ADHD – What’s in a name?
Paper presented at the British Educational Research Association Annual
Conference, University of Warwick, 6-9 September 2006
Simon Bailey
PhD research student, Nottingham University
Introduction
In recent years, Attention Deficit Hyperactive Disorder (ADHD) has become one of
the most commonly diagnosed psychiatric conditions amongst children; estimates
from treatment records suggest diagnostic rates as high as 30-40% in some schools in
America (BBC, 1999), while estimates in the UK are usually reported at around 5%
(BBC, 2003a). Of these, the vast majority are given some form of pharmaceutical
treatment – most commonly methylphenidate (Ritalin), of which around 250,000
preparations are prescribed in the UK (BBC, 2003b). The prominence of these
treatments along with the fact that diagnosis is made chiefly within the discourses of
psychology, psychiatry and paediatrics, reflects the dominance which the biological
model of mental disorder holds over current understandings of ADHD, a notion also
supported by the industry dependence on the Diagnostic and Statistical Manual for
Mental Disorder. Currently in a text revision of its fourth edition and written by an
elite task force of members of the American Psychiatric Association, who recently
also took over the writing of the other major published criteria for ADHD – the
International Classification of Diseases (ICD-10).
This paper concerns the increasingly popular psychiatric taxonomy ADHD and its
connections and contingencies within the educational context – from where a child is
most likely to enter the diagnostic process. The main focus of this paper is the
Diagnostic and Statistical Manual for Mental Disorder (DSM-IV-TR), which contains
the criteria most often used for a diagnosis of ADHD in children. Using sociocultural theories of risk, and Latour’s concept of translatability (Latour, 1987) I will
argue for a radical overhaul of this current politics of psychiatric regulation. Through
a brief re-telling of the history of the DSM, and its place in the context of psychiatry
and education I will present an analysis of some of the practices through which the
manual has gained and retains a legitimate truth telling function regarding children.
One such practice I shall argue is the manual’s distinctive use of language, through
which abstract taxonomy is connected to a broad range of school and class based
situations.
Experimenting with some re-translation, I shall briefly explore the
possibility of re-equating this seemingly value free language of science with the
oppressive consequences it implies for those most directly affected by it.
In
conclusion I shall return to the current translation and the implications of the practices
it helps to conceal.
2
Despite, or perhaps in part owing to, the pre-dominance of the bio-psychiatric model
for mental disorder, there exists a broad and varied critical literature on ADHD.
Questions concerning the aetiology, diagnosis and treatment of ADHD have
frequently been posed by academics and professionals, medical and otherwise
(Breggin, 2002, Fone & Nutt, 2005, Rafalovich, 2001, 2005, Singh, 2002b, Stein,
2002, Tait, 2005, Weathers, 2001). There is also a growing literature concerning the
varied experiences of the teachers, children, parents and families who have become
entangled in this discourse (Bussing et al., 2003, Daley et al., 2005, G. Edwards et al.,
2001, Harborne et al., 2004, Johnston & Mash, 2001, Johnston et al., 2002, Maniadaki
et al., 2005, Nolan et al., 2001, Singh, 2003, 2005, 2006 (Submitted), Whalen et al.,
2006, Whalen et al., 2002). The sociological critique which emerged on the back of
theses on medicalisation and anti-psychiatry has grown into a substantial body of
knowledge, increasingly extending into areas such as critical theory, historiography
and genealogy (Danforth & Navarro, 2001, Harwood, 2003, 2005, Laurence &
McCallum, 1998, Lloyd et al., 2006, Prosser, 2006a, 2006b, Singh, 2002a).
Nevertheless, the bio-psychiatric model steamrollers on, levels of diagnosis keep
going up and professionals become more and more reliant on the DSM; polarising the
dominant and critical discourses on ADHD in which one often confronts “not a
partner in the search for truth, but an adversary, an enemy who is wrong, who is
harmful and whose very existence constitutes a threat” (Foucault, 1984, p. 382).
Risk consciousness and natural development
There are those who claim that among the most important concepts to our social order
and the practice of our everyday lives, is risk (Beck, 1992, Gabe, 1995, Giddens,
1991, Lupton, 1999). Risks and risk analysis have become embedded on a discursive
plain of contested knowledge, which breeds a dependency on those with the right
knowledge and the ability to communicate it effectively into the language of everyday
social action. The aggressive mistrust of welfarism and lack of faith in collective
action which some claim characterise our current political state (Fraser, 1997, Young,
1990) has individualised our political environment, furthering this dependence on, and
helplessness in the face of, authority. Our daily lives are perforated by the constant
injunction to make a choice – from the daily budgeting of time and resources to the
3
long term management of work, family and education to the often critical decisions
regarding health – choices never free of restrictive circumstances, never free of the
opportunity cost of the choice we didn’t make, never free of the necessity of making a
choice. As Beck states, “even where the word ‘decisions’ is too grandiose, because
neither consciousness nor alternatives are present, the individual will have to ‘pay for’
the consequences of decisions not taken” (Beck, 1992, p. 135).
