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12 and HoldingA Guide to Asperger SyndromeA Lethal InheritanceA Mother's Courage: Talking Back to AutismA Parent's Guide to Asperger Syndrome and High-Functioning AutismA Special EducationA Toss Of The DiceA Tribe ApartA User Guide to the GF/CF Diet for Autism, Asperger Syndrome and AD/HDA Walk in the Rain With a BrainABC of Eating DisordersADD-Friendly Ways to Organize Your LifeADHD Grown UpADHD in the Schools: Assessment and Intervention StrategiesAdolescence and Body ImageAdolescent DepressionAggression and Antisocial Behavior in Children and AdolescentsAll Alone in the UniverseAlpha GirlsAmericaAnother PlanetAntisocial Behavior in Children and AdolescentsAsperger Syndrome and Your ChildAsperger Syndrome, Adolescence, and IdentityAsperger's and GirlsAssessment of Childhood DisordersAttention Deficit DisorderAttention-Deficit Hyperactivity DisorderAttention-Deficit/Hyperactivity DisorderAutism - The Eighth Colour of the RainbowAutism and MeAutism's False ProphetsAutistic Spectrum DisordersBad GirlBeen There, Done That? DO THIS!Before I DieBetween Two WorldsBeyond AppearanceBig Mouth & Ugly GirlBipolar ChildrenBipolar Disorder in Childhood and Early AdolescenceBipolar DisordersBipolar KidsBlackwell Handbook of Childhood Cognitive DevelopmentBody Image, Eating Disorders, and ObesityBody Image, Eating Disorders, and Obesity in YouthBoy AloneBrain-Based Therapy with Children and AdolescentsBreaking PointBreathing UnderwaterBringing Up ParentsBullying and TeasingBullying PreventionBut I Love HimCan't Eat, Won't EatCaring for a Child with AutismCatalystChild and Adolescent PsychiatryChild and Adolescent Psychological DisordersChild and Adolescent PsychopathologyChild NeuropsychologyChild Well-BeingChildren and SexualityChildren Changed by TraumaChildren with Emerald EyesChildren with Sexual Behavior ProblemsChildren, Sexuality and SexualizationChildren’s Dreaming and the Development of Consciousness City of OneCommunication Issues In Autism And Asperger SyndromeConcepts of NormalityConcise Guide to Child 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FieldsMind to MindMommy I'm Still in HereMore Than a LabelMy Flesh and BloodMyths of ChildhoodNew Hope for Children and Teens with Bipolar DisorderNew Look at ADHD: Inhibition, Time, and Self-ControlNo Child Left DifferentNo Two AlikeNon-Drug Treatments for ADHDNot Much Just Chillin'NurtureShockOdd Girl OutOdd Girl Speaks OutOne Hot SecondOne in ThirteenOphelia SpeaksOphelia's MomOur Journey Through High Functioning Autism and Asperger SyndromeOut of the WoodsOvercoming ADHDOvercoming School AnxietyParenting a Child Who Has Intense EmotionsParenting Children With ADHDParenting Your Out-Of-Control TeenagerPediatric PsychopharmacologyPediatric PsychopharmacologyPediatric PsychopharmacologyPeople with HyperactivityPhobic and Anxiety Disorders in Children and AdolescentsPINSPlease Don't Label My ChildPraising Boys WellPraising Girls WellProblem Child or Quirky Kid?Problem GirlsPsychotherapy for Children and AdolescentsPsychotherapy with Children and AdolescentsPurgeRaising a Moody ChildRaising BlazeRaising Generation RxRaising Resilient ChildrenReady or Not, Here Life ComesReclaiming Our ChildrenRedressing the EmperorReducing Adolescent RiskRemembering Our ChildhoodResilience in ChildrenRethinking ADHDReweaving the Autistic TapestryRitalin is Not the Answer Action GuideRitalin NationRunning on RitalinRunning with ScissorsRutter's Child and Adolescent PsychiatrySeeing EzraSex and the American TeenagerSex, Therapy, and KidsSexting