Attention deficit disorder, hyperactivity, impulsiveness... Diagnosing children and adolescents suffering from ADHD as early as possible is essential, according to the French National Health Authority, which published a list of recommendations on Monday to improve their care, which is currently uneven.
"Several teachers thought he wasn't listening at school; at home, he was extremely unruly." Camille Therond, whose son is now 14, consulted a number of specialists—ENT specialist, psychologist, pediatrician, speech therapist, psychologist—before a psychiatrist finally labeled his behavioral problems "ADHD" (attention deficit hyperactivity disorder).
A long journey: “we wandered from middle school to CE2,” she sums up.
For a long time, this disorder was a "reality that was often denied," explains Christine Getin, director of the HyperSupers – TDAH France association, which contacted the HAS with the Ministry of Health to move the issue forward.
"They were seen as restless and poorly behaved children. The problem supposedly came from their upbringing, with a lot of blame placed on the mothers, as if there was no scientific reality behind these disorders," she continues.
Classified in the category of neurodevelopmental disorders, their prevalence is estimated at around 51% of children worldwide.
- Interview -
"When a disorder is so common, we cannot restrict diagnosis and treatment to a small number of specialists," says Olivier Bonnot, professor of child and adolescent psychiatry at Paris-Saclay University, who chaired the HAS working group.
In 2015, the High Authority for Health made recommendations for the first time to better identify them.
Nearly ten years later, she goes further by explaining how to make a diagnosis. According to her, this should be based on an interview with the child and their parents in order to assess the child's development in all its dimensions (neurological, psychomotor, emotional, etc.).
It must also include a clinical examination and a collection of information from those around him (family, school, etc.).
"What makes the diagnosis so subtle is that many children may appear impulsive or have attention deficit disorders," recalls Olivier Bonnot.
"This time, we finally have a clear procedure for establishing a medical diagnosis that will be set in stone," says Christine Getin.
The High Authority for Health goes further by issuing recommendations for treatment.
As a first line of treatment, "non-drug" interventions are recommended, such as psychoeducation, which consists of providing information on ADHD, its impacts and how to function with this disorder.
– Ritalin
"Recognition and understanding of the difficulties presented by the child have a positive impact on their quality of life and their intra-family relationships," she writes.
In addition, if necessary and depending on the severity of the disorder, drug treatment may be prescribed, recommends the HAS.
The only molecule available in France for the treatment of ADHD in children from 6 years old and adolescents is methylphenidate, better known commercially as Ritalin.
Currently, only pediatricians, psychiatrists and child neurologists are authorized to initiate such treatment.
In France, "professionals caring for children with ADHD are still few in number and unevenly distributed across the country," regrets the HAS, which leads to a lengthening of the time taken for diagnosis and intervention.
With the aim of expanding the range of healthcare available, the HAS is calling on the public authorities to extend these skills to other doctors (particularly general practitioners) by setting up structured, qualifying training.
"Today, the wait times for getting an appointment with a psychologist are so long that helpless parents often spend astronomical sums on all kinds of assessments that are not necessarily useful," warns Christine Getin.
"The average time before a correct diagnosis is currently estimated at between 3 and 6 years," recalls Olivier Bonnot. However, for a child, "six months is almost a school year."
English 
French