In this so called reflexive modernisation (Beck, 1992, Giddens, 1991) every choice
involves risks of one sort or another, and this places a high premium on the ability to
calculate the danger value of a given choice. When risk is a primary and ever present
consideration then we become anxious slaves to knowledge; it becomes the tool with
which we can ‘search for certainty’ (McWilliam & Singh, 2004) colonise the
immediate threats and render them relatively danger free. If a domain of knowledge
proves persuasive in its account of risk management then that domain stands to gain
heavy alliance, and what could in that case be seen is the inter-imbrications of
knowledge and power (Foucault, 1975, Foucault & Gordon, 1980).
One such domain of knowledge which has had particular salience with some of the
phenomena I am dealing with today is developmental psychology. Within education,
this domain is most commonly associated with the genetic epistemology of Jean
Piaget. Through his stages of cognitive development, Piaget created our view of how
children think in their early years. From sensorimotor, to preoperational through
concrete to formal operational, Piaget constructed a matrix through which he claimed
children learned to think conceptually and hypothetically (Piaget, 1976). What Piaget
also constructed in this process was a normative and ordinal grid into which children
could be distributed according to their perceived powers of perception. The axis of
this grid is a dual one in which children are subjected to “not just iniquitous
comparison with their peers…but also a constant evaluation against a 'gold standard'
of the normal child.” (James et al., 1998, p. 19).
A principle concern with these ideas that remains largely unheeded today is the ghosts
of theories past: degeneracy theory, whose pathogenic communities had secured
psychiatry’s place in the medical establishment in the mid-19th century (Goodson &
Dowbiggin, 1990); a ‘dangerous’ social Darwinism (Dennet, 1996), by which
4
institutional eugenics could be justified through the assertion of nature’s order (Baker,
2002); and Binet’s intelligence quotient, first devised as a means to identify ‘retarded’
learners and now promoted to a standardized, generalized examination in mental
competence – according to one author it was during his time working on a French
version of this test that Piaget observed the rhythms and regularities of the contents of
children’s minds which “would drive his life’s work” (Mooney, 2000, p. 60).
In constructing childhood as a set of developmental stages on the way to proper
maturation, Piaget unwittingly cast children as inferior to and dependent on adults
(Jackson & Scott, 1999, James et al., 1998). In setting up a normative and ordinal
ideal, against which the supposedly observable contents of a child’s mind could be
compared, he also created the possibility of ‘taming’ some chance (Hacking, 1990).
The huge influence that Piaget’s stages and developmental psychology in general
have on education is illustrative of a trend which can be understood in terms of the
attempted relief of ‘risk anxiety’ (Jackson & Scott, 1999) through the progressive
colonization of children and childhood (Cannella & Viruru, 2004). A plethora of
techniques have emerged to augment this strategy, each concerned to understand,
nurture and shape the future via manipulation of the present, and it is to one of these
techniques I would like to turn now.
Translating risk
I have argued so far that discursive practices associated with risk combined with
prevalent domains of knowledge currently serve to make the school, classroom,
teacher and child legitimate spaces for moral and political intervention. Through this
analysis, risk becomes “a calculative rationality tethered to assorted techniques for the
regulation, management, and shaping of human conduct” (Dean, 1999, p. 132). To
this idea I would like to introduce Bruno Latour’s concept of translatability (Latour,
1987).
I have already illustrated some of the ways in which ‘risk consciousness’ (McWilliam
& Singh, 2004) defines the need for calculable spaces, through which the seemingly
intractable present and future dangers of everyday life can be rendered manageable.
5
We ‘know’ about some of these spaces – these “troubled places” (Thomson, 2002),
you may know them as the ex-coalfield community, the inner-city estate, the school
on special measures and the child with low self-esteem.
Within the classroom, this calculative regime can be seen to operate through the
habituation of the routine school day, through which order and norm are translated
into a regulative strategy which functions to distribute, divide, separate and mark out
those who do not accept its rationale. While from a distance one can see that this
rationale lies in nothing more than obedience to the routine itself, and as such is no
more than a “mechanism by which authorities instantiate government” (Rose &
Miller, 1992, p. 183), at the level of the everyday experience of the powerless it
represents the constant injunction to regulate oneself, temper unruly subjectivities and
forfeit the freedom to determine one’s actions or the conditions of those actions
(Young, 1990, p. 38).
The legitimation for these practices in the classroom can once again be found in the
domain of the psy-sciences. The extent to which it seems natural to think of children
and schooling in terms of the developmental paradigm is illustrative of the way in
which psychology’s foothold in the practice of schooling is not just beyond reproof
but goes almost un-noticed.
