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Doody's Review ServiceReviewer: Harlan R. Gephart, MD (University of Washington School of Medicine)
Description: This book is written to counteract the current medical practice of medicating (usually with Ritalin or stimulant medication) children diagnosed with ADD and ADHD. The author does not accept these as diagnostic entities, but rather blames parenting deficiencies ("unintentional neglect") as the major cause of ADD and ADHD, which he redefines respectively as "inattention" and "highly misbehaving." In doing so, he ignores a great deal of current scientific data from Great Britain, Norway, and the U.S., which are clearly demonstrations of the scientific basis of ADHD for most children.
Purpose: The purpose is to counteract the use of medication by providing a behavioral approach to parenting to serve as an alternative treatment program.
Audience: The audience is primarily the parents of children manifesting these problems, and to a lesser extent educators and healthcare providers.
Features: Despite an emphasis on cognitive therapy (i.e., changing the child's behavior by changing his/her thinking), the author describes rather contemporary and well-accepted behavioral techniques including ignoring, reinforcement, time-out, and reinforcement removal. I feel the sections on identifying target behaviors and the school daily report card are particularly well stated and can be helpful to parents.
Assessment: Unfortunately the helpful material found in the later sections of the book are negated to some extent by the overwhelming bias against medication treatment in the earlier sections. Statements implicating Ritalin usage in childhood as either resulting in addiction or substance abuse in adolescence, have not been found to be true in recent scientific inquiry, and do a disservice to the management of this difficult and complex disorder, particularly since recent research (e.g., NIMH, MTA, study 1999) demonstrates that medication plus behavioral therapy gives the best results in ADHD.