What Was Going To Be A More Thoughtful And Nuanced Response

I posted the following article on Facebook, condemning it as "crap." I got several responses that challenged my assertion, and I thought those thoughtful responses deserved a more in-depth and thoughtful argument from me. But then I began to look at this again, and I went off the rails a little, because this article is crap.

Before I continue, I wish to express gratitude for my friends who challenge me and force me to think more carefully. Now, this author is a Ph.D. writing in Psychology Today, so I expect a higher standard of analysis and precision. But it is perfectly OK for me to make frog jokes.

Why French Kids Don't Have ADHD

1. Actually, they do. The article says so.

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%.
2.She admits below that the definitions are different in the two countries, making this an invalid comparison from the get go. 

3. [omitted]

How come the epidemic of ADHD—which has become firmly established in the United States—has almost completely passed over children in France?
4. What is the standard for "epidemic?" This seems designed to inflame, not educate. Historical trends would help us to see if there was an epidemic, as well as the realization that definitions and diagnostics change over time. 

Is ADHD a biological-neurological disorder? Surprisingly, the answer to this question depends on whether you live in France or in the United States.
5. Yes, because they define them differnetly, as she admits. So, not surprising in the least!

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.
6. Really? Because I found this, which I don't see as conforming to her characterization:
http://www.medscape.com/features/slideshow/adhd11

French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes.
7. Per the link above, so do Americans.

 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.
8. Hm. One of my friends suggested this article was not anti-science, but anti-Big Pharma. But of course, the author Marilyn Wedge, Ph.D., is a family therapist. No possible motive to push therapy, right? I really dislike reflexive anti-drug thinking, just because "Big Pahrma" does certain things poorly.

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.
9. Once again, the very first thing I got on Google disputes this simplistic characterization. 

French child psychiatrists don't use the same system of classification of childhood 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 of Psychiatry 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.
10. So the basis for comparison is fundamentally different, and make the whole article suspect for that reason alone, as I suggested above.

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.
11. Once again, inflammatory, not helpful, commentary.  And a false dichotomy: One can use medication in conjunction with therapy. This begins to read more an more like an attack on the use of drugs per se.

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.
12. And to what extent is that, exactly? And yet more evidence that the comparison of rates is bogus. 

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.
13. Once again: The article is premised on the assertion of different rates of ADHD, yet again, we see the comparison is bogus. This is really lazy stuff here. I'll also note here that the rates of ADHD around the USA vary considerably, from about 5 to 15 percent. No attempt is made to discuss why that might be, and it also undercuts the sweeping generalizations she has and will make.


The DSM specifically does not consider underlying causes.
14. From the APA website: " Since the causes of most mental disorders are subject to ongoing scientific inquiry, DSM avoids incorporating competing theories in its diagnostic definitions. This feature has been an important element in the widespread clinical acceptance of DSM, and has allowed a wide scope of research investigation."

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.
15. Again, the APA website: " No information about treatment is included." Jesus, this really IS crap. But there is more!

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.
16. No assertion that the "American approach," which again remains undefined, doesn't do this. But a good insight, I agree.

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.
17. Does it? Bare assertion, unsupported by any citation or evidence.

And then, of course, there are the vastly different philosophies of child-rearing in the United States and France.
18. There is most certainly no such thing as an American philosophy of child-rearing, and I'm not sure there is a single "French" philosophy either. No evidence or citation or proper definition s provided.

These divergent philosophies could account for why French children are generally better-behaved than their American counterparts.
19. If it could account for it, it could also not account for it. So lazy, I'm geting mad now. And the second part, about the relative behavior, is one of those "everyone knows it is true" things, that may or not actually BE true. Again, no definition no evidence, just bare assertion. What does "generally" mean? What is "better-behaved?" Which Americans? Which French kids? This sentence alone tempts me to disregard everything else the good doctor asserts.

And, 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.
20. OK, I'd have to read the book.  Except she aleady talked above why the numbers are differnt, and the arguments make no sense!I hope Pamela Druckman is smarter than our good doctor!

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.
21. I have no qualms with the idea that structure is good for kids. I'm not sure what this has to do with ADHD, but sure, structure is nice. And there are plenty of AMERICAN sources espousing this philosophy as well. I know, because I have it, and I am not (thank the baby Jesus) French*.

French parents let their babies "cry it out" if they are not sleeping through the night at the age of four months.
22.The jury is out on whether this is good practice. I find it highly irresponsible of this author to frame this as positive without qualification.

