This exam is worth 200 points (100 points per question). Answer both questions. The page limit for EACH question is about 2 typed pages, in 12 point Times or Cambria font, double spaced, with one inch margins. Number your answers and combine them into one document. Make sure to properly reference and support your answers throughout, and include references for the entire exam at the end of question two. References do not count for the page limit.IMPORTANT: Both questions ask you to reference a few graphs in your response. You will need to look at the PDF version of the final exam posted under “files” on bCourses to see the graphs, which I cannot reproduce here. Guidelines:Use your own words rather than quote from the texts.The work you turn in must be your own; do not collaborate with other students, and do not repurpose any material you have turned in for a previous assignment in any class.Tips:Make sure you address each point specified in the prompts.Strive for clarity in your writing by using simple, jargon-free language.Do not reproduce the question at the top of the page as this takes up valuable space you could use to answer the question.Proofread your work. 1.Summarize Twenge’s findings on teen use of “new media”, and her argument about how social media use might affect teens’ mental health. Next, describe Pugh’s concept of the economy of dignity and discuss how social media could be viewed in terms of the economy of dignity and concepts like “scrip”, in light of your discussion of Twenge’s work. Finally, if we treat social media as part of teens’ economy of dignity, what would you predict about how parents from different social class backgrounds might respond to their children’s social media desires and why? Do the graphs below from the Pew Research Center fit into your predictions?2.Over the last few weeks, we have considered two different examples of social control around children’s school behavior that is labeled as deviant or disruptive: criminalization and medicalization. Use class readings to define and explain each perspective. Then, compare and contrast the following for each perspective a) processes for how teachers and school personnel take action around disruptive school behavior b) how they think about the source of the behavior, and c) the possible consequences of the different approaches for students’ academic trajectories, according to the authors you are citing. Finally, what do the arguments you have summarized above along with the graphs below suggest about how school discipline practices are socially patterned? Refer to both the graphs and class readings to support your answer.Again, see the PDF version of the final for the graphs.
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FINAL EXAM for SOCIOLOGY 111C, Spring 2020
This exam is worth 200 points (100 points per question). Answer both
questions. The page limit for EACH question is up to 3 typed pages (3 pages + 3
pages = 6 total pages for two questions), in 12 point Times or Cambria font, double
spaced, with one inch margins. Number your answers and combine them into
one document. Make sure to properly reference and support your answers
throughout, and include references for the entire exam at the end of question
two. References do not count for the page limit.
– Use your own words rather than quote from the texts.
– It is essential to keep to the page limit for this exam.
– The work you turn in must be your own; do not collaborate with
other students, and do not repurpose any material you have turned
in for a previous assignment in any class.
Make sure you address each point specified in the prompts.
Strive for clarity in your writing by using simple, jargon-free
Do not reproduce the question at the top of the page as this takes up
valuable space you could use to answer the question.
Proofread your work.
TURNING IN THE EXAM: Turn in an electronic copy of your exam to bCourses
anytime up until the due date, May 13th at 6 pm.
1. Summarize Twenge’s findings on teen use of “new media”, and her argument
about how social media use might affect teens’ mental health. Next, describe
Pugh’s concept of the economy of dignity and discuss how social media could
be viewed in terms of the economy of dignity and concepts like “scrip”, in
light of your discussion of Twenge’s work. Finally, if we treat social media as
part of teens’ economy of dignity, what would you predict about how parents
from different social class backgrounds might respond to their children’s
social media desires and why? Do the graphs below from the Pew Research
Center fit into your predictions?
2. Over the last few weeks, we have considered two different examples of social
control around children’s school behavior that is labeled as deviant or
disruptive: criminalization and medicalization. Use class readings to define
and explain each perspective. Then, compare and contrast the following for
each perspective a) processes for how teachers and school personnel take
action around disruptive school behavior b) how they think about the source
of the behavior, and c) the possible consequences of the different approaches
for students’ academic trajectories, according to the authors you are citing.
Finally, what do the arguments you have summarized above along with the
graphs below suggest about how school discipline practices are socially
patterned? Refer to both the graphs and class readings to support your
Graphs for question 1: refer to these in your answer as “Figure 1”, “Figure 2” and
“Figure 3”. These figures are from the Pew Research Center’s “Teens, Social Media
and Technology 2018” Report.
Graphs for question 2: (refer to these using the figure number on each graph).
