National increase and local variations in ADHD diagnoses - A mixed-methods study of school contexts

ADHD has increased more in Sweden than in almost any other country and now constitutes the single most common psychiatric disorder among children.

Rates of ADHD also vary greatly within Sweden, but neither the temporal increase nor the local variation can be explained by comparable variation in underlying symptoms.

Why, then, do we observe this rise in diagnoses and apparent disconnect between diagnoses and symptoms?The aim of this project is to study the local prevalence and use of ADHD diagnoses across compulsory school contexts. To this end, we use a mixed methods design in three interlinked subprojects. Subproject 1 uses register data and multilevel models to study how the prevalence of ADHD varies across schools.

Subproject 2 uses a qualitative case study approach to study how students, guardians and school staff in different school contexts understand, negotiate, and use ADHD-diagnoses.

Subproject 3 uses longitudinal survey data and decomposition methods to analyze if different school contexts account for variation in ADHD diagnoses over time and across schools.The project is the first to systematically study the role of school contexts for ADHD diagnoses.

It thereby contributes with knowledge concerning the dynamics, management and consequences of school difficulties and disabilities in a juridified and marketized public sector, as well as with practically relevant insights concerning possibly inappropriate pedagogical practices and medical misdiagnoses.