French parents, Druckerman observes, love their children just as much as American parents.
23. Idiotic. Just, idioctic. OF COURSE THEY DO, TWIT.

They give them piano lessons, take them to sports practice, and encourage them to make the most of their talents.
24. See 23 above.

But French parents have a different philosophy of disciplinine. 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.
 25. Great! What this has to do with ADHD I have no idea.

Finally, French parents believe that hearing the word "no" rescues children from the "tyranny of their own desires."
26. Don't say "finally" and then make addition points. And, perhaps it makes them subject to the tyranny of authoritarianism.  Obviously you have to say "no" to your kids. Again, stupid.


And spanking, when used judiciously, is not considered child abuse in France.
27. And bathing is not considered normal*. Who the fuck cares what they define child abuse as. I guess the good doctor doesn't want us to spare the rod?

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.
28. Conclusion not supported by the evidence. This is C+ work in college, and this lady has a Ph.D.?

The children grow up in families in which the rules are well-understood, and a clear family hierarchy is firmly in place.
29. Great. What this has to do with ADHD...

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.
30. AAs you can tell, I love broad assertions unbsupported by evidence that get a pass because "we all know it is true." Horse feathers.  And, for what it is worth, the Wall Steet Journal and Huffington Post publish this lady. Two pillars of journalism there.

Copyright © Marilyn Wedge, Ph.D.

*All potshots at the frogs are based on a recent experience with one particularly vile amphibian, and are not meant to be taken at face value.

The Hell of American Day Care

via LG&M

Because I'm not depressed enough today. 

The Hell of American Day Care An investigation into the barely regulated, unsafe business of looking after our children

Stopping The Gunman

I thought this was interesting. The "if only someone with a gun could have stopped them" fantasy is really interesting. It shows a monumental disregard for reality.

Actual Suggestions

Ed of Gin & Tacos has decided to put forward concrete proposals. Have a look-see.

An Essay On Assholes

This makes me think of my step-mom (RIP), whose favorite word was "asshole." She had this great Mid-western (Chicago) way of saying it. Anyway, for your consideration and amusement:

How Fox News created a new culture of idiots

Why Reagan Was The Devil Incarnate, Chapter Eleventy Hundred: Destroying Public Higher Education

[via LG&M]

I get frustrated when people can't or won't see that this is not an accident, it is not inevitable, and it is not "just how things are." There is a conscious, coordinated effort to destroy American civil society, in the name of "small government" ideology. This story deals in part with Ronnie Raygun's involvement.

Unions And The NFL Ref Strike

As usual, I am tilting at windmills, but Jaysus H. Christ on a Popsicle stick, if ANYTHING can get Americans to THINK about labor issues, this should be the vehicle. This article is long and involved, and worth every second of your time.

Choice excerpts:

What's Really Holding Back The United States

Basically, the South sucks. The rates of divorce, teen pregnancy, poverty, obesity, low education, etc. are all higher down there, too. Not to mention the fundamentalism. However, to be fair, at least in terms of urban areas, the North's racism is just as bad, if not worse.

Making Tomorrow's Leaders Today

Yes, this is picking the worst examples, and spinning them into an indictment of an entire system. And I'm fine with that, because I still think, on balance, the Greek system is both lame and destructive.

And yes, I know there are exceptions. Hence, "on balance."

Why Don't They Just Get Jobs?

[via Crooked Timber]

This article is stunning.

Using a different definition of distress, Luke Shaefer of the University of Michigan and Kathryn Edin of Harvard examined the share of households with children in a given month living on less than $2 per person per day. It has nearly doubled since 1996, to almost 4 percent. Even when counting food stamps as cash, they found one of every 50 children live in such a household.

From the original post: "The result is striking because of the $2 figure, which is derived, not from a US poverty line, but from the World Bank Poverty line for developing countries. These children aren’t just poor by American standards - they would be considered poor in sub-Saharan Africa."

If we, as a nation, are to be judged not by the success of the wealthiest, but by the suffering of the poorest, I submit we are a failure.

It is hard to tell which of Clinton's policy choices was the worst (NAFTA, repeal of Glass-Steagal, the much-vaunted surplus), but "ending welfare as we know it" has got to be among the most cruel and short-sighted. And "liberals" idolize that asshole.

Yet Another Teachers Strike Post

Hey, it matters a lot to me. For some insight into the shameless dishonesty of David Brooks, and more significantly, the breath-taking douche-baggery of Rahm Emanuel, I give you Charles Pierce, who you should be reading every day.