The psy-sciences make up a kind of “intellectual
machinery” which renders thinkable childhood and schooling under certain
descriptions, and provides through an “array of techniques of inscription” a rational
assemblage of ways in which translation occurs – when lived experience can be made
calculable, and calculation makes what is lived governable (Rose, 1998, p. 54). One
such technique in this strategic translation, I argue here, is the Diagnostic and
Statistical Manual.
Before I come onto the language games of the DSM it is perhaps worth noting the
presence of the ‘S’ in DSM – something that my pre-occupation with the ‘D’ has
often led me to obscure, however, it is a powerful way in which the ‘facts’ of one’s
life become translated into the art of government. Statistics emerged as a science with
a powerful truth telling capacity in the early eighteenth century with the birth of civil
society and emergence of ‘the problem of population’ as the primary question facing
the science of government (Foucault, 1979, 1991).
6
Through the gathering of
numerical information on events and happenings this new ‘science of state’ revealed
regularities by which order and governance could be kept, forging what would be a
“lasting relation between knowledge and government” (Rose, 1998, p. 58). When
combined with a domain of knowledge such as psychology this concrete science of
state is able to construct “moral topographies of the population” (Rose, 1998, p. 74),
‘taming the wild profusion’ (Foucault, 1974) of unrule and disorder, domesticating it
through the natural rhythms and regularities of statistics (Hacking, 1990). The heavy
usage of statistics to legitimate the diagnosis of mental disorder is a key illustration of
an alliance with a governmental rationale – the numbers provide the intelligence with
which to assess the condition of its chosen population – the first step in the attempt to
“materialize the mind” (Rose, 1998, p. 109) which a project like the DSM represents.
As the words of the creators of the first DSM attest: “the collection of statistics on
mental illness and morbidity has long been a stepchild of Federal Government” (APA,
1952, p. x)
The emergence of the DSM
The DSM first appeared in 1952, prepared by the Committee on Nomenclature and
Statistics of the American Psychiatric Association and designed to succeed the
Statistical Manual for use of Institutions of the Insane, first published in 1918. As
such progressive editions (APA, 1968, 1980, 1987, 1994, 2000) aimed to provide not
only a “structural grid of demarcation for action on the action of others, but also
substantiate the science of psychiatry” (Harwood, 2005, p. 67). This period from
around the turn of the century to the 1950s is significant for a number of contextual
reasons which may be elaborated through a brief history.
The turn of the century had seen the first educational provision for children with
‘special needs’ the guidance from this was grounded in the “dividing practices” of the
medical profession which linked the educational provision of this new population
“very firmly with a prior medical examination” (Copeland, 1997, p. 713). In 1902
George Stills made his accounts of “a morbid ‘passionateness’ in children lacking
‘inhibitory volition’” (Laurence & McCallum, 1998, p. 184) – now commonly cited
as the medical genesis of ADHD.
7
This account was part of a wider debate concerning unruly children – the explanatory
argument for which raged between the psychoanalytic and bio-psychiatric model of
explanation (Kirk & Kutchins, 1992, Singh, 2002a). The latter model won two
significant victories: first, in the 1930s, Bradley’s successful experiments on the
therapeutic use of amphetamines to modify behaviour in children (Laurence &
McCallum, 1998, Singh, 2002a) and secondly in the ‘discovery’ of cerebral trauma
(Hacking, 1994) and the means to measure it in the Electroencephalogram (EEG)
which benefited from the mass experimentation made possible by the Second World
War (Laurence & McCallum, 1998).
The 132-paged DSM-I appeared via a seven-man task force, with no input from over
half the APA's members and was met with some indifference. Organizations were
unwilling to transfer their classifications over from the ICD and criticism was made of
the lack of guidance on childhood mental disorder (Jenkins, 1973). The second
edition of the manual, which was published in 1968, sought to address these
criticisms. However the popularity which it, and to a greater extent its successor,
gained was again contingent on changing social practices. One significant decade of
events was the pharmaceutical revolution, where, by 1961, 150,000 pharmacological
preparations were available, of which 90% had not existed ten years earlier (Singh,
2002a, p. 592). This included the first emergence of methylphenidate in 1955 as a
treatment for depression, and had by the 1970s helped establish mental disorder as a
formidable industry.
This context of a kind of battle ensuing between the psychoanalytic and biopsychiatric discourses represents not just two competing explanations for mental
disorder, but two entirely competing epistemologies. The psychoanalytic model as
represented most famously by Freud, sought aetiological explanation for mental
disturbance in childhood development, the dynamic model of the mind and the now
commonsense theories of ambivalence and repression. The bio-psychiatric model
represented less famously by the German psychiatrist Emil Kraepelin was concerned
less with aetiological theorisation and more with descriptive efforts to classify and
categorize psychiatric disorders symptomatically.
