Chantier : Agitated children, turbulent trajectories - Comparative research

An international and multidisciplinary network

Aims of the network

The  network “Agitated children, Turbulent Trajectories” is the continuation of a research program on agitated children trajectories initiated in 2013 by the SAGE team. After investigating several Parisian neighborhoods, the program developed a comparison between three French regions (Paris, North, Sarthe). It is now expanding the comparison internationally, starting with workshops between research teams from Brazil, Chile, United Kingdom and Sweden.

Within this multidisciplinary and international research network, we are now studying how agitated children are treated and cared for at school, in medical and family settings. The comparative analysis will highlight differences in what care settings offer, taking into account social, political and cultural contexts.

Several teams from Brazil, Chile, France and Sweden joined during the international workshop held in Paris in January 2017. In 2018, the network secured funding from IRESP, with two objectives: collaborative publications and a second workshop in Chile from 5 to 9 November 2018.

Our aim is to make “Agitated children, Turbulent Trajectories” a long term social science research network adressing the problems of agitated children with a comparative perspective between Europe and South America.

Five cross-disciplinary research topics

1 – From hyperactivity to problems with attention and agitation

While much social science research takes the diagnosis of ADHD as a starting point, our approach takes a different stance; we consider problems that arise in social situations and attempt to understand how different actors take them into account. On a macrosociological level, differences in the national contexts induce different ways of dealing with these issues. For example, in school setting in Chile, actors emphasize attentional problems, while in health care setting in France professionals focus on agitation. Locally, in the family, in school or in health services, there are great variations in how problems of concentration / attention / agitation / impulsivity / aggressivity / violence are considered and defined.

2 – Medicalization and demedicalization

Various studies have shown that treating these difficulties with medication raises very complex issues. This is particularly the case with the use of methylphenidate-based medicines. On the one hand, drug treatment is far from being the only possible treatment and can be supplemented, bypassed or replaced by many other treatments. On the other hand, many forms of care besides prescribing drugs can participate in a medicalization process. Therapies and/or changes in the professional-child relationship can also transform everyday life as well as the vision of the problem as medical.

3 – Social affiliations and inequalities

It also emerges strongly from the data collected that the social affiliation of families heavily influences the educational and medical trajectories of agitated children. Yet, the effects in terms of social inequalities are very difficult to identify. In many cases, the different pathways linked to social affiliation cannot be simplified in an analysis in terms of “winners” and “losers”. A new analytical frameworks may be necessary, while further investigation and analysis are required to explore these links.

4 – Agitation and gender

Gender differences clearly influence pathways, regarding both the identification of pathological  disorders and the prescription, orientation or management of care. Here again, many elements varying at the same time make the analysis more complex: girls are fewer in number, and mostly described as having attentional problems than as being agitated. They are also less concerned by school problems. In Chile, women commonly naturalize their ADHD diagnosis, while men tend to think in terms of potentially creative difference. What can be said about the construction of these differences ? Is it a matter of perception or of objective differences in behaviour? How do processes of socialization and differential responses interact?

5 – Families and professionals

Our last axis of reflection concerns the way relationships are forged and developed between families and the various professionals they meet, in the fields of education, health and social work. Here again, structural differences between national contexts are essential. Beyond understanding these differences and, more specifically, how professionals are structured in institutions, we aim to understand how families and professionals engage in partnerships and collaborations. While the injunction to co-construct with parents varies in the different contexts, it is worth understanding how some families actually become partners, while others keep acting as patients and expect to be taken care of.

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