Notes on ADHD Diagnosis in France vs. the U.S.

ADHD Diagnosis and Treatment in the United States

• Prevalence of ADHD: 9% of school-aged children diagnosed with ADHD and treated with medications in the U.S.

• Medical Perspective:

  • U.S. child psychiatrists view ADHD as a biological disorder caused by brain dysfunction.

  • Treatment primarily involves psycho-stimulant medications like Ritalin and Adderall.

ADHD Diagnosis and Treatment in France

• Prevalence of ADHD: Less than 0.5% of French children diagnosed and medicated for ADHD.

• Medical Perspective:

  • French child psychiatrists consider ADHD as rooted in psycho-social and situational factors rather than strictly biological.

  • Treatment focuses on identifying and addressing underlying social issues, often through psychotherapy or family counseling.

• Alternate Classification System:

  • France uses CFTMEA (Classification Française des Troubles Mentaux de L'Enfant et de L'Adolescent) instead of DSM to classify childhood emotional problems.

  • Emphasizes understanding psychosocial causes rather than relying solely on medications.

Differences in ADHD Diagnosis

• Broader Definition in the U.S.: DSM allows for a wider interpretation of ADHD, leading to more children receiving this diagnosis, which may not take underlying causes into account.

• Impact of Labeling: The U.S. ratification leads to “pathologizing” normal childhood behaviors, causing an inflated number of ADHD diagnoses.

Dietary Influences on Behavior

• French Approach to Diet:

  • French clinicians consider nutritional factors, such as the impact of artificial colors, preservatives, and allergens on behavior.

  • Parents and clinicians in France may employ dietary interventions, whereas U.S. focus on medications often overlooks these factors.

Parenting Styles and Discipline

• French Parenting Philosophy:

  • Emphasizes a firm structure and consistent rules from a young age.

  • Children learn to wait for specific meal times and undergo a firm approach to sleep training, such as allowing babies to "cry it out."

  • Discipline is consistent, and limits are viewed as essential for providing children a sense of security and happiness.

• Cultural Perspectives:

  • French parents set clear limits, believing this fosters self-control and discipline.

  • Spanking is culturally acceptable when used judiciously, contrasting with American approaches.

Conclusion

• Comparison of Self-Control:

  • French children generally develop self-control earlier due to the structured environment.

  • The clear family hierarchy and consistent discipline contribute to better behavior without the need for medications.