Taking charge of ADHD

Dr. Barkley, a well-known expert in the field of Attention Deficit/Hyperactivity Disorder (ADHD), has authored another eloquent, easily digestible, and detailed exposé on a difficult subject. Despite the fact that it was created primarily for parents, as a child and adolescent psychiatrist, I found it to be chock-full of important information backed up by scientific evidence. This history, of course, is the bedrock of our clinical practice and our best protection against what can seem like an endless barrage of attacks on our profession. The book is easy to read and, despite its 320-page length, is well-balanced in material and useful in suggestions.

This book, which is full with anecdotes and a compassionate grasp of the human experience of ADHD, should be required reading for most parents. The book is broken into four sections. Part I, which takes up a third of the book, gives an in-depth look into ADHD. A brief history of the condition is followed by a clinical description, all of which leads to the primary argument that ADHD is much more than the DSM IV criteria. ADHD is thought to be caused by a lack of inhibition and a lack of self-control, and it is linked to higher executive frontal lobe performance. This larger perspective allows for a better understanding of the numerous academic, social, behavioral, psychological, emotional, and family issues that these children face.

Part 2 is about taking charge as a parent. There's advise on how to get a professional evaluation, how to deal with emotional reactions to the diagnosis, guiding principles, including those from personal development master Stephen Covey, and parental self-care.

Part III provides guidance on behavioral control, peer conflict resolution, and adolescent and school concerns. The behavioral methods are aimed at a younger age group and, while they repeat the basics, they serve as a helpful reminder that foundational principles come first.

Part IV, on drugs, was a little short on content. While the stimulants were well-represented, the other agents received only six pages. The allusion to tricyclics being used for the treatment of depression in youngsters is an obvious inaccuracy. Although bupropion is mentioned, there is no mention of venlafaxine. The medicine chapter did not live up to the rest of the book, given the availability of a number of outstanding psychopharmacology books on the market at the time of release and the need for parents to have an excellent source of information.