What If We're Treating The Solution And Making The Problem Worse?

The standard view of ADHD doesn't go unchallenged. Not every psychologist believes ADHD is a biological effect that's located in a child's brain.

One such dissenting voice is that of Marilyn Wedge, PhD, author of A Disease Called Childhood: How ADHD Became An American Epidemic. In an article for Psychology Today earlier this year, Dr Wedge raised the question: Why don't French kids have a similar ADHD rate to American kids?

After all, both are highly industrialized, adavanced societies with similar economies and similar lifestyles. Sure, American kids eat more junk food (and yes, there are people who think junk food causes ADHD and they could well have a point) but otherwise, Jack and Jaques are living pretty similar lives. 

In very different cultures.

The French medical establishment doesn't use the DSM. It uses the French equivalent, the CFTMEA, or Classification Francais de Troubles Mentaux de L'Enfant et L'Adolescent. Where the DSM lists ADHD as a biologically-caused condition, the CFTMEA says the roots are in the child's unhappiness and the recommended treatment is a combination of psychotherapy and family counselling. 

The result? Fewer children with ADHD. Exactly what the difference is is open to question: Dr Wedge uses her article to suggest that ADHD is largely an American probelm, while studies show that "the epidemiology of ADHD in French children is similar" to that seen in other countries. (Source: Journal of Attention Disorders.) The rate of incidence was found to be about the same, in that study. Other sources claim to have found a bigger difference. 

The key stat for us, though, is this one: In France, 0.5 percent of kids are diagnosed and medicated for ADHD. (Source: Care2.com.)

As well as drugging fewer children, the French use a tighter set of diagnostic criteria, so they catch fewer cases that are on the borderline of the definition. The opposite approach in the US has led to a phenomenon journalist Ryan D'Agostino called "the drugging of the American boy." (Source: Esquire magazine.)

And the worst thing about the way we treat ADHD is that we treat what we can see. And the fidgeting, messing around, refusal to sit still and other aspects of the condition that catch doctors', teachers', and parents' eyes (and are part of the reason boys are diagnosed with ADHD three times as often) might not be symptoms of the condition. They might be coping strategies.

A small study of teens and preteens recently showed that children with ADHD were more likely to succeed at cognitive tasks if they were allowed to fidget. (Source: New Scientist)

In other words, the "excess" physical activity seen in kids with ADHD might not be a result of reduced brain function; it might be a coping mechanism, one that should be encouraged.

Even more importantly, it's the vigor of the movements themselves, rather than their frequency, that seems to be positively corellated with improved test scores. Maybe that goes some way toward explaining the higher incidence of ADHD in boys? After all, boys are socially permitted to make vigorous movements and the form of ADHD most commonly diagnosed in boys involves this fiudgeting and twitching. The form most commonly diagnosed in girls involves physical lethargy — and worse cognitive impairment.

READ How Can You Tell If An Adult Has ADHD?

It beats Ritalin.