, p. 93).
Abikoff, H., Jensen, P., Arnold, E., Hoza, B., Hechtman, L., Pollack, S., et al. (2002). Observed Classroom Behavior of Children With ADHD: Relationship to Gender and Comorbidity. Journal of Abnormal Child Psychology, 30(4), 349-359.
Baker, B. (2002). The Hunt for Disability: The New Eugenics and the Normalization of School Children. Teachers College Record, 104(4), 673-703.
Ball, S. (1995). Politics and Policy Making in Education. London: Routledge.
Bauermeister, J., Matos, M., Reina, G., Salas, C., Martinez, J., Cumba, E., et al. (2005). Comparison of the DSM-IV combined and inattentive types of ADHD in a school-based sample of Latino/Hispanic children. Journal of Child Psychology and Psychiatry, 46(2), 166-179.
Bauman, Z. (2005). Work, consumerism and the new poor (2nd ed.). Maidenhead: Open University Press.
Beck, U. (1992). Risk Society: Towards a New Modernity. London: Sage.
Bekle, B. (2004). Knowledge and attitudes about Attention-Deficit Hyperactivity Disorder (ADHD): A comparison between practicing teachers and undergraduate education students. J Atten Disord, 7(3), 151-161.
Berwid, O. G., Curko Kera, E. A., Marks, D. J., Santra, A., Bender, H. A., & Halperin, J. M. (2005). Sustained attention and response inhibition in young children at risk for Attention Deficit/Hyperactivity Disorder. Journal of Child Psychology and Psychiatry, 46(11), 1219-1229.
Bibou-Nakou, I., Kiosseoglou, G., & Stogiannidou, A. (2000). Elementary Teachers' Perceptions Regarding School Behavior Problems: Implications for School Psychological Services. Psychology in the Schools, 37(2), 123-134.
Blackman, G. L., Ostrander, R., & Herman, K. C. (2005). Children with ADHD and Depression: A Multisource, Multimethod Assessment of Clinical, Social, and Academic Functioning. J Atten Disord, 8(4), 195-207.
Blair, I. P., Mitchell, P. B., & Schofield, P. R. (2005). Techniques for the identification of genes involved in psychiatric disorders. Australian and New Zealand Journal of Psychiatry, 39(7), 542-549.
Bradshaw, L., & Mundia, L. (2005). Understanding pre-service teachers' construct of disability: a metacognitive process. Disability and Society, 20, 563-574.
Breggin, P. (2002). The Ritalin Fact Book: What your doctor won't tell you about ADHD and stimulant drugs. Cambridge: Perseus.
Buitelaar, J., Van der Gaag, R., Swaab-Barneveld, H., & Kuiper, M. (1995). Prediction of clinical response to methylphenidate in chidlren with attention-deficit hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1025-1032.
Caplan, P. (1995). They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal. New York: Addison-Wesley.
Conrad, P., & Schneider, J. (1980). Deviance and Medicalization: From Badness to Sickness. St Louis: Mosby.
Cooksey, E., & Brown, P. (1998). Spinning on its Axes: DSM and the Social Construction of Psychiatric Diagnosis. International Journal of Health Services, 28(3), 525-554.
Copeland, I. (1997). Psuedo-science and Dividing Practices: a genealogy of the first educational provision for pupils with learning difficulties. Disability & Society, 12(5), 707-722.
Daley, D., Renyard, L., & Sonuga-Barke, E. (2005). Teachers' emotional expression about disruptive boys. British Journal of Educational Psychology, 75, 25-35.
DfES. (2003). Excellence and Enjoyment: A Strategy for Primary Schools: Department for Education and Skills.
DfES. (2004). Every Child Matters: Change for Children: Department for Education and Skills.
Dick, D., Viken, R., Kaprio, J., Pulkinnen, L., & Rose, R. (2005). Understanding the Covariation Among Childhood Externalizing Symptoms: Genetic and Environmental Influences on Conduct Disorder, Attention Deficit Hyperactivity Disorder, and Oppositional Defiant Disorder Symptoms. Journal of Abnormal Child Psychology, 33(2), 219-229.