Figures 2, 4 and 6 are from Discipline Disparities for Black Students, Boys and
Students With Disabilities, U.S. Government Accountability Office, Report to
Congressional Requesters, March 2018. Figure 1 is from, Morgan, P. et al (2013)
“Racial and Ethnic Disparities in ADHD Diagnosis from Kindergarten to Eighth
Grade”. Pediatrics, Vol 132:1
Note on Figure 1: Understanding “hazard functions” is not necessary to interpret
this graph for the purposes of question 2. The “hazard function” is indicating the
probability of an ADHD diagnosis at different points in time.
Relational Troubles and Semiofficial Suspicion:
Educators and the Medicalization of
Texas Tech University
Using an interview-based analysis of the accounts of interactions between
educators, parents, and clinicians, this study explores educators’ roles in
interpreting childhood troubles as the medical phenomenon of attention
deficit-hyperactivity disorder (ADHD). The analysis of interviews shows
how children’s “personal” troubles become understood as “relational” ones,
prompting increasingly sophisticated social responses. I argue that the institution of education, operating in a clinical capacity but lacking the legitimate authority to assign ADHD diagnoses, plays a hybridized, semiofficial
role in the medicalization process. This assertion informs a critique of the
“informal/official” dichotomy found in the sociology of deviance lexicon,
and furthers previous positions in the sociology of mental health that have
implicated school representatives in the social construction of behavior
It is a matter of course that symbolic interactionist frameworks remain highly effective in illustrating how deviance is produced by the interplay between negotiated
meanings and social organization. Such frameworks are especially useful for analyzing the social construction of behavior disorders. As discourses addressing behavior disorders surface in popular, academic, and clinical circles, it is imperative
that sociological analyses continue to examine the connections among parties that
contribute to the social construction of such phenomena. Attention deficit-hyperactivity disorder (APA 1994:79–85),1 or ADHD, is a case in point. Increasingly discussed in sociological terms (Conrad 1975, 1976; Conrad and Potter 2000; Malacrida
2002, 2004; Rafalovich 2001b), the diagnosis of ADHD and its treatments have exploded in frequency since the early 1990s. With an estimated four million schoolchildren diagnosed with ADHD, three-fourths of whom take stimulant medications,
clinicians argue that ADHD is the most prevalent behavioral problem in the schoolage population (Diller 1998). Because it is a behavior disorder that is associated
Direct all correspondence to Adam Rafalovich, Texas Tech University, Department of Sociology, Anthropology,
and Social Work, Box 41012, Lubbock, TX 79409; e-mail: Adam.Rafalovich@ttu.edu.
Symbolic Interaction, Vol. 28, Issue 1, pp. 25–46, ISSN 0195-6086, electronic ISSN 1533-8665.
© 2005 by the Society for the Study of Symbolic Interaction. All rights reserved. Please direct all requests for permission to photocopy or reproduce article content through the University of California
Press’s Rights and Permissions website, at http://www.ucpress.edu/journals/rights.htm.
Volume 28, Number 1, 2005
with schoolchildren, ADHD has been and continues to be of concern for educators,
who commonly know about ADHD and are prominently involved in detecting it.
Schools have been associated with ADHD and its conceptual precursors for decades, as evidenced by the early clinical literature that linked inattention and hyperactivity to the onset of encephalitis lethargica, or “sleepy sickness” (Abrahamson
1920; Ebaugh 1923; Kennedy 1924; Strecker 1929; Stryker 1925). This literature argued that the psychological after-effects of encephalitis were responsible for a variety of antisocial behaviors in children, including the avoidance of school obligations
(Rafalovich 2001a). Seminal clinical studies advocating the use of stimulant medication for hyperactive and/or attention deficient children concluded that the success
of drugs such as Benzedrine and Ritalin could be measured through dramatic improvements in both comprehension of and enthusiasm for schoolwork (Bradley
1937, 1950; Bradley and Green 1940; Eisenberg 1972; Eisenberg et al. 1963). In addition, the educator-oriented literature argues that teachers’ clinical knowledge of
ADHD should be expanded and become the basis for medical assessments (Black
1992; Bloomingdale 1985; Burnley 1993; Dowdy 1998). This necessitates empirical
investigations of educators’ role in medicalization.
Drawing from semistructured interviews with the adult authorities associated
with ADHD children (parents, teachers, and clinicians), this article explores the
specific role of educators in the medicalization of childhood problems that are understood as symptomatic of ADHD. I use the term “medicalization” to refer to the process by which deviant acts (a) become understood to originate from a medical cause
and are therefore perceived to be beyond an individual’s control; and (b) are believed to be treatable through medical knowledge and the application of techniques
by medical experts. By examining how parents, teachers, and clinicians account for
their interactions with each other, this study illustrates some of the ways that the social contexts of family, school, and clinic are interconnected and transform childhood troubles into discernible forms of deviance. As corroborated by accounts from
all three respondent groups, schools are by far the most common institutional context for the discovery of children’s troubles that are believed to be indicative of
ADHD and are the institutions most involved in moving a case of suspected ADHD
toward a formal diagnosis.
