Once again, Dr. Barkley, a recognized authority in the field of Attention-deficit/Hyperactivity Disorder (ADHD), has written an eloquent, easily digestible and thorough exposé on a complex topic. Although written primarily for parents, as a child and adolescent psychiatrist I found it filled with useful information well supported by the scientific literature. This background is, of course, the foundation on which our clinical practice is based and is our best defense against, what sometimes seems like, an endless onslaught against our profession.
The book is easy to read and, in spite of its length at 320 pages, is well apportioned in its content and practical in its advice. Rich in anecdote and warm in understanding of the human experience of ADHD, this book should be a must for most parents.
The book is neatly divided into four parts. Part I, which occupies a third of the book provides an in depth understanding of ADHD. A history of the disorder is followed by a clinical description that leads into the central thesis that ADHD is much more than the list of criteria in DSM IV. ADHD is posited to be about an inability to inhibit, a failure in self-control and is related to higher executive frontal lobe functioning. This broader understanding invites a greater appreciation of the many academic, social, behavioral, psychological, emotional and family problems accompanying these children.
Part II deals with taking charge as parents. There is advice on how to seek a professional assessment, managing the emotional reactions to the diagnosis, guiding principles, including those of personal guru Stephen Covey, and advice on parental self care.
Part III offers assistance on behavioral management, solving peer problems, and managing adolescent and school issues. The behavioral strategies are targeted at a younger age group and, although repetitious of the basics, are, nonetheless, an important reminder that first principles come first.
Part IV, on medications was somewhat disappointing in breadth. While the stimulants were well covered, only six pages were devoted to the other agents. An obvious error is the reference to tricyclics sometimes being used for the treatment of depression in children. No mention is made of venlafaxine although bupropion is included. Given the presence of a number of excellent psychopharmacology books on the market at the time of publication and the need for parents to have an excellent source of information, the medication chapter did not live up to the rest of the book.
An excellent section on tapes, videos, books, academic references, support groups and websites rounds out a memorable read.
Dr. Barkley has produced a book that will be added to the list of practical, reasoned, well thought out and helpful resources for parents who are looking for it all in one place.