Problematic behavior in children is not always a mental disorder
Doctors are increasingly giving children medicine to help teachers and parents cope with their embarrassing behavior. Certain behaviors or actions of children, such as not sitting still, are considered evidence of a mental disorder and used to justify an official diagnosis. This has led to an increase in diagnoses of children with disorders such as attention deficit hyperactivity disorder (ADHD) and drug treatment with stimulants, antipsychotics, and antidepressants.
(Readers should be aware that this article was first shared in 2014)
The problem with giving children such diagnoses is that they obscure other interpretations of children and their behavior.
It distracts from considerations of what is best, educationally, for each child. And it encourages reliance on definitions of mental disorders to account for the normality or abnormality of childhood. In a new delivered, Valerie Harwood and I called this trend psychopathologizing.
In the United Kingdom, approximately 5% of school-age children would have ADHD. The growth in diagnoses of mental disorders appears to be a global phenomenon, with estimates of the global prevalence of ADHD at 5.29% and an average in Europe of 4.6%. The figures are much higher in Australia (11.2%), America (11%) and Africa (8.5%).
In our research, we interviewed child mental health psychiatrists, school psychologists, teachers providing additional educational support, and youth work professionals in Australia, England and Scotland. All expressed major concerns about the increase in diagnoses and drug prescriptions. Recent press debates, in The Conversation and elsewhere, on whether ADHD is “real” to turn away from a more striking – and “real” – enthusiasm to label more and more children as mentally ill.
The risk of psychopathologization is greater for particular ethnic groups and for children from disadvantaged backgrounds. In the UK, children and young people living in poorer conditions are four times more likely be diagnosed with ADHD.
Boys outnumber girls in ADHD diagnoses four to one, as is the case with most neuropsychiatric conditions. But there is a referral bias, where boys are referred more frequently than girls because of their aggressive behavior. It takes the boys / girls ratio in mental health clinics or hospitals at between six and nine, to one.
Girls are considered to be more likely to have the characteristics of less common attention deficit disorder, including sluggishness and anxiety. But because by its nature it does not involve hyperactivity, they may not be referred or be misdiagnosed.
Catch ’em and treat’ em young
There is great enthusiasm for addressing very young children’s mental health issues (or their risk) under the rubric of “intervention”. Some of these interventions even target unborn children, for example, by minimizing maternal stress and encouraging healthy behavior on the part of the mother during pregnancy.
The first stages of life are key moments of intervention for future healthy minds. The newborn, as well as the prenatal (or prenatal) periods, are considered to be the times in a child’s life that have the most potential for preventing, detecting or correcting mental health problems.
This potential decreases as age increases, on a descending scale from fetus, newborns, infants, toddlers and preschoolers. The “developing brain” of very young children is seen as important in preventing mental problems.
For the child entering primary school, the scrutiny is intensified and aims to determine whether he or she will “fit in” to the school and adapt to his or her expectations and practices. For children who worry, psychopathologization begins in earnest.
The acceptance that things have now been ‘put on the right track’ is generating a period when practices such as separation using different schools and classrooms, pharmaceuticals and behavior management programs for parents at home. home or for teachers within schools, turn into a large-scale operation.
Put others in danger
In high school, a darker tone emerges that reveals an acceptance that behavioral problems in older children are unlikely to be resolved. The mentally abnormal youth of secondary age is considered to present a danger and a risk to teachers and other students. The measures put in place at this stage are “palliative” and aim to control the condition of the young person and to minimize the impact. The purpose of this control and containment is to protect the safety of others and of society in general.
In colleges and universities, psychopathology becomes linked to the struggling student with depression and a concern for the dangerous potential for potency and violence. Higher education institutions are looking to learn lessons from incidents such as the Virginia Tech massacre.
Diagnosing potency has become common practice within institutions, as has efforts to detect danger by “connecting the dots” and assessing the threat. The other forms of behavioral disorders that gained attention in the early stages of schooling are receiving much less attention.
Are there any alternatives?
Several of the professionals we interviewed described explicit efforts to resist being diagnosed with children with ADHD or other behavioral disorders and described three lines of resistance. These concerned the language used by teachers and parents. One interviewee, a school psychologist, said: “We are trying to change the language and move people away from what they think is the wrong kid and help people understand that there is a context here. , the reason we get the behavior could be that experience or that experience ”.
Others have tried to encourage teachers to look beyond the child’s difficulties in order to take an interest in the family situation and to change the perceptions of families who have come “to seek a prescription”. These professionals have successfully interrupted referrals for diagnoses by showing teachers and parents better ways to understand and respond to children’s behavioral issues.
Good teacher training could also help reduce the number of children diagnosed. If teachers were helped to find children’s behavior less of a threat and more of a challenge interesting, with the resources and support to enable them to respond effectively, a diagnosis of disorder may become less appealing. This would require some form of teacher training that emphasizes meeting the needs of all children in the classroom and helps teachers develop an enthusiasm for the diversity that children bring.