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

Educational experiences of young people with ADHD in the UK: Secondary analysis of qualitative data from the CATCh-uS mixed-methods study

BACKGROUND

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity and/or impulsivity. Young people with ADHD have poorer educational and social outcomes than their peers. We aimed to better understand educational experiences of young people with ADHD in the UK, and make actionable recommendations for schools.

METHODS

In this secondary analysis of qualitative data, we used Thematic Analysis to analyse information relating to experiences of education from 64 young people with ADHD and 28 parents who participated in the Children and adolescents with ADHD in Transition between Children's services and adult Services (CATCh-uS) study. Emerging patterns within and across codes led to organization of the data into themes and subthemes through an iterative process.

RESULTS

Two main themes were generated. The first described young people's early experiences of education, often within a mainstream setting; we labelled this the problematic provision loop, as this was a negative cycle that was repeated several times for some participants. The second theme described young people's more positive progression through education once they progressed out of the problematic loop.

CONCLUSIONS

Educational experiences for young people with ADHD are often negative and fraught with complication. Young people with ADHD often found themselves on a more positive trajectory after they were placed in an alternative form of education provision (mainstream or otherwise), or where they were able to study topics that interest them and play to their strengths. We make recommendations that commissioners, local authorities and schools could consider in order to better support those with ADHD.

Sociodemographic Disparities in Attention-Deficit/Hyperactivity Disorder Overdiagnosis and Overtreatment During Elementary School

Attention-deficit/hyperactivity disorder (ADHD) overdiagnosis and overtreatment unnecessarily exposes children to potential harm and contributes to provider and community skepticism toward those with moderate or severe symptoms and significant impairments, resulting in less supportive care. Yet, which sociodemographic groups of children are overdiagnosed and overtreated for ADHD is poorly understood. We conducted descriptive and logistic regression analyses of a population-based subsample of 1,070 U.S. elementary schoolchildren who had displayed above-average levels of independently assessed behavioral, academic, or executive functioning the year prior to their initial ADHD diagnoses and who did not have prior diagnostic histories. Among these children, (a) 27% of White children versus 19% of non-White children were later diagnosed with ADHD and (b) 20% of White children versus 14% of non-White children were later using medication. In adjusted analyses, White children are more likely to later be diagnosed (odds ratio [OR] range = 1.70-2.62) and using medication (OR range = 1.70-2.37) among those whose prior behavioral, academic, and executive functioning suggested that they were unlikely to have ADHD.

Effects of Environmental Quality Perception on Depression: Subjective Social Class as a Mediator

Although the relationship between environment and public depression has aroused heated debate, the empirical research on the relationship between environmental quality perception and public depression is still relatively insufficient. This paper aims to explore the influence of environmental quality perception on public depression and the mediating role of subjective social class between environmental quality perception and public depression. Using the China Family Panel Studies data of 2016 for empirical analysis, this study’s results show that environmental quality perception has a significant effect on public depression and subjective social class also has a significant effect on public depression. In addition, we found that subjective social class can play a partial mediating role between environmental quality perception and public depression, and the intermediary effect only comes from the contribution of the perception of living environmental quality, not the perception of overall environmental quality. That is to say, the perception of living environment quality deeply affects the subjective social class, and then induces public depression. In order to alleviate the relationship between environmental quality and public depression, it is recommended that the state environmental protection department and civil affairs department strengthen the improvement of public living environment so as to promote individual subjective social class and reduce the risk of public depression. Moreover, it is suggested that research with longitudinal design and comprehensive indicators be undertaken in the future.