是標籤還是特殊需求？ADHD與教育場域醫療化的再思考

Label or Special Needs?: Rethinking the Medicalization of ADHD in Educational Settings

近年來，愈來愈多學童被診斷為患有注意力缺失／過動症（Attention Deficit/Hyperactivity Disorder, ADHD），並且有不低的比例正在接受精神藥物治療；與此同時，社會上對這個疾病的爭議不絕如縷，也為教師如何認識與處理孩子的注意力短暫或過動與衝動表現，帶來艱鉅挑戰。這篇回顧性論文，首先以社會學視角概述ADHD與醫療化（medicalization）的歷史，再根據醫療專業社群內部的批判論述，檢視ADHD作為精神疾病分類標籤的科學問題，並從相關社會科學研究來討論ADHD標籤為學生帶來的「雙面刃」效果。本文最後從支持教師擴大專業能力，而非補救學生個別診斷的立場，對理解與ADHD相關的學校困難提出建議，目的是讓教師更有資源來解決實質面臨的教學問題，並支持學生的多樣性，發展有利於所有學生的教育。

In recent years, an increasing number of students have been diagnosed with attention-deficit/hyperactivity disorder (ADHD), and a significant number of these students are being treated with psychiatric medication. However, controversies surrounding this condition persist in society, posing significant challenges for teachers in understanding and addressing students’ problems related to inattention, hyperactivity, and impulsivity. This review article begins with a sociological overview of the historical trajectory of ADHD and the process of medicalization. It then examines the scientific foundations of ADHD as a psychiatric classification label, drawing primarily on critical discourses within the medical field. Specifically, it scrutinizes the confusion between description and explanation brought about by ADHD labeling, the reification of an abstract concept of disorder, the assumed distinction from normality, and the normative implications of symptom connotations. In addition, the article explores the “double-edged sword” effect of ADHD labeling on students, as evidenced by relevant social science research. The article concludes by proposing conceptual recommendations for comprehending the challenges associated with ADHD in educational settings and advocating for teacher support and capacity building. This approach aims to provide teachers with enhanced resources to address practical pedagogical issues, promote student diversity, and develop educational practices that benefit all students.