and Young PeopleSexual Teens, Sexual MediaShort Term 12Should I Medicate My Child?SmashedSnapshots of AutismSongs Without WordsSophie Spikey Has a Very Big ProblemSpeakStaying Connected to Your TeenagerStick FigureStraight Talk about Psychiatric Medications for KidsStraight Talk about Psychological Testing for KidsStraight Talk about Your Child's Mental HealthStrange SonStudent DepressionSuicidal Behavior in Children and AdolescentsSurvival Strategies for Parenting Children with Bipolar DisorderSurviving OpheliaTaking Charge of ADHD, Revised EditionTaming the Troublesome ChildTemple GrandinThe American Psychiatric Publishing Textbook Of Child And Adolescent PsychiatryThe Anti-Romantic ChildThe Bipolar ChildThe Boy Who Loved WindowsThe Boy Who Was Raised as a DogThe Buffalo TreeThe Bully Action GuideThe Bully, the Bullied, and the BystanderThe Burn JournalsThe Color of AbsenceThe Curious Incident of the Dog in the Night-TimeThe Depressed ChildThe Developing MindThe Dragons of AutismThe Einstein SyndromeThe EpidemicThe Evolution of ChildhoodThe Explosive ChildThe Eyes of van GoghThe Fasting GirlThe Field of the DogsThe Flight of a DoveThe Hidden Gifts of the Introverted ChildThe Horse BoyThe Identity TrapThe Inner World of a Suicidal YouthThe Inside Story on Teen GirlsThe Kindness of StrangersThe Last Normal ChildThe Little MonsterThe Medicated ChildThe Myth of LazinessThe New Gay TeenagerThe Nurture AssumptionThe OASIS Guide to Asperger SyndromeThe Other ParentThe Perversion of YouthThe Philosophy of AutismThe Psychoanalytic Study of the ChildThe Real Truth About Teens and SexThe Ride TogetherThe Rise and Fall of the American TeenagerThe Science of ADHDThe Sex Lives of TeenagersThe Survival Guide for Kids With LD*The Unhappy ChildThen Again, Maybe I Won'tTherapy with ChildrenThings I Have to Tell YouThings Tom LikesThrough the Glass WallThumbsuckerTotally WiredTouching Spirit BearTrauma in the Lives of ChildrenTreating ADHD and Comorbid DisordersTreatment of Childhood DisordersTwistedUnder the Wolf, Under the DogUnhappy TeenagersUnstrange MindsWastedWe've Got IssuesWeather Reports from the Autism FrontWhat about the KidsWhat in the World Are Your Kids Doing Online?What Works for Whom?What Would Joey Do?What's Happening to My Body? Book for BoysWhat's Happening to My Body? Book for GirlsWhat's Happening to Tom?When Nothing Matters AnymoreWhen Your Child Has an Eating DisorderWhose America?Why Don't Students Like SchoolWill's ChoiceWinnicott On the ChildWorried All the TimeYou Hear MeYoung Minds in Social WorldsYoung People and Mental HealthYour Child, Bully or Victim?
Attention-deficit hyperactivity disorder (ADHD) was first identified over 100 years ago, but it remains an intensely controversial entity. It's common for professionals to disagree over whether an individual child has the disorder, and a few prominent psychologists and psychiatrists don't even believe that it exists. This odd state of affairs is in part due to a lack of standardized assessment techniques. Despite "best practices" guidelines developed by organizations such as the American Academy of Pediatrics (AAP), most professionals have their own preferred set of assessment tools, leading to diagnoses that sometimes say more about the evaluator than the child. Admittedly, it's hard to translate guidelines like those of the AAP into actual practice without specific instruments with which to assess the disorder. Attention-Deficit Hyperactivity Disorder: A Clinical Workbook effectively bridges this gap between official guidelines and clinical practice.