Faraone, S. V., Biederman, J., & Zimmerman, B. (2005). Correspondence of parent and teacher reports in medication trials. European Child and Adolescent Psychiatry, 14(1), 20-27.
Fielding, S. (2000). Walk on the left! Children's geographies and the primary school. In S. Holloway & G. Valentine (Eds.), Children's geographies. Playing, living, learning (pp. 230-244). London: Routledge.
Foucault, M. (1967). Madness and civilization : a history of insanity in the age of reason (R. Howard, Trans.). London: Routledge.
Foucault, M. (1972). The archaeology of knowledge (A. Sheridan, Trans.). London: Routledge.
Foucault, M. (1974). The order of things : archaeology of the human sciences. London: Routledge.
Foucault, M. (1976). The History of Sexuality. vol 1: The Will to Knowledge (R. Hurley, Trans.). Harmondsworth: Penguin.
Foucault, M. (1979). Discipline and punish : the birth of the prison (A. Sheridan, Trans.). Harmondsworth: Penguin.
Foucault, M. (1980). Two Lectures. In C. Gordon (Ed.), Power-knowledge : selected interviews and other writings, 1972-1977 (pp. 78-108). Brighton: Harvester.
Foucault, M. (1982). The Subject and Power. In H. Dreyfus & P. Rabinow (Eds.), Michel Foucault: Beyond Structuralism and Hermeneutics (pp. 208-226). Brighton: Harvester Press.
Foucault, M. (1996). The return of morality. In S. Lotringer (Ed.), Foucault Live: Collected Interviews 1961-1984. New York: Semiotext(e).
Foucault, M. (1997). For an ethics of discomfort. In S. Lotringer (Ed.), The Politics of Truth: Michel Foucault (pp. 135-146). New York: Semiotext(e).
Fraser, N. (1997). Justice Interruptus: Critical Reflections on the "Postsocialist" Condition. London: Routledge.
Gale, T., & Densmore, K. (2000). Just Schooling: explorations in the cultural politics of teaching. Buckingham: Open University Press.
Garb, H. (1997). Race Bias, Social Class Bias, and Gender Bias in Clinical Judgement. Clinical Psychology: Science and Practice, 4(2), 99-120.
Giddens, A. (1991). Modernity and Self-Identity: Self and Society in the Late Modern Age. Cambridge: Polity.
Goffman, E. (1968). Stigma : notes on the management of spoiled identity. Harmondsworth: Penguin.
Gomez, R., Harvey, J., Quick, C., Scharer, I., & Harris, G. (1999). DSM-IV AD/HD: Confirmatory Factor Models, Prevalence, and Gender and Age Differences Based on Parent and Teacher Ratings of Australian Primary School Children. Journal of Child Psychology Psychiatry and Allied Disciplines, 40(2), 265-274.
Goodson, I., & Dowbiggin, I. (1990). Commonalities in the history of psychiatry and schooling. In S. Ball (Ed.), Foucault and education: Disciplines and knowledge (pp. 105-129). London: Routledge.
Gore, J. (1993). The Struggle for Pedagogies: Critical and Feminist Discourses as Regimes of Truth. London: Routledge.
Gore, J. (1995). Foucault's Postructuralism and Observational Education Research: A Study of Power Relations. In R. Smith & P. Wexler (Eds.), After Post-Modernism: Education, Politics and Identity (pp. 98-111). London: Falmer Press.
Gore, J. (1998). Disciplining Bodies: On the Continuity of Power Relations in Pedagogy. In T. Popkewitz & M. Brennan (Eds.), Foucault's Challenge: Discourse, Knowledge, And Power in Education (pp. 231-251). New York: Teachers College Press.
Habermas, J. (1981). A Theory of Communicative Action, vol 1: Reason and Rationalization of Society. Boston: Beacon Press.
Habermas, J. (1996). Three Normative Models of Democracy. In S. Benhabib (Ed.), Democracy and Difference: Contesting the Boundaries of the Political (pp. 21-30). Princeton NJ: Princeton University Press.
Hall, S. (1994). Cultural Idenity and Diaspora. In P. Williams & L. Chrisman (Eds.), Colonial Discourse and Post-Colonial Theory (pp. 392-403). New York: Columbia University Press.
Harwood, V. (2005). Diagnosing 'Disorderly' Children. London: Routledge.
