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In 2009, a scientific symposium entitled “Confronting Eu­ ro­ pean Practices on ADHD” was held in Paris. Or­ ga­ nized conjointly by HyperSupers (the main advocacy group for French patients and families affected by ADHD) and ADHD Eu­ rope (the main Eu­ro­pean ADHD advocacy organ­ization), the conference attracted several world-­ renowned specialists such as Aribert Rothenberger, Eric Taylor, and Tobias Banaschewski. The event served as a platform for some French participants to publicly voice their concerns: Franck Baylé, a psychiatrist, stated that “the [French] situation can be considered dramatic,” and Diane Purper Ouakil, another psychiatrist, declared that in France “treatments prescribed to ­ children have not been evaluated nor their efficacy proven” and criticized the French academic community for failing to contribute to research on this topic and provide medical education on ADHD (HyperSupers and CPPS 2010). In a conversation with Christine Gétin, the president of HyperSupers, one of the eminent foreign guests, joked: “I thought that France was years ­ behind. I was wrong. France is only fifteen years ­ behind” (interview).­ These observations are not new; in the early 2000s, Carla Sept, a ­ mother of a child with ADHD, posted the following excerpt on her website: Applied research on neurological prob­ lems such as dyslexia, dysphasia, and of course hyperactivity barely exists. Professionals work in their own corners 12 The French ADHD Landscape Maintaining and Dealing with Multiple Uncertainties Madeleine Akrich Vololona Rabeharisoa 234   Global Perspectives on ADHD without sharing their knowledge and practices. Speech pathologists ­ don’t like neurologists intruding into their domain and think they know best. Psychiatrists think that they can take charge of every­ thing and continue to apply psychoanalytical theories without taking neuroscience into consideration. Teachers distrust speech pathologists . . . ​ and the latter often criticize educational methods and think they are forced to do teachers’ jobs.1 The fact that France is lagging ­behind other Eu­ro­pean countries in the field of ADHD is often pointed to, in both lay and expert discourses. However, this “backwardness” rhe­ toric overlooks the transformation of the French ADHD landscape over the past 15 years. The purpose of this chapter is to document the emergence of ADHD as a public issue in France in the late 1990s and to examine how this issue has evolved since then. To describe this pro­ cess, we analyze the content of 13 official reports commissioned by French institutions from 1999 to 2014. This choice was motivated by several ­ factors. First, ­ these reports (almost one each year on average) enable us to precisely follow the evolution of the conceptualization of ADHD and the elaboration of concrete solutions to the difficulties encountered by ­ children with the disorder. Second, ­ these reports are the outcomes of collective work, involving dif­fer­ ent proportions of representatives of all concerned actors: psychiatrists, neurologists, psychologists, patients and parents, the Ministère de la Santé, the Ministère de l’Education, the Comité Interministériel du Handicap (CIH), and so forth. Third, the drafting and publication of a number of ­ these reports have provoked heated debates, evidenced by the significant number of press articles in which ­people have commented or taken positions. Fi­ nally, ­ these reports provide crucial empirical data on the articulation between scientific knowledge and the politics of care related to ADHD. Our analy­ sis leads us to three main observations. First, specialists from a variety of disciplines, ranging from neurology to neuropsychiatry, neuropediatrics, child psychiatry, psy­ chol­ ogy, and the cognitive sciences, participated in expert groups mobilized by French institutions. In contrast to the situation described by the ­ mother on her website, the French field of expertise on ADHD can no longer be reduced to psychoanalytical theories versus the neurosciences. Second , the psychodynamic approach to ADHD that prevailed in the early 2000s in France now coexists with multiple conceptions of the disorder and has even become somewhat marginalized based on the content of the reports we studied. Moreover, as a result of extensive public debate on ADHD, the condition has come to be viewed as a serious disorder, the ­ causes and consequences of which The French ADHD Landscape   235 have sparked much discussion. Third, professionals, public authorities, and families ­ today confront difficulties in translating the acknowledged complexity of ADHD into solutions, which requires cooperation between the health system and the school system. In this chapter, we pres­ ent ­ these findings in detail. First, we describe the French context, particularly the alleged historical “backwardness” with regard to ADHD, and we provide evidence on the need for...


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