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Back to Normal: The Overlooked, Ordinary Explanations for Kids' ADHD-, Bipolar-, and Autistic- Like Behavior
A veteran clinical psychologist exposes why doctors, teachers, and parents incorrectly diagnose healthy American children with serious psychiatric conditions.
In recent years there has been an alarming rise in the number of American children and youth assigned a mental health diagnosis. Current data from the Centers for Disease Control reveal a 41 percent increase in rates of ADHD diagnoses over the past decade and a forty-fold spike in bipolar disorder diagnoses. Similarly, diagnoses of autism spectrum disorder, once considered, has increased by 78 percent since 2002.
Dr. Enrico Gnaulati, a clinical psychologist specializing in childhood and adolescent therapy and assessment, has witnessed firsthand the push to diagnose these disorders in youngsters. Drawing both on his own clinical experience and on cutting-edge research, with Back to Normal he has written the definitive account of why our kids are being dramatically overdiagnosed—and how parents and professionals can distinguish between true psychiatric disorders and normal childhood reactions to stressful life situations.
Gnaulati begins with the complex web of factors that have led to our current crisis. These include questionable education and training practices that cloud mental health professionals’ ability to distinguish normal from abnormal behavior in children, monetary incentives favoring prescriptions, check-list diagnosing, and high-stakes testing in schools. We’ve also developed an increasingly casual attitude about labeling kids and putting them on psychiatric drugs.
So how do we differentiate between a child with, say, Asperger’s syndrome and a child who is simply introverted, brainy, and single-minded? As Gnaulati notes, many of the symptoms associated with these disorders are similar to everyday childhood behaviors. In the second half of the book Gnaulati tells detailed stories of wrongly diagnosed kids, providing parents and others with information about the developmental, temperamental, and environmentally driven symptoms that to a casual or untrained eye can mimic a psychiatric disorder. These stories also reveal how nonmedical interventions, whether in the therapist’s office or through changes made at home, can help children.
Back to Normal reminds us of the normalcy of children’s seemingly abnormal behavior. It will give parents of struggling children hope, perspective, and direction. And it will make everyone who deals with children question the changes in our society that have contributed to the astonishing increase in childhood psychiatric diagnoses.
In recent years there has been an alarming rise in the number of American children and youth assigned a mental health diagnosis. Current data from the Centers for Disease Control reveal a 41 percent increase in rates of ADHD diagnoses over the past decade and a forty-fold spike in bipolar disorder diagnoses. Similarly, diagnoses of autism spectrum disorder, once considered, has increased by 78 percent since 2002.
Dr. Enrico Gnaulati, a clinical psychologist specializing in childhood and adolescent therapy and assessment, has witnessed firsthand the push to diagnose these disorders in youngsters. Drawing both on his own clinical experience and on cutting-edge research, with Back to Normal he has written the definitive account of why our kids are being dramatically overdiagnosed—and how parents and professionals can distinguish between true psychiatric disorders and normal childhood reactions to stressful life situations.
Gnaulati begins with the complex web of factors that have led to our current crisis. These include questionable education and training practices that cloud mental health professionals’ ability to distinguish normal from abnormal behavior in children, monetary incentives favoring prescriptions, check-list diagnosing, and high-stakes testing in schools. We’ve also developed an increasingly casual attitude about labeling kids and putting them on psychiatric drugs.
So how do we differentiate between a child with, say, Asperger’s syndrome and a child who is simply introverted, brainy, and single-minded? As Gnaulati notes, many of the symptoms associated with these disorders are similar to everyday childhood behaviors. In the second half of the book Gnaulati tells detailed stories of wrongly diagnosed kids, providing parents and others with information about the developmental, temperamental, and environmentally driven symptoms that to a casual or untrained eye can mimic a psychiatric disorder. These stories also reveal how nonmedical interventions, whether in the therapist’s office or through changes made at home, can help children.
Back to Normal reminds us of the normalcy of children’s seemingly abnormal behavior. It will give parents of struggling children hope, perspective, and direction. And it will make everyone who deals with children question the changes in our society that have contributed to the astonishing increase in childhood psychiatric diagnoses.
