Why French Kids Don't Have ADHD

French children don't need medications to control their behavior.

Published on March 8, 2012 by Marilyn Wedge, Ph.D. in Suffer the Children

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. 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 withdrugs, 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.

Related Articles

• Gaslight Stories
• Psychology's Shaky Scientific Foundations. Part 2 of Phenomics—the Phinal Phrontier
• Why French Kids Don’t Have ADHD—Part 2
• How the Road to Understanding Depression Runs through Bereavement
• Sadness Gone Mad

Find a Therapist

Search for a mental health professional near you.

Find Local:

• Acupuncturists
• Chiropractors
• Massage Therapists
• Dentists
• and more!

French child psychiatrists don't use the same system of classification ofchildhood emotional problems as American psychiatrists. They do not use the Diagnostic and Statistical Manual of Mental Disorders or DSM.According to Sociologist Manuel Vallee, the French Federation ofPsychiatry developed an alternative classification system as a resistance to the influence of the DSM-3. This alternative was the CFTMEA(Classification Française des Troubles Mentaux de L'Enfant et de L'Adolescent), first released in 1983, and updated in 1988 and 2000. The focus of CFTMEA is on identifying and addressing the underlying psychosocial causes of children's symptoms, not on finding the best pharmacological bandaids with which to mask symptoms.

To the extent that French clinicians are successful at finding and repairing what has gone awry in the child's social context, fewer children qualify for the ADHD diagnosis. Moreover, the definition of ADHD is not as broad as in the American system, which, in my view, tends to "pathologize" much of what is normal childhood behavior. The DSMspecifically does not consider underlying causes. It thus leads clinicians to give the ADHD diagnosis to a much larger number of symptomatic children, while also encouraging them to treat those children with pharmaceuticals.
The French holistic, psycho-social approach also allows for considering nutritional causes for ADHD-type symptoms—specifically the fact that the behavior of some children is worsened after eating foods with artificial colors, certain preservatives, and/or allergens. Clinicians who work with troubled children in this country—not to mention parents of many ADHD kids—are well aware that dietary interventions can sometimes help a child's problem. In the United States, the strict focus on pharmaceutical treatment of ADHD, however, encourages clinicians to ignore the influence of dietary factors on children's behavior.
And then, of course, there are the vastly different philosophies of child-rearing in the United States and France. These divergent philosophies could account for why French children are generally better-behaved than their American counterparts. Pamela Druckerman highlights the divergent parenting styles in her recent book, Bringing up Bébé. I believe her insights are relevant to a discussion of why French children are not diagnosed with ADHD in anything like the numbers we are seeing in the United States.
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 sportspractice, 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.
Copyright © Marilyn Wedge, Ph.D.

Marilyn Wedge is the author of Pills are not for Preschoolers: A Drug-Free Approach for Troubled Kids

Website:  MarilynWedgephd.com
Twitter: marilyn Wedge
Facebook: www.facebook.com/pages/Marilyn-Wedge

http://opinion.inquirer.net/52833/posttraumatic-stress-disorder-in-children

Posttraumatic stress disorder in children

By Leonardo Leonidas
Philippine Daily Inquirer

9:46 pm | Saturday, May 18th, 2013

 0 4 0

The adult posttraumatic stress disorder or PTSD is now a well-accepted condition, which was first observed among Vietnam War veterans. Now I think there is another form of PTSD—the fetal posttraumatic stress disorder.

This condition occurs during pregnancy. At a time when we think that the fetus is well-protected inside the mother’s womb, silently and invisibly environmental toxic chemicals and substances are invading its fragile brain. And during this time, too, the fetus is affected by the mother’s diet and, more importantly, her emotions and stress.

During the first 10 to 18 weeks of gestation of the fetus, the brain is actively growing by the billions of individual neurons. By the end of the 18th week all brain cells that a newborn will have are completely formed, and they have reached their predetermined locations. This is the first major event in the formation of the brain.

The second big event in fetal brain development is the elaboration of cortical connections, the growth of the axons and dentritic arms that transport information from one neuron to another. This is called synaptogenesis. This all happens from the second trimester of gestation and after birth.

During these two stages, the brain growth is vulnerable to exposure from toxic neurochemical substances.

