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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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Chapter 4 draws attention to school discipline, particularly the use of medicalization as social control in schools. While a growing body of criminological and sociological research has examined racial disparities in school punishment, none have considered how schools effectively operate as clinics for children with diagnosed (or undiagnosed) behavior problems. Findings of both school- and district-level racial disparities in these forms of discipline are important. Notably, because schools with larger African-American student bodies do have higher levels of misbehavior (Skiba et al. 2013), the overreliance of punitive discipline and the underuse of IDEA and Section 504 may exacerbate racial inequalities early in childhood and further contribute to disparities across the life-course.

Policy Implications There are a number of policy implications that can be gleaned from this dissertation.

First and foremost, this dissertation continues to shed light on ill-conceived and poorly executed harsh school disciplinary policies that provide limited deterrence and almost no long-term benefits for children. Importantly, as Chapter 2 reveals, these policies are much more likely to affect young African-American boys than White boys over time, even after controlling for problem behavior. Furthermore, as Chapter 4 suggests, these policies are more abundant in schools and districts with relatively larger AfricanAmerican populations. Consequently, the negative outcomes associated with school punishment, including possible long-term involvement in the criminal justice system, is concentrated among already disadvantaged African-American males.

While this dissertation suggests that caution should be taken when dispensing harsh school punishment, it does not claim that schools should increase the use of therapy and medication instead. While I make the argument that medicalization is, in most cases, a more preferable alternative to school punishment, it is not without its downsides. In particular, Chapter 3 suggests that early therapy and medication establishes a long-term pattern of medicalized social control. While more severe behavior problems may subside, repeated and routine use of psychotropic medication may lead to other problems, including depression (Currie, Stabile, and Jones 2013) and an overreliance on medicalization instead of dealing with social problems that may underlay problem behavior (Conrad 2007).

Finally, if the federal government is going to mandate adherence to two qualitatively different school disciplinary procedures, there needs to be clearer guidelines about when and where each approach is appropriate. Furthermore, there should be improved funding behind IDEA programs and increased awareness in the AfricanAmerican community of their children’s legal rights under both IDEA and Section 504.

In order to provide children with an equal and free access to a public education, we need to structure the social control of child behavior problem in an more equitable and beneficial manner that is conducive to rehabilitation rather than exclusion.

Limitations and Future Directions There are several limitations to this dissertation that must be addressed in future research.

First, because the NLSY79-CYA was intended to capture aspects of health and development in childhood, there are not good measures of school racial and disciplinary context. This is an important omission, since African-American boys are more likely to attend predominately African-American school with harsh disciplinary policies. Not only does school environment influence the decision to punish or provide therapy and treatment, but schools with harsh disciplinary policies may influence long-term trajectories as well. For example, Hirschfield (2008a) and colleagues suggest that school discipline criminalizes all students, not just those who misbehave (Kupchik 2010). For example, the use of uniforms and SROs to closely monitor movement in the hallway reflects the ways in which prisons manage the behavior of convicts (Hirschfield 2008a;

Kupchik and Monahan 2006). This serves to prepare African-American students in particular for an adulthood in which risk of incarceration is a much more salient experience, regardless of behavior (Wacquant 2001). While I attempt to address this limitation in Chapter 4, by taking a unique look at how schools organize their own disciplinary policies, I am unable to assess how school policies affect individual students attending these schools.

Another limitation of dissertation is the focus on just African-Americans and Whites (and just males in the first two chapters). Indeed, research suggests that Latinos experience similar forms of discrimination in both the criminal justice and healthcare systems (Alegria et al. 2008; Losen and Martinez 2013). For Chapters 1 and 2, I reduce my sample to the male children of African-American and White mothers. I focus on young males for several reasons. First, younger male children are overwhelmingly more likely to be suspended or expelled and diagnosed with behavior disorders than their female peers. Second, many of the mechanism behind the labeling of behavior vary for boys and girls (Bertrand and Pan 2013; Cuffe, Moore, and McKeown 2005). I chose to remove children of Latino descent for similar reasons. In particular, Latinos in the NLSY – Child Survey are not representative of Latinos nationwide. Like the rest of the sample, they are representative of young boys born to US mothers who were ages 14-22 in 1979, and are thus native-born. Second, decisions about punishment, schooling, and medical treatment for Latinos are often informed by things such as language barriers and immigration status, something that does not necessarily apply to White and Black boys (Alegria et al. 2008; Losen and Martinez 2013). While scholars have demonstrated that Latinos are over-represented in school punishment statistics (Losen and Martinez 2013;





Rios 2011) and may be underserved by the mental health system (Alegria et al. 2008), I save these questions for future analysis.

