RE: illness and moral culpability

From: Navarro, Virginia L. (virginia_navarro@UMSL.EDU)
Date: Mon Mar 13 2000 - 13:05:43 PST


Here is Scot Danforth's comments on the Hyper Talk paper. My posting
reminding people Scot and I co-authored this paper did not get posted.

Here's my reply to Kathie and Nate....
In regard to Kathie's comment about 3rd grade, I recall attending a lecture
once in which Mel Levine (I believe) noted that grades 3 and 4 stir up the
most diagnoses of learning disabilities. He attributed this to a shift in
the mode of literacy from 'learning to read' to 'reading to learn.' We could
call this a developmental change or we could say the curriculum shifts in
emphases or we might say the teachers' expectations change. Your comment
about ADHD reminds me of this and makes me wonder how the developmental
paths of children and the behavioral expectations (e.g. sitting still,
concentrating for extended periods on text) jibe or fail to jibe at certain
points.
That said, in our current study, Virginia and I are looking at the case of a
boy diagnosed ADD in seventh grade. In our interviews with his teachers,
they claimed that new diagnoses at the middle school level are very common.
We also noticed a recent article in the newspaper about the many 3-to-5
year-olds taking Ritalin or Prozac. I wonder about how specific constructs
(ADHD, depression) "creep" as medical discourse travels to new territory,
new populations, new issues or problems.
Human subjects....The students who collected data were instructed to simply
keep notes on linguistic events related to ADHD within the course of their
usual activities. The subjects or the people who ended up in the data could
have been anyone who happened to mumble the word 'hyperactive' while in the
presence of one of the data collectors. We couldn't anticipate who that
might or might not be. Informed consent made no sense in this situation. We
viewed it, for right or wrong, as students documenting their own experiences
in journals. The students did so as part of a class project whereby the
entire class attempted to come to some grasp of the cultural meanings of
ADHD in the local area. Since the students agreed to document their
experiences as part of the class, we did not put this study through a formal
human subjects review.
Ideology...as I address this I wonder if Virginia would say something
different than I would. I throw in my two cents, knowing that her nickel is
probably worth more. I think that we see 'ideology' as more than a bundle of
ideas. Our research leans heavily on James Gee in this regard, on his
conceptualization of language as a social tool inevitably toting political
baggage from one use to the next. Saying this, I don't mean to essentialize
terms or vocabularies, for as we saw in this study, people often take words
and constructs and re-tool them to their own purposes. It is more like
saying that terms and vocabularies bring political tendencies (grammars of
hierarchy, inclusion-exclusion, prominence- deference) that are both
historical (built over time) and present in the current moment. While a
given language user might subvert or reslant the ideological history of a
term-construct in current usage, doing so often produces a novel utterance
that may be viewed as nonsensical or odd.
Resistance - I imagine that Virginia and I did little in this paper to hide
our fascination with the ingenuity of resistance. I agree that the
resistance does not sit outside of the medical discourse. I think that the
everyday folks in our study often appropriated the medical discourse, but
the resistance occurs in the specific application of the discourse. I recall
seeing a sculptor interviewed on TV who showed off his tools that he used to
scrape, scratch, and fulfill requirements of his craft. He said that he
started out using tools officially manufactured for use in making
sculptures. He said that he soon began gathering all sorts of bits and
pieces of this and that, fashioning odd items together to make his own
tools. He bent up his original tools and crafted new ones to do what he
wanted them to do. Language users engaged in resistance, I think, do some of