About 40 years ago when I started my pediatric practice in Bangor, Maine, in the United States, I don’t remember seeing many children afflicted with autism, ADHD (attention deficit hyperactivity disorder), OCD (obsessive-compulsive disorder), and bipolar disorder.

Now, about 5 to 10 percent of school children are diagnosed to have ADHD. In the United States, one in every 50 children is found to have autism; in the Philippines, the rate is 1:500. Four decades ago, autism was rarely recognized in a physician’s office.

The No. 1 cause, I think, of many of our children’s behavioral and school difficulties is significant stress during pregnancy. The other is failure of pregnant mothers to consume enough food with DHA, an omega-3 fatty acid.

In my nursery rounds in Maine, I noticed that about 30-40 percent of mothers who just delivered a baby had a history of depression, drug or sexual abuse, suicide attempts, or methadone use.

How can stress during pregnancy cause chronic mental disabilities in children? Research findings in the United States, Canada, Israel, Japan, France, and other countries have shown that when a pregnant mother is chronically stressed, her cortisol level, the stress hormone, goes up in her blood. Then it goes to the placenta and ultimately circulates in the fetal brain.

Exposure by the fetal brain to high levels of cortisol causes language delay, cognitive difficulties, and neuropsychiatric disorders in children. Researchers call this “prenatal programming.”

In lab tests, six pregnant rhesus monkeys were exposed to unpredictable noise and were repeatedly removed from their cages during mid- to late gestation. Another set of six pregnant monkeys were not disturbed in their cages. Those monkeys whose mothers were prenatally stressed later showed abnormal social behaviors like mutual clinging and less social behavior.

In January 1998, there was an ice storm in Quebec, Canada. Hundreds of pregnant women were exposed to the hardships associated with power failure. From this group of mothers, 58 toddlers were investigated at two years old. Members of the Douglas Hospital Research Centre found that the low general intellectual and language abilities of the toddlers were the result of the stressful events that their mothers experienced during the ice storm, a natural disaster. The researchers also found that the higher the level of stress and the earlier it was experienced during pregnancy, the lower were the cognitive and language abilities of the toddlers.

The other factor that contributes to some of the behavioral and cognitive disabilities of many children is the failure of pregnant mothers to take enough DHA, the fatty acid needed by the fetal brain for optimal growth. During fetal brain development, about 60 percent of the energy required for brain cell growth comes from DHA.

When I interviewed mothers with children with autism or ADHD, eight out of 10 said they did not eat fish because of fear of mercury.

Trina, a teacher, had a typical first child who did well in school. There was no family history of autism. Her first pregnancy was happy and without any complication. In her second pregnancy, she became a principal. She neither ate fish nor took DHA supplements. During that time, she had severe job-related stress because of management and personnel disputes which she took personally. She delivered a son who was suspected to be blind at six months old. At two, he could not speak any clear words or complete a sentence. The boy is autistic.

Leonardo Leonidas, MD,  retired in 2008 as assistant clinical professor in pediatrics from Boston’s Tufts University School of Medicine, where he was recognized with a Distinguished Career Teaching Award in 2009. He is a 1986 graduate of the UP College of Medicine. He authored the eBook “How to Raise A Happy, Smart Child” (http://www.amazon.com/dp/B005UZGCMA).

Read more: http://opinion.inquirer.net/52833/posttraumatic-stress-disorder-in-children#ixzz2TfTpTvPa
Follow us: @inquirerdotnet on Twitter | inquirerdotnet on Facebook

Yoga program focuses on wounded warriors

May. 18, 2013 - 11:01AM   |  

Comments

• A
• A

A YogaFit for Warrior program is being taught to base yoga instructors that will help those troops suffering from PTSD. (Photos courtesy of Shaye Molendyke)

By Markeshia Ricks
Staff writer

• RELATED TOPICS

• News

Lt. Col. Shaye Molendyke has seen the mental health effects of war up close and personal. She worked the psychiatric ward at Landstuhl Regional Medical Center, and daily, she saw the invisible effects of war on troops.

“When the war first started, I saw the first trickling in of [post traumatic stress disorder] symptoms, even though it wasn’t really discussed, which was kind of odd in hindsight,” Molendyke said. “But [I saw] a lot of anxiety, depression and suicidal behavior.”

But she never knew her own injury, her background in counseling and love for yoga would one day allow her to help her fellow troops.