These limitations notwithstanding, this dissertation advances our knowledge on how race influences important social control practices including and beyond the criminal justice system. In doing so, this dissertation provides a framework for future research on the criminalization and medicalization of social control. For example, as mentioned early, future research should include Latinos and females. Importantly, for Latinos, scholars need to consider the dual nature of criminalization as well. Specifically, not only are the behavior problems of Latinos more likely to viewed with suspicion but, in may contexts, their very presence can be criminalized through misperceptions of immigration status (Rios 2009). Furthermore, while the behavior problems of males and females may manifest themselves differently, there is a growing convergence in terms of social responses to these behaviors, as the rates of both punishment and medicalization of females is growing steadily (Cuffe, Moore, and McKeown 2005; Losen and Martinez 2013).

Additionally, future research should consider the ways in which increases in incarceration rates and changes in the funding and effectiveness of public health and educational services influence the rates of prescriptions for behavioral medication. For example, as states and districts rely on increasingly punitive school disciplinary policies, do White parents use their resources to preemptively seek treatment for their children’s minor behavior problems as a means of providing an extra disciplinary buffer. By examine individual rates of punishment and medication usage across varying disciplinary and racial contexts, I can get a more nuanced view of just who is getting criminalized or medicalized and under what conditions.

In conclusion, these findings demonstrate that racial disparities in social control begin early in life, continue well into adulthood, and exist at both individual and institutional levels. In shedding light on these key patterns, I draw attention to the important role of race and racial minority status in influencing how behavior is socially constructed and what strategies of social control are most important. These findings demonstrate that race matters, at times more than problem behavior and economic resources. Thus, a legacy of racialized social control that began with slavery and Jim Crow and continued with mass incarceration may indeed extend well into childhood (Alexander 2012; Irwin, Davidson, and Hall-Sanchez 2013; Kupchik and Ward 2013).

As this dissertation reveals, these preconceived notions of criminality and mental health reproduce longstanding inequalities that systematically channel White boys out of harm’s way through therapy and medication while painting the problems of African-American males as immoral and criminal.

–  –  –

Alegria, Margarita, Bernice A. Pescosolido, Sandra Williams, and Glorisa Canino. 2011.

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Alexander, Michelle. 2012. The New Jim Crow: Mass Incarceration in the Age of Colorblindness. The New Press.

Anglin, Deidre M., Philip M. Alberti, Bruce G. Link, and Jo C. Phelan. 2008. “Racial Differences in Beliefs about the Effectiveness and Necessity of Mental Health Treatment.” American Journal of Community Psychology 42(1-2): 17-24.

Bailey, Rahn K., Shahid Ali, Shagufta Jabeen, Hilary Akpudo, Jaymie U. Avenido.

Theresa Bailey, Jessica Lyons, and Amelia A. Whitehead. 2010. “AttentionDeficit/Hyperactivity Disorder in African-American Youth.” Current Psychiatry Reports 12(5): 396-402.

Barkley, Russell A. 1997. “Behavioral Inhibition, Sustained Attention, and Executive Functions: Constructing a Unifying Theory of ADHD.” Psychological Bulletin 121(1):65-94

------------. 2002. “Psychosocial Treatments for Attention-Deficit/Hyperactivity Disorder for Children.” Journal of Clinical Psychiatry 63(S12):36-43 Behnken, Monic P., W. Todd Abraham, Carolyn E. Cutrona, Daniel W. Russell, Ronald L. Simons, and Frederick X. Gibbons. 2014. “Linking Early ADHD to Adolescent and Early Adult Outcomes Among African-Americans.” Journal of Criminal Justice 42(2): 95-103.

