Dr John M Davis University of Edinburgh The Medicalisation Of Problem Behaviour john.davis@ed.ac.uk

1. Dr John M Davis University of EdinburghThe Medicalisation Of Problem Behaviour john.davis@ed.ac.uk

2. 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

3. Medical Modelling The Context • Early Years Assessments - Physical Norms • Base-Line Assessment - Educational Norms • National Testing, Targets and League Tables • Health Scare Mongering

4. 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/

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

6. 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)

7. ADHD Medical Model • Dietary • Genetic • Neurological • Psycho-social • Environmental

8. 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."

9. 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

10. Disabled Children Defined as victims Concentrate on Negatives Not thought to be able to make choices Known as a Label - ‘Wee Asperger’s Boy’ Prevented from Meeting Other Children Experience Barriers To Transition

11. 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)

12. Socal 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.

13. 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

14. 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)

15. 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

16. 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

17. 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.

18. 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

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

20. Conclusion What Do You Think?

21. Resources 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

22. 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.html#PE-BasicMoves

23. Resources Better Behaviour Scotland http://www.betterbehaviourscotland.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?i=1

24. References 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

25. 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 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.

26. 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.