Interrogating the Effectiveness of Educational Practices: A Critique of Evidence-Based Psychosocial Treatments for Children Diagnosed with Attention-Deficit/Hyperactivity Disorder

Abstract

In this paper, we critically evaluate the literature of evidence-based psychosocial interventions for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). Our paper is structured around five main criticisms. First, the evidence-based psychosocial interventions are formulated on the basis of the categorical diagnosis of ADHD, which is an ambiguous diagnostic entity. Second, they claim homogeneity among children diagnosed with ADHD. Third, they diffuse non-pedagogical language in education. The fourth criticism refers to the methodological bias by which evidence is produced. The fifth and final criticism describes how this body of literature promotes a pedagogical practice that relies on manualized approaches to be considered effective.

ADHD in the DSM-5-TR: What has changed and what has not

“…In contrast, scientific research on etiology and pathophysiology of people diagnosed with ADHD rather questions the current operationalization of ADHD as a categorical diagnosis in line with the "neo-Kraepelinian" view of discrete boundaries between health and disorder [e.g., 11]. Given DSM's multifaceted influence in organizing institutional (e.g., insurance eligibility, disability payments, educational services, legal decisions), academic (e.g., direction of research, fund allocations, course and textbook contents), and social and psychological lives (e.g., identity recognition, stigma, empathy), [e.g., (25,(29)(30)(31)], it seems unlikely that DSM would recategorize its classifications according to science it purports to adhere to.…”

How Can Social Capital Become a Facilitator of Inclusion?

“…We argue that pedagogical practices can be considered inclusive if the subjects of mutual inclusion are not only the students themselves but also their families. A school environment can be regarded as inclusive if it involves, and collaborates with, families, and helps parents support their children in the out-of-school environment to achieve common goals with the school [2,19,21,22,93]. As it is known, children spend more time with their families than at school.…”

“…(1) The first thematic focus considers schools as a starting point. Although there is a sceptical view of inclusion [15,16], the majority of the literature believes that an inclusive pedagogical environment can help students with special educational needs to be successful [2,3,[17][18][19][20][21][22][23][24][25][26][27]. However, this is only true if there are truly appropriate conditions provided at the school level [2,15,19,22,28].…”

The (Un)real Existence of ADHD—Criteria, Functions, and Forms of the Diagnostic Entity

“…To better understand how these processes work, we will next focus on meanings given to the ADHD diagnostic entity and their functions deployed through cultivating psycho-medical discourse of ADHD in institutional and social practices. Drawing from our previous research on how identities, agencies, and moral responsibility are negotiated in relation to the ideas about ADHD (Honkasilta et al, 2015 , 2016 ; Honkasilta and Vehkakoski, 2019 ) and medication use (see Honkasilta and Vehkakoski, 2017 ) as well as how the diagnosis impacts social and educational practices (see, Koutsoklenis and Gaitanidis, 2017 ; Koutsoklenis, 2020 ; Koutsoklenis et al, 2020 ), we have identified four functions and nine specific forms of the ADHD diagnosis as a semiotic mediator in the literature. Below, we present and analyze each of them and provide examples drawn from empirical studies (see Table 2 for a summary).…”

“…When problems associated with ADHD are recognized as a valid psychiatric disorder a promise is entailed of them being taken seriously and responded respectfully in institutional and social practice. However, organizing practice on the basis of the diagnosis has doubtful effectiveness (Koutsoklenis and Gaitanidis, 2017 ; Timimi, 2017 ).…”