Hinshaw, S. P. (2005). The stigmatization of mental illness in children and parents: developmental issues, family concerns, and research needs. Journal of Child Psychology and Psychiatry, 46(7), 714-734.
Holligan, C. (2000). Discipline and normalization in the nursery: the Foucaultian gaze. In H. Penn (Ed.), Early childhood services: Theory, policy and practice. Buckingham, PA: Open University Press.
Jahnukainen, M. (2001). Experiencing special education: Former students of classes for the emotionally and behaviorally disordered talk about their schooling. Emotional Behavioural Difficulties, 6(3), 150-166.
Jensen, P., & Hoagwood, K. (1997). The book of names: DSM-IV in context. Development and Psychopathology, 9, 231-249.
Johnston, C., Seipp, C., Hommersen, P., Hoza, B., & Fine, S. (2005). Treatment choices and experiences in attention deficit and hyperactivity disorder: relations to parents' beliefs and attributions. Child: Care, Health and Development, 31(6), 669-677.
Kirk, S., & Kutchins, H. (1992). The Selling of DSM: The Rhetoric of Science in Psychiatry. New York: Aldine de Gruyter.
Kuntsi, J., Rijsdijk, F., Ronald, A., Asherson, P., & Plomin, R. (2005). Genetic Influences on the Stability of Attention-Deficit/Hyperactivity Disorder Symptoms from Early to Middle Childhood. Biological Psychiatry, 57, 647-654.
Livingston, K. (1997). Ritalin: miracle drug or cop-out? The Public Interest, Spring, 3-18.
McCallum, D. (1998). Dangerous Individuals: Government and the Concept of Personality. In M. Dean & B. Hindess (Eds.), Governing Australia: Studies in Contemporary Rationalities of Government (pp. 108-124). Cambridge: Cambridge University Press.
Meulen, E. M., Bakker, S. C., Pauls, D. L., Oteman, N., Kruitwagen, C. L. J. J., Pearson, P. L., et al. (2005). High sibling correlation on methylphenidate response but no association with DAT1-10R homozygosity in Dutch sibpairs with ADHD. Journal of Child Psychology and Psychiatry, 46(10), 1074-1080.
Miller, T. (1993). The Well-Tempered Self. Baltimore: Johns Hopkins University Press.
Miller, T., & Leger, M. C. (2003). A Very Childish Moral Panic: Ritalin. Journal of Medical Humanities, 24(1/2), 9-33.
Newcorn, J., Halperin, J., Jensen, P., Abikoff, H., Arnold, E., Cantwell, D., et al. (2001). Symptom Profiles in Children With ADHD: Effects of Comorbidity and Gender. Journal of the American Academy of Child and Adolescent Psychiatry, 40(2), 137-146.
Nolan, E., Gadow, & Sprafkin. (2001). Teacher Reports of DSM-IV ADHD, ODD, and CD Symptoms in Schoolchildren. Journal of American Academy for Child and Adolescent Psychiatry, 40(2), 241-249.
Penn, H. (2000). Where should children learn: Space and segregation. In H. Penn (Ed.), Early childhood services: Theory, policy and practice (pp. 83-89). Buckingham, PA: Open University Press.
Plomin, R. (2005). Finding genes in child psychology and psychiatry: When are we going to be there? Journal of Child Psychology and Psychiatry, 46(10), 1030-1038.
Popkewitz, T., & Lindblad, S. (2004). Historicizing the future: Educational reform, systems of reason, and the making of chidren who are the future citizens. Journal of Educational Change, 5, 229-247.
Poulou, M. (2005). Perceptions of students with emotional and behavioural difficulties: a study of prospective teachers in Greece. Emotional and Behavioural Difficulties, 10, 137-160.
Price, T., Simonoff, E., Asherson, P., Curran, S., Kuntsi, J., Waldman, I., et al. (2005). Continuity and Change in Preschool ADHD Symptoms: Longitudanal Genetic Analysis with Contrast Effects. Behavior Genetics, 35(2), 121-132.
Rafalovich, A. (2005). Exploring clinician uncertainty in the diagnosis and treatment of attention deficit hyperactivity disorder. Sociology of Health & Illness, 27(3), 305-323.
