«The Social Control of Childhood Behavior via Criminalization or Medicalization: Why Race Matters DISSERTATION Presented in Partial Fulfillment of the ...»
Data and Methods The dissertation relies on data from multiple sources. For Chapter 2 and Chapter 3, I use data from the National Longitudinal Study of Youth, 1979 Cohort – Child and Young Adult Sample (NLSY79-CYA). The NLSY79 is a prospective longitudinal study originally designed to analyze educational and labor market experiences of Americans who were born between the ages of 1957 and 1965. The total NLSY79 sample includes 12,686 male and female respondents. Respondents were interviewed every year from 1979 through 1994 and every other year from 1996 until 2010. While the NLSY79 was conceived as a labor market study, it has expanded to include important family conditions and health issues, including behavior problems. In 1986, researchers began a separate biennial survey of all children born to the females in the original NLSY79. By 2010, the NLSY-Child and Young Adult Survey included information on 11,504 children from 4,932 mothers, ranging from 0 to 38 years of age. For this analysis, the NLSY-Child and Young Adult Survey is beneficial for several purposes. Not only does the study period of the project coincide with unparalleled changes in both school punishment and medically diagnosed behavior problems in American boys (Losen and Martinez 2013; CDC 2012), but it contains prospective and repeated information on important developmental and socioeconomic characteristics from birth to young adulthood.
Analytic Samples (NLSY-CYA) Chapter 2 examines Black-White disparities in the social construction of child problem behavior. Because of this focus, the final sample for Chapter 2 is restricted to the male children of African-American and White mothers who were between the ages 6 to 14 during the years 1988 to 2010. After removing the boys who were missing information on the independent and dependent indicators of interest, my final sample includes 3,631 boys who contributed 11,802 person-years to the analyses described below.
Chapter 3 examines how Black-White disparities in the social construction of child problem behavior contribute to racial disparities in criminalized versus medicalized social control. Because of the need for variables measured during childhood and young adulthood, the total sample for Chapter 2 includes those African-American and White males who were younger than 15 years old in 1988 and contributed at least two years of data following their fifteen birthday. After removing those observations that were missing or unable to contribute data for my dependent or central independent variables, my final sample contained 3,030 respondents.
Data for Chapter 4 was combined from multiple sources of official data. Rates of school punishment and enrollment of students covered under IDEA or Section 504 comes from Part 2 of the 2009-2010 U.S. Department of Education Civil Rights Data Collection (CRDC). The CDRC data contains cumulative and end of year data for the 2009-2010 school year for over 85 percent of U.S. schools and districts (U.S.
Department of Education 2012). The National Center for Education Statistics (NCES) Common Core of Data Elementary/Secondary School Universe Survey: School Year 2009-2010 provided all school-level independent and control variables. All district-level independent and control variables are taken from the School District Demographics System American Community Survey (ACS) Profiles, 2006-2010. The final sample includes 50,095 public elementary and middle schools nested within 6,128 districts located in the 48 contiguous states.
Chapter 2: School Punishment, Therapy and Medication, and the Social Construction of African-American and White Boys’ Problem Behavior Over the past twenty-five years, school suspension and expulsion rates in the United States have increased more than 33 percent (Bertrand and Pan 2013; Losen and Skiba 2010). Nearly one in four American boys will have been suspended or expelled from school at least once by the time they reach 10th grade (Bertrand and Pan 2013).
Alongside this increase in the use of suspensions and expulsions, American boys are being diagnosed and treated for behavior disorders at unprecedented rates. For example, the number of diagnosed cases of ADHD increased by almost 400% and prescriptions for stimulant drugs, often marketed as treatment for the growing number of behavioral and conduct disorders, have increased tenfold (Centers for Disease Control [CDC] 2012;
Conrad 2013; Setlik, Bond, and Ho 2009; Thomas et al. 2006).
These trends in school discipline and medically diagnosed child behavior problems provide a reflective example of how childhood behavior problems are socially constructed. Specifically, the ways in which society defines and manages childhood behavior do not necessarily reflect the nature of the behavior itself (Conrad 2007; Conrad and Barker 2010). Instead, definitions of behavior are often shaped by the social status of the child and the dominant attitudes of the social control institutions responsible for controlling behavior (Paternoster and Iovanni 1989; Conrad and Barker 2010). Recently, scholars have pointed to two dominant trends in the way in which child misbehavior has been socially constructed: criminalization and medicalization. Specifically, to control misbehaving children, schools and parents have turned to defining and managing their actions through strategies motivated by both the criminal justice and healthcare systems (Heitzeg 2009; Medina and McCranie 2011). Despite common theoretical and conceptual histories, scholarly work examining the social construction of child behavior has been delegated to separate literatures and isolated from one another. Research rarely, if ever, considers how school punishment and therapy and/or medication for behavior problems operate as opposing or collaborative approaches to child misbehavior. As a result, we know little about whether or why some children who misbehave experience harsh school discipline while other children become medicalized and receive therapy and/or medication for behavior problems.
In this paper, I argue that the social construction of childhood problem behavior is a racialized process similar to that observed in the criminal justice and health care systems serving adults. Specifically, as the criminalization and medicalization of child misbehavior has increased over time, White boys are being medicalized and receiving therapy or medication for behavior problems, while African-American boys are being criminalized through school suspensions and expulsions. Furthermore, I argue that disparities in criminalization versus medicalization are not explained by differences in the frequency of misbehavior. Instead, I argue that African-American boys are suspended at greater levels than White boys and White boys are medicalized at greater levels than African-American boys because of differences in blameworthiness, perceptions of threat, and social and structural constraints.
