Why so few French kids have ADHD

At least 9 percent of U.S. children are medicated for Attention Deficit Hyperactivity Disorder, compared to less than .5 percent of French children, writes Marilyn Wedge in Why French Kids Don’t Have ADHD in Psychology Today. Wedge is the author of Pills are Not for Preschoolers: A Drug-Free Approach for Troubled Kids. 

While U.S. psychiatrists see ADHD as a biological disorder treatable with drugs, French doctors “look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context.” They try to treat the underlying problem with psychotherapy or family counseling.

In addition, French parents are  more likely than Americans to teach their children to control their behavior.

Pamela Druckerman highlights the divergent parenting styles in her recent book, Bringing up Bébé

. . . From the time their children are born, French parents provide them with a firm cadre—the word means “frame” or “structure.” Children are not allowed, for example, to snack whenever they want. Mealtimes are at four specific times of the day. French children learn to wait patiently for meals, rather than eating snack foods whenever they feel like it. French babies, too, are expected to conform to limits set by parents and not by their crying selves. French parents let their babies “cry it out” if they are not sleeping through the night at the age of four months.

. . . Consistently enforced limits, in the French view, make children feel safe and secure.

Raised in families where the adults are in charge, French children learn to control their behavior without the need for medications, concludes Wedge.

What’s the most loving thing you can say to your child? According to my husband, the father of three successful adult children, the answer is: “No.”

About Joanne

Comments

  1. Stacy in NJ says:

    Great. The French teach their kids self-control. Now, the question is what happens to them between the early years and adulthood that turns them into, well, French people.

  2. George Larson says:

    This is not a new idea. I was born in 51. My mother said i was a schedule baby. I was fed by the clock.

  3. Mark Roulo says:

    It appears that this is not a USA compared to France issue, but a USA compared to most of the rest of the world issue.

     

    From a Washington Times article:

    In 30 years, there has been a twenty-fold increase in the consumption of attention-deficit disorder medications. America is responsible for 90% of worldwide consumption of Ritalin.

    http://communities.washingtontimes.com/neighborhood/appalachian-chronicles/2012/jun/24/doping-america-part-2-ritalin-generation

    Maybe the rest of the world also has a 9% rate of diagnosing ADHD, but the rest of the world doesn’t prescribe nearly as much Ritalin to deal with it.

  4. cranberry says:

    Direct-to-consumer pharmaceutical advertising is not permitted in the European Union.

  5. What this sounds like to me is “Children having problems with hyperactivity have bad parents.” I don’t think that’s necessarily the case–though certainly parent-blaming is the great American pastime (autism, homosexuality, allergies, mental problems, and more have been or are blamed on bad parents). The parents I know who have kids struggling with ADHD are great people who work hard to give their kids the structure they need and who give medication only as a last resort. If it’s bad parenting, why do so many families have one kid with ADHD and two kids who are pretty ordinary?

    Blaming children’s difficulties on bad parenting often comes down to superstition–it’s a self-defense mechanism in a lot of people. If you (the general you) can blame problems on bad parenting, then your kids won’t suffer, because you of course are–or would be–a Good Parent. The plain fact that your child may have health or mental problems is too scary to contemplate.

    • cranberry says:

      French schools also have 1.5 – 2 hour lunch breaks: http://www.readyforfrance.com/family/schools.php.

      One forgets how drastically the American school system has changed. Many schools don’t have recess. Students sit in groups, rather than rows. Physical education is cut. Students aren’t walking to school anymore. It is difficult to enforce behavioral expectations in school. All of this means the school day is much harder for young children, especially boys.

      Were the US to ban direct-to-consumer marketing of pharmaceuticals, and (re)institute lunch, recess and PE in schools, the rates of diagnosed ADHD might drop.

