An astonishing 11% of children between the ages of 4 and 17 have been diagnosed with ADHD/ADD in the United States. That equals 6.4 million children. In France, the prevalence of ADHD/ADD among children depends on who you ask. Marilyn Wedge, Ph.D., in her article titled Why French Kids Don’t Have ADHD, asserts that only 0.5% of French children have the disorder. However, David Knowle, Ph.D., says the numbers are more like 3.5% to 5.6%.
Even with these more liberal numbers, there are still at only half as many children or fewer in France, per capita, that have ADHD/ADD. In addition, the psychiatric community in these two countries treat ADHD/ADD very differently. To understand these differences in treatment, it is important to first understand the differences in how the professionals in each country view the causes and diagnoses of ADHD/ADD.
Views on the Cause(s)
Part of the reason there are such different statistics in terms of ADHD/ADD between the U.S. and France is because the psychiatric community in the two countries have very different ideas as to what causes the disorder. In the U.S., ADHD/ADD is considered to be a biological-neurological disorder, which means its cause in rooted in biology. In contrast, in France the disorder is viewed as a psycho-social disorder, meaning that they believe ADHD/ADD is rooted in social and situational causes. These two opposing views are critical because they dictate the very different treatment approaches used in the two countries.
Methods for the Diagnosis
In the U.S., medical professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to review a checklist of behaviors and ADD symptoms. The disorder is diagnosed based on a narrow classification of the behaviors and ADD symptoms the child has. There is very little, if any, regard for anything beyond the behaviors and ADD symptoms, such as potential social, emotional, or dietary causes.
In France, Classification Française des Troubles Mentaux de L’Enfant et de L’Adolescent (CFTMEA) is used. The CFTMEA looks beyond the child’s behaviors and ADD symptoms and offers a list of criteria that begins with potential social issues that might underlie these behaviors and symptoms. The list of criteria also includes potential psychological issues and dietary contributors.
Because the medical community in the U.S. views the cause of ADHD/ADD as strictly biological, the preferred treatment method is the use of ADHD drugs. Two thirds of the children diagnosed with ADHD/ADD in the U.S. are prescribed ADHD drugs. These ADHD drugs include medications such as Adderall and Ritalin. In fact, 80%-85% of the ADHD drugs prescribed worldwide are consumed in the U.S.
In France, a holistic approach is taken in the treatment of children with ADHD/ADD symptoms and behaviors. Examining problems in the child’s social environment is the first step in treating these children. Any psychological issues that come to the surface are treated with the use of psychotherapy and/or family counselling. Dietary considerations are also examined. Many children diagnosed with ADHD/ADD have a noticeable increase in their ADD symptoms when they eat certain types of food, such as refined foods and foods with artificial colors and preservatives. This issue is corrected for in France, but American treatment protocols leave no room to address it.
It is important to note the cultural considerations when comparing the treatment of ADHD/ADD in the U.S. and France. The two cultures raise their children in very different ways and some in the medical community believe this contributes to the prevalence and treatment of ADHD/ADD. Children in France grow up with a much stricter set of limitations and a very different diet than American children, leading them to have a better nutritional foundation and better able to exhibit self-control. Many feel that this makes French children less susceptible to ADHD/ADD.
It seems that there are not necessarily more children with ADHD/ADD-like symptoms and behaviors in the U.S. than there are in France, but because there are different treatment options in France, many of these children benefit from forms of treatment other than ADHD drugs. The cause of their behavior and symptoms is considered different in each country, and as a result, the number of children officially diagnosed with ADHD/ADD and given ADHD drugs in France is far lower than in the U.S.