G. K. Chesterton wrote, “Science in the modern world has many uses; its chief use, however, is to provide long words to cover the errors of the rich.” A rich man cannot be a thief. He must be a kleptomaniac. America, the richest society in the history of the world, applies this use of science with diligence.
We apply it most diligently on behalf of our children. No red-blooded American child would misbehave. Our children have disorders.
In an article entitled “Why French Kids Don’t Have ADHD,” Marilyn Wedge says, “In the United States, at least 9% of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications.” In France she says the number is less than half a percent. Why don’t French kids have ADHD?
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 with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context. They then choose to treat the underlying social context problem with psychotherapy 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.
The real question is not “Why don’t French kids have ADHD?” The real question is “Why do American kids have it?” After all, we’re the ones who are abnormal.
We really don’t have an ADHD epidemic in this country. Our brains are not less healthy than the French. Instead, we have an epidemic of parents looking for a scientific excuse for their own disappointment in their children, and we have a glut of lazy doctors willing to prescribe whatever drugs parents request.
Hyperactivity? Yes, many of our children are hyperactive. Inability to focus? Yes, many of our children cannot focus their attention on a particular task. I’m not saying that the symptoms of ADHD aren’t real. These symptoms, however, do not stem from biological imbalances that require medication. The problem isn’t our children; the problem is us. We’ve created their social context, and it’s not a place where they can thrive. It’s time to admit that parents are the problem, not the children.
Let me add that I don’t think that parents need medication either. Maybe we can learn from the French.
[Cross-posted at First Thoughts]
Reflection and Choice 
10 responses to “Why American Kids Have ADHD and French Kids Don’t”
I tend to agree. Find the problem, not medicate the problem. Also might be interesting to see how influential the pharmaceutical companies are. Maybe they don’t push their drugs like candy in France. Thanks.
These are some very sweeping statements. I know a number of people who tried a lot before ever turning to medicine, and in at least a few cases, it helps tremendously. These aren’t people in rich families. Middle class, perhaps.
Do we overdiagnose? Probably, though I’m not a good judge of that. It seems overly dismissive to say that there are no biological reasons dramatically influencing a lot of the issues which psychiatry tries to diagnose.
Chris, everyone in America is rich. That’s a sweeping statement too, but it’s mostly true.
I agree with this article whole heartedly. Growing up around kids with “ADHA” all my life and seeing the family situations they came from I know that the ADHD is nothing more than the need for a good “spare the rod, spoil the child” test. Loved this article!
So true. We are so addicted to all kinds of medication and we tend to gravitate to drugs to solve our issues instead of digging deeper to find the root cause of the problem.
I hate that I’m going to use the first time in a long time to chat with you in a blog response that disagrees with your assessment. I hope you can forgive me, and I hope we can catch up for real sometime soon. 😉
“These symptoms, however, do not stem from biological imbalances that require medication.”
I disagree with you here. Your post’s conclusion reads as though it’s coming from a person who doesn’t really know what it’s like to have ADD, and reads like a person who favors natural cures, or who believes that chemical imbalances that drive psychological problems are largely a farce, or who has a slight, perhaps subconscious, disdain for prescribed drug treatment for people who have psychological imbalances, or some combination of those.
All I can say in response is to give you my experience. I was diagnosed with ADD as an adult. I realized after being diagnosed that I had ADD most all of my life, but I never knew that most other people had a much easier time at focusing than I did. I assumed that everyone processed information and had the same kind of (or lack of) focus that I did. If I had lived in generations past (or perhaps lived in France), I may have lived my whole life without a diagnosis and without treatment. I would have made it through life, sure, but I would have slogged through life with a harder go at it than most other people, and I would never have been the wiser.
Perhaps there’s another conclusion that you didn’t consider: That French doctors and psychologists are still a little bit behind and backward, and are telling children, and adults, that their imbalances don’t “require medication,” and that they simply need to change their environment or social context. And in doing so, perhaps they are neglecting their patients real needs out of a stubborn reluctance to admit that some issues like ADD are real and are really biological imbalances that can benefit from medication.
I don’t know what exactly the cause of my ADD is. Was it a poor diet as a child? Was it something in the water? Maybe you are partially right, and it was way too many cartoons and TV watching as a child. But what I do know is that I have it, that I’ve had it for all my life as far as I can tell, and that changing my environment or social context will not fix it. And as far as I can tell, eating a better diet may reduce some of the symptoms by a small amount, but only maybe and only by a small amount.
The medication I take is has been a wonderful thing, and it makes me glad for technology and medicine. You simply can’t know unless you’ve experienced it, but when I am on medication I feel much more normal, the way I imagine most people who don’t have ADD in their normal lives. I am able to focus, and able to be more productive.
To say that my ADD is not a biological imbalance is simply not true. Maybe it was all the cartoons (probably not, because I didn’t watch more TV than the average kid, most of whom didn’t have ADD) , but whatever the cause, my brain now is what it is, and I can’t control it. I can’t make my ADD go away. There surely are cases where kids are prescribed medication when they don’t need them, and diagnosed with ADD or ADHD when they don’t really have it. But be careful not to say that ADD and ADHD don’t exist, or that medication isn’t helpful. They do and it is, for many people.
Mike, thanks for your comment, and I appreciate hearing your perspective. As I said, the symptoms of ADD are real, but almost 10% of our kids on medication is unconscionable. Here’s some other things to think about.
1. ADD/ADHD is diagnosed clinically. There’s no biological test to run.
2. Brain chemistry probably is skewed in kids suffering from these symptoms. But scientists have long known that brain chemistry affects behavior AND behavior affects brain chemistry. Changing behavior habits WILL change your brain chemistry.
