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What are the specific trajectories of ADHD in Chile? What is the current situation? How does the past express itself in the pres­ ent, and what does this point ­toward in the ­future? ­These are some of the questions that we explore throughout this chapter as we discuss some of the social and historical pro­ cesses that have ­ shaped the way ADHD is currently diagnosed, treated, and contextualized in Chile. In a broad sense, the Chilean history of ADHD in ­ children and adolescents can be portrayed as one of contrasts. ADHD and the use of stimulant medi­ cation have been ­ matters of concern for experts in the medical and educational fields, social scientists, and the general public. The main concern regarding the diagnosis is rooted in the fact that ADHD has become one of the leading reasons for­ mental health consultation for both ­ children and young adults (Vicente et al. 2012a), and stimulant medi­ cation is one of the key ways to treat the disorder. Regardless of the concern, ­ these high rates of ADHD and requisite stimulant consumption have been mostly omitted from official rec­ ords. Governmental institutions such as the Ministerio de Salud and the Ministerio de Educación have produced ­ little significant and coherent data on the subject. Although guidelines for treatment and management of the disorder have been produced for medical and educational purposes (Ministerio de Salud 2008; Ministerio de Educación 15 From Problematic ­ Children to Problematic Diagnosis The Paradoxical Trajectories of Child and Adolescent ADHD in Chile Sebastián Rojas Navarro Patricio Rojas Mónica Peña Ochoa The Paradoxical Trajectories of ADHD in Chile   311 2009), ­ these documents are mainly technical and provide procedural protocols.­There is no attempt to explain how ADHD became a widespread phenomenon or to provide the catalyst to produce research related to the topic. Some scholars who are in­ de­ pen­ dent from the government have tried to engage with the topic of ADHD in universities across the country. ­ These studies vary in their aims and methods. Some are interested in the epidemiological aspects of the disorder (Vicente et al. 2012a; De la Barra et al. 2013), whereas­ others focus on the lived experiences of ­ children diagnosed with ADHD (Peña, Rojas Navarro, and Rojas Navarro 2014; Rojas Navarro and Rojas 2015) or on the neurobiology of the disorder (Aboitiz and Schröter 2005). However, ­ there has been ­ little integration of ­ these efforts. This lack of integration, in combination with the scarce production of official data about the subject by governmental institutions or by institutions working in relation to the Chilean government, produces considerable gaps in the understanding of this phenomenon. The existing data are at most partial, and occasionally contradictory. Throughout this chapter, we work ­ under the assumption that the above-­ mentioned difficulties—­ the lack of systematic studies, data production, and research agendas—­ are not reasons to dismiss the study of ADHD in Chile as being impossible, partial, or irrelevant, but rather constitute a phenomenon in and of itself. Our work ­here contributes to organ­izing the dispersed ele­ments of the past and pres­ ent history of ADHD in Chile, in the form of a “bricolage.” The anthropologist Claude Lévi-­ Strauss (1966) defined the “bricoleur”—­ the maker of a bricolage —as someone using a heteronomous repertoire in order to elaborate a patchwork. Likewise, we found ourselves in need of bringing together dif­fer­ ent materials, observations, and experiences across policy, lay, and scientific resources in order to convey meaning (Lincoln and Denzin 2003). We are not aiming for a coherent ­ whole; indeed, one of our core arguments is that ADHD in Chile is, for now and perhaps for the foreseeable ­ future, a heterogeneous object that defies coherence (Whitehead 1968). For ­ these reasons, this chapter follows some of the trajectories ADHD has traveled in the Chilean context and explores the key ­ factors and actors involved in its shaping. In order to tackle how ADHD has been understood in medical and educational contexts, we systematically reviewed the Chilean Boletín de la Sociedad de Psiquiatría y Neurología de la Infancia y Adolescencia (Bulletin of the Society of Psychiatry and Neurology of Childhood and Adolescence), searching for articles that addressed the topic of ADHD from 1993 to 1999. We deci­ ded to start in 1993­ because it is then that, according to the editorial of the 1993 June issue, the journal 312   Global Perspectives on ADHD “became of age,” turning more “mature and responsible” (Dev­ ilat 1993...


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