Rethinking ADHD : integrated approaches to helping children at home and at school

201 Pages·2002·1.06 MB·English

by  Ruth Schmidt Neven

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Rethinking ADHD
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Rethinking ADHD
Integrated approaches to helping children
at home and at school
Ruth Schmidt Neven, Vicki Anderson and Tim Godber
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Copyright © 2002 Ruth Schmidt Neven, Vicki Anderson, Tim Godber
All rights reserved. No part of this book may be reproduced or transmitted in any
form or by any means, electronic or mechanical, including photocopying, recording
or by any information storage and retrieval system, without prior permission in
writing from the publisher. The Australian Copyright Act 1968(the Act) allows a
maximum of one chapter or 10 per cent of this book, whichever is the greater, to be
photocopied by any educational institution for its educational purposes provided
that the educational institution (or body that administers it) has given a
remuneration notice to Copyright Agency Limited (CAL) under the Act.
First published in 2002 by
Allen & Unwin
83 Alexander Street
Crows Nest NSW 2065
Australia
Phone: [phone]
Fax: [phone]
Email: [email protected]
Web: www.allenandunwin.com
National Library of Australia
Cataloguing-in-Publication entry:
Neven, Ruth Schmidt.
Rethinking ADHD: integrated approaches to helping children
at home and at school.
Bibliography.
Includes index.
ISBN 1 86508 816 1.
1. Attention-deficit hyperactivity disorder. 2. Behavioral
assessment of children. I. Anderson, Vicki A. II. Godber,
Tim. III. Title.
618.928589
Typeset by Midland Typesetters
Printed by Southwood Press
10 9 8 7 6 5 4 3 2 1
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Contents
About the authors vi
1 Rethinking ADHD: An illness of our time 1
2 Neuropsychology and the diagnostic dilemmas of ADHD 14
3 A critique of the medical model 39
4 Risk factors for the developing child: A psychodynamic
approach 58
5 The capacity for attention and the developmental process 81
6 The concept of self-regulation: Creating links between a
neuropsychological and a psychodynamic approach 97
7 ADHD in a public health context 111
8 Coming full circle: Towards a new paradigm for helping
children, parents and families 127
9 Recommendations for a multidisciplinary approach
to ADHD 136
Appendix 1: DSM-IV criteria for ADHD 148
Appendix 2: ICD-10 classification of mental and behavioural
disorders criteria 150
Glossary 153
References 159
Index 182
v
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About the authors
Ruth Schmidt Neven is a child and adult psychotherapist who
trained at the Tavistock Clinic in England. With over 30 years’
experience of work with children, parents and adolescents, she is
committed to promoting knowledge and understanding about child
and family development in the broader community. She has been a
pioneer in the field of parent education in the United Kingdom,
setting up the national organisation Exploring Parenthood. She
came to Australia in 1989 to take up the first position of Chief
Psychotherapist at the Royal Children’s Hospital in Melbourne, a
post she held until 1994. Ruth is currently the director of the Centre
for Child and Family Development, which offers counselling and
psychotherapy to children and families, as well as professional
training courses. Ruth writes and lectures extensively on all aspects
of child development and parenting in Australia and overseas.
She has provided training and consultancy to government and
non-government agencies. She has written two books, Exploring
Parenthood and Emotional Milestones: From Birth to Adulthood, both
published by the Australian Council for Educational Research. She
is currently engaged in research on how professionals construct the
mental health problems of children and families.
Vicki Anderson, PhD, is a paediatric neuropsychologist of some
twenty years’ experience who currently holds positions as a Senior
Lecturer, Department of Psychology, University of Melbourne, and
Senior Research & Clinical Neuropsychologist, Royal Children’s
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About the authors
Hospital, Melbourne. She started her career at the Royal Children’s
Hospital, where she worked as a clinician and then Coordinator of
Neuropsychology Services, until taking up a lectureship at the
University of Melbourne. Her interests are in disorders of childhood
that impact on the central nervous system, including both develop-
mental and acquired disorders. She has published over 40 papers in
this field and has attracted over one million dollars in research
funding. Her research group has recently established the Centre for
Child Neuropsychological Studies (CNS) at the Royal Children’s
Hospital.
Tim Godber lectures in psychological assessment and health
psychology at La Trobe University in the Bachelor of Public Health,
Bachelor of Pharmacy and Bachelor of Behavioural Science degree
programs. He is a psychologist and teacher with extensive experi-
ence working with children and parents in Australia and overseas.
His research career began at the Royal Children’s Hospital with a
study of the cognitive effects of cranial irradiation and his interests
now focus on preventive mental health, the impact of develop-
mental disability on family functioning and the diagnostic issues
associated with the use of paediatric intelligence tests.
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1
Rethinking ADHD:
An illness of our time
The past ten to fifteen years have seen significant changes in the
way in which children’s behaviour problems have been described
and diagnosed. These changes have been particularly striking in
North America where, according to Barkley (1998a), 3–5 per cent of
the school-age population has been prescribed psychostimulant
drugs. Australia and the United Kingdom have also experienced
dramatic increases in the numbers of children and adolescents diag-
nosed with attention deficit disorder (ADD) or attention deficit
hyperactivity disorder (ADHD). In Australia for example, there has
been a twentyfold increase in prescription rates for these drugs
since 1990 and current figures indicate that more than 300000
prescriptions are issued annually (Mackey & Kopras, 2001). In
North America the increase in rates of diagnosis for ADHD and
drug prescriptions has been so rapid that the statistics are consid-
ered to be obsolete by the time they are published in scientific
journals (McCubbin & Cohen, 1999).
What is ADHD? How the problem is currently presented
The fourth edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV), published by the American Psychiatric Associ-
ation and regarded as the standard internationally recognised
manual of criteria for the assessment and diagnosis of mental
disorder, identifies the three core manifestations of ADHD as
1