256 pages, Hardcover
First published January 1, 2013
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1192 people want to read
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Displaying 1 - 30 of 61 reviews
February 13, 2017
The thing with this book is that it's not necessarily about what the title says it is about. A more "correct" title would be "Back to Normal: The Overlooked, Ordinary Explanations for Boys". There are instances where female children are brought up and even used as an example but for the most part the book is about male behavior and how people may not understand male behavior.
Another problem I had with the book is that it's redundant and a bit on the fluffy side. Those are problems I tend to have with the category of book, though.
There were also instances where he would lay down facts and then later on say something that makes the facts previously laid down seem unnecessary such as pointing out the male advantage in IQ test and then a page later talking about how females tend to have more test anxiety which would lead to them scoring lower on test. At that point, it's weird that these to facts are a page apart because one makes the other seem...unnecessary. That was just one issue where I felt "fluff" was a problem.
There were also things he would deem "normal" and say that people see male children though female traits and yada yada. It was written that when boys rough-play or whatnot people assume things are being "taken too far". But, he doesn't really nail down what "too far" is. Such as, there was an instance where a kid was upset and pointed a finger gun at another child and made sound effects. He said the child that the finger gun was pointed at was uncomfortable and that someone should teach the child to respond better to behaviors like that. So, in this instance he said the finger-gun point child could benefit from better ways to handle their feelings but had it written that the kid that was uncomfortable with the finger gun needed to not be uncomfortable.
That seemed strange to me that the problem lied with the child that was uncomfortable. The idea here is that there are male behaviors that are normal and then there are abnormal ones. The extent in which abnormal behaviors are not brought up is pretty extreme. In the end, everything seems to be "normal". So, what exactly makes on ADHD, Bipolar, and/or autistic.. unclear.
The finale part of the book would have been better suited at the start of the book. Instead of so much fluff, I think there should have been more time spent on talking about how to be more critical of professionals. He gave reasons on WHY one should be critical but how to question professionals and their diagnosis is also very important. He could of perhaps talked more about how parents could work to resist the temptation of a "quick fix" to problems.
Another problem I had with the book is that it's redundant and a bit on the fluffy side. Those are problems I tend to have with the category of book, though.
There were also instances where he would lay down facts and then later on say something that makes the facts previously laid down seem unnecessary such as pointing out the male advantage in IQ test and then a page later talking about how females tend to have more test anxiety which would lead to them scoring lower on test. At that point, it's weird that these to facts are a page apart because one makes the other seem...unnecessary. That was just one issue where I felt "fluff" was a problem.
There were also things he would deem "normal" and say that people see male children though female traits and yada yada. It was written that when boys rough-play or whatnot people assume things are being "taken too far". But, he doesn't really nail down what "too far" is. Such as, there was an instance where a kid was upset and pointed a finger gun at another child and made sound effects. He said the child that the finger gun was pointed at was uncomfortable and that someone should teach the child to respond better to behaviors like that. So, in this instance he said the finger-gun point child could benefit from better ways to handle their feelings but had it written that the kid that was uncomfortable with the finger gun needed to not be uncomfortable.
That seemed strange to me that the problem lied with the child that was uncomfortable. The idea here is that there are male behaviors that are normal and then there are abnormal ones. The extent in which abnormal behaviors are not brought up is pretty extreme. In the end, everything seems to be "normal". So, what exactly makes on ADHD, Bipolar, and/or autistic.. unclear.
The finale part of the book would have been better suited at the start of the book. Instead of so much fluff, I think there should have been more time spent on talking about how to be more critical of professionals. He gave reasons on WHY one should be critical but how to question professionals and their diagnosis is also very important. He could of perhaps talked more about how parents could work to resist the temptation of a "quick fix" to problems.
June 26, 2018
This is a fine book for parents with children who do not have these disorders, but are being pushed toward a diagnosis. However, the book rather trivializes the struggles of children who may actually be suffering from these disorders. Furthermore, the entire book is written about the male experience and completely ignores the issues girls' face in school.
December 11, 2013
I agree highly with the author's assertion that many normal childhood developmental stages are chronically misunderstood as diseases such as ADHD. This book would have been more helpful if A.) The doctor could have discussed more tips on dealing with these types of children and B.) If he could have acknowledged that the problem is often with the school system / homework, and it's okay if kids never do learn the importance of buckling down to pure busywork.