This article addresses, within an interactionist framework, how children’s troubles become “cooperatively” framed (Miller and Silverman 1995:725) as medical
phenomena and illustrates educators’ constancy throughout the medicalization process. As Conrad (1976) has asserted, educators tend to “prelabel” disruptive children before formal medical diagnoses are established—a process that illustrates the
role of nonclinical entities in the medicalization process. As medicalization has become an increasingly potent social force, it is imperative that studies address how
“prelabeling” unfolds in our current social context. This inquiry may first address
how lay actors appropriate medical knowledge, which then informs their perspectives on deviant behavior. As ADHD has attained undeniable notoriety in North
America, it is important to analyze more thoroughly how medical knowledge in
Relational Troubles and Semiofficial Suspicion
classrooms affects the disorder’s epidemiology. We may ask why teachers appear wont to link some disruptive behavior to ADHD and not to some other,
nonmedical cause. Does teachers’ “prelabeling” constitute the application of
medical knowledge and therefore represent a fundamental change in their professional purview, or is “prelabeling” simply a way of easing the pain of professional responsibility?
A second way in which “prelabeling” may be investigated is by exploring how
medicalizing parties account for their interactions with each other. Malacrida (2004)
began a needed discussion of this topic by asking Canadian and British mothers of
ADHD children about their perceptions of educators’ role in medicalization. Based
on the respondents’ accounts, he paints an intriguing picture of how little alternative
options for social control in Canadian schools engender medicalization, whereas British schools exercise greater social control and are far less inclined to apply medical
labels. Such an intriguing study of accounts may be furthered by supplementing
parents’ accounts with those of teachers and clinicians. Including multiple perspectives enables a more comprehensive exploration of how adult authorities approach
children suspected of suffering from ADHD.
Emphasizing educators’ centrality to medicalization, this study details how educators conceptualize the “nature” of ADHD children, including how they frame
such children’s abilities and disabilities; how school representatives organize themselves in response to such children, specifically, how school-based teams (SBTs) aid
educators in presenting a case for “probable ADHD” to parents; and how educators’ clinical knowledge about ADHD blurs the distinction between pedagogical
and clinical practices.
FORMS OF TROUBLE AND THE INTERACTION ORDER
The process whereby an informal, yet disturbing “trouble” becomes normalized
and forgotten or progressively interpreted as a specific form of deviance is directly
shaped by the social organization of persons associated with it. In other words, “the
natural history of a trouble is intimately tied to—and produces—the effort to do something about it” (Emerson and Messinger 1977:123).2 This perspective follows the
mainstay sociology of deviance assertion that we do not recognize deviance through
the intrinsic nature of the deviant act but through the way people respond to that
act (Becker 1963). These responses, which are often rooted in the politically charged
communicative dynamics among parties, may construct the “interaction order”
(Maynard 1988:312) that develops in response to deviant acts.
Medicalizing conversations within the “interaction order” are regulated by social
statuses, for example, “experts” and “nonexperts.” Elaborating Goffman’s (1961)
discussion of the differences between “informal” and “formal” suspicion in the diagnosis of the mentally ill, Emerson and Messinger (1977:121) argue that various
agents transform a trouble into a designated form of deviance by discussing it in
“informal” and then “official” realms. The failure of informal measures to remediate
Volume 28, Number 1, 2005
troubles mobilizes parties who implement such measures in an increasingly sophisticated manner. As Emerson and Messinger (1977:123) describe, the shift in the
social response to a trouble indicates the point at which a transitory “personal”
trouble is publicly acknowledged and is, therefore, a “relational” trouble. Because
they pertain to the social perceptions of one’s mental health and often necessitate
clinical opinions, relational troubles are often medicalized. In this article, I presume
that the medicalization of children’s behavior is an artifact of social responses and
thus discuss the problems that precipitate suspicions of, and assessments for, ADHD
as “relational” troubles.
I examine the medicalization of children’s relational troubles by exploring how
parents, teachers, and clinicians account for their interaction with each other. As the
interviews with parents and teachers make clear, the suspicions that lead to an
ADHD diagnosis overwhelmingly stem from troubles in a school context. Both
parents and teachers say that these suspicions bolster more sophisticated types of
inquiry into a child’s problems, leading to the documentation of behavior and pedagogical intervention. The interview data suggest that teachers are markedly influential in the diagnosis of ADHD, which is informed largely by observations and assessments conducted at the school. This article also explores accounts depicting
instances when this process encounters resistance from involved parties. Although
the social transformation of personal troubles into relational medical ones follows
common themes, some accounts from parents, teachers, and clinicians draw on less
medicalizing interpretations of trouble.
METHODS AND DATA
From August 2001 to February 2002, I recruited parents, teachers, and clinicians from
two North American cities (one in western Canada, the other in the southwestern
United States)3 with populations of roughly 500,000 and 200,000 respectively. Both
the design and the implementation of this study were reviewed and approved by my
university’s Human Subjects Committee. As the starting point of this sample, parents were recruited from a variety of locations, including Children and Adults with
Attention Deficit Hyperactivity Disorder (CHADD) meetings and support groups
for parents of children with learning disabilities. I recruited respondents from meetings that were not open to the public by asking the facilitators to hand out a flyer
summarizing my research—an approach that proved effective when potential respondents could not be contacted directly. As this project solicited accounts about
children who are already perceived to be vulnerable, it was imperative to dispel any
notions that this research may be threatening (Blum 1952) or that I was an invasive
outsider (Trice 1970). As such perceptions can gravely affect interview accounts and
respondent recruitment, I expended considerable effort to be as open as possible
about the nature of this research project. In particular, I wanted respondents to
understand that I was neither judging their relationship to ADHD nor conducting
any type of clinical experiment. These declarations aided greatly in helping to
Relational Troubles and Semiofficial Suspicion
convey the necessary everyday experience (see Fontana and Frey 2000) of those
adults involved in the social dynamics of ADHD.
The sample for this study consisted of eighty-one respondents, including thirty
parents, twenty-five teachers, and twenty-six clinicians. Respondents from all groups
were recruited according to a “snowball approach” (Biernaki and Waldorf 1981;
Marshall 1996), denoting that the sample grew as respondents referred me to others
whom they understood to have experience with ADHD.4 Parents represented a wide
range of occupations. Their ages ranged from twenty-seven to fifty-one years, and
their ADHD-diagnosed children’s ages ranged from six to seventeen. Twenty-six of
the parent respondents reported to have boys with ADHD; four respondents had
girls with the disorder.5 Twenty-one of the parent respondents were women and nine
were men. Teacher respondents’ ages ranged from twenty-eight to sixty-four; fourteen were men and eleven were women. They were drawn from fourteen schools
and taught grade levels ranging from preschool to tenth grade. Nine teacher respondents taught mixed grades, primarily because they were the special education
teachers at their schools and therefore provided special assistance to children from
all grade levels. Clinician respondents are defined in this study as having the credentialed authority to make diagnoses and recommend treatment for ADHD. They
ranged from thirty-one to sixty years of age; ten were women and sixteen were men.
A cross section of clinical professions is represented here, including clinical psychologists, psychiatrists, pediatricians, general practitioners, and family therapists.
Parents proved crucial gatekeepers who invariably held information about clinicians and educators who were close to their ADHD-diagnosed children. Allowing
parents to act as a referral source helped to avoid the arduous random sampling of
clinician and teacher populations. Prior to the interview, parents were asked who
their children’s teacher(s) and clinician(s) were at the time of their diagnosis, or which
clinicians and teachers they knew to have significant experience dealing with ADHD.
I then contacted these potential teacher and clinician respondents by telephone and
subsequently mailed an introductory letter summarizing the purposes of the research. After receiving the introductory letter, all respondents were required to sign
a consent form guaranteeing that the data obtained in the interview would be held
in strict confidence and that any publication or presentation of the material would
protect their anonymity.
Interviews, conducted by telephone or in person, lasted between twenty and
ninety minutes. They were initially structured around a schedule designed for each
respondent group but in many cases were allowed to take on an informal, conversational tone. Telephone interviews were invariably shorter and were scheduled when
respondents had time conflicts and could not meet face-to-face. To keep data outcomes consistent, the schedule for telephone interviews was the same for face-toface interviews. Due to the sensitive nature of ADHD and the initial resistance of
Volume 28, Number 1, 2005
some respondents, I chose not to tape record the interviews.6 To avoid “waivering
calibrations” (Webb at al. 1966:22), I wrote down the informants’ responses and
read those back to them to ensure …
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