What the mass emergence of
psychopharmacology; the rise to dominance of the bio-psychiatric model of mental
disorder; and, the mass expansion and take-up of the DSM classification system all
8
share is an instrumental rationality – a “what works” reasoning that rather than
attempt to theorise aetiologically instead reverses the logic and takes the existence of
a cluster of symptoms and an effective treatment as all the proof of the aetiological
and diagnostic validity it needs. Thus the claim that “the shift from DSM-II to DSMIII marked an important moment in the history of psychiatry, as the bio-psychiatric
model came to dominate over the psychoanalytic model” (Cooksey & Brown, 1998,
p. 527) needs to be fully acknowledged for the epistemological slippage that it
implies.
So, 1980 and the appearance of the third DSM. The largest increase in diagnostic
categories – the biggest increase of which came in mental disorders of childhood and
adolescence (Kirk & Kutchins, 1992, p. 101), which included the first appearance of
“Attention Deficit Disorder”. That the epistemological shift described above had
gone by largely unacknowledged is illustrated by the following quote from “the
highest ranking psychiatrist in the federal government”(Kirk & Kutchins, 1992, p. 6):
“The decision of the APA first to develop DSM-III and then to promulgate its use
represents a significant reaffirmation on the part of American psychiatry to its medical
identity and its commitment to scientific medicine...There is not a textbook of
psychology or psychiatry that does not use DSM-III as the organizing principle for its
table of contents and for classification of psychopathology” (Klerman, 1984, In Kirk
& Kutchins, 1992, p. 6)
Translating the DSM
With regards nosology, the DSM is a categorical classificatory system, in which
children are paired off against clusters of clinical criteria which are either present or
absent – as one critic puts it, this process “strictly speaking, is a yes-or-no, an eitheror affair” (Hempel, 1965, p. 151); and this reflects the ‘anti-epistemology’ described
above. In the face of the complex and changing reality it seeks to pin down, this type
of classification encourages “an ongoing process of definition and refinement”
(Rapoport & Ismond, 1996, p. xvii). This rationale appears to leave a somewhat open
remit as to what behaviour or symptoms may or may not be one day construed as
reflecting mental illness – one only has to go back to DSM-I, for example, to find
9
homosexuality given it’s own pathology (Lafferty, 2000). This argument is also
substantiated by the DSM’s ill-defined concept of ‘mental disorder’ – again in the
words of the creators of the most recent manual: “although this manual provides a
classification of mental disorder, it must be admitted that no definition adequately
specifies precise boundaries for the concept of ‘mental disorder’” (APA, 2000, p.
xxx). And if one is puzzled over this rather casual approach “over what might be the
most elemental of details” (Harwood, 2005, p. 37) then one need look no further for
explanation than the potential diagnostic freedom which it denotes – it’s potential for
translatability (Latour, 1987).
Some excerpts from the DSM criteria for inattention:
“fails to pay close attention to details and makes careless errors in schoolwork”
“has trouble keeping attention on tasks”
“neither follows through on instructions nor completes chores, schoolwork, or
jobs”
“has trouble organizing activities and tasks”
“dislikes or avoids tasks that involve sustained mental effort”
“loses materials needed for activities (assignments, books, pencils, tools, toys)
“loses materials needed for activities (assignments, books, pencils, tools, toys)”
10
Some excerpts from the criteria for hyperactivity-impulsivity:
“squirms in seat or fidgets”
“inappropriately leaves seat”
“talks excessively”
“answers questions before they have been completely asked”
“has trouble awaiting turn”
“interrupts or intrudes on others”
(Source: APA, 2000)
These criteria are qualified by the statement that “symptoms need to manifest
themselves in a manner and degree which is inconsistent with the child’s current
developmental level…persisting for at least 6 months to a degree that is maladaptive
and immature” (APA, 2000).
Without any strong underlying concept of what actually constitutes mental disorder
and what does not, the first thing that is striking about these criteria is the ease with
which a diagnosis could be made. I have extracted twelve of the eighteen criteria
above – but six matching criteria from each section is enough to make a diagnosis of
ADHD. The criteria are also densely clustered – the inattention criteria are all to do
with an inability to focus on, organize or carry through tasks, it is almost as though
the same thing is being said in six slightly different ways. What the DSM, has
achieved with this criteria is a highly visual and rational tool, thoroughly practiced at
“knowing and speaking its objects into existence” (Harwood, 2005, p. 48), of making
its objects translatable. And because several concerning elements of this diagnostic
practice go unquestioned – the non-existent aetiology; the “what works”
epistemology; the vaguery of underlying constructs and the contingency of the
classroom – a convincing diagnostic argument will continue to be made on the extent
to which one can recognise a problem child within these criteria. As such the DSM
represents a convincing “act of persuasion” by which an actor confers on themselves
“authority to speak or act on behalf of another actor or force” (Callon & Latour, 1981,
p. 279).
Thus through its ability to reformulate the objects, instruments and tasks of biopsychiatry with reference to this specific domain of the school – the DSM aids the
11
psy-sciences in achieving the government of action at a distance (Rose & Miller,
1992).
