It is bad enough being French so there has to be some blessings…champagne is one…foie gras another…but for the kids it seems they don’t have much incidence of ADHD.
In the United States, at least 9% of school-aged children have been diagnosed withÂ 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 ADHDâwhich has become firmly established in the United Statesâhas 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 withÂ drugs, French doctors prefer to look for the underlying issue that is causing the child distressânot in the child’sÂ brainÂ but in the child’s social context. They then choose to treat the underlying social context problem withÂ psychotherapyÂ 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.Â
I think Americans tend to over diagnose everything and like to label things…syndrome this, or disorder this…
The French holistic, psycho-social approach also allows for considering nutritional causes for ADHD-type symptomsâspecifically the fact that the behavior of some children is worsened after eating foods with artificial colors, certain preservatives, and/or allergens. Clinicians who work with troubled children in this countryânot to mentionÂ parentsÂ of many ADHD kidsâare well aware that dietary interventions can sometimes help a child’s problem. In the United States, the strict focus on pharmaceutical treatment of ADHD, however, encourages clinicians to ignore the influence of dietary factors on children’s behavior.
And then, of course, there are the vastly different philosophies of child-rearing in the United States and France. These divergent philosophies could account for why French children are generally better-behaved than their American counterparts. Pamela Druckerman highlights the divergent parenting styles in her recent book,Â Bringing up BĂ©bĂ©.Â I believe her insights are relevant to a discussion of why French children are not diagnosed with ADHD in anything like the numbers we are seeing in the United States.
Hmm I wonder what makes French kids better behaved? Is it a lifetime of having their country invaded?
From the time their children are born, French parents provide them with a firmÂ cadreâthe 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 notÂ sleepingÂ through the night at the age of four months.
French parents, Druckerman observes, love their children just as much as American parents. They give them piano lessons, take them toÂ sportspractice, and encourage them to make the most of their talents. But French parents have a differentÂ philosophyÂ of disciplinine. Consistently enforced limits, in the French view, make children feel safe and secure. Clear limits, they believe, actually make a child feel happier and saferâsomething that is congruent with my own experience as both a therapist and a parent. Finally, French parents believe that hearing the word “no” rescues children from the “tyranny of their own desires.” And spanking, when used judiciously, is not consideredÂ child abuseÂ in France.
So easy really…boundaries, saying no and meaning no and a pat on the back low enough and hard enough.