2024-09-23 08:30:06
ELOISE HEINZER
As soon as he entered kindergarten, Naïm “problem” : he is particularly agitated, impatient and impulsive. The teacher advises Rahma Jdab, her mother, to ” to consult “. Initially, the pediatrician from the maternal and child protection service (PMI) assured him that Naïm was “jealous of his little brother and looking for attention”she remembers. Later, the nurse and the child psychiatrist from the medical-psychological center (CMP), who will follow Naïm for three years, assure her that she is “too fusional” with his son. “When I mentioned attention deficit disorder with or without hyperactivity [TDAH]after watching a report on TV, they said it was an invention”she blurted, bitter. The diagnosis of the disorder – defined by an attention deficit and/or hyperactivity and/or impulsivity – will eventually arrive a few months later, outside the CMP. In the meantime, the structure made a report (concerning information) to child welfare for neglect – which was not followed up after a summons from Rahma Jdab.
The recommendations for good practice in the management of ADHD in children, unveiled Monday September 23 by the High Authority for Health (HAS), aim to avoid these situations. “Neurodevelopmental disorders [TND] – autism spectrum disorder, “dys”, etc. – have been included in the American Reference Manual for Mental Disorders since 2013. It was time to recognize ADHD”explains the professor of child and adolescent psychiatry Olivier Bonnot, from the Barthélemy Durand hospital (Essonne), who chaired the working group.
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They were requested by a co-referral from the General Directorate of Health and the HyperSupers ADHD France association. in 2019 : so far, in France, only location recommendations intended for primary care physicians existedalready driven by this association. From now on, the HAS defines the diagnosis and the care pathway in detail – “and above all the corresponding levels of evidence”insists Doctor Nathalie Franc, child psychiatrist at Montpellier University Hospital, who participated in the work.
“No room for bla-bla”
According to these recommendations, “any doctor trained in the diagnosis and treatment of ADHD can make the diagnosis.” Ultimately, primary care doctors (pediatricians and general practitioners) should be able to identify and diagnose a simple disorder without comorbidities – or, in the event of suspicion of a complex disorder, to redirect the patient to a doctor or a specialized structure, if they have not followed secondary training. A standard examination grid, listing various diagnostic reference scales, is made available.
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