In testing racial disparities in the criminalization and medicalization of child problem behavior, I make several contributions to extant criminological and medical sociological literature on the social construction of childhood behavior. I bring together prior theoretical work from criminology on racial discrimination in criminal sentencing with that from medical sociology on racial disparities in mental health and health care access. I investigate a range of possible responses to child misbehavior, rather than a dichotomous indicator of either punishment versus no punishment or medication versus no medication. Moreover, I take advantage of a prospective longitudinal panel study to examine the processes of criminalization and medicalization at the individual level over an extended period of time. I examine characteristics associated with criminalization and medicalization on a group of children born to a cohort of mothers raising kids during a period of rapid growth in the use of both school punishment and medically diagnosed behavior disorders. In doing so, I assess the influence of race and behavior on the likelihood of criminalization versus medicalization on a single group of children who grew up during a period of extreme changes in the social construction of child behavior.
I draw from labeling theory and the cumulative disadvantage/advantage framework (Bernburg 2009; Link et al. 1989; Paternoster and Iovanni 1989) to test assumptions about how race influences the social construction of child misbehavior over time, net of the frequency or severity of behavior. Using twenty-two years of panel data on a sample of young African-American and White males, I answer four important questions about the social construction of child behavior. First, has the criminalization and medicalization of children’s behavior increased over time? Second, are there racial disparities in school punishment and therapy/medication of behavior problems? Third, are these disparities explained by racial differences in frequency of behavior problems between African-American boys and White boys? Finally, how have the criminalization and/or medicalization of White and Black boys’ behavior changed over time?
Conceptual Framework The Social Construction of Child and Adolescent Behaviors Over the past twenty-five years, the social construction of child behavior has become increasingly modeled on both the criminal justice and healthcare systems. For example, American public schools have borrowed strategies from the police and courts to manage school disruptions, particularly the use of exclusionary formal punishment (Hirschfield 2008a; Kupchik 2010; Lyons and Drew 2006; Simon 2007). Moreover, an increasing proportion of students are suspended or expelled for less serious violations of school rules including tardiness, rude demeanor, poor grades, and even behavior that occurs off-campus (Kupchik 2010). In contrast to this crime control approach, many childhood behaviors, both deviant and routine, are becoming symptoms of medically recognized disorders and falling under the jurisdiction of psychiatrists and psychologists, who then treat such disorders with psychotherapy, psychotropic medication, or a combination of both (Conrad 2007). For a growing number of boys in the United States, misbehavior results in the therapy or medication of a mental or behavior disorder such as Attention Deficit Hyperactivity Disorder (ADHD) (Conrad and Slodden 2013; Conrad 1992a). Sociologists identify these processes as criminalization and medicalization, respectively.
The Criminalization of Child Misbehavior The criminalization of school discipline refers to the ways in which schools control individual children’s behavior through strategies rooted in the philosophy and practice of our legal system (Simon 2007). For example, analogous to mandatory minimum sentencing in the criminal justice system, schools are implementing zero tolerance policies that mandate school removal for even minor displays of misbehavior (Hirschfield 2008a; Simon 2007). Further, schools are adopting many of the surveillance methods and supervision strategies used in the criminal justice system as part of a child’s daily setting, including metal detectors, the use of cameras and police officers on school grounds, and random locker searches for contraband (Hirschfield 2008a; Kupchik 2010).
As more schools adopt these approaches to social control, more children risk punishment for a growing number of behaviors, both in and out of school, and are being forcibly removed from the educational process as a result of these behaviors (Kupchik 2010;
Skiba et al. 2013).
As school discipline increasingly reflects a crime control strategy, the experiences of school punishment is comparable to that of the criminal justice process. Suspension and expulsion tells others that the young man has committed as serious offense, leading to an official and unofficial designation as a rule-breaker (Kupchik 2010; Skiba 2008).
Similar to the ways in which incarceration removes offenders from the community and make it difficult to return, suspensions and expulsions remove children from the classroom setting, forcing them to stay home or isolating them in rooms specifically designated for in-school suspension or removing them from school for extended or indefinite periods (Ferguson 2001; Rios 2006). As a result, teachers and administrators are made aware of past school transgressions or infractions and are more likely to view labeled children with suspicion, increasing student teacher conflict and the possibility of stricter regulation and surveillance of behavior (Hirschfield 2008a; Kupchik 2010).
Amongst their peers, such students are noted for their rule violations and potentially cutoff from pro-social social groups and activities, increasing the likelihood of delinquent peer relationships (Ferguson 2001; Kupchik 2010). This separation from school is detrimental for the future educational success of the child.
The Medicalization of Child Misbehavior While young boys are being removed from school in record numbers, many are becoming patients of psychiatrists and psychologists and being treated with psychotherapy, psychotropic medication, or a combination of both (Conrad 2007).
Behaviors and actions that may lead to punishment in a classroom setting are also becoming the telltale symptoms of a number of common childhood mental illnesses/behavioral disorders. These include restlessness, impulsivity, inattention, and hyperactivity (Conrad and Slodden 2013; Conrad 1992a). By defining individual behavior in medical terms, the mental health system has been able to assert jurisdiction over behaviors that were traditionally the concern of other social institutions, including schools and the legal system (Conrad 2007; Medina and McCranie 2011).