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Cold Comfort

Cold Comfort: Mothers, Professionals, and Attention Deficit (Hyperactivity) Disorder

Claudia Malacrida
Copyright Date: 2003
Pages: 288
  • Book Info
    Cold Comfort
    Book Description:

    Mothers of children with Attention Deficit Disorder must inevitably make decisions regarding their children's diagnosis within a context of competing discourses about the nature of the disorder and the legitimacy of its treatment. They also make these decisions within an overriding climate of mother-blame. Claudia Malacrida'sCold Comfortprovides a contextualized study of how mothers negotiate with/against the 'helping professions' over assessment and treatment for their AD(H)D children.

    Malacrida counters current conceptions about mothers of AD(H)D children (namely that mothers irresponsibly push for Ritalin to manage their children's behaviour) as well as professional assumptions of maternal pathology. This thought-provoking examination documents Malacrida's extensive interviews with mothers of affected children in both Canada and the United Kingdom, and details the way in which these women speak of their experiences. Malacrida compares their narratives to national discourses and practices, placing the complex mother-child and mother-professional relations at the centre of her critical inquiry.

    Drawing on both poststructural discourse analysis and feminist standpoint theory, Malacrida makes a critical contribution to qualitative methodologies by developing a feminist discursive ethnography of the construction of AD(H)D in two divergent cultures. On a more personal level, she offers readers a moving, nuanced, and satisfying examination of real women and children facing both public and private challenges linked to AD(H)D.

    eISBN: 978-1-4426-7303-8
    Subjects: Sociology

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-2)
  4. Prologue
    (pp. 3-12)

    Our beautiful daughter. Straight back, round head. Sweet, smart, beanie. Standing at the bus stop every morning amid happy, laughing children. Going to school, eager to learn, eager to live, eager to be part of it all. She is seven years old.

    A lovely winter morning – crisp and sunny and glistening, as only an Alberta winter morning can be. I strip the duvet off the bed and lay it on the open windowʹs sill, to take advantage of the sun and the clean foothills air. Pausing, I breathe in the delights of the day – dazzling sunlight, sparkling snowdrifts,...

  5. 1 Why Attention Deficit (Hyperactivity) Disorder, Why Mothers?
    (pp. 13-43)

    The above e-mail came in response to a public call for research participants that I posted in the faculty of education at the University of Calgary. I believe it eloquently expresses some of the unfounded assumptions that circulate about mothers, about difference, and about attention deficit order (ADD). This brief letter reflects assertions in popular and professional discourse about ADD that tie it to both neonatal and postnatal maternal failings. In these discursive claims, mothers of children who are different are suspected of poor prenatal practices, including alcohol and drug use during pregnancy. They are also criticized for providing inadequate...

  6. 2 Methodology
    (pp. 44-64)

    Poststructural theories of knowledge and human subjectivity have had a tremendous influence on recent research and theory related to psychiatry, medicine, health, and the body (Turner, 1997). Poststructuralism, informed by an understanding of the body and illness as both historically situated and discursively constituted, eschews debates about whether a particular illness has some prediscursive basis in nature. Instead, poststructural approaches seek to uncover how discourse, knowledge, and language circulate in ways that produce the effect of an illness that operates asthoughit is real and natural. The focus thus becomes a ʹcritical epistemology of disease categories as elements of...

  7. 3 British and Canadian Con(text)ual Spaces
    (pp. 65-102)

    The above quotations exemplify central aspects of the general debate over AD(H)D and Ritalin as legitimate diagnoses and treatments. As well, the quotations reflect the relative positions of the debates within Canadian and British discourse during the time of this research. On the Canadian side of the Atlantic, parents worry that ADD¹ has become an ʹepidemicʹ and that Ritalin has been used irresponsibly as a way to compensate for educational, environmental, and social problems. In the United Kingdom parents struggle to an extent with these same issues. In addition, however, British mothers struggle to locate professionals who consider ADHD as...

