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Book Forum: Child/Adolescent Psychiatry   |    
Handbook of Neurodevelopmental and Genetic Disorders in Children
CRAIG L. DONNELLY, M.D.
Am J Psychiatry 2002;159:1070-1071. doi:10.1176/appi.ajp.159.6.1070
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Edited by Sam Goldstein and Cecil R. Reynolds. New York, Guilford Publications, 1999, 602 pp., $70.00.

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Contemporary neurobehavioral assessment of children calls on clinicians to have a sophisticated knowledge base that spans the ever-widening biopsychosocial framework. Rapid advancements in behavioral genetics, neuropsychology, and developmental neuropsychiatry present a challenge for clinicians in their attempts to keep current with the state of the art and science in the field. The primary objective of the Handbook of Neurodevelopmental and Genetic Disorders in Children is to provide a stand-alone compendium of the impact of genetics on neurodevelopment in children. As such, the text brings together leading experts in genetics, neurodevelopment, developmental psychopathology, and neuropsychology to provide a magnum opus resource manual for clinicians.

The text is divided logically into three sections. Section 1, Basic Principles and Applications, is an overview of the role of neuropsychology in assessment, treatment, and management of children with neurodevelopmental and genetic disorders. This section contains excellent, detailed, and reasonably up-to-date information on comprehensive neuropsychological assessment instruments and assessment strategies as well as a contemporary primer on current models for understanding genetics and its importance in child neurobehavioral development. Topics including structural and biochemical differences in children with genetic disorders and the use of neuroimaging in diagnostic assessment are covered comprehensively, yet in a readable and easily understandable fashion. Psychosocial issues related to emotional, family, educational, and behavioral problems are covered with sophistication and nuanced insights that complement the more technical chapters. Section 1 provides a cohesive framework for understanding the complexities of neuropsychological assessment and medical genetics from which the remainder of the text flows.

Section 2 covers common disorders with presumed genetic etiologies: learning disabilities, attention deficit hyperactivity disorder (ADHD), Tourette’s syndrome, anxiety disorders, autism, and pervasive developmental disorders. Each chapter presents a vast amount of information and relevant data in comprehensive reviews presented from a neuropsychological perspective. The chapters are well organized, detailed in terms of their presentations of assessment and treatment methodologies, and strongly buttressed by extensive references. A minor but forgivable criticism is that the medication treatment sections tend to be rather sparse and not up-to-date, although it is not a primary aim of the text to be a psychopharmacology manual. For example, there is no mention of the use of atypical neuroleptics in the treatment of Tourette’s syndrome, nor does the ADHD chapter present data from the important multimodal treatment of ADHD study.

Where the chapters excel is in providing excellent historical overviews as well as specific and practical frameworks for assessment and treatment that are detailed and comprehensively biopsychosocial. Particularly strong is the chapter on learning disabilities, which presents a functional paradigm for intervention in tandem with a highly detailed account of the assessment process. One will not find a great deal of speculation; the authors stick close to empirical evidence in the writing of their chapters. In the chapter on learning disabilities, for example, one will find a balanced and proportional account of nonverbal learning disabilities in the context of general learning disabilities. The chapters are uniformly well written and cohesive; treatment recommendations follow nicely from the neuropsychological assessment strategies that are presented.

Section 3 of the text, the longest, contains 14 chapters overviewing less common genetically based disorders that are seen in academic and general practice settings. Examination of these relatively less common disorders is instructive regarding the relationships between genetics and behavior. Syndromes covered in this section include Turner’s, Tourette’s, fragile X, Noonan’s, phenylketonuria, Rett’s, Prader-Willi, Klinefelter’s, Down’s, neurofibromatosis, and seizure disorders, among others. This section is particularly valuable for the updated information the chapters provide on genetic advances in the diagnosis and neurobiology of these disorders. Sensitive, detailed, and highly illustrative case vignettes are presented outlining the convergence of genetics and the neuropsychological and neurobehavioral phenotypes of the disorders. Clinicians who strive to understand the connection between genetics, brain function, and brain structure on the one hand and behavioral/psychological phenomena on the other will find these chapters highly satisfying and thought provoking. The chapters in section 3 are well referenced, and many include contacts, addresses, web sites, and online support/news groups for the respective syndromes. This is particularly useful for clinicians seeking to keep abreast of new developments and for providing information to parents and families.

In sum, Goldstein and Reynold’s text succeeds marvelously in providing a comprehensive resource on genetic disorders and neurodevelopment in childhood. The book is to be recommended to clinicians, including child psychiatrists, pediatric neurologists, general and behavioral pediatricians, child psychologists and neuropsychologists, and especially those who may be several years out of training and wish to update their knowledge of the relationship between genetics and neuropsychology. For the practicing clinician involved in the day-to-day assessment and treatment of children, this text is a required resource on the bookshelf. The child clinician of the 21st century needs a working knowledge of genetics, neurodevelopment, and neuropsychology, even if these are not primary areas of interest or expertise. A working knowledge of these areas is essential for contemporary clinicians to be fully competent in assessing the range and complexity of children seen in clinical practice and to offer the most up-to-date treatment and management interventions.

The text has both great practical utility, e.g., providing discrete frameworks for assessment and detailed recommendations for interventions in learning-disabled children, as well as a cohesive wide-angle perspective on the vast, exciting, and promising area of the impact of genetics on neurodevelopment.

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