Trauma-sensitive approach

A severe injury forced Molendyke to hang up her running shoes and pick up a yoga DVD. That was 15 years ago. Now, when she’s not on the job in the Air Force Reserve, she’s trying to bring a new yoga program to a military installations.

The program is called YogaFit for Warriors, and it is designed with wounded warriors, emergency ­responders and those who may suffer from PTSD, stress, anxiety and other mental and physical traumas in mind.

A master trainer for YogaFit, ­Molendyke designed the program with YogaFit founder Beth Shaw and yoga therapist Kristy Manual to prepare teachers to work specifically with military members.

Molendyke, who also is an Air Force spouse based at MacDill Air Force Base, Fla., will be going mostly to Army bases in the next six months, including Fort Campbell, Ky.; Fort Bliss, Texas; Joint Base San Antonio, and Fort Belvoir, Va., to train yoga instructors in trauma-sensitive yoga.

Molendyke said the YogaFit approach doesn’t require people to contort themselves into challenging poses, or to even do poses that make a person suffering from PTSD feel vulnerable.

“It’s accessible,” she said. “We’re not using Sanskrit. We’re speaking in terms everybody understands. We’re making it user-friendly.”

She said military members who take a YogaFit for Warriors class, or a yoga class taught by someone trained in the techniques, will be in control of their yoga practice.

“We invite people into their practice,” she said. “It’s not command oriented, and that’s a change for the military. People are used to being told ‘Do this, do this now,’ which is well suited for war. But then they come home and the pressures of war are relieved, and that’s where the symptoms of PTSD kick in ­pretty strongly.

“We give them that control back,” she said.

Stigma-free healing

Each instructor trained in YogaFit for Warriors is taught ways to modify their classes to provide safe environments for military members who might be experiencing symptoms of PTSD such as hyper-vigilance, anxiety and depression. Molendyke said that could be anything from not turning off lights, using any kind of straps, not touching someone or making sure class members never practice with their backs to a door.

Molendyke said research has shown yoga to not only be a pathway for healing PTSD, it also shows those who suffer from it are more open to accepting alternative treatments. She believes a program like YogaFit for Warriors will be a gateway to healing that isn’t happening under more traditional methods, such as cognitive behavioral therapy.

A new study in the Journal of Alternative and Complementary Medicine shows active-duty troops are using some alternative therapies — massage therapy, meditation and guided imagery therapy — for stress reduction at rates up to seven times higher than civilians.

The reason why troops are turning to these complementary and ­alternative treatments is unknown and needs more study, researchers­­concluded.

Molendyke thinks she knows at least one reason why troops are gravitating to these non-traditional methods.

“The stigma attached to being seen for PTSD in the military — you’re certainly not going to say, ‘I’m having trouble managing my emotions,’ ” she said. “What I hope happens is that people hear how yoga can help, then they go to a yoga class in their military community where someone has been trained and teaches a trauma-sensitive class ... where they’re getting help and they don’t have to self identify, or ... go and try to get in line at the VA for 18 months.”

Retired Col. Elspeth Ritchie, a former Army psychiatrist, wrote in the January issue of Psychiatric Annals that troops might be more drawn to alternative treatments because they are often offered outside of traditional mental health clinics or by civilian practitioners not involved in military health care, allowing military members to sidestep the stigma associated with mental health care.

Men welcome

While military bases are clamoring to get YogaFit for Warriors, Molendyke still has one more group of folks to convince — military men.

While both men and women in Eastern cultures embrace yoga, women are the primary teachers and practitioners in the West.

“I am a big proponent that men do better coming in the door to yoga, and are better suited to being successful because they’re strong,” she said. “They can hold poses properly for a longer time.”

Molendyke said military men in particular would likely find success in yoga because they tend to have core and upper body strength, and good body awareness from lifting weights. Flexibility is something that can be worked on.

Her dream would be to get physical training leaders and personnel at health and wellness centers trained because they’re in a good position to work with troops struggling with PTSD.

The program also is aimed at getting military spouses certified in the YogaFit for Warriors techniques, which not only would benefit the warrior in their home, but give them a portable skill.

“After seeing rates of suicide climb so dramatically in the military, something just had to be done,” Molendyke said. “I knew my YogaFit family could help heal my military family.”■

http://www.airforcetimes.com/article/20130518/NEWS/305180004/Yoga-program-focuses-wounded-warriors