Bernburg, Jon Gunnar. 2009. “Labeling Theory.” Pp. 187-207 in Handbook on Crime and Deviance, Handbooks of Sociology and Social Research., edited by Marvin D. Krohn, Alan J. Lizotte, and Gina Penly Hall, Dodrecht. Springer.

Bertand, Marianne, and Jessica Pan. 2013. “The Trouble with Boys: Social Influences

and the Gender Gap in Disruptive Behavior.” American Economic Journal:

Applied Economics 5(1): 32-64.

Blokland, Arjan A. J., and Paul Nieuwbeerta. 2010. “Life-Course Criminology.” Pp. 51in International Handbook of Criminology, edited by Shlomo Giora Shoham, Paul Knepper, and Martin Kett. CRC Press.

Bowditch, Christine. 1993. “Getting Rid of Troublemakers: High School Disciplinary Procedures and the Production of Dropouts.” Social Problems 40(4):493-509.

Box-Steffensmeier, Janet M. and Bradford S. Jones. 2004. Event History Modeling: A Guide for Social Scientists. Cambridge Press.

Brinkman, William B., Susan N. Sherman, April R. Zmitrovich, Marty O. Visscher, Lori E. Crosby, Kieran J. Phelan, and Edward F. Donovan. 2009. “Parental Angst Making and Revisiting Decisions about Treatment of AttentionDeficit/Hyperactivity Disorder.” Pediatrics 124(2): 580-589.

Bussing, Regina, Nancy E. Schoenberg, and Amy Perwien. 1998. “Knowledge and Information about ADHD: Evidence of Cultural Differences Among AfricanAmerican and White Parents.” Social Science and Medicine 46(7): 919-928.

Bussing, Regina, Mirka Koro-Ljungber, Kenji Noguchi, Dana Mason, Gillian Mayerson, and Cynthia W. Garvan. 2012. “Willingness to Use ADHD Treatments: A Mixed Methods Study of Perceptions by Adolescents, Parents, Health Professionals, and Teachers.” Social Science and Medicine 74(1): 92-100.

Cameron, A. Colin and Pravin K. Trivedi. 2013. Regression Analysis of Count Data. 2nd Edition Cambridge University Press. New York, NY.

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Chricos, Ted, Kelle Barrick, William Bales, and Stephanie Bontrager. 2007. “The Labeling of Convicted Felons and Its Consequences for Recidivism.” Criminology 45(3): 547-581.

Cohen, Stanley. 1985. Visions of Social Control. Cambridge, MA: Polity Press Conrad, Peter. 1975. “The Discovery of Hyperkinesis: Notes on the Medicalization of Deviant Behavior.” Social Problems 23(1):12–21.

----------. 1992a. Deviance and Medicalization: From Badness to Sickness. Temple University Press.

----------. 1992b. “Medicalization and Social Control.” Annual Review of Sociology 18:209–32.

----------. 2005. “The Shifting Engines of Medicalization.” Journal of Health and Social Behavior 46(1):3–14.

----------. 2007. The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders. JHU Press.

----------. 2013. Medicalization: Changing Contours, Characteristics, and Contexts.” Pp.

195-215 in Medical Sociology on the Move: New Directions in Theory, edited by William C. Cockerham. Dordrecht. Springer.

Conrad, Peter and Kristin K. Barker. 2010. “The Social Construction of Illness: Key Insights and Policy Implications.” Journal of Health and Social Behavior 51(S):S67-S79.

Conrad, Peter, and Valerie Leiter. 2004. “Medicalization, Markets and Consumers.” Journal of Health and Social Behavior 45(S):158–76.

Conrad, Peter, and Deborah Potter. 2000. “From Hyperactive Children to ADHD Adults:

Observations on the Expansion on Medical Categories.” Social Problems 47(4):559.

Conrad, Peter, and Caitlin Slodden. 2013. “The Medicalization of Mental Disorder.” Pp.

61–73 in Handbook of the Sociology of Mental Health, Handbooks of Sociology and Social Research, edited by Carol S. Aneshensel, Jo C. Phelan, and Alex Bierman. Springer Netherlands. Retrieved March 6, 2013 (http://link.springer.com/chapter/10.1007/978-94-007-4276-5_4).



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