Children often find it hard to concentrate for long periods of time, become easily distracted and experience periods of hyperactive behaviour. Many parents across the world to have deal with these niggling issues on a day-to-day basis.
However, these seemingly common problems can sometimes turn into despair for a parent, when a child’s behavioural problems become so severe and so frequent that they are actually diagnosed with a neuro-developmental disorder: Attention Deficit/Hyperactive Disorder or ADHD.
According to Psychology Today, in the US, approximately 9% of school-going children have ADHD. A survey amongst 2,400 children aged 6-12 in Singapore indicated that close to 5% of Singaporean kids had disruptive behaviour disorders. Worldwide ADHD rates are around 5% too. However in France, only 0.5% of kids have been diagnosed with the same disorder. This begs the question of why would a medical disorder affecting how a child thinks and behaves vary so much between different countries?
Nature vs nurture
The disorder has long been considered to be a biological-neurological disorder, which suggests that there is little a parent can do to prevent it. If its root cause lies with nature, then why fight it? The huge difference between American and French children indicates that the picture isn’t so black and white after all.
Pharmaceutical culture
Many might view America’s and even Singapore’s approach to dealing with the issue as a somewhat narrow minded one, when compared to French ADHD treatment. In recent years, Ritalin and Adderall have gained a reputation in America as being super drugs, which will cure all sins from young troublemakers.
In both Singapore and America, ADHD treatment relies far more on prescribed medication. Although scientists worldwide will agree that both Ritalin and Adderall are effective ways to quickly increase attention and reduce hyperactivity in children, these drugs are not long term cures and will only mask the problem.
Triggers of ADHD
The French approach has less emphasis on popping pills, and more on the upbringing of the child. In France, when a child is beginning to show signs of ADHD, they are asked what is giving them the problem. They are referred to a psychiatrist who will then give them a tailor-made style treatment, depending on what triggers the ADHD. This generally involves a course of psychotherapy or family counselling where the problematic situations will be discussed. They are asked why they are receiving the problem, not why they are making the problem.
Healthy food for a healthy brain
Nutrition is yet another factor. Statistics show that as many as 33% of American children are obese, whereas only 16% of French children have this problem. Sugary food, preservatives, MSG, artificial colours and allergens, all of which American fast food is infamous for, can trigger behavioural disorders. This, combined with the lack of exercise, can be enough to eventually lead to ADHD.
Furthermore, it is usual for French families to sit down together for a meal 3 or 4 times per day. This decreases the temptation for kids to binge on junk food, whilst also giving the child structure and routine early on in their lives. In Singapore, obesity rates have been around 12% for the last three years.
Being cruel to be kind
In Pamela Druckerman’s book Bringing Up Bébé, it is argued that saying ‘no’ more frequently to children sets rules and boundaries for children to follow and understand. This will eventually make them feel safer, happier and have greater self control.
It was also noted by Druckerman that the more rigid structure that French parents enforce means that their children and are better behaved in public, throw fewer tantrums and won’t seek snacks between meals.
What is the answer?
France’s secret lies both in parenting strategies and ADHD treatment. A French child is far less likely to develop ADHD than any other child due to a more disciplined and structured upbringing. When a child does develop signs of ADHD, the specific treatment tackling the cause of the behavioural problem seems to be more effective than simply signing yet another month’s prescription slip.
How to spot ADHD Symptoms in children?
Children with ADHD generally exhibit 3 main symptoms. Inattentiveness, impulsiveness and hyperactivity. These symptoms must be present before the age of 7 and cause impairment in at least two settings – home, school and another outside social environment.
Where can you get a diagnosis in Singapore?
If you suspect your child has ADHD, do speak to your school’s counsellor. The school counsellor will then use their judgement to arrange for the child to be assessed by REACH. After assessment, the student might be referred to the NUH child psychiatry clinic or The child guidance clinic at IMH for further assessment and/or treatment.
Psychiatrist, Dr Munidasa Winslow, talks about ADHD treatment