Discussing a text of La Perriere, Foucault remarks “that a good ruler must have
patience, wisdom and diligence. What does he mean by patience? To explain it, he
gives the example of the king of bees, the bumble-bee, who, he says, rules the beehive without needing a sting.” (Foucault, 1991, p. 96). What I propose here is that the
government from a distance that the DSM achieves is partially contingent on its
ability to remove its sting. Therefore I would like to conclude this section with a brief
reflection on how one might go about putting the sting back in.
The DSM – ‘beyond good and evil’
I have argued that one of the ways the DSM has become an expert in speaking its
objects into existence and telling the truth about ‘disordered’ children is through its
embodiment of a neutral and wise authority. What I have tried to highlight is some of
the contingencies that the authority of this truth telling depends on – social and
discursive practices which have made the child’s head a legitimate calculable space,
and conferred the authority upon certain competent professionals to make inscriptions
upon such a space. My desire is to make these processes a little more visible, as such
I would like to propose a new nomenclature for ADHD, which re-acquaints the
discourse with its oppressive implications.
The first thing that is being implied with the label ADHD is a deficiency. This
denotes a pathological inability to complete tasks and activities according to the
normative structure available within the classroom. Given the generality of the
criteria, many 5-7 year olds must at some time or another display enough of the
behaviours listed above to qualify for a diagnosis, therefore the pathology must lie in
the fact that the behaviour has been observed for at least six months as well as the
opinion that the behaviour is developmentally inappropriate (as gauged against the
child’s peers). Thus, this child’s deficiency differs from the ‘normal deviance’ one
expects, and they can therefore be described as not only deficient but abnormally so.
12
It is obvious that the ADHD child represents a danger – to themselves, their peers,
their teachers and their parents. However, as I have argued here, our social order as a
whole is suspended by risk anxiety in a perpetual state of perceived danger. What
makes the ADHD child a particular danger is the location of their psychopathology to
internal origins. As slaves to the degenerate genes and structural abnormalities that
this biologically derived rationale implies, “there is little hope of change and every
chance of future pathology” (Harwood, 2005, p. 57).
Thus, this child’s danger
represents more than the common threat one expects, and they can therefore be
described not only as dangerous but highly so.
What this gives us is Abnormally Deficient and Highly Dangerous, which, by happy
coincidence, means we need not change the acronym. However, having Abnormally
Deficient and Highly Dangerous doesn’t make sense. Fortunately what I have been
talking about here in the ADHD label is a mode of subjection which seeks to tether
identity to a simple construct.
As such we can emphasise the ontological shift
involved and talk about the child as being Abnormally Deficient and Highly
Dangerous.
The neutral language of ADHD as represented in the DSM allows what should be
seen as a highly concerning set of practices to become specks on the “all too familiar
and poorly known landscape” (Foucault, 1997, p. 144) of action upon action and the
conduct of conduct. The sting of psy-science - deficit, stigma, fatalism, essentialism
and dependency are all introduced to the child at the earliest possible age, concealed
behind the supposedly empowering language of special needs (Corbett, 1996) and the
“incontrovertible factuality” (M. Edwards, 2004) of biological inheritance.
Childhood and Danger
The emergence of the dangerous ADHD child is made possible through the discursive
practices justified by risk consciousness (McWilliam & Singh, 2004); the perceived
threat of the unruly child; troubled community; failing school – unified perhaps only
through the means by which they have been fabricated – for, it is “only in the analysis
of risks that the hazard comes into existence” (Fox, 1999, p. 20).
What dominant
translations of experience such as the DSM obscure is the extent to which children –
13
‘mentally ill’ or otherwise – and the institution of childhood itself has become
something of a “targeted population” (Dean, 1999, p. 148).
Childhood, it has been observed, inhabits something of an ambivalent plane in our
attitudes and practices. As fearful of notions of ‘lost innocence’ as we are of deviance
and the “barbaric future” (Popkewitz & Lindblad, 2004) it heralds, childhood is
increasingly constructed “as a precious realm under siege from those who would rob
children of their childhoods, and as being subverted from within by children who
refuse to remain childlike” (Jackson & Scott, 1999, p. 86). Propelled by the will to
protect, nurture and keep from harm; empowered by domains of knowledge through
which we understand such notions as ‘development’ and ‘socialization’, and ever
vigilant for the tell tale signs that spell a future of educational failure,
unemployability, deviance and criminality; a colony of risk anxiety has been
constructed in which children – their movements, spaces, utterances, and habits are
divided, safe from dangerous (Cannella, 1999).
The institutionalisation of children in compulsory schooling serves to exclude them
from full participation in adult society and re-inscribes relations of dependence.
School also provides an important arena in which domains of knowledge have
developed with their associated implications for political structure and moral practice
(Foucault, 1984, pp. 387-388, Rose & Miller, 1992, p. 178). And when through the
wholly accepted wisdoms of the developmental paradigm (James et al., 1998) and the
effects of low self-esteem (Cruikshank, 1996) one can see so many spectres of
theories past; “pathogenic communities”, “degenerate genes” (Goodson &
Dowbiggin, 1990) – then one understands the extent to which these divisions, this
protection, these well intentioned acts of kindness, have contributed to the perceived
need for constant vigilance and the encountering of the contents of the child’s mind as
a legitimate space of invasion.