August 21, 2021
In this book, clinical psychologist Enrico Gnaulati argues that, far too often, well-meaning parents, teachers, and psychiatrists misinterpret normal quirky kid behavior as symptomatic of mental health conditions such as ADHD, Autism, and Bipolar Disorder. Instead of the labels and medication favored by many psychiatrists, Gnaulati stresses the need for "a more humanistic, experiential, individualized approach...to reach, comprehend, and help kids" (8).
I became interested in this topic far before I had my own kids. While teaching English at a suburban public high school in an affluent US town, I grew increasingly alarmed by the number of students (especially boys) in my classes being diagnosed with ADHD. Many of these boys were totally capable of sustaining interest in (and waxing eloquently about) a variety of topics but struggled to get through homework assignments and tests. Most were avid gamers with helicopter parents bent on getting their kids into Ivy League universities. One kid, whom I would describe as lazy yet lovable, even asked me one time in all sincerity how he could get a diagnosis so that he, too, could have fifteen extra minutes on my tests and quizzes. His parents were of a more laid back variety. I've known kids whose diagnoses seemed very legitimate (I am not questioning that there are kids with mental health conditions in need of treatment; neither does this author) but, many of my students with labels and accommodations struck me as, for lack of a better term, completely normal kids struggling with completely normal issues.
Now I have my own kids and the pleasure of observing all manner of quirky behavior! I think Gnaulati's argument is extremely important and I plan to enter the adolescent phase with my eyes wide open to these issues.
Back to Normal is, to me, a five star book—persuasive argumentation delivered by a winsome, unpretentious writer who doesn't take himself too seriously and has a great sense of humor. In addition to being helpful, this is a fun one to read. I would genuinely like to invite the author over for dinner. If you look at his picture, his authorial personality totally matches his face—a cool guy!
I became interested in this topic far before I had my own kids. While teaching English at a suburban public high school in an affluent US town, I grew increasingly alarmed by the number of students (especially boys) in my classes being diagnosed with ADHD. Many of these boys were totally capable of sustaining interest in (and waxing eloquently about) a variety of topics but struggled to get through homework assignments and tests. Most were avid gamers with helicopter parents bent on getting their kids into Ivy League universities. One kid, whom I would describe as lazy yet lovable, even asked me one time in all sincerity how he could get a diagnosis so that he, too, could have fifteen extra minutes on my tests and quizzes. His parents were of a more laid back variety. I've known kids whose diagnoses seemed very legitimate (I am not questioning that there are kids with mental health conditions in need of treatment; neither does this author) but, many of my students with labels and accommodations struck me as, for lack of a better term, completely normal kids struggling with completely normal issues.
Now I have my own kids and the pleasure of observing all manner of quirky behavior! I think Gnaulati's argument is extremely important and I plan to enter the adolescent phase with my eyes wide open to these issues.
Back to Normal is, to me, a five star book—persuasive argumentation delivered by a winsome, unpretentious writer who doesn't take himself too seriously and has a great sense of humor. In addition to being helpful, this is a fun one to read. I would genuinely like to invite the author over for dinner. If you look at his picture, his authorial personality totally matches his face—a cool guy!
November 12, 2013
Children as a Commodity
This stark and brave book by Enrico Gnaulati, PHD., should be required reading for every parent.
There as so many moving parts in a child's make up that to assume someone can reach any diagnosis based on fifteen minute interviews and vaguely broad checklists is reckless.
The book begins with how Big Pharma has pushed adult medications (which show little promise of preventing anything aside from good health and extra cash) onto children; a practice called "off label prescriptions". He cites the horrific example of the case of Rebecca Riley, who at four died because of off label prescriptions that child psychiatrist Dr. Kifuji felt were warranted.
Although we wonder why anyone would consider a two year old to be so riddled with ADHD that a cocktail of adult drugs would be advisable is a question central to this book. Why are so many children being diagnosed with such diverse "disorders" and then prescribed expensive drugs. This has become more common if children (mostly male) do not meet certain requirements.
