I had to write a paper for one of my classes this year. I actually had to write multiple long papers, but this one is fresh in my mind. Oh, ya! I made it through the first year of my PhD. Anyways, back to the topic at hand. I had to write a paper for my critical policy course and could not choose a topic, because, as we know, when it comes to ADHD, I want to address all the things, LOL. My professor suggested an annotated bibliography and a reflection on the common threads related to research. Great idea!! Which is why he is a professor, and I am not. 

I just finished a 20+ page annotated bibliography of 11 academic research papers looking at ADHD, education, teachers and the use of medication to regulate behaviour. As someone with ADHD and a parent of children with ADHD, I hate to admit that none of the information surprised me. The information and threads I’ve explored are not novel, but they serve as a stark reminder of the imperative for our education system to overhaul its approach to ADHD. 

My Reflection:

Using a sociological perspective, I approached the articles from a question regarding how research frames the relationship between medication and students with attention deficit hyperactivity disorder (ADHD).  As a student with this disorder and a parent of children with ADHD currently in the education system, I seek to understand teachers’ perceptions of this disorder related to students’ abilities and the medicalization of behaviours associated with ADHD. 

The information gathered, combined with my personal experiences, provided me with a rich context for reflecting on the relationship between medication, student ability and teacher perspectives of this disorder and the potential implications for student academic experiences. Despite the diverse topics covered in the articles, they all share common threads stemming from the consequences of the ADHD label and the need to control or curb the behaviours of these students. When measured against the ideal normal student, the mismatch between ability and expectation translates into a deficit within an institution that treats students as though they all learn the same. Rooted in the medical deficit perspective, including perceived reduced academic ability, it is deemed that these individuals require treatment and medication. The infiltration of the medical field into education demonstrates the need to control individuals who function outside of societal expectations. This raises questions about the ethics of medicating individuals to fit societal norms andextending childhood behaviour as a medical problem requiring management, often without accounting for any underlying social issues.  

 The articles were consistent in acknowledging that ADHD affects millions of people worldwide and has become one of the most globally diagnosed disorders, with “5.3% of all children and adolescents worldwide diagnosed” (Adamis et al., 2024, p.317). The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the diagnostic guide for psychiatric disorders, and knowledge production, which has renamed and redefined ADHD to extend the criteria and further medicalize the disorder. Defined by inattention, lack of impulse control and hyperactivity that interfere with people’s daily lives, and treated by medications, it has also become a multi-billion-dollar industry.  To obtain a diagnosis, ADHD must impact a student’s life for 6 months or longer and in two or more settings, such as school and home. Referred to by some as “disorder spotters,” teachers hold a significant role in the diagnostic process.  Teachers are often the first to identify ADHD symptoms, notifying parents and administration, recommending medication and pushing for referrals for assessment (DeGroote et al., 2022).  Many teachers acknowledge no formal training and the assignment of all challenging classrooms to ADHD, despite them not being official ADHD symptomology. 

The subjectivity of assessment and reporting during the diagnostic process relies on a list of normative behaviours established by a small group of psychiatrists, which fails to account for any culture or potential underlying social issues.  It is essential to understand that students with ADHD experience the education system differently from other students, including underachievement, peer rejection and low classroom engagement compared to their non-ADHD peers.  The ADHD label carries a weight discussed in the articles, not just affecting the student’s sense of self, but also through stereotypes and stigmas. Teachers report medication makes the student seem normal.  The medication addresses some symptoms but has not been reported as positively impacting academic performance.  There is a misconception that ADHD impacts intelligence when it only impacts how students learn; they are not the same.

There is ongoing advocacy in which I have participated to have barrier-free academic support for students with ADHD.  There is also an increased argument that many students learn differently, and pharmacological treatment would not be necessary if schools were better at recognizing students’ needs rather than demanding students to change. Teachers express that medication, the preferred ADHD treatment, makes students seem normal, further “othering” students with ADHD, which is consistent with the hegemonic deficit discourse that impacts behaviours, performance and functioning, by normalizing the ableist narrative which favours the normal student.  

The prevalence of ADHD, among other neurodiverse diagnoses, has led to advocacy of neurodiverse brains as natural rather than deficit-focused. The narrative needs to change to recognize these individuals’ strengths. Although the ADHD label may help individuals develop an understanding of themselves, it also reinforces the abnormal stigma that impacts self-esteem and motivation. This shift in perspective can empower students with ADHD to better understand their diagnosis, improve teacher relationships, and improve the academic experience for all students. 

By understanding the common threads as focused on medication as a means of normalizing the ADHD student, rather than the institution changing, the expectation is on the student to change. If the education system could move beyond the medical deficit model to a social model that understands the whole educational experience of students with ADHD including the social influences that would be a start in establishing a functional learning environment by providing an intersectional approach to assessment that accounts for all aspects of the individual, including societal influences, is essential in the diagnostic process and in providing adequate supports.  This approach may provide the foundation for establishing policies to better address the learning needs of all students, not only those with an ADHD diagnosis. 

I walk away from this paper thinking once again that with increased rates of diagnosis why does the system demand the medicalization of childhood behaviours to conform with the perceived normal student? At what point does the system modify itself to the needs of an ever growing population of students? These students comprise a large portion of the future.