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«The Social Control of Childhood Behavior via Criminalization or Medicalization: Why Race Matters DISSERTATION Presented in Partial Fulfillment of the ...»

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Additionally, the argument that the use of IDEA and Section 504 reflect the medicalization of school discipline does have several drawbacks. Importantly, schools use both IDEA and Section 504 for a range of disorders. While I tried to attend to this by including only those most associated with misbehavior, I am unable to account for misdiagnoses by school professionals. Nevertheless, models examining total IDEA enrollment yielded similar findings. Additionally, schools are allowed to suspend kids enrolled in an IDEA or Section 504 plan for short periods of time, provided they consider behavior problems. Indeed, rates of suspension for kids on IDEA plans are relatively high (Kim, Losen, and Hewitt 2010). However, as stated earlier, schools may be prone to misdiagnose and punish kids with other disorders that have little to do with behavior.

Particularly in African-American communities, where schools have limited human resources, behavior problems are more likely to go undiagnosed or treated as learning problems (Davison and Ford 2002; Kim, Losen, and Hewitt 2010). To ensure that I am examining how schools define and manage similar behavior problems, such as hyperactivity and classroom disruption, I rely on a measure including only those children covered plans that cover just those disorders characterized by behavioral symptoms.

Finally, the use of student-police contact as a control for extreme behavior problems in the school may underestimate the level of student misbehavior in the school.

For example, teachers and administrators may have knowledge of illegal activity that they do not report to police or they may be more likely to suspend students for relatively minor infractions in lower crime schools. Despite these concerns, research suggests that actual police presence is relatively common in American schools (Kupchik 2009; 2010).

Consequently, the likelihood of police officers allowing crime to go unabated is relatively low (Kupchik 2010). Moreover, minority students are actually more likely to be suspended for minor transgressions than are White students and the use of punitive school discipline for minor infractions is more common in schools with higher levels of crime and violence (Kupchik 2010).

Despite these shortcomings, this paper helps to bring together literatures from criminology and medical sociology on the social construction of the social control of childhood behavior. By examining how schools use criminalized and medicalized school discipline differently across different racial and ethnic contexts, this paper strengthens the claim that criminalization and medicalization are racialized social processes that benefit majority Whites at the expense of racial and ethnic minorities. Furthermore, these disparities begin at extremely early ages and exist even when federal law requires that no such disparities exist (Kim, Losen, and Hewitt 2010). Findings from this paper confirm that attempts to examine deviance and misbehavior must consider the layering of medical and criminal social control, both at an individual and an institutional level.

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There has been a marked increase in the use of both punitive school discipline and therapy and medication to manage child problem behavior. However, research examining these different responses to child behavior problems is typically separated by disciplinary interests and rarely speaks to one another. Consequently, we know little about whether school punishment and therapy or medication affect the same children or whether they serve as alternative forms of social control for different groups of children.

Additionally, research on these responses to child problem behavior have focused primarily on the short-term effects of either punishment or medication on grade repetition, high school graduation, and other indicators of well-being during childhood and adolescence (Barkley 1997;2002; Currie, Stabile, and Jones 2014; Rafalovich 2013).

Scholars have yet to examine how early patterns of social construction of behavior problems serve to criminalize young men by increasing the risk of involvement in the criminal justice system or medicalize them through the repeated and routine reliance on mental health services to control behavior problems. These gaps in the research have left us with an incomplete understanding of how child problem behavior is socially constructed. Furthermore, despite increasing use of both punishment and medication, we remain unclear about the long-term and widespread impact of these changing policies.

Findings from the three papers deepen our understanding of how the layering of social control is a racialized process which occurs throughout the life-course and manifests itself in multiple social institutions (Medina and McCranie 2011). Rooting this analysis in criminological and legal theories of criminalization (Hirschfield 2008a; Rios 2006; 2011; Simon 2007) and medical sociological theories of medicalization and health disparities (Conrad 1992b; 2007), I demonstrate that the problem behavior of AfricanAmericans and Whites is socially constructed in fundamentally different ways from childhood through adolescence and young adulthood. Furthermore, I reveal how the racial composition of local populations influences the ways in which schools, as primary socializing institutions, construct and control child behavior by implementing different disciplinary strategies. Additionally, I incorporate contributions to labeling theory from both criminology and medical sociology (Link and Phelan 1995; Link et al. 1989; Lopes et al. 2012; Sampson and Laub 1997) to demonstrate how racial disparities in the social construction of problem behavior in childhood can translate into different life-course trajectories characterized by further criminalization or medicalization.

Drawing from this rich theoretical literature has enabled me to initiate an important and timely conversion between two literatures about how we, as a society, define and manage deviance. Below I provide a brief summary of the findings of each chapter and draw attention to several important contributions of this dissertation to the criminological and medical sociological literatures. I finish by addressing the limitations of this dissertation and describing future research plans that builds on these papers and further push our understanding of social control.

Summary of Results Chapter 2 uses a focal concerns perspective and relies on contributions to labeling theory from both criminology and medical sociology to investigate racial disparities in the social construction of child problem behavior. I focus on two important processes for socially constructing behavior rooted in differing views on misbehavior and social control: school punishment (suspensions and expulsions) and the use of therapy or medication. In chapter 2, I argue that school punishment encompassed criminalization as social control because it excludes and isolates children who misbehave and marks them as a troublemaker for the remainder of their school career (Ferguson 2001; Rios 2011). On the other hand, the use of therapy or medication is medicalized social control because it relies on medical definitions and technology to manage behavior (Conrad 1992a).

