Medicalization of youth’s difficulties is growing, and the situation is worrisome. In the case of ADHD/ADD, school staff members play a role in this medicalization because they are often the first to notice the behaviours and mention the difficulties. This infographic is intended to make them aware of the associated issues

Blackburn, Marie-Ève

Blais, Marie-France

Brault, Marie-Christine

Dubois-Bouchard, Camélia

Constellation

Since the 2000s, the prevalence of ADHD/ADD diagnoses among youthhas been rising, in Québec as well as elsewhere in the world.Attention deficit disorder with or without hyperactivity (ADHD) is apsychiatric diagnosis characterized by inattentive and/or hyperactiveand/or impulsive behaviours of which the frequency and intensity areinappropriate for the person’s age. Sometimes, inattention ispredominant (ADD).The percentage of youth having been diagnosed with ADHD/ADD atsome point in their lives is unevenly distributed by gender, age,socio‑economic status, as well as school and geographical context.ADHD/ADDITS PREVALENCE ISINCREASINGThe prevalence is higherThis infographic is intended to make them aware of the associated issues.Medicalization of youth’s difficulties is growing, and the situation is worrisome. In the case ofADHD/ADD, school staff members play a role in this medicalization because they are often the first tonotice the behaviours and mention the difficulties.Among boysAmong children fromsocio‑economicallydisadvantaged familiesIn certain grades and schoolenvironmentsAmong the youngest in the class In some regions ofQuébec and elsewherein the worldAND IS UNEVENLYDISTRIBUTEDThis infographic was created from the research of Marie-Christine Brault, PhD, professor at UQAC and researcher at the VISAJ Chair and the IUJD. (e.g., born in September in Québec) The Case ofADHD/ADDMedicalization ofChildren’s Difficulties:Medicalization occurs when the medical sphere takes charge of aneveryday life situation or reaction (sadness, timidity, impulsivity, etc.). It isa collective action involving a diversity of actors (health, school, family,media, etc.).MEDICALIZATION© Chaire VISAJ and Institut universitaire Jeunes en difficulté (2021) 1/6Of thecausesOf thetreatmentThe causes of ADHD/ADD are still not clearly established.Nonetheless, the hypotheses lean towards multiple causes involvingbiological factors, but also environmental ones (stress, parents’ divorce,poverty, etc.)Medication is the main treatment used, despite the fact thatpsychological, educational and social interventions may also improvethe situation.A FEW REALITIESOfscreeningThere is no infallible test to ascertain the presence of a psychiatricdisorder in a child. A diagnosis is made based on an interpretation ofthe symptoms. Given the multiple causes, this interpretation issometimes difficult to make.Several people are worried about the significant rise in the prevalence of thediagnosis and the use of medication.The process leading to an ADHD/ADD diagnosis is complex, but it always involvesadults’ perceptions of a child’s behaviours and difficulties.What school staff members notice…The School’s RoleHow can I helpthis child andthe others inthe class?The child is ofteninvolved in fightsin the schoolyard…The child isunable to makefriends.The child isconstantly causinga disturbance inclass.The child is failing inschool.The child’s head isalways in theclouds!The child makesmouth noises andnever keeps still!In daycare, the childoften forgets his/herbelongings.© Chaire VISAJ and Institut universitaire Jeunes en difficulté (2021) 2/6When the increase in the prevalence of ADHD/ADD diagnoses cannot be explained solely by individual andbiological factors, it is necessary to look at what is happening in the social environment.The child must behyperactive…The child musthaveADHD/ADD.The actors’ adherence to the biomedical explanations for ADHD/ADD;A positive personal or professional experience with a diagnosis or withmedication;A lack of knowledge of what ADHD/ADD really is, which sometimes leads toconfusion between symptoms and disorder;A lack of time or of school services or difficult work conditions;An academic performance context;A feeling of powerlessness with respect to the child and his/her livingconditions.THE USE OF A MEDICAL INTERPRETATION ISREINFORCED BY…The child has potential; Idon’t understand his/herfailures. Might he/shehave an attention deficitproblem?And how some school staff members interpret it through a medical lens…I’ll ask theparents to go fora consultation.