This comprehensive and recently updated book forms part of the Cambridge Child and Adolescent Psychiatry series that is aimed at both practitioners and researchers in child and adolescent mental health services and developmental and clinical neurosciences. Several themes recur throughout the book, demonstrating the current concerns and issues within this field. One such theme is the development of diagnostic criteria relating to hyperactivity and attention disorders of childhood. These criteria have gone through considerable changes over time and remind us that ICD and DSM criteria are not set in stone. Many authors here provide evidence that our current approach to diagnosis and classification may not best support emerging scientific developments in the study of hyperactivity. In addition, they discuss research findings suggesting that the presence of a clinical diagnosis of attention-deficit hyperactivity disorder (ADHD) alone does not carry a poor prognosis unless it is in conjunction with serious functional impairment.
There remain numerous unresolved issues within the field of attentional and hyperactivity disorder research and practice and this book addresses many of them. For example, what does one do with children who meet criteria in one environment but not another? How do sub-threshold cases fit into our understanding of the stability of these disorders? One chapter highlights the uncertainties of the reliability and validity of some measures widely employed in research and practice. There is also exploration of the false assumption that behavioural inattention and inhibition should be reflected in the laboratory measurement of inattention and inhibition. Emerging neuropsychological literature increasingly highlights the misnomer of ADHD: many children with clinically diagnosed ADHD or hyperkinetic disorder do not demonstrate deficits in certain aspects of attentional processing. Rather, a deficit in state regulation has been hypothesised and this is discussed in some detail.
This book communicates issues of which many practitioners and researchers may not be aware, as publications in this field are often clinically oriented and do not address these fundamental concerns. The absence of a chapter on treatment (other than the one relating to the USA Multimodal Treatment Study of Children with ADHD – the MTA study) is unfortunate, but there are plenty of other sources of information on the subject.
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