French children and ADHD

Hat tip to Mr. Albert Mohler and his podcast for pointing me to this article.

The magazine Psychology Today was the scene of a bit of a tiff concerning one professional’s opinion about ADHD (Attention Deficit Hyperactivity Disorder). The context, as I understand it, was the recent publication of the newest edition of the Diagnostic and Statistical Manual of Mental Disorders — or the DSM — which is, essentially the “Bible” of mental disorder diagnosis. Mr. Mohler had much to say about it and, indeed, apparently it is a terribly flawed book. The principle that comes to mind is one I warn my kids about from time to time: If all you have is a hammer, every problem looks like a nail. In the mental health professions, this philosophy does seem to reign to a certain extent.

But, in particular, it was Mr. Mohler’s pointing to an argument about ADHD that caught my attention and eventually led me to a statement that you rarely see in mainstream publications anymore, let alone a work like Psychology Today.

The title of the Psychology Today article was, “Why French Kids Don’t Have ADHD” by Dr. Marilyn Wedge (you can read it by clicking on the title).

It clearly began with punch:

“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.”

The point, of course, is that biologically, there is not so much different between an American child and a French child that 9% of American children should have a “biological” disorder that only 0.5% of French children do.

The debate then ensues: Is it that French children are actually different? Is it just that French doctors are ill informed? American doctors would be quick to say their French counterparts are too slow to recognize what is a true “disorder” (and responses in Psychology Today have, indeed, said as much), while French doctors would say that American doctors are far too quick to do so.

But what struck me was the common sense in Dr. Wedge’s article — that how a child is reared absolutely does have an impact on such things. Perhaps not 100%, but certainly not 0% and, in truth, far, far greater. In particular, the final section grabbed me with it’s information and advice that is sadly all too rare these days:

“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.

“French parents, Druckerman observes, love their children just as much as American parents. They give them piano lessons, take them to sports practice, and encourage them to make the most of their talents. But French parents have a different philosophy of discipline. Consistently enforced limits, in the French view, make children feel safe and secure. Clear limits, they believe, actually make a child feel happier and safer—something 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 considered child abuse in France.

“As a therapist who works with children, it makes perfect sense to me that French children don’t need medications to control their behavior because they learn self-control early in their lives. The children grow up in families in which the rules are well-understood, and a clear family hierarchy is firmly in place. In French families, as Druckerman describes them, parents are firmly in charge of their kids—instead of the American family style, in which the situation is all too often vice versa.”

By the way, the “Druckerman” to whom she is referring is Pamela Druckerman who has appeared in these posts before. (“French Moms and Social Psychologist Silliness“, 2/7/2012.)

I was both shocked and delighted that a mainstream magazine like Psychology Today would allow someone to mention spanking in anything other than a negative light. But to focus on just that would miss the point. The idea of parents running a house, creating the “framing” and “structures” and not allowing the children to be the center and “pace setters” of that home was refreshing to see.

I’d write more, but I lack the time. (Actually, I lacked the time to write even this, but–hey–too late!) Just thought it was worth putting out there. And, for kicks, I will add a vive la france!

19 thoughts on “French children and ADHD

  1. Anyone who as observed children while shopping or at the park, etc. would most likely say “Amen”. While camping last year we watched the family at the next site being told by their son what he would and would not do. I am imaging that they must have said no or some thing similar to their daughter who appeared a wee pit younger than the boy because she began to scream loudly. We were blessed to discover that they left early the next morning. The article is correct in far to many instances; children are running the households any more and what a very cruel thing to do to them. Their childhood actually stolen out from under them when they are given such authority.

  2. Terri Dorothy

    I do not disagree with the evaluation of French parenting vs. American parenting. However, I think there is an additional factor (note – this is additional, not instead of). French children are not inundated with the avalanche of processed foods including an incredible variety of additives, preservatives and pesticides. Those have an undeniable impact on the developing brain. Combine that with the non-parenting that seems prevalent in the American society and it’s no wonder we have so many diagnosed cases of ADHD.