© Chaire VISAJ and Institut universitaire Jeunes en difficulté (2021) 3/6Might the child havea disorder that Ididn’t detect?That is why we are talking about medicalization of difficulties.Medicalization of children may have the followingconsequences:Proposal of inappropriate solutions to the difficulties;Dismissal of the real disorder (dyslexia, etc.) or concealment ofsocial problems and those relating to living conditions;Unnecessary consumption of medication and side effects(growth delay, loss of appetite, sleep disorder, etc.);Emphasis on the children’s deficits rather than on theirstrengths;The children’s identity being reduced to a label that is difficultto get rid of and that could lead to stigmatization, which canhave various consequences (loss of self-esteem, less positiveschool experiences, etc.);Long-term repercussions that affect their personal,professional and relational progress.Why is this an issue?An accurate diagnosis can have positive outcomes.The problem arises when a child is wrongly diagnosed.A FEW CONSEQUENCES OF MEDICALIZATION4/6© Chaire VISAJ and Institut universitaire Jeunes en difficulté (2021)Careful! Medicalization is not synonymous with medication.This is one of the aspects of medicalization!Have we triedeverything with thechild, even moremarginal practices inwhich things mustbe done differently?Is the childexperiencingupsetting eventsat home?The child seems moreimmature; could it bebecause he/she isamong the youngest inthe class?What should bedone to make allstudents in theschool move more?Have we banked onthe child’s strengths,despite his/herdifficultiesHow can the child beplaced at the heart ofthe solutions?How can the variouspedagogical approachesbe best utilized tofacilitate everyone’slearning?How do we introduce a“school vision” thatensures continuity of thealternative measuresthat have worked with astudent?Is it a lack of time and ofschool resources thatleads to medicalization?How can communicationchannels be established forthe adults (parents, teacher,etc.) in the children’scircles?“Reflecting on medicalization means broadening thefocus, looking away for a moment from theindividual who is calling for help, to examine his/herenvironment and living conditions.”AND WHAT IF WE BROADENEDOUR FOCUS INSTEAD? (Anne-Marie Boucher, La Presse, October 12, 2020)There would thus be multiple other ways to reflect on the children’sdifficulties© Chaire VISAJ and Institut universitaire Jeunes en difficulté (2021) 5/6REFERENCESBélanger, S.A., Andrews, D., Gray, C., Korczak, D. Société canadienne de pédiatrie, Comité de la santémentale et des troubles du développement. Paediatr Child Health 2018, 23(7):454–461.Boucher-Lafleur, A.-M. (12-10-2020). Évitons la médicalisation de la crise de la santé mentale. La Presse,Section Débat, p.5. Brault, M. C. (2019). Mémoire déposé dans le cadre du Mandat d'initiative sur l'augmentationpréoccupante de la consommation de psychostimulants chez les enfants et les jeunes en lien avec leTDAH. Québec, Université du Québec à Chicoutimi. Conrad, P. (2007). The medicalization of society: on the transformation of human conditions into treatabledisorders., Johns Hopkins University Press.Conseil supérieur de l’éducation (2017). Pour une école riche de tous ses élèves. S’adapter à la diversitédes élèves de la maternelle à la 5e secondaire. Avis au Ministre de l’éducation, du loisir et du sport,Québec, 155p.Diallo et collègues (2019). Surveillance du trouble du déficit de l'attention avec ou sans hyperactivité(TDAH) au Québec. Institut national de santé publique (2019)te Meerman, S., Batstra, L., Grietens, H., & Frances, A. (2017). ADHD: A critical update for educationalprofessionals. International Journal of Qualitative Studies on Health and Well-Being, 12(sup1), 1298267.Marie-Christine Brault, Université du Québec à Chicoutimi (UQAC) andMarie-France Blais, Institut universitaire Jeunes en difficulté (IUJD)DESIGNContact: marie-christine_brault@uqac.caWith funding from:Fonds de recherche du Québec – Société et culture (FRQSC)Social Sciences and Humanities Research Council (SSHRC)In collaboration with:Marie-Eve Blackburn, ÉCOBES, research and transfer, Cégep de Jonquière; Camélia Dubois-Bouchard, ÉCOBES, research and transfer, Cégep de Jonquière;and the participants of the workshops for co-creating tools to build awareness of the ADHD/ADD social issue© Chaire VISAJ and Institut universitaire Jeunes en difficulté (2021) 6/6To cite this document:Brault, M.-C., Blais, M.-F., Blackburn, M.-È., & Dubois-Bouchard, C. (2021). Medicalization of children’s difficulties: The case ofADHD/ADD [Infographic]. Chaire VISAJ and Institut universitaire Jeunes en difficulté.

Medicalization of children's difficulties: The case of ADHD/ADD

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Medicalization of children's difficulties: The case of ADHD/ADD

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