  8. 4 Mothers Talk about the Early Years
    (pp. 103-139)

    The above quotation, from a Canadian psychiatrist who has published a book, made a country-wide speaking tour, and given several interviews to the Canadian press on his theories of ADD,¹ provides some insight into the suspicions that professionals can bring to their assessments of children who are experiencing social, educational, and behavioural difficulties. Dr Gabor Maté is somewhat unique among critics of AD(H)D in that he agrees that AD(H)D is a biological problem. To him, however, this biological problem stems from poor early childhood bonding, resulting in defective brain development. For the vast majority of AD(H)D sceptics, however, the intermediate...

  9. 5 Ideals and Actualities in Identification and Assessment
    (pp. 140-180)

    Each of these quotations, one from a Canadian professional working in the field of ADD who is directing her comments to parents seeking services, and the other from National Health Services guidelines provided to U.K. health and psy sector professionals, offer an idealized depiction of how assessment for AD(H)D should unfold. As well, each implicitly responds to criticisms that occur in both professional and lay discourse about AD(H)D. In short, these texts argue against a number of circulating critiques and assumptions in both professional and lay discourse relating specifically to AD(H)D and more generally to the psychiatric labelling and medication...

  10. 6 Challenges and Conflicts in Treating AD(H)D
    (pp. 181-214)

    The above quotations, one from a North American journal for elementary school teachers, and the other from a recent policy document generated by the British government on ADHD and methylphenidate (Ritalin), offer idealized portrayals of treatment protocols for children with AD(H)D. As with professional knowledge and hegemonic truth claims deployed over the assessment of AD(H)D, these quotations also offer arguments against unspoken criticisms that recur about the treatment of AD(H)D, both in lay and professional or academic discourse. The truth claims embedded within these idealized treatment portrayals include assurances that the typical response to an AD(H)D diagnosis might include a...

  11. 7 Resistance, Risk, and the Chimera of Choice
    (pp. 215-242)

    One of the concepts I wished to explore in my discussions with mothers was the Foucauldian understanding of knowledge as a form of power and of power as available to all actors through resistance based on an appropriation of knowledge and discourse. As noted earlier, my interviews were undertaken with the assumption that mothers are not simply objects of medical, psychiatric, educational, and helping professional discursive practices. I also assumed that mothers of AD(H)D children are active subjects who interpret, interface, advocate, and care for their children both in conjunction with, and in opposition to, these multiple professionals. Thus, I...

  12. Conclusion
    (pp. 243-252)

    My focus on maternal narratives has been, in part, a response to professional, lay, and academic claims that mothering a child with attention deficit disorder, with or without hyperactivity AD(H)D, is difficult and stressful in and of itself (cf. Atkins, 2000; Berry, 2000; Chisholm, 1996; Foss, 1999; Frederick and Olmi, 1994; Lacharité and Piché, 1992; Londsdorf, 1991; Minde, 1987; Rees, 1998c). In these discursive claims, the AD(H)D child is described as a burden and a worry, while the mothers and families of AD(H)D children are depicted as places of pathology and inadequacy. Additionally, these texts shore up the position of...

  13. Epilogue
    (pp. 253-258)

    The year I gave up, the year I refused to play on the ʹteamʹ any longer, was the year we began to get our daughter back. Despite our trepidation over what she might miss from not attending a community school, despite my misgivings about the legitimacy of her diagnosis, despite the worry that this would just be one more false alley along which to become further lost, Hilary went to the school for children with special needs.

    I remember the first parent-teacher meeting at that school like it was yesterday. The teacher sat across from us, eyes open, and told...

  14. Appendix 1 ICD-10 (1993) Diagnostic Criteria for Research
    (pp. 259-261)
  15. Appendix 2 DSM IV (1994) Criteria for AD(H)D
    (pp. 262-263)
  16. Appendix 3 Brief Biographical Details of Participants
    (pp. 264-273)
  17. Appendix 4 Interview Guide
    (pp. 274-276)
  18. Appendix 5 List of Textual Materials Examined
    (pp. 277-277)
  19. Appendix 6 Sample Parent Assessment Observation Checklists
    (pp. 278-280)
  20. References
    (pp. 281-294)
  21. Index
    (pp. 295-304)