Within this context of risk anxiety the ADHD child emerges as a danger from several
perspectives. They disrupt classroom life, put other’s education on hold, marginalise
the teacher’s ability to keep order, and through the association of ADHD with other
‘learning difficulties’ they endanger their own educational future as well. For parents
of an ADHD child the task becomes accounting for oneself in the face of having
14
produced such a phenomenon (Singh, 2004); for parents of other children the task
becomes making sure that their own child is not being lead astray or in any other way
having their education jeopardised (Armstrong, 2003, Benjamin, 2002). For teachers
the task of inclusion is constantly foreshadowed by the need to produce results, the
extensive network of accountability and performance tying the everyday experience
of the classroom to the future of the school (Benjamin, 2002, Curtis, 2006,
McWilliam & Singh, 2004, Selwyn, 2000, Slee, 1997, 1992).
Thus, social and discursive practice, the focus on that which threatens the prescriptive
order and norm, open up spaces of perceived disruption and unruliness, and states the
case for political and moral intervention. Viewed through the lens of risk anxiety,
problems of regulation and management such as ADHD, appear everywhere and it is
easy to see how enclosures of expertise may establish themselves with their “tranquil
yet seductive territory of truth” (Rose & Miller, 1992, p. 188).
15
Bibliography
APA. (1952). Diagnostic and Statistical Manual for Mental Disorder (DSM-I) (1st
ed.). Washington D.C: American Psychiatric Association.
APA. (1968). Diagnostic and Statistical Manual for Mental Disorder (DSM-II).
Washington D.C: American Psychiatric Association.
APA. (1980). Diagnostic and Statistical Manual for Mental Disorder (DSM-III).
Washington D.C: American Psychiatric Association.
APA. (1987). Diagnostic and Statistical Manual for Mental Disorder (DSM-III-R).
Washington D.C: American Psychiatric Association.
APA. (1994). Diagnostic and Statistical Manual for Mental Disorders (DSM-IV). (4th
ed.). Washington D.C: American Psychiatric Association.
APA. (2000). Diagnostic and Statistical Manual for Mental Disorder: Text Revision
(DSM-IV-TR). Washington D.C: American Psychiatric Association.
Armstrong, F. (2003). Spaced Out: Policy, Difference and the Challenge of Inclusive
Education. London: Kluwer.
Baker, B. (2002). The Hunt for Disability: The New Eugenics and the Normalization
of School Children. Teachers College Record, 104(4), 673-703.
BBC. (1999, 23rd February). Drug to control children's behaviour 'overused'. Retrived
from http://bbc.co.uk 15th August 2006.
BBC. (2003a, 24th July). Schools in row over Ritalin. Retrieved from http://bbc.co.uk
15th August 2006.
BBC. (2003b, 19th July). Sharp rise in chilren's Ritlain use. Retrived from
http://bbc.co.uk 15th August 2006.
Beck, U. (1992). Risk Society: Towards a New Modernity. London: Sage.
Benjamin, S. (2002). The Micropolitics of Inclusive Education: An ethnography.
Buckingham: Open University Press.
Breggin, P. (2002). The Ritalin Fact Book: What your doctor won't tell you about
ADHD and stimulant drugs. Cambridge: Perseus.
Bussing, R., Zima, B. T., Gary, F. A., & Garvan, C. W. (2003). Barriers to Detection,
Help-Seeking, and Service Use for Children with ADHD Symptoms. Journal
of Behavioral Health Services and Research, 30(2), 176-189.
Callon, M., & Latour, B. (1981). Unscrewing the big Leviathan: How actors
macrostructure reality and how sociologists help them to do so. In K. Knorr
Cetina & A. Cicourel (Eds.), Advances in Social Theory (pp. 277-303).
London: Routledge and Kegan Paul.
Cannella, G. (1999). The Scientific Discourse of Education: predertermining the lives
of others - Foucault, education, and children. Contemporary Issues in Early
Childhood, 1(1), 36-44.
Cannella, G., & Viruru, R. (2004). Childhood and Postcolonization: Power,
Education, and Contemporary Practice. London: RoutledgeFalmer.
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.
Corbett, J. (1996). Bad-Mouthing: The Language of Special Needs. London: The
Falmer Press.
16
Cruikshank, B. (1996). Revoloutions within: self-government and self-esteem. In A.
Barry, T. Osborne & N. Rose (Eds.), Foucault and Political Reason:
Liberalism, Neo-Liberalism and Rationalities of Government (pp. 231-251).
London: UCL Press.
Curtis, B. (2006). Is the National Primary Strategy transforming or ossifying English
primary schools? Paper presented at the NERA conference, University of
Orebro, Sweden.