  3. obeirne

    Hello Mr. Smith: I believe I recently received on my FB page a post concerning this article or an article referring to this article and shared it. It certainly throws the cat among the pigeons in the world of psychology and I will share again. As to the levels in Ireland I must admit I am ignorant, but I will check it out. But will the elite of the science of psychology examine these findings or will they, as with the experts in other fields, ignore and hope it will go away and stop spoiling their own pet theories. And example I have in mind is the current hearings – if it can be called debate – in the Oireachtas [ the Irish Houses of Parliament ] on the question of legalizing abortion on the supposed [ initially ] restricted basis of a threat to the life of the would-not-be mother because of the claimed risk of suicide. A great number of psychiarists have given evidence that abortion will not curtail or eliminate the threat of suicide. Yet the majority of the politicians are dismissing the assertions of the psychiarists, although the psychiarists have based their findings on credible evidence. Apparently the commitee has been persuaded by a minority in that field that their colleagues who have appeared before the committee are wrong. Interestingly, women who became suicidal as a result of having had abortions will not be called before the relevant committee. It seems that the majority politicians have been swayed by the minority opinion, but this may be due to the left-wing Labour Party, a minority in the current coalition government, have arm twisted the major and overall conservative Fine Gael Party into committing itself to a core policy of the ultra liberal Labour Party – of which many of the main leadership are either atheists, agnositics or secularists. This surrender of the majority party may have been based on a threat or an implied threat of withdrawal from government by the Labour Party, but I have no evidence to back this theory up. Nevertheless, the Labour Party are determined to have their way on this issue. However, this situation does reveal how the elite of this profession are unwilling to consider views contrary to their own set-in-stone opinions. It is not unlikely that other elitists in the professions have a similar mind-set.

  4. The French have the right idea. Discipline a child properly when it is needed. Of course raising a child in a well structured environment is also the right idea. Children should never be allowed to rule in a family.

  5. Teresa

    Dear Mr. Smith, I have seen this article posted several times now on Facebook. Although I agree with parents disciplining their children and being in control of their households, I would just like to say that my parents raised my two siblings and me exactly like the article describes the French children being raised. My sister and I though do have ADHD, even though it went undiagnosed for over 50 years. Yes, we learned to be self-disciplined in many ways, but the condition has caused grief over the years because no one knew what was going on. No, neither of us needed medication to behave, but denying that a condition exists just because one is well-behaved is not necessarily a good situation.
    One author has suggested that ADHD is found more commonly in places like America and Australia because there seems to be a genetic connection to having it. Risky behavior is a symptom of ADHD and at one time leaving one’s home in Europe and moving to places like America or Australia, which were once wilderness was considered risky behavior.
    And thanks for posting the comment about diet, Terri. I’ve seen first-hand hyperactive reactions, not only to foods or substances ingested, but also to dyes absorbed by the skin and fumes breathed in. I feel the article may be a bit simplistic on this subject.

  6. Thanks much, Teresa, for your perspective, and I hope I can communicate more clearly than I may have: I’m not saying that there are not natural differences in individuals. Jeanine has often said that she would probably have been diagnosed ADHD when she was younger, which I find very easy to believe. And diet was certainly a key for her family to manage her hyperactivity. Though I do think that such doctors classify too many things as “disorders” versus the “norm” when many of those conditions are rightly understood as part of the variety of humanity. Many boys are “labeled” as having a condition when other studies have shown their condition clearly: they’re boys. 🙂

    I do suspect, for a number of reasons, that ADHD is “over diagnosed” in America and, consequently, over medicated. Yet, I chose the word “suspect” for a reason — I wouldn’t want to say that it is a strong belief, and I do believe there can be something biological behind some instances, hence my wife’s family’s success with diet choices. Whether U.S. doctors are right, French doctors are right, or the answer is somewhere in the middle, I look forward to knowing without doubt one day.

    Thanks for sharing your experience and perspective! In any successful car ride, we need to use both the gas and the brake to get where we’re going. 🙂

  7. Teresa

    Thank you, Mr. Smith. I wasn’t aiming my comments at what you had said, but at the article, and at the fact that the article was being passed around among church members as if it were the end all to the subject. The author I mentioned above, Thom Hartmann, gives the perspective in his book, Attention Deficit Disorder: A Different Perception, that ADHD is found in personality types who tend toward active, adventursome, fast-thinking, changing activities. He likens them to the “hunters” of the past, and those without ADHD to “farmers” or people who gravitate towards steady, repetitive, unchanging activities which involve little risk. The young “hunters” of today’s society, in general, don’t do as well in classroom settings where they are required to sit still for hours on end, although ADHD also gives one the ability to “hyper-focus” on something that grabs one’s interest. I don’t necessarily agree with everything Mr. Hartmann says, but it is an interesting perspective to think about. There are also different types and degrees of ADHD including one type that does not have the symptom of hyperactivity, and yet still carries the attention difficulties. So, there is much more to the subject than the article implies.

