The French ADHD landscape : Revisiting the “backwardness” of France
The purpose of this paper is to analyse the dynamics of problematization of ADHD in France and to understand how it emerged as a public issue in the last 15 years, drawing on the abundant production of reports related to the disorderduring this period.Until the end of the 1990s, the massive lack of academics’ interest in ADHD, may have delayed its coming as an issue worth debating and enquiring about. As a consequence, ADHD emerged as a public issue in quite peculiar circumstances:
– Firstly, the INSERM collective expertises on various disorders, in which ADHD surfaced as an unsettled condition, provided high visibility to international bodies of literature and brought in a biological-oriented conception of these disorders, opening up debates on their very nature.
– Secondly, Hypersupers, the main French group of patients and families concerned with ADHD, took initiatives for assembling scientists and clinicians who manifested an interest in ADHD, though holding divergent views, an effort which culminated in the organization in 2009 of an international conference. Hypersupers also produced experiential knowledge on the disorder in order to “state the fact” of ADHD.
– Thirdly, working groups on disorders more or less associated to ADHD blossomed, which Hypersupersjoined in some cases. All together, these successive groups sustained reflection over the last 15 years, and progressively constituted an epistemic community. Their enduring effort helps to understand the continuing elaboration and re-elaboration of public policies on these conditions.
– Fourthly, the 2005 French Disability Act led to the invention of the notion of “cognitive disability” which offered a conceptual framework for articulating medical care and education interventions that Hypersupers has long promoted, as much as it helped professionals working with disabled persons to enact such a multimodal approach.
The progressive emergence and installation of ADHD does not imply its univocal positing within the French scientific and medical landscape.The multimodal approach that Hypersupers and its network has been promoting from its beginnings is core to the French problematization of ADHD and led to ADHD care models integrating a variety of interventions, including psychotherapies.We end the paper by some reflections on the issue of medicalization and the implications that the continuing problematization of ADHD as an unsettled condition have on public policies.