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Book Forum: CHILD PSYCHIATRY   |    
Learning Disorders and Disorders of the Self in Children and Adolescents
FRED R. VOLKMAR, M.D.
Am J Psychiatry 2003;160:199-199. doi:10.1176/appi.ajp.160.1.199
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New Haven, Conn.

By Joseph Palombo. New York, W.W. Norton & Co., 2001, 332 pp., $32.00.

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This volume focuses on an important and understudied topic—psychotherapeutic interventions for children with learning disorders. Although a large literature exists on the diagnosis of these conditions and on educational and behavioral interventions, relatively few books have addressed the implications of these disorders for the child’s long-term mental health. The attempt to bridge the gaps between neuropsychologists, learning disabilities specialists, and clinical psychotherapists is clearly needed.

The author adopts a self-psychology perspective on diagnosis and treatment and uses a well-integrated conceptual framework to approach these conditions. Within this perspective Palombo strongly emphasizes developmental factors as the child copes with his or her pattern of strengths and weaknesses in building a more coherent and cohesive self-narrative. Several different patterns of learning difficulties are discussed, including attentional problems, dyslexia, nonverbal learning disability, problems with executive functioning, and Asperger’s disorder. The pattern of strengths and weaknesses associated with these problems and their implications for the child’s development and for psychotherapy are also discussed.

The book includes a helpful series of case examples that illustrate the author’s approach in helping the child develop a personal narrative to foster a greater sense of integration and self-cohesion. These examples illustrate the author’s approach and highlight critical issues in dealing with children who have learning problems.

The book is well organized around three major considerations—developmental, diagnostic, and treatment considerations. The chapter on deciding when to treat is particularly well done, as is the chapter on working with parents. This book will be of great interest to psychiatrists, psychologists, social workers, and other mental health professionals who work with children who have learning disabilities.

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