      • I agree, Cranberry. I get compliments from coaches and teachers about my kids, but as homeschoolers they spend more time running around and jumping than most kids. Our school time is focused, but I send them out to burn off energy periodically. I’ve often wondered if they’d be diagnosed with something if they had to sit still for longer stretches of time. At our co-op many of the small kids take PE, and if kids get wiggly in class the teachers will get a parent or teenager who is free to run the kid up and down the stairs a few times. That usually seems to take care of it.
        In no way am I implying that ADD/ADHD isn’t real (I’ve known a few ADD/ADHD kids), just that I’m not sure that it’s as prevalent as the current levels of prescriptions would imply.

      • I’m with you on recess and a lunch break long enough to allow outside play, but not on PE. By the time my younger kids were in ES, all competition was removed, anything that “everyone” couldn’t do, wasn’t done at all, there was too much standing around and there was far too much paper/book work (rules of softball etc.) My kids were full-time athletes and found PE to be pure torture. Even when my older kids were in ES, I had to fight to get permission for my second son (when in 2nd, 3rd) to do the mile run with the 5th-6th graders – even though he was running 10ks every weekend, plus playing travel soccer. By MS, kids need to shower after PE, which means that there’s no time left to exercise, so it’s just a waste of time.

        My older kids’ ES teachers would allow active kids (almost all boys) to run a couple of laps around the playground (visible and directly accessible from classrooms), if they’d finished their work. If raining, run stairs or do jumping jacks in the hallway. On their own! Those teachers have long since retired and it’s a different world now – not always for the better. Normal boy behavior has been pathologized; they’re seen as defective girls and drugged.

        • Another possible factor: French students are bigger coffee drinkers than American students are, even at relatively young ages, and caffeine is a stimulant similar in its effects to Ritalin et al–i.e., it improves focus.

          • Roger Sweeny says:

            I suspect they are also bigger smokers. Nicotine is, of course, also a stimulant. I have wondered for years how many teens take up smoking as unintentional self-medication.

          • cranberry says:

            American students drank soda pop with caffeine (Coca Cola, Pepsi, Mountain Dew.) I suppose the soda has disappeared in the anti-obesity push.

            Hmm. Wonder what would happen if schools opened espresso bars?

  6. Herewegoagain says:

    Hi Joanne,
    1. I have ADHD, which in my case involves lifelong chronic cognitive issues. I have problems processing information to a degree that impacts my life significantly. I will always have to keep working on it. I have a whole host of coping mechanisms to help me, and a lot of energy goes into trying to get through the day.
    2. I was raised with structure, regular home cooked meals, very little to no soft drinks, a good dose of affirmation and discipline. I was told “no” a lot growing up.
    3. I still have ADHD.
    4. I am not medicated. It seems in the US medication seems to be the first route, but this is not necessarily the case outside of the US. Also, a lot of people may be too sensitive to medication to tolerate it (in my case).
    5. ADHD isn’t an excuse for not trying. Perhaps some will use it as an excuse. But the diagnosis is supposed to give you or your child the tools for understanding how to deal with their difficulties, which are far more chronic and lifelong than those in more ‘typical’ kids. Someone with ADHD will need therapy- CBT, maybe occupational therapy, extra lessons etc to address their cognitive or behavioural problems, a lot of structure. Medication is really only one aspect of it.
    6. I understand the concern about the over medication of kids. I’m concerned too. But there are many kids out there who face very real difficulties and, with all the love, support and discipline in the world, will continue to face these difficulties (though a lack of these things will of course make the problem far worse). There is a real lack of understanding about special education, and the tone and bent of such articles only make it worse.

  7. Only partly true, but it fits a mythology so many Americans prefer!

    These numbers are not broken down by race, or prenatal substance abuse, or insurance payment requirements. Things suddenly become clear when one does that. This is apples and oranges.

    ADHD is overdiagnosed, but it does also have a large genetic and biological component. Looking for a social context is not a way of fixing things, but of avoiding fixing them. Nostalgic retrospectives of one’s own childhood are the most unreliable set of memories. Take a breath, all. You have forgotten most of the real data and reinterpreted the rest.