Psychology Today on ADHD: French children don’t need medications to control their behavior

French children don't need medications to control their behavior.Fortunately neither of my children suffer from attention difficulties, but as a teacher I have worked with many students that do.   What typically happens in an American classroom where a child has trouble fitting into existing routines, the problem is seen as with the child and not the environment.  Typically these children receive a diagnosis of attention deficit disorder or attention deficit hyperactivity disorder (ADHD) and medication.  This is the wrong approach, especially when we look at France.

According to Psychology Today, “French children don’t need medications to control their behavior.”

In the United States, at least 9% of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5%. How come the epidemic of ADHD—which has become firmly established in the United States—has almost completely passed over children in France?

Is ADHD a biological-neurological disorder? Surprisingly, the answer to this question depends on whether you live in France or in the United States. In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological–psycho stimulant medications such as Ritalin and Adderall.

French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children’s focusing and behavioral problems withdrugs, French doctors prefer to 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 then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child’s brain.

The article goes on to discuss many differences between the French and American systems for diagnosing and treating children with behavior problems:

  • The French use CFTMEA instead of the DSM-3, which focuses more on underlying conditions that cause the behaviors rather than pharmaceutical products that reduce symptoms.
  • The French consider dietary influences on behavior (see our 2007 post Food Additives Linked to Hyperactivity in Children).
  • “French parents have a different philosophy of discipline. Consistently enforced limits, in the French view, make children feel safe and secure.”

I do not agree with some aspects of French parenting described in the Psychology Today article as beneficial or reducing hyperactivity in children.  Particularly these practices are a cause for concern:

  • “And spanking, when used judiciously, is not considered child abuse in France.”
  • “French parents let their babies “cry it out” if they are not sleeping through the night at the age of four months.”

Spanking and crying it out are definitely not reasons why there is less ADHD in France.

As a teacher, I try to consider the classroom environment when looking at children’s behavior. Do we have “runways” in the classroom that encouraged children to run inside.  Simple furniture arrangement can solve that. Do we expect children to sit too long before changing activities?  Do we allow for children to move around?  Are we teaching children at their developmental level?  When work is too hard or too easy for children, they will misbehave. They don’t have the maturity to tell us any other way.

Diet can not be underestimated in influencing children’s behavior. Food additives, such as colorants, as well as high fructose corn syrup do not sustain children with consistent energy through the day.  In fact, we just found out today that one of our parents allows her second grade son to have coffee in the morning!  No wonder he is bouncing of the walls when he arrives at school!

Although there is much I disagree with in comparing the French to the Americans, the statistics don’t lie.  We need less children on medication.  Instead of always viewing the problem within the child and expecting them to conform to our expectations, we should look at the individual and adapt to their special needs.  We cannot forget to consider how the standard American diet is partially responsible for the statistics.

Image: Girl Playing Hopscotch on Bigstock

 

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