Why French Kids Don't Develop ADHD

Attention deficit hyperactivity disorder, better known as ADHD, is a common problem among American children. Overall, about 9% of all American children of school age have been diagnosed with the condition. At least 10% of children in the poorest families (those that have incomes of poverty level and lower) are labeled as having ADHD, and 11% of the children of families that in the second tier of incomes (100 to 200% of poverty level).

Most American children treated for the condition receive, oddly enough, psychostimulant drugs that are in the same chemical class as methamphetamines, such as Ritalin and Adderall. In Europe, ADHD is seldom treated with drugs. What accounts for the difference?

How ADHD Is Diagnosed In The USA

In the United States, ADHD is a psychiatric diagnosis made under guidelines laid out in the latest diagnostic and statistical manual, the DSM-5. The official guidelines require mental health professionals to look for specific kinds of behaviors.

• Often forgetful in daily activities.
• Often easily distracted by extraneous stimulation.
• Often loses tools for daily activities (forgetting homework, losing books, losing lunch money, and so on).
• Often avoids or expresses displeasure with tasks that require sustained mental effort, such as homework.
• Often has difficulties organizing activities or tasks.
• Often fails to finish assigned tasks or duties.
• Often does not listen to what is being said.
• Often has difficulties sustaining attention to work or play.
• Often makes careless mistakes or fails to give attention to details in work or play.
• Hyperactive, evidenced by fidgeting or squirming in seat.
• Hyperactive, evidenced by leaving seat when sitting is expected.
• Hyperactive, evidenced by running or climbing excessively. In teenagers and adults, this may be diagnosed by expressions of subjective feelings of restlessness.
• Hyperactive, evidenced by difficulty in playing or pursuing leisure activities quietly.
• Hyperactive, evidenced by impulsivity in leaving lines (queues).
• Hyperactive, evidenced by impulsivity of blurting out answers to questions before they are asked.

Adolescents and adults only need to meet 5.

How ADHD Is Diagnosed in France

French mental health professionals refer to the Classification Française des Troubles Mentaux de L'Enfant et de L'Adolescent to diagnose ADHD. This massive reference volume doesn't list symptoms to be masked by medications. Rather, it is intended to help French mental health professionals to recognize the underlying causes of children's behavior.

See Also: Is ADHD A Fake Disorder?

In France, counselors and psychiatrists look at the same behaviors, but they also consider:

• How severe are the child's symptoms compared to other children in the same class, the same family, or the same community? If all the children in a classroom show the same dysfunctional behaviors, maybe the problem is the classroom, not the children.
• Is the child assigned monotonous, unrewarded tasks? Boring activities naturally invite acting out. This is not an illness.
• Have the symptoms lasted at least six months? Temporary behavior problems may have temporary, non-medical causes.

A Different Approach To Treating ADHD

Treatment of attention deficit hyperactivity disorder in France is different, too.

They take a more holistic view of the child's mental health. For instance, a French therapist would probably consider:

• Is the child exposed to artificial dyes, colorings, preservatives, and flavorings in his or her diet? Is the child given foods that can cause allergies? Is the child given too much sugar? American therapists usually know that dietary interventions can make a huge difference in child behavior, but the guidelines do not call for changing American children's diets.
• Has the child been given a strong "cadre," or structure? French parents usually provide firm guidelines for their children's behavior. Children are not allowed to eat whenever they want, for instance. They are required to eat at mealtime. French parents may allow babies to "cry it out," at least for a few minutes, before offering comfort.
• Has the child been provided clear limits for his or her behavior? French parents exert their authority by declaring, “C’est moi qui décide” (“It’s I who decide”). They are usually are not at all hesitant to tell their children "no." Telling children what they cannot do, as well as what they can, is thought to free them from the tyranny of their desires. Setting limits is believed to help children feel both happier and more secure.
• Has the child been exposed to physical discipline? In the US, as well as in most countries in northern Europe, spanking a child can be equated with child abuse. In France, a light swat to a firm whack on the side of the head, the bottom, or the arm, used judiciously, is considered part of any parent's prerogatives for disciplining a child. (But we cannot recommend it where customs or law prohibit it.)

See Also: How Can You Tell If An Adult Has ADHD?

ADHD is seen as a failure of parenting, or teaching, or food, or community structure, that requires changes on the part of adults rather than blaming the child. But just as the French approach does not shame the child for inattention or hyperactivity, it does not shame the parents. Parents are not expected to be consumed with child rearing. They are not competitive, obsessive, helicopter parents who lack a life of their own. What, however, can American parents who have children who have ADHD take away from the French experience?

• If your family is under financial stress, chances are that your child will be under emotional stress. This isn't an illness. It goes away when your financial position improves.
• If your child has ADHD, part of the problem could be diet. First, get rid of sugar, colors, and preservatives. (Most soft drinks are bad for ADHD.) Try to provide fresh foods as your family budget permits.
• Make sure your child has interesting activities at school. Be involved in your child's education. And,
• Remember, ADHD isn't your fault or your child's fault — and it isn't something you necessarily need to medicate away, either. Changing environment can be at least as important as trying to change your child.