Daley, D., Renyard, L., & Sonuga-Barke, E. (2005). Teachers' emotional expression
about disruptive boys. British Journal of Educational Psychology, 75, 25-35.
Danforth, S., & Navarro, V. (2001). Hyper Talk: Sampling the Social Construction of
ADHD in Everyday Language. Anthropology and Education Quarterly, 32(2),
167-190.
Dean, M. (1999). Risks, calculable and incalculable. In D. Lupton (Ed.), Risk and
sociocultural theory (pp. 131-159). Cambridge: Cambridge University Press.
Dennet, D. (1996). Darwin's Dangerous Idea: Evolution and the meaning's of life.
London: Penguin.
Edwards, G., Barkley, R., Laneri, M., Fletcher, K., & Metevia, L. (2001). ParentAdolescent Conflict in Teenagers with ADHD and ODD. Journal of Abnormal
Child Psychology, 29(6), 557-572.
Edwards, M. (2004). Too many tablets to swallow. Times Educational Supplement,
Retrieved 15 August 2006, from http://www.tes.co.uk/.
Fone, K., & Nutt, D. (2005). Stimulants: use and abuse in the treatment of attention
deficit hyperactivity disorder. Current Opinion in Pharmacology, 5, 87-93.
Foucault, M. (1974). The order of things : archaeology of the human sciences.
London: Routledge.
Foucault, M. (1975). Discipline and punish : the birth of the prison (A. Sheridan,
Trans.). Harmondsworth: Penguin.
Foucault, M. (1979). On Governmentality. Ideology & Consciousness(6), 5-21.
Foucault, M. (1984). Polemics, Poitics and Problematizations: An interview. In P.
Rabinow (Ed.), The Foucault Reader (pp. 381-390). London: Penguin.
Foucault, M. (1991). Governmentality. In G. Burchell, C. Gordon & P. MIller (Eds.),
The Foucault Effect: Studies in Governmentality (pp. 87-104). Chicago:
University of Chicago Press.
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).
Foucault, M., & Gordon, C. (Eds.). (1980). Power/Knowledge: Selected interviews
and other writings 1972 - 1977 by Michel Foucault. Brighton: Harvester
Press.
Fox, N. (1999). Postmodern reflections on 'risk', 'hazards' and life choices. In D.
Lupton (Ed.), Risk and sociocultural theory (pp. 12-33). Cambridge:
Cambridge University Press.
Fraser, N. (1997). Justice Interruptus: Critical Reflections on the "Postsocialist"
Condition. London: Routledge.
Gabe, J. (Ed.). (1995). Medicine, Health and Risk: Sociological Approaches.
Cambridge: Blackwell.
Giddens, A. (1991). Modernity and Self-Identity: Self and Society in the Late Modern
Age. Cambridge: Polity.
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.
17
Hacking, I. (1990). The Taming of Chance. Cambridge: Cambridge University Press.
Hacking, I. (1994). Memero-politics, trauma and the soul. History of the Human
Sciences, 7, 29-52.
Harborne, A., Wolpert, M., & Clare, L. (2004). Making Sense of ADHD: A Battle for
Understanding? Parents' Views of their Children Being Diagnosed with
ADHD. Clinical Child Psychology and Psychiatry, 9, 327-340.
Harwood, V. (2003). Drawing on Foucaultian genealogy to consider the
constructions of psychopathology and sexualities in young people. Paper
presented at the NZARE & AARE, Aukland.
Harwood, V. (2005). Diagnosing 'Disorderly' Children. London: Routledge.
Hempel, C. (1965). Aspects of Scientific Explanation and Other Essays in the
Philosophy of Science. New York: The Free Press.
Jackson, S., & Scott, S. (1999). Risk anxiety and the social construction of childhood.
In D. Lupton (Ed.), Risk and sociocultural theory (pp. 86-107). Cambridge:
Cambridge University Press.
James, A., Jenks, C., & Prout, A. (1998). Theorizing Childhood. Cambridge: Polity.
Jenkins, R. (1973). Behavior Disorders of Childhood and Adolescence. Springfield,
Il: Charles C. Thomas.
Johnston, C., & Mash, E. (2001). Families of Children With AttentionDeficit/Hyperactivity Disorder: Review and Recommendations for Future
Research. Clinical Child and Family Psychology Review, 4(3), 183-207.
Johnston, C., Murray, C., Hinshaw, S., Pelham Jr, W., & Hoza, B. (2002).
Responsiveness in Interactions of Mothers and Sons With ADHD: Relations to
Maternal and Child Characteristics. Journal of Abnormal Child Psychology,
30(1), 77-88.
Kirk, S., & Kutchins, H. (1992). The Selling of DSM: The Rhetoric of Science in
Psychiatry. New York: Aldine de Gruyter.
Lafferty, R. (2000). Queerly Ill: The Rise and Fall of the Illness of Homosexuality.