this with the medical discourse. They twist it and remake it to their
ideological, practical, moral needs. Sometimes this calls for slight
adjustments and sometimes it calls for more dramatic overhauls.
Final comment. Nate said that "deconstructing certain discourses carry a
higher price than others." The danger of deconstructing ADHD is, if we push
to the extreme, that we might no longer view issues of childhood
(mis)behavior and school achievement in terms of individual pathology and
treatment model of medicine. For all those kids and families who have found
some degree of satisfaction by way of diagnosis and treatment, it is a
loss. That can't be denied. On the other hand, we have to wonder what this
means for our schools and families and communities when the medical
metaphors of pathology are increasingly applied to childhood. Do human
activities necessarily benefit when they are medicalized? Is it necessarily
safe when new aspects of everyday life are viewed as medical phenomena to be
treated, adjusted, augmented, controlled? I think there are dangers in
conflating medicine with morality such that alternative ways of
conceptualizing, talking about, and addressing lived experience (e.g. human
relationships, moral decisions) become difficult to arrange.
Scot Danforth
>
>
>-----Original Message-----
>From: Nate [mailto:schmolze@students.wisc.edu]
<mailto:[mailto:schmolze@students.wisc.edu]>
><mailto:[mailto:schmolze@students.wisc.edu]
<mailto:[mailto:schmolze@students.wisc.edu]> >
>Sent: Friday, March 10, 2000 1:32 PM
>To: Navarro, Virginia L.
>Subject: February xmca paper
>
> <<hyper talk / extra talk>> <<Hyper Talk>> Virginia,
>
>I hesitated till now, but was wondering when you had time if you
could
>respond to some of the questions. This is partly my fault, I
usually
>send a message out explaing the process to the authors and I do not
>think I did that for you.
>The idea behind the collective reading is twofold, one being a time
for
>particular authors to receive feedback, and another being for
readers to
>have an opportunity to get questions answered.
>I am attaching the two messages thus far.
>Nate
>
>
>
>
>
>Message-ID:
<fc.004c4c8c01af2a05004c4c8c01af2a05.1af2ebd@ceo.cudenver.edu
<mailto:fc.004c4c8c01af2a05004c4c8c01af2a05.1af2ebd@ceo.cudenver.edu> >
>From: Katherine Goff <Katherine_Goff@ceo.cudenver.edu
<mailto:Katherine_Goff@ceo.cudenver.edu> >
>Reply-To: xmca@weber.ucsd.edu <mailto:xmca@weber.ucsd.edu>
>To: xmca@weber.ucsd.edu <mailto:xmca@weber.ucsd.edu>
>Subject: hyper talk / extra talk
>Date: Tue, 7 Mar 2000 11:21:17 -0600
>MIME-Version: 1.0
>Content-Type: text/plain
>
>i just finished reading Virginia's paper and found it informative
on
>many
>levels.
>but i wanted to comment on a couple of ideas that emerged for me.
>
>first, my son was labeled ADHD in third grade (he's now 17 and no
longer
>taking ritalin) and in several of your transcripts people mentioned
>third
>grade. i also remember reading somewhere that the majority of kids
>diagnosed ADD/ADHD were third grade boys. as a teacher who works
with
>kids
>in all the grades of an elementary school, my intuition says that
the
>primary grades (pre-K through 2) are assumed to be prepatory, to
lay the
>groundwork, so to speak, for the real work of school which begins
in
>third
>grade. that's when kids are expected to know how to sit quietly for
>longer
>periods of time, to know how to "study." to begin taking lengthy
>standardized tests, to do research, etc.
>
>
>the other thing i wondered about might be connected in some way to
>Nate's
>question about "human subjects." i understand the constraining
aspects
>of
>language on identity (i think) as Wertsch's quote about both
opening and
>narrowing doors of experience,
>and i assume "language users" is what (or who) you were looking at
in
>your
>research,
>but i continue to struggle with the limits of language as the only
way
>to
>define the self, or identity, or who we are and what we can do.
>
>but then, again, i only seem to have the tool called language with
which
>to make a self or a world. . .
>
>
>
>kathie
>
>^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
>.........Our words misunderstand us..............................