This made me think that the majority of drugs issued to children are emotional in the sense that they offer an excuse for the parents and have little to do in helping the child. That's my conclusion, not his. Of course, the high price of excuses may also make them fashionable. A short list of the most popular drugs show that there's a sophisticated excuse for about $500 a month. Having worked with children for more than twenty years has shown me how smart they are, how eager they are for attention, and how they creatively combine the two to avoid negative consequences. With high expectations and helicopter parenting (popular term among teachers, etc) it seems to me that there isn't anyone in the child's corner. In the last few chapters he addresses some of the ways a parent can get involved in a good way and not a controlling way.
p. 71 "Do we label boys as mentally unstable, behaviorally unmanageable, academically underachieving, in need of special-education services, or displaying behavior warranting school suspension, just because their behavior deviates noticeable from that of the average girl?"
It seems that some adults in a particular child's life want to exert some control over them, "for their own good".
Teachers are cited in more and more studies as the metaphorical hinge that moves the massive gate of medicated compliance. All the while parents, for whatever reason, have so overly scheduled their children's lives that they have become increasingly involved but oddly less connected. Parent or Pal; pick one.
After reading this book over and over trying to absorb all the fascinating information and insight, with highlights and notes on almost every page, I am overwhelmed by the complex mess that has been created around children just being children (for the most part).
As parents, adults, caregivers, and professionals we all need to look at the needs of the child first.
I wonder how many Hollywood actors will pick this cause up and run with it, like so many others.
Answer: Zero.
This book is going to be unpopular among many people, but for parents who are willing to ask the tough questions, this is for you.
This stark and brave book by Enrico Gnaulati, PHD., should be required reading for every parent.
There as so many moving parts in a child's make up that to assume someone can reach any diagnosis based on fifteen minute interviews and vaguely broad checklists is reckless.
The book begins with how Big Pharma has pushed adult medications (which show little promise of preventing anything aside from good health and extra cash) onto children; a practice called "off label prescriptions". He cites the horrific example of the case of Rebecca Riley, who at four died because of off label prescriptions that child psychiatrist Dr. Kifuji felt were warranted.
Although we wonder why anyone would consider a two year old to be so riddled with ADHD that a cocktail of adult drugs would be advisable is a question central to this book. Why are so many children being diagnosed with such diverse "disorders" and then prescribed expensive drugs. This has become more common if children (mostly male) do not meet certain requirements.
This made me think that the majority of drugs issued to children are emotional in the sense that they offer an excuse for the parents and have little to do in helping the child. That's my conclusion, not his. Of course, the high price of excuses may also make them fashionable. A short list of the most popular drugs show that there's a sophisticated excuse for about $500 a month. Having worked with children for more than twenty years has shown me how smart they are, how eager they are for attention, and how they creatively combine the two to avoid negative consequences. With high expectations and helicopter parenting (popular term among teachers, etc) it seems to me that there isn't anyone in the child's corner. In the last few chapters he addresses some of the ways a parent can get involved in a good way and not a controlling way.
p. 71 "Do we label boys as mentally unstable, behaviorally unmanageable, academically underachieving, in need of special-education services, or displaying behavior warranting school suspension, just because their behavior deviates noticeable from that of the average girl?"
It seems that some adults in a particular child's life want to exert some control over them, "for their own good".
Teachers are cited in more and more studies as the metaphorical hinge that moves the massive gate of medicated compliance. All the while parents, for whatever reason, have so overly scheduled their children's lives that they have become increasingly involved but oddly less connected. Parent or Pal; pick one.
After reading this book over and over trying to absorb all the fascinating information and insight, with highlights and notes on almost every page, I am overwhelmed by the complex mess that has been created around children just being children (for the most part).
As parents, adults, caregivers, and professionals we all need to look at the needs of the child first.
I wonder how many Hollywood actors will pick this cause up and run with it, like so many others.
Answer: Zero.
This book is going to be unpopular among many people, but for parents who are willing to ask the tough questions, this is for you.
August 24, 2016
I wanted to read this book because I do feel that many of the diagnoses the author highlights in the book ARE over diagnosed, and I also think that behavioral cognitive therapy ALONG with pharmaceutical interventions are important for those who need them. HOWEVER, I was not pleased with the way this author dismissed medication and many individuals, who, after reading his description, probably DID have a mild form of a disorder. I agree that labels can be dangