Navigating Professional Knowledges: Lay Techniques for the Management of Conflictual Diagnosis in an AD/HD Support Group

Abstract

Purpose – I analyze how laypersons and professionals navigate challenges to the legitimacy of Attention Deficit/Hyperactivity Disorder (AD/HD). The disorder is modeled as a cultural object manifested in the discursive practices of multiple actors forming a knowledge coalition of professionals, laypersons, governmental, and corporate actors. Coalition members faced challenges to the disorder derived from popular skepticism and from professional's contradictory knowledge claims and diagnostic practices.

Methods – I observed these processes in a two-year, ethnographic case study supplemented with a two-stage, open-ended interview with core members of an AD/HD informational and support group.

Findings – Parents and coalitional professionals managed these challenges differently depending on the status of the source (professional vs. nonprofessional) and the alignment (within the coalition vs. nonaligned) of the challenge. Nonprofessional skeptics were easily countered as ignorant moralists who lacked objective knowledge of the disorder – a tactic termed credentialism. The contradictory diagnoses and treatments of professionals were managed as instances of mal-diagnosis – a construct employed by both professionals aligned with the diagnosis and laypersons associated with the disorder. Finally, while parents actively sought a diagnosis as an objective valorization of their status, they remained skeptical of AD/HD; however, in achieving diagnosis they also worried that the methods used to establish a diagnosis were possibly unreliable.

Originality/value – This study contributes to the emergent sociology of diagnosis by describing the techniques used by laypersons and some professionals in maintaining a contentious diagnosis.

Citation

Fuller, P.C. (2011), "Navigating Professional Knowledges: Lay Techniques for the Management of Conflictual Diagnosis in an AD/HD Support Group", McGann, P. and Hutson, D.J. (Ed.) Sociology of Diagnosis (Advances in Medical Sociology, Vol. 12), Emerald Group Publishing Limited, Leeds, pp. 211-232. https://doi.org/10.1108/S1057-6290(2011)0000012014