3. ADD medication is a proven performance enhancer for non-ADD children and adults. The implication is huge. Non-ADD people get the same benefits of improved concentration. This means that the drug isn’t fixing a biological imbalance, or else it would not help “normal” people too. It’s doing something else.
Concentration takes sustained practice. It’s not “normal.”
Good to hear from you, Mike.
Collin, thanks for your response, as well.
I do truly hate that it’s been forever since we’ve talked, and that here I am finding a reason to get back in touch, but it’s over an issue we happen to disagree on. So, sorry again for that. By the way, you and S. get mentioned a lot by me to some of the closest people in my life here. If you asked them, they could tell you all about yourself. 🙂
Any time I find myself heading to Houston, we’ll have to grab lunch if you have time. And you and S. have a beautiful family.
OK, so now on with it.
1. I am not sure the point you want to make here. It seems as though you are suggesting that if there is no biological test for ADD/ADHD (henceforth ADD), and people rely on clinical diagnoses, then there is no real proof that ADD is an actual biological condition. Or that perhaps you allow that ADD can be a biological condition, but that the vast majority of cases are suspect because of a clinical diagnoses.
That seems a little bit like begging the question. It’s as though you have already concluded that ADD is usually not a biological reality outside of a person’s control, that it is caused by environmental or social causes, and so because ADD is diagnosed clinically and not supported by empirical data from a biological test, you see that as supporting your foregone conclusion.
Do you cast suspicion on the biological reality of other conditions that are diagnoses clinically? (bi-polar disorder; manic depression, dissociative disorder, etc.) Granted, some disorders are environmentally caused. But are you suspicious of the idea that there can be disorders relating to brain chemistry that are caused by genetic reasons, or some other biological miswiring of the brain?
But the other problem with your point is that it’s just not true. There have been many studies showing biological connections to ADD. Not trying to spam, but here are a few interesting articles:
http://www.sciencedaily.com/releases/1998/11/981124063106.htm
http://www.additudemag.com/adhd/article/783.html
http://www.webmd.com/add-adhd/childhood-adhd/news/20031204/brain-scans-reveal-adhd-differences
http://articles.washingtonpost.com/2009-09-22/news/36869441_1_attention-deficit-hyperactivity-disorder-dopamine-nora-volkow
http://www.decodedscience.com/addadhd-diagnostically-challenging-try-brain-imaging/5424
2. Again, you accept that brain chemistry may be skewed in people, but you indicate that it’s environmentally caused. That if they or their parents had only done something different, or if they do something different now, the ADD will go away. The studies above should indicate that you’re not correct about that. And my personal experience tells me that you’re not correct. Sometimes people have little to no control over their brain chemistry, as hard as that is to try to believe. Telling someone with manic depression and anxiety disorder, or telling someone like me with ADD to just change behavior or environment to find a cure, is like telling someone without an arm to “just grow a new arm.”
3. Of course ADD medication, like ritalin or adderall, will have an affect on people without ADD. But that doesn’t make any kind of point, as far as I can see. Who said that a certain medicine cannot have any affects on non-sufferers in order to be effective for sufferers?
Your last statement again seems to show that you think my problem as an ADD sufferer, or anyone with ADD for that matter, simply isn’t concentrating enough. It’s hard work, and I haven’t done the hard work to learn how to concentrate like everyone else.
Again, all I can say is that you are wrong, and are speaking from a perspective of not having ADD and not knowing what it is like. Working hard to concentrate doesn’t make ADD go away. That’s like saying that someone who suffers traumatic brain damage from asphyxiation and is now mentally disabled would be able to regain the damaged parts of their brain if they would only apply a little “sustained practice.”
I hope my response doesn’t come across as rude or in an argumentative way, because I definitely don’t mean it that way. Just some things from a different perspective.
Hope you are doing well.
Of course you don’t come across as rude, and I hope we can have lunch sometime soon.
I am glad for Michael’s comments. ADD has been viewed on CT scans with different stimulants to see how the mind is reacting and there is proof it is different that your ‘regular’ brain. It is hereditary in my family. My Grandpa and Dad both had it and my grandpa’s childhood and diet were very different than my dads childhood and again I was raised differently than both of them with yet a different diet. I agree that it should be looked at as a therapist focused treatment first not because there is no real difference in the ADD brain BUT because if we do get trained and have the proper support we can excel more easily. When in grade school I had 2 friends diagnosed with ADD. Their home lives were, to just be frank, crap. They raised themselves and had no real structure or rules parents abusing drugs and or alcohol. My life was very different. I had parents who sat with me to help with homework, asked about my day, kept me on a bedtime schedule, etc. I thought ADD was fake too…Then I turned 26 and had my second child and a second round of postpartum depression and postpartum OCD(I have suffered from depression and stress induced OCD on and off many times in my life as well but just beard it as best I could, turns out both are possible symptom of ADD as well). I saw a therapist and after talking she asked me if I ever was tested for ADD(at the time not knowing my dad was diagnosed and my grandpa was suspected to have had it). I said no. She tested me and I did. I got brave told my dad and he said “Oh I thought you knew,” Gee thanks dad LOL! My upbringing compared to my friends was very different and I was able to excel. Now as a stay at home mom managing 2 little kid’s schedules I struggle a lot. So I need to put some very deliberate plans in place to raise them the best I can. After researching the ADD Brain and how depression and OCD look in the brain I am amazed how brain chemical imbalances and how the brain processes them are so intricate and malleable. I now use Amino Acids to naturally help balance myself-5-HTP is very helpful and I also take Now Foods True calm and True focus blends. I never did go on a stimulant because it is a lifelong thing if you begin to feel you need them and side effects are not great.