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Review of "Assessment of Childhood Disorders"

By Eric J. Mash & Russell A. Barkley (Editors)
Guilford Press, 2008
Review by Benjamin J. Lovett, Ph.D. on Sep 9th 2008
Assessment of Childhood Disorders

The diagnosis of childhood psychological disorders is a topic that comes up at cocktail parties as often as university seminar rooms, since most of us know children who have been diagnosed with one disorder or another. ADHD, child bipolar disorder, learning disabilities—these are far from arcane terms today, and anyone who has children or works with them has heard them more often than they would probably like. The diagnosis of these disorders is based on assessments by various mental health professionals, and for almost 30 years, Assessment of Childhood Disorders has served as a guide to the tools used in clinical assessments as well as the issues that arise while conducting them. Its new edition is the longest yet, 800 pages with information on 16 different conditions, including some that are rarely covered in competing texts.

The first, introductory chapter is a careful analysis of the issues common to all child assessment situations, and at times, the issues can seem overwhelming. The chapter reads like a like a list of things not to be forgotten when assessing children: the importance of the situation in determining children's thoughts, feelings and behaviors; the importance of assessing the family and other contexts as well as the child; the need for assessment to yield information relevant to treatment planning as well as prognosis; the various advantages and disadvantages of "labeling" children as having a disorder; and so on. Although the list may seem so inclusive that nothing is left out, the authors do privilege some approaches to assessment over others; for instance, they argue that clinicians should search the immediate environment for the causes of symptoms before exploring the remote past of children's histories, and they argue for viewing children's behaviors displayed during an assessment as samples of their typical behavior, rather than as signs of underlying thoughts and feelings. These positions are consistent with a behavioral approach to assessment, one that appears to guide many of the other chapters.

The other chapters are each devoted to a specific disorder or set of disorders, and they vary widely in comprehensiveness; the chapter on ADHD is almost 80 pages long whereas the chapter on early-onset schizophrenia is only 25 pages long. However, just the presence of a chapter on schizophrenia in children sets the book apart from other assessment texts, and if its chapter is shorter than the others, that reflects the comparative lack of research on child schizophrenia (and correspondingly low prevalence) rather than any carelessness on the part of the authors. Another unique contribution is the chapter on pediatric bipolar disorder; although the diagnosis is now quite common, it is surprisingly difficult to find general reviews on its assessment, and this chapter integrates the latest research along with critical thinking about the construct of bipolar disorder in children.

The editors have allowed the authors of each chapter to determine the type of information that is most pertinent to each disorder, and although this leads to unevenness across chapters, the reader benefits from it. For instance, the chapter on suicidal and self-harming behavior includes helpful information on ethical issues and emergent situations, while the chapter on child abuse reviews current legal controversies. Another quality varying across chapters is the way in which authors deal with controversies in the assessment and diagnosis of each disorder. For instance, in the chapter on pediatric bipolar disorder, Eric Youngstrom acknowledges the tremendous increase in diagnosed cases and notes the perception, common to many psychologists, that the disorder is being overdiagnosed. He then proceeds to defuse many of the concerns by pointing out similarities between bipolar symptoms in children and adults and noting the utility of a bipolar diagnosis in treatment planning. In their chapter on learning disabilities, Deborah Speece and Sara Himes take a different approach; they discuss the two major approaches to LD identification (assessing information processing skills and monitoring a student's responsiveness to remedial instruction) separately, before providing a critical evaluation of each and concluding that "both approaches require more work to claim the high ground."

Since the primary purpose of Assessment of Childhood Disorders is to review research related to assessment tools and issues, its treatment of controversial issues, while stimulating, takes a back seat to didacticism. And indeed, the text serves its reference function very well. It is comprehensive in the sense of covering many conditions (e.g., personality disorders in adolescents) not covered by other assessment texts, even if the coverage of each condition is somewhat unique. Admittedly, it is too technical for most parents and schoolteachers interested in childhood disorders, but it is perfect for graduate students and practicing clinicians, as well as behavioral science researchers interested in getting up to date on conditions that may relate to their own work. Moreover, as Eric Mash and John Hunsley detail in the opening chapter, much has changed since the last time the text was published (in 1997), and so those who benefited from the earlier edition would do well to update their libraries with this one.

© 2008 Benjamin J. Lovett

Benjamin J. Lovett, Ph.D., is an assistant professor of psychology at Elmira College, where he teaches classes on a variety of topics in applied psychology and his research focuses on the conceptual and psychometric foundations of psychoeducational assessment and psychiatric diagnosis.