They Don't WANT Educated Masses

A point I have raised many times.

Amen!

He's spot on correct.

The War On Manliness: The Golf Front

Yes, Virginia, people really do think like this:

The recent Augusta National Golf Club decision to allow membership for women is another misguided capitulation in the relentless war against men, our associations and camaraderie.
Women harangue, whine and verbally assault us with their demands for more power. They openly set their goal as wanting "everything." Let's be honest and clear — women have always been and continue to be the dominant influence and power in interpersonal relations, sexual interactions, in the family, in social and cultural arenas, the schools and in our churches.
It is estimated that women control three-quarters of the wealth in the nation and they certainly enjoy their seven extra years of life.
Recent history is awash with the number of organizations that have become feminized following their forced acceptance of females. There are thousands of women's groups, hundreds in any given region. How many men's or boy's organizations can you find in your area? Any?
Men also have a right to freely associate and develop their own identities, roles and goals, values and purposes. We are different, and it's not the power but the camaraderie that brings us together. Women do not fit in, and we resent them either overtly or subconsciously for their unwanted intrusion.
Many people have observed that if it were not for sex, men and women would rarely come together. Let's recognize those differences and retain a common sense separateness.
— Don Hilbig, Beloit

I was going to give this the treatment, if you know what I mean, but I'm just too sad. [via LG&M]

Well Said

Original post here.

Keys to success

In "Little Red Hen retold" (Forum, Aug. 11), Jim Evans, who bakes his own bread, misses the point of President Barack Obama’s statement, "You didn’t get there on your own." That is not the same as saying, "You had nothing to do with it."

It means that no matter how much grit, entrepreneurship, energy, intelligence and personal sacrifice you put into a successful business or project, it could not have succeeded without others. To be sure, you were the catalyst. Without your efforts, it could not have happened. But you were a necessary condition of your success, not a sufficient one.

You deserve enormous credit for what you achieve. But you did not achieve it in a vacuum. You depend on a social and economic milieu that empowers you.

Nobody does anything by himself. No matter how determined, industrious or John Galt you are — you did nothing by your own guts and determination alone.

You owe your success to the background community of people who made your success possible: farmers, miners, road-builders, police officers, inventors, bankers, teachers, your own employees.

It’s because of them that you have achieved what you have. Without them it couldn’t have happened.

Bangs L. Tapscott

Salt Lake City

The "Self-Made" Myth

[via G&T comment section]

This looks like an interesting read. The ignorance of history and lack of common sense needed to believe the myth that America's wealthy are the product solely of their own hard work is staggering. Fair arguments can be made about the optimal extent of government involvement in the market, but the die-hard Randian types are stunningly, glaring wrong. Of course government can needlessly constrain individual achievement, and of course it can make unwise policy choices. But the harm to our society from the efforts that go too far the other way, that is, to limit regulation and and "let loose the power of the market," seems, to me, to be vastly more detrimental.

The Right Brain

This book looks interesting. I tend to agree that the divide in this country is "unfixable" because people aren't even speaking the same language. From the interview with the author:

We can't count on facts to change minds - emotions and values trump facts almost every time. Nor can we rely on our [liberals'] own natural, nuanced, complex style of communication to reach the public. The research suggests that our very instincts are leading us to only know how to talk to ourselves; conservative styles of communication - decisive, direct - have a great appeal to the right and, likely, the middle. And we can use this research not only to better reach conservatives, but to reach people who are moderate or undecided, but who also have some conservative attributes.

At a minimum, this helps me to understand why I can't seem to get through to certain people. I often forget that facts and reason simply aren't important to them.

We Have A Winner

Congratulations to the Wanker Of The Decade: Tom "Suck On This" Friedman. The most disturbing thing about American public discourse isn't the loonies that we all love to hate, like Limbaugh, or the politicians peddling their bullshit, like, well, pretty much every politician. The thing that is truly "sign of the Apocalypse" bad is that someone like The Mustache Of Understanding himself is considered a person worth listening to, and given a platform for his idiocy.

Check out the rest of the list here.

Know Why Liberals Think Conservatives Are Racist?

Because only a right-wing site would allow something this grotesque. The link is to Sadly, No!, so don't worry about giving hits to a site that publishes racist screeds.

Chomsky On Education

[via Truthout]

I don't take his word for every little detail, but I think he has the big picture just about right. I firmly believe that the elite wish to suppress critical thinking and train drones. Power has tried to preserve itself this way for a long time.