ADHD can't be diagnosed using a blood test or anything so objective, and so the most common method involves a combination of observation (especially if a child is being evaluated), interviews (with parents, teachers, and the child or adult being assessed), and behavior rating scales (standardized lists of symptoms and behaviors). Barkley & Murphy's book focuses on the latter two strategies, and has over 150 pages of interview forms and rating scales, complete with information on how to use them to assess ADHD and related conditions. Some of these instruments have been scattered in different books and journal articles, and others remain unpublished except for their presence in this text; when put together, the result is a treasure trove of clinical tools for assessing what is perhaps the most common child behavior disorder today.
The official diagnostic criteria for ADHD, from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), form the backbone of any competent ADHD assessment process, and the assessment forms found in this book cover all of those criteria. For instance, the main diagnostic criterion for ADHD states that the individual displays excessive levels of inattention, hyperactivity, or impulsivity. Many of the forms ask about specific symptoms within each of these areas (e.g., blurting out answers before questions have been completed), and the number of symptoms endorsed by informants can be tallied to estimate the severity of problems.
Another DSM-IV diagnostic criterion, one too often ignored, is "clinically significant impairment"--essentially, to qualify for a diagnosis of ADHD, an individual must not only have symptoms, but must have trouble adapting to life's demands because of the symptoms. For instance, a child who has symptoms but is able to follow instructions at home, keep up with work in school, and interact with peers appropriately would not be diagnosed with ADHD. The book's impairment-related forms will be a welcome resource for clinicians, many of whom struggle to assess this area adequately. Barkley and Murphy include forms for teachers as well as parents, helping to catch impairment in different settings.
A third DSM-IV criterion states that the symptoms must lead to impairment before age 7. Although the exact age is a topic of considerable debate among researchers, the age criterion raises the topic of onset and prognosis more generally. Since recent studies suggest that the majority of children with ADHD will continue to show deficits in their adult years, it is refreshing to see that Barkley and Murphy devote almost half of their text to assessing adults for ADHD. This section of the book includes forms investigating which symptoms were experienced back in childhood, as well as areas of impairment not relevant in young children (e.g., driving).
Two caveats hinted at earlier should be noted before readers of this review decide to purchase the book. First, the book is not a source of general information about ADHD. Although there are several "fact sheets" meant for use with clients and their parents, there are no discussions of recent research on ADHD, its causes, or its treatment. The book is instead a clinical tool for those who have specialized training and already know that information. Second, on a related point, the book is not meant for the general public, and should not be purchased by readers interested in determining whether they (or their family members, friends, coworkers, etc.) have ADHD; as with any psychological problem, a professional assessment is the best idea in this situation.
Even as a resource for trained professionals, the ADHD Clinical Workbook has certain limitations worth noting. First, although there are many forms for teachers to complete, very few focus on academic impairment: low grades, poor exam scores, lack of homework completion, etc. Since many school referrals, especially at the middle and high school levels, are prompted by academic problems, these types of impairment require more comprehensive assessment. Second, I would have liked to see more assessment instruments that help with differential diagnosis--that is, separating out ADHD from other disorders that share certain symptoms. Certain features of ADHD--especially inattention--are common to many psychological problems (e.g., anxiety, depression, etc.), and one of the hardest clinical tasks to differentiate ADHD from these related syndromes.
Despite these limitations, Barkley & Murphy's workbook remains a must-have for those who do ADHD assessments, whether they are psychiatrists, pediatricians, psychologists, clinical social workers, or others. It is not a book for laypeople, and could actually do more harm than good in the hands of the untrained, but when used by professionals in the service of identifying children, adolescents, and adults whose needs fall under the heading of ADHD, the book's contents can lead to more reliable diagnostic practices and more accurate treatment planning.
© 2007 Ben Lovett
Ben Lovett is a doctoral candidate in the psychology department at Syracuse University, where his research and clinical work focuses on children with ADHD and learning disabilities.