Social class, teachers, and medicalisation lag: a qualitative investigation of teachers' discussions of ADHD with parents and the effect of neighbourhood-level social class

Health Sociol Rev. 2021 Jul;30(2):188-203. doi: 10.1080/14461242.2020.1820364. Epub 2020 Sep 22.

Abstract

While medical sociologists have explored how teachers aid the medicalisation process of Attention Deficit Hyperactivity Disorder (ADHD), there is a paucity of work investigating the role of neighbourhood-level social class. This paper has two main aims. First, to explore how teachers discuss ADHD with parents, and second, to understand how these discussions differ based upon neighbourhood-level social class. To achieve these aims, I utilise grounded theory and interviews with thirty-four elementary school teachers. Emergent themes describe the following process: (a) reifying biological causation of ADHD, (b) evidence gathering, and (c) furtive diagnosis. Findings suggest teachers in upper-class areas skipped steps in the process or easily managed each step while discussing ADHD with parents. Teachers in lower-class areas were met with barriers that affected the likelihood of children receiving a furtive diagnosis from teachers, thus reducing the likelihood of meeting with a medical professional and receiving medical intervention. Findings explain disparities in medication use for ADHD by neighbourhood-level social class and help to explain the social reproduction of social class. By building on the literature regarding cultural capital and mental health literacy, I conceptualise 'medicalisation lag' as integral to the medicalisation process and to the social reproduction of social class.

Keywords: ADHD; Medicalisation; cultural capital; parents; social class; teachers.

MeSH terms

  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Child
  • Grounded Theory
  • Humans
  • Parents
  • School Teachers
  • Social Class