A case of attention-deficit/hyperactivity disorder diagnosis: Sir Karl and Francis B. slug it out on the consulting room floor

Abstract

Drawing upon conversation analysis and critical discourse analysis, and in the frame of what is currently called discursive psychology, we open up a significant macro-social problem -indeed a global problem -to inspection at a local level by reference to a naturally-occurring instance of talk-in-interaction. The problem is the documented increase in diagnoses of ADHD (AttentionDeficit/Hyperactivity Disorder) in recent years -particularly for boys, particularly in Anglophone countries, and particularly by reference to schoolbased conduct -and its consequent 'treatment' by amphetamines (including Ritalin [methylphenidate]) and related medications (Singh, 2002a). The local instance of talk-in-interaction is a transcript of a diagnostic session involving a young boy, his parents and a paediatrician. We aim to show that the local instance can shed light on just how routine and mundane it is for children to be positively diagnosed and medicated merely on presentation for the possibility of the 'disorder', even when parents are manifestly sceptical about (even resistive to) the diagnosis and its methodological grounds.

Doing Fence Sitting

“…Discursive psychology has been used in previous studies to explore how professional accounts of psychiatric medication can be employed to serve rhetorical and persuasive functions in managing questions about its efficacy (Harper, 1999), to examine the ways in which psychiatric diagnoses are produced in professional discourse (Wooffitt & Allistone, 2005), and to study how the professional use of psychological terms can be the site of discursive struggle (McHoul & Rapley, 2005). As such, discursive psychology was considered to provide a framework well suited to the aim of this study: to explore clinical psychologists' constructions of mental health and its perceived impact on their work with service users.…”

Power Struggle, Submission and Partnership: Agency Constructions of Mothers of Children with ADHD Diagnosis in Their Narrated School Involvement

“…Paradoxically, educational social practice is claimed to be strongly committed to medical, rather than inclusive discourse (Lloyd, 2006), co-establishing the medical model of disability, i.e. institutional commitment to explain a child's undesirable behaviour through psycho-medical explanations while disregarding its contextual and social origins (e.g., Gresham, 2002; Thomas & Loxley, 2007, see also Hjörne & Säljö, 2004;McHoul & Rapley, 2005). Thus, instead of home and school taking joint educational responsibility for children with manifest difficulties in selfregulation and in regulating attention, activity and impulsivity 'appropriately', the medical model labels the behaviour as a neuropsychological dysfunction called attention deficit hyperactivity disorder (ADHD).…”

The ‘child’s best interests’ as an argumentative resource in family mediation sessions

“…We view mediation as an institutional practice in that talk in mediation settings is normally goal oriented with particular forms of talk permitted; moreover, participants attend to their institution-relevant identities -for example, mediator, parent, ex-partner (Drew and Heritage, 1992). In discursive approaches, a few cases, analysed in detail, are assumed to shed light on widespread practices and assumptions, and also possibly highlight future areas to be investigated on a larger scale (McHoul and Rapley, 2005). Discursive Psychology's emphasis on the construction of specific versions encourages the researcher to consider the practices that those versions are part of, and the particular work that they perform (Edwards and Potter, 2001).…”

“…We used a Discursive Psychology approach, drawing on elements of critical discourse analysis and CA to understand how participants display understandings in everyday, or 'naturally-occurring', talk (Edwards and Potter, 2001;McHoul and Rapley, 2005). Discursive approaches have no recognisable 'method' in terms of formalised procedures, but share a set of assumptions about language practices -an 'analytic mentality' (Schenkein, 1978).…”