Retrieved from http://lafferty.ca/writings/ 15th August 2006
Latour, B. (1987). Science in Action. Cambridge, Mass: Harvard University Press.
Laurence, J., & McCallum, D. (1998). The Myth-or-Reality of Attention-Deficit
Disorder: a genealogical approach. Discourse, 19(2), 183-200.
Lloyd, G., Stead, J., & Cohen, D. (Eds.). (2006). Critical New Perspectives on
ADHD. London: Routledge.
Lupton, D. (Ed.). (1999). Risk and sociocultural theory. Cambridge: Cambridge
University Press.
Maniadaki, K., Sonuga-Barke, E., Kakouros, E., & Karaba, R. (2005). Maternal
Emotions and Self-Efficacy Beliefs in Relation to Boys and Girls with
AD/HD. Child Psychiatry and Human Development, 35(3), 245-263.
McWilliam, E., & Singh, P. (2004). Safety in numbers? Teacher collegiality in the
risk-conscious school. Journal of Educational Enquiry, 5(1), 22-33.
Mooney, C. G. (2000). Theories of Childhood: An introduction to Dewey, Montessori,
Erikson, Piaget and Vygotsky. St Paul, MN: Redleaf Press.
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.
Piaget, J. (1976). The Child and Reality. New York: Penguin.
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.
18
Prosser, B. (2006a). ADHD: Who's failing who? Sydney: Finch Publishing.
Prosser, B. (2006b). Seeing Red: Critical Narrative in ADHD research. Teneriffe,
Queensland: Post Pressed.
Rafalovich, A. (2001). Psychodynamic and Neurological Perspectives on ADHD:
Exploring Strategies for Defining a Phenomenon. Journal for the Theory of
Social Behavior, 31(4), 397-418.
Rafalovich, A. (2005). Exploring clinician uncertainty in the diagnosis and treatment
of attention deficit hyperactivity disorder. Sociology of Health & Illness,
27(3), 305-323.
Rapoport, J., & Ismond, D. (1996). DSM-IV Training Guide for Diagnosis of
Childhood Disorders. New York: Brunner/Mazel.
Rose, N. (1998). Inventing our selves: Psychology, Power, and Personhood.
Cambridge: Cambridge University Press.
Rose, N., & Miller, P. (1992). Political power beyond the state: Problematics of
government. The British Journal of Sociology, 43(2), 173-205.
Selwyn, N. (2000). The National Grid for Learning: panacea or Panopticon? British
Journal of Sociology of Education, 21(2), 243-255.
Singh, I. (2002a). Bad Boys, Good Mothers, and the "Miracle" of Ritalin. Science in
Context, 15(4), 577-603.
Singh, I. (2002b). Biology in Context: Social and Cultural Perspectives on ADHD.
Children & Society, 16, 360-367.
Singh, I. (2003). Boys Will Be Boys: Fathers' Perspectives on ADHD Symptoms,
Diagnosis, and Drug Treatment. Harvard Review of Psychiatry, 11, 308-316.
Singh, I. (2004). Doing their jobs: mothering with Ritalin in a culture of motherblame. Social Science and Medicine, 59, 1193-1205.
Singh, I. (2005). Will the "Real Boy" Please Behave: Dosing Dilemmas for Parents of
Boys with ADHD. The American Journal of Bioethics, 5(3), 1-14.
Singh, I. (2006 (Submitted)). Clinical Implications of Ethical Concepts: Moral selfunderstandings in children taking methylphenidate for ADHD. Clinical Child
Psychology and Psychiatry.
Slee, R. (1997). Imported or Important Theory? Sociological interrogations of
disablement and special education. British Journal of Sociology of Education,
18(3), 407-419.
Slee, R. (Ed.). (1992). Is there a desk with my name on it? The politics of integration.
London: Falmer.
Stein, D. (2002). The Ritalin Is Not The Answer. San Francisco: John Wiley & Sons.
Tait, G. (2005). The ADHD debate and the philosophy of truth. International Journal
of Inclusive Education, 9(1), 17-38.
Thomson, P. (2002). Schooling the rustbelt kids: Making the difference in changing
times. Stoke-on-Trent: Trentham Books.
Weathers, L. (2001). ADHD: A Path to Success: Ponderosa Press.
Whalen, C., Henker, B., Ishikawa, S., Jamner, L., Floro, J., Johnston, J., et al. (2006).
An Electronic Diary Study of Contextual Triggers and ADHD: Get Ready, Get
Set, Get Mad. Journal of the American Academy of Child and Adolescent
Psychiatry, 45(2), 166-174.
Whalen, C., Jamner, L., Henker, B., Delfino, R., & Lozano, J. (2002). The ADHD
Spectrum and Everyday Life: Experience Sampling of Adolescent Moods,
Activities, Smoking, and Drinking. Child Development, 73(1), 209-227.
Young, I. M. (1990). Justice and the Politics of Difference. Princeton NJ: Princeton
University Press.
19
20