Rappley, M. (2005). Attention Deficit-Hyperactivity Disorder. New England Journal of Medicine, 352(2), 165-173.
Remschmidt, H. (2005). Global consensus on ADHD/HKD. European Child and Adolescent Psychiatry, 14(3), 127-137.
Rhodes, S. M., Coghill, D. R., & Matthews, K. (2005). Neuropsychological functioning in stimulant-naive boys with hyperkinetic disorder. Psychological Medicine, 35, 1109-1120.
Rodriguez, A., & Bohlin, G. (2005). Are maternal smoking and stress during pregnancy related to ADHD symptoms in children? Journal of Child Psychology and Psychiatry, 46(3), 246-254.
Scheff, T. (1975). Labelling Mental Illness. In T. C. Heller (Ed.), Mental Health Matters. London: Macmillon.
Sciutto, M. J., Terjesen, M. D., & Bender Frank, A. S. (2000). Teachers' Knowledge and Misperceptions of Attention-Deficit/Hyperactivity Disorder. Psychology in the Schools, 37(2), 115-122.
Singh, I. (2002). Bad Boys, Good Mothers, and the "Miracle" of Ritalin. Science in Context, 15(4), 577-603.
Slee, R. (1997). Imported or Important Theory? Sociological interrogations of disablement and special education. British Journal of Sociology of Education, 18(3), 407-419.
Stein, D. (2002). The Ritalin Is Not The Answer. San Francisco: John Wiley & Sons.
Stevenson, J., Langley, K., Pay, H., Payton, A., Worthington, J., Ollier, W., et al. (2005). Attention deficit hyperactivity disorder with reading disabilities: preliminary genetic findings on the involvement of the ADRA2A gene. Journal of Child Psychology and Psychiatry, 46(10), 1081-1088.
Szasz, T. S. (1961). The myth of mental illness : foundations of a theory of personal conduct. New York: Harper & Row.
Szasz, T. S. (1994). Cruel Compassion: Psychiatric Control of Society's Unwanted. New York: John Wiley & Sons.
Thomson, P. (2002). Schooling the rustbelt kids: Making the difference in changing times. Stoke-on-Trent: Trentham Books.
Timimi, S., & Taylor, E. (2004). ADHD is best understood as a cultural construct. British Journal of Psychiatry, 184(1), 8-9.
Todd, R. D., Huang, H., Smalley, S. L., Nelson, S. F., Willcutt, E. G., Pennington, B. F., et al. (2005). Collaborative analysis of DRD4 and DAT genotypes in population-defined ADHD subtypes. Journal of Child Psychology and Psychiatry, 46(10), 1067-1073.
Valencia, R. (Ed.). (1997). The Evolution of Deficit Thinking: Educational Thought and Practice. London: Falmer Press.
Walkerdine, V. (1986). Post-structuralist theory and everyday social practices: the family and the school. In S. Wilkinson (Ed.), Feminist Social Psychology: Developing Theory and Practice. Milton Keynes: Open University Press.
Walsh, B. (1993). How Disabling Any Handicap Is Depends on the Attitudes and Actions of Others: A Student's Perspective. In R. Slee (Ed.), Is there a desk with my name on it? The politics of integration. London: Falmer Press.
Watling, R. (2004). Helping them Out: The Role of Teachers and Healthcare Professionals in the Exclusion of Pupils with Special Educational Needs. Emotional Behavioural Difficulties, 9(1), 8-27.
Wolraich, M., Lambert, E., Baumgaertel, A., Garcia-Tornel, S., Feurer, I., Bickman, L., et al. (2003). Teachers' Screening for Attention Deficit/Hyperactivity Disorder: Comparing Multinational Samples on Teacher Ratings of ADHD. Journal of Abnormal Child Psychology, 31(4), 445-455.
Yeh, M., Morley, K. I., & Hall, W. D. (2004). The policy and ethical implications of genetic research on attention deficit hyperactivity disorder. Australian and New Zealand Journal of Psychiatry, 38(1-2), 10-19.
Young, I. M. (1990). Justice and the Politics of Difference. Princeton NJ: Princeton University Press.
This document was added to the Education-Line database on 13 October 2006