The article states that only 0.5% of French children are diagnosed as having ADHD and that the “epidemic” of ADHD has “almost completely passed over France”. After considerable research I’ve since found the article to be incorrect, incredibly misleading and damaging to the entire ADHD community.
The reason why so few children are diagnosed with ADHD is because the ICD (International Center for Diseases) diagnostic criteria that France uses is 13 years old and has an extremely narrow band in which a child can get a diagnosis. ADHD exists; it’s just significantly harder to get a diagnosis.
In the US and Australia we use the DSM-IV/V (Diagnostic and Statistical Manual of Mental Disorders) criteria, re-released in 2013, which has 9 inattention symptoms that would lead to a diagnosis of ADHD. The ICD-10 has 5 and does not include poor organizational symptoms such as:
- Often does not follow instructions and fails to finish schoolwork.
- Often loses things needed for tasks and activities.
- Is often forgetful in daily activities.
- Often has trouble organizing activities.
Difficulty organizing tasks, items and activities is a key element of diagnosing ADHD from an early age. As the child grows up, these symptoms translate into chronic problems with forgotten or lost homework assignments, clothing and possessions buried in piles of clutter, and difficulty maintaining any consistent routines.
When studies were conducted it was found that of the children who received an ADHD diagnosis under the DSM, only 22% would have received a diagnosis under the ICD criteria.
French kids do have ADHD, however the diagnostic criteria are so restrictive, that they’re not being diagnosed at the same rates as those in America (9-11%) or Australia (5-7%). If France were to use the current DSM criteria, their rate of ADHD would be similar to Australia.
It has become so difficult for families in France to get a diagnosis that a support group HyperSupers has been established. Parents were frustrated that their children were reaching their teens before a diagnosis. They were struggling with social services who were threatening to put their children in foster homes, since they were convinced that their parents had poor parental skills, due to inaccurate diagnosis or refusal to consider this disorder.
If 78% of French children with ADHD are not getting the diagnosis that those under the DSM are, what are the consequences?
HyperSupers was created to support families and to try to prevent a long and chaotic medical process, in the hope that an early diagnosis can improve the future for these children both in their academic as well as in their social and professional life, in their teenage and adult life. This would also help to reduce the social cost of ADHD in France (for example early school drop-outs, drugs, alcoholism and suicide).
Elias Sarkis MD, a board-certified child and adolescent psychiatrist and Distinguished Fellow of the American Psychiatric Association states:
"The reality is that there are French kids in prison, a high rate of tobacco use, and kids dropping out of school. In France there is a strong negative cultural belief against medication for children with psychiatric disorders.”
France’s “Victim of Crimes” rate is higher than America’s. Ignoring the issue of childhood psychiatric disorders won’t make them go away. France’s suicide rate is twice the rate of Britain and 40% higher than Germany and the US. Should we really be looking to France as a great example of how to deal with psychiatric illness? I don’t think so!
In France, ADHD is regarded as a psycho-social condition and it is believed that strategies such as diet, parental education and firm discipline are all that is required. Research has proven that ADHD is in fact a biological-neurological disorder.
Studies show that children and adults with ADHD tend to have abnormal functioning, or dysregulation, of certain brain chemicals known as neurotransmitters. There also tends to be abnormal functioning in the nerve pathways that regulate behavior. In addition, children with ADHD may have certain parts of the brain that are smaller or less active than they are in children who don't have ADHD.
I won’t deny that a healthy diet, positive parenting and discipline will help a child with behavioural issues, but they will not fix ADHD! Making claims that France does not have ADHD due to psycho-social interventions is misleading and incorrect. It also leads to comments and preconceptions such as “I’ve always believed in good nutrition and my children don’t have ADHD”, “ADHD is just another word for poor parenting”, and “Those parents who unfortunately have these problems are not spending enough time with their little ones.”
France has been well documented for their old school beliefs, recently highlighted by the film “Le Mur” or The Wall, which interviews prominent French psychiatrists. The film leaves the viewer wondering whether France’s treatments for pediatric developmental disorders are stuck in some sort of bizarre Freudian time warp. The French psychiatrists explained how the mother was the cause for autism, and still believe that “being a Refrigerator Mum causes autism”. A theory that was thoroughly debunked over 50 years ago in the rest of the world.
French children do have ADHD. It’s only a matter of time before the consequences of burying their heads in the sand about childhood psychiatric disorders will unfold. The author of “Why French Kids Don’t Have ADHD”, Marilyn Wedge, PhD, has also written a book called “Pills are not for Preschoolers”. Her controversial article shows little to no regard for the families having to deal with ADHD on a daily basis by simplifying the disorder to something that can be fixed with diet and parenting. She is also a strong advocate of not medicating children and does not believe ADHD is psychiatric disorder, despite significant evidence to the contrary.
I feel for those French children and families who genuinely have ADHD and are made to struggle without a diagnosis or medical intervention. I can only hope that with more awareness to their cause, French parents will get some support to help their children, who have ADHD, before it’s too late.