>.....We are our words, and black and bruised and blue.
>Under our skins, we're laughing....................................
>.........................Adrienne
Rich..................................
>^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
>Katherine_Goff@ceo.cudenver.edu
>http://ceo.cudenver.edu/~katherine_goff/index.html
>
>Message-ID:
<NDBBKIFGKLIGPKCKKGODAEHOCBAA.schmolze@students.wisc.edu
<mailto:NDBBKIFGKLIGPKCKKGODAEHOCBAA.schmolze@students.wisc.edu> >
>From: Nate <schmolze@students.wisc.edu
<mailto:schmolze@students.wisc.edu> >
>Reply-To: xmca@weber.ucsd.edu <mailto:xmca@weber.ucsd.edu>
>To: Xmca <xmca@weber.ucsd.edu <mailto:xmca@weber.ucsd.edu> >
>Subject: Hyper Talk
>Date: Fri, 3 Mar 2000 09:45:41 -0600
>MIME-Version: 1.0
>Content-Type: text/plain
>
>Virginia,
>
>I found the paper on ADHD very interesting. I particularily liked
how
>various dominant discourses were defined and their relationship to
each
>other were described. A couple questions emerged when reading the
>paper.
>
>1). Ideology: This word was used throughout the paper, so I am
curious
>of
>how you are using it. The glossery of Bakhtin (1981) points out a
>differentiation between American and Russian use of the word.
>
>"This is not to be confused with its politically oriented English
>cognate.
>"Ideology" in Russian is simply an idea system. But, it is swmiotic
in
>the
>sense that it involves the concrete exchange of signs in society
and in
>history."
>
>So, my question would be are you using ideology more in line with
>Bakhtin or
>the more political conatation in the American sense of the term.
>
>
>2). I was curious about the issue of "human subjects" in the paper.
It
>is
>mentioned the undergraduates were given info about the study, but
no
>information on the subjects themselves. The field notes were taken
from
>the
>undergraduates "everyday life" so I am curious how the human
subject
>issues
>were dealt with. This is a very big issue at our University right
now,
>so I
>am curious how it is addressed in this kind of research.
>
>3). I enjoyed how resistance to dominant discourses was addressed.
In
>reference to the Medical Discourse you stated,
>
>"Many speakers in our data rejected, contested, or refashioned
large
>aspects
>of the Medical Discourse. Our claim here is that the cultural power
of
>Medical Discourse as a way of framing childhood behavior problems
is so
>dominant that language users have little choice but to contend with
it
>in
>some fashion, whether they appropriate the Discourse with reflexive
>acceptance, mild modification, or dramatic resistance."
>
>For me, it was useful because it didn't position resistance outside
the
>Medical Discourse, but rather very much related to it.
>
>
>4). Lastly you end the paper by stating,
>
>"We are left with the sense that medical and educational
professionals
>must
>remain ever attentive to the possibility that a Discourse can limit
the
>opportunities for parents, teachers, and community members to
actively
>question and reconstruct communal life, to constructively imagine
and
>discuss more hopeful and promising practices and structures of
>conviviality."
>
>While I agree with this, there does seem to be certain (or fear
>of)consequences for those who need medication. I remember after the
>initial
>school shootings there was a sense that if we "kid watched" certain
kids
>better, got them the medication they needed, the shootings could be
>prevented. This was discussed discursively in the Media Discourse
>section,
>yet it was not addressed pragmatically. Which is too say, I really
>enjoyed
>the paper, but deconstructing certain discourses carry a higher
price
>than
>others. Demonstrating how "development" is socially constructed
through
>the
>discourses of psychology and Developmentally Appropriate Practice
seem
>to
>carry less risk than demonstrating the social construction of ADHD
>through
>the Medical Discourse.
>
>Nate

Virginia Navarro, Ph.D.
University of Missouri, St. Louis
8001 Natural Bridge Road
St. Louis, MO 63121
(314) 516-5871
Virginia_Navarro@umsl.edu <mailto:Virginia_Navarro@umsl.edu>
FAX: (314) 516-5784



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