Because racial inequalities are prevalent throughout the criminal justice and mental health systems that influence these forms of social control, I argue that the social construction of child problem behavior will be racially patterned as well.

Overall, the findings from Chapter 2 support this hypothesis. First, as the use of suspensions and expulsions increased dramatically between 1988 and 2010, AfricanAmerican boys are significantly more likely to be punished than White boys and White boys are significantly more likely to receive therapy or medication for behavior problems than African-American boys. Furthermore, racial differences in child problem behavior, as measured by the CBCL externalizing behavior scale, could not explain racial differences in punishment and therapy or medication. Finally, African-American boys are not only more likely to suspended or expelled without receive treatment for behavior problems than White boys,, but the rate of increase in school punishment for AfricanAmerican boys over time is far more pronounced.

Chapter 3 uses a group-based modeling strategy to test a series of hypotheses involving criminalized and medicalized social control as possible life-course trajectories that young men may follow. I draw on insights from both criminology and medical sociology regarding the long-term implications of labeling in childhood to demonstrate that labeling in childhood can influence involvement with varying institutions of social control across the life-course. Specifically, I argue that racial disparities in labeling in childhood help to contribute to racial disparities in criminalized and medicalized social control across the life-course.

Results from Chapter 3 are generally supportive of these hypotheses.

Specifically, African-Americans are more likely than White boys to follow criminalized social control trajectories than low-risk trajectories. At the same time, White males are more likely than African-Americans to follow medicalized social control trajectories than low-risk trajectories. Furthermore, young men who were punished in school during childhood have a greater risk of following a trajectory associated with routine or repeated contact with the legal system and were unlikely to follow trajectories which involved seeking out mental health services to control behavior in adolescence and young adulthood. On the other hand, young men who experienced only therapy or medication during childhood with experiencing punishment were not significantly more likely than those who received no label to follow a criminalized life-course trajectory, but they were more likely to use mental health services for extended periods of the life-course. Finally, because White boys with behavior problems are more likely to receive therapy or medication during childhood than African-American boys, they are able to avoid criminalized trajectories of social control. However, the use of therapy or medication increases the likelihood that White males will use medicalized social control during young adulthood. Conversely, for many African-Americans, school punishment may commence a process in which the misbehavior of young African-American males is viewed as criminal, thus leading to long-term criminalization throughout adulthood.

Chapter 4 shifts the focus to the ways in which school- and district-level racial composition can influence the use of both suspension and expulsion and the use of services covered under the Individuals with Disabilities Education Act (IDEA) of 1990 and Section 504 of the Rehabilitation Act of 1973, intended to provide tools to assist children with medically recognized behavior problems. Drawing from theories of racial inequality in both criminology and medical sociology, chapter 3 examines a series of hypotheses regarding the independent and moderating influence of school-level and district-level racial composition on both criminalized and medicalized school discipline.

Findings from Chapter 4 are generally supportive of these hypotheses. First, schools with relatively larger African-American student bodies have greater rates of school punishment than other schools in their districts. Additionally, districts with larger African-American populations have larger average rates of school punishment than other districts. Conversely, schools with relatively larger African-American student bodies have lower rates of students covered under IDEA or Section 504 than other schools in their districts. Furthermore, districts with larger African-American populations also have lower rates of students covered under IDEA or Section 504 than do other districts.

Finally, the positive association between school-level African-American composition and punitive school discipline is attenuated in districts with relatively larger AfricanAmerican populations. On the other hand, the negative association between school-level African-American composition and rates of coverage under IDEA and Section 504 is more pronounced in districts with relatively larger African-American populations.

Contributions of Dissertation This dissertation bridges criminological and medical sociological literatures on deviance and social control over the life-course and across multiple units of analysis. Generally speaking, this dissertation addresses racial disparities in social control at very young ages.

Furthermore, it reveals that these disparities only intensify over time and over the lifecourse. Finally, this dissertation points to the important role that schools play in socially constructing child problem behavior across racially distinct communities.

Racial Disparities in the “Layering” of Social Control Chapter 2 suggests that, while the frequent display of problem behaviors during childhood increases the likelihood of both school punishment and the use of therapy or medication, it does not explain the association between race and labeling. Furthermore, the problem behavior of Whites and African-Americans in socially constructed in fundamentally different ways. Findings from Chapter 2 suggest that scholars need to examine racial inequalities in the criminalization and medicalization of behavior problems beginning at very early ages.

There is scant research on the long-term implications of the labeling of child problem behavior. Findings from Chapter 3 reveal that racial disparities in the social construction of child problem behavior translate into racial disparities in social control in young adulthood. One of the most interesting findings from Chapter 3 is the ways in which criminalized or medicalized forms of social construction in childhood not only increase the odds of similar forms of adult social control, but block off pathways to different social control. For example, punishment does not lead to treatment in the future and treatment may prevent long-term involvement with the criminal justice system.

Thus, because Whites are more likely to use medicalization, they can escape long-term criminalization. Indeed, even Whites are punished in school, the use of therapy and medication during childhood can help them to avoid legal troubles later in life.

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