Attention Deficit Hyperactivity Disorder: The Clinical Spectrum, by B. T. Rogers, T. R. Montgomery, T. M. Lock, and P. J. Accardo (Eds.). Baltimore: York Press, 2001. Paperback, 272 pages, Cost: $36.50.
This book provides the reader with a medical perspective on attention deficit hyperactivity disorder (ADHD) that is of interest to speech-language pathologists. It is divided into 3 sections and 12 chapters, providing readers with an appreciation of the neurobiology, physiology, and genetic aspects of ADHD. The authors discuss study of attention and its relationship to molecular science and present how specialists view this disorder, ranging across clinicians, therapists, and other health professionals who contribute to the understanding of the child's neurodevelopmental status. The reader who perseveres finds that, as the book progresses, the authors provide descriptions of many treatments for children and predictors for long-term outcomes.
SECTION ONE: PATHOPHYSIOLOGY
The authors combine to "dissect" how ADHD can be ascertained given the specifics of brain chemistry and neurobiology. However, they also address the nitty-gritty surrounding medications, alternative treatments, therapeutic interventions, and weaknesses in the frontal lobe area that result in difficulties with social and emotional behaviors and executive function as observed in the lens of attentional differences. The reader is provided with a description of the neurochemical underpinnings of ADHD and how this relates to various areas of weaknesses. The information in neurology and biology segue into visual processing and predict that molecular neuroscience should produce new treatments for ADHD in the future.
SECTION TWO: DIFFERENTIAL DIAGNOSIS
Each chapter in this section describes how different diagnosticians look at ADHD. Chapter 3 by Accado provides an interesting breakdown of diagnoses made by his fellow physicians. He describes using a Sherlock Holmes manner, using the following three processes:
* The Scotland Yard method of a massive collection of data, which is a linear left-brained, slow team-based process.
* The Dr. Watson method, which is identified as right-brained pattern and very brief.
* The Sherlock Holmes method, which combines the "worst of both 1 and 2."
Other diagnosticians describe the comorbid conditions associated with ADHD (e.g., learning disabilities, language learning disabilities).
Across chapters, it becomes apparent that most diagnosticians use the DSM-IV as their bases for decision making (i.e., hyperactivity, inattention, impulsivity). Of particular note is Chapter 7 by Weinberg, Harper, and Brunback who provide a detailed discussion of disorders of vigilance and especially of hypovigilance.
Chapter 8 by Musiek and colleagues addresses auditory processing disorders and the interaction between ADHD and CAPD. Speech-language pathologists will find this familiar ground, including the difference in opinions related to CAPD as an "input" disorder and ADHD as an "output" disorder. Nevertheless, it is especially helpful to both audiologists and speech-language pathologists because of the careful analysis of Ritalin and other medications and their effect on learning and behavior.
SECTION THREE: TREATMENT AND OUTCOME
Chapters 9 through 12 complement the earlier chapters and expand the discussion to include parent training, teacher consultations, and nonstimulant medication alternatives for children and adolescents with ADHD. This reviewer recommends that parents who wish to consider nonstimulant medication be referred to this chapter, written by Nebesh-Jutsyshyn and colleagues.
The closing chapter (12) by Hechtman helps the reader to tie together much of the information found throughout the text. There is a tremendous amount of information covered in the book and, although it is well-organized and structured, Hechtman's summary is welcome, even to well-read professionals. It is particularly useful to those who deal with children and adolescents who suffer from ADHD and language disabilities. The scope and consequences of ADHD are indeed of great importance, and this text addresses what is now known in considerable detail. It serves as a resource for readers who wish to discover the current medical perspectives.