  8. Steve

    Instead of repeating the good points already made, I’d like to offer another thought. What about physical exercise? Kids are little fireballs of energy, constantly changing and growing. If they’re fidgety and have a difficult time concentrating, maybe they need to get outside, run around, and play. Spend that energy.

    I’m not suggesting every case ADHD involves pent-up energy, of course. But I don’t think sedentary kids who sit around snacking on chips and sodas is a good idea, either. Maybe I don’t know what I’m talking about, but we have boys in our family, and their Mom has always been a bug about keeping her boys physically active.

  9. The emphasis of Proverbs 22:6 is mainly on the topic of your child departing from the faith and truth when they grow older, but it also portends to extend that training into many aspects of one’s future.

    The upbringing of a child or lack thereof, determines who and what they will become in their future. Be it a First-fruit, or simply a well balanced, all around good person.

    The same holds true for the other side of the coin. The upbringing of a child or lack thereof, (especially with an absent or dysfunctional parent) can also determine one’s orientation, lifestyle and repeating pattern in life.

    We are all definitely a product of our upbringing, be it good or bad.

    Thank you for a great article Mr. Smith.

  10. obeirne

    Excellent point, Steve Moody. Children do not go out to play and thus get fun exercise as much as they did in the past. A point worth considering very seriously.

  11. anonymous

    Considering how common it is for different ethnicities to be susceptible to certain physical illnesses, I don’t think it’s a stretch AT ALL that American children may be more genetically predisposed. I am also quite interested to know what the stats are on French adults diagnosed with ADHD are. When childhood emotional responses are met with “cry it out alone” and physical punishment, children learn that it is inappropriate to *express* their feelings, but are unable to stop having them. This can very easily lead to emotional problems and mental illness later in life.

  12. The problem, Anonymous, is that there is no such thing as an “American” ethnicity. There is increasingly no such thing as an “American” culture, even. Common threads in ethnicity can’t apply to the difference between American and French children (and adults). Certain common threads in our culture may, and so may other influences mentioned above.

  13. anonymous

    @John Wheeler: not sure how you can say that there is no such thing as American culture and then say that American culture is the prime cause of this issue in the next thought. What I was attempting, poorly, to point out is that when you have two completely separate continents such as North America and Europe, there are bound to be genetic features that are more common in one place than another. I do agree that the “nurture” side of things has a lot to do with how people develop, but until actual studies are done that show that the speculations here are even close to true, I see no reason to piece things together in this manner.

  14. Hi, Anonymous! You didn’t read what I said very well. Go back and read it again, please. I didn’t say there is no such thing as “American” culture and then say “American” culture is the prime cause of this problem. That is exactly what I didn’t say.

    On the other hand, your self-clarification is helpful, but it’s still far more likely that the difference between France and America on this issue is a cultural rather than a genetic matter. We are far less homogenous genetically than France is, and yet genetic anomalies tend to concentrate (even to arise) in homogenous populations. But while we are experiencing greater cultural fragmentation as well (unless immigration has affected the situation in France more than I know), there is still a common thread culturally: French children still have an environment which is better for them than American children have. That is essentially what I said above.

    Basically you’re arguing from silence in return – on the pretext of waiting until more studies are done. Yes, by all means, let’s study the matter more, but in the meantime let’s follow the positive evidence we have where it leads.

  15. anonymous

    @John: I apologize and I see your point now. However, I don’t believe that this IS evidence – correlation by no means equates to causation. Agree to disagree?

  16. Teresa

    Hi Anonymous & John, I just did a brief search on numbers of those with ADD in the United States and in France. The numbers published by the CDC and the Mayo Clinic seem to come in somewhere in the range of 3% to 7.5% in the USA. I didn’t see any estimates for France, but wiki.answers.com has a very brief article on the subject of how many people have ADD worldwide. It says that very consistently, across all cultures and nations the numbers of people with ADD are about 3% to 6%.
    I find in my own life that I tend to research and read about things that personally affect me. Thus, not only do I have ADD, but so do several of my children, and I’ve taught for the past 3 years at a school whose population overwhelmingly has AD/HD. And so, I have read about and and done some research into ADD. John, with all due respect, you need to do more reading on the subject. I’m not saying that children shouldn’t be raised in a disciplined manner, but just that there is more to this subject than has been intimated by the article comparing French and American child rearing.
    Mr. Hartmann’s theory is that ADD is more of a personality type rather than an illness. Men of the past whom he feels may have had this condition are Thomas Edison, Benjamin Franklin, Sir Richard Francis Burton, Ernest Hemingway, and Thomas Carlyle. I wonder how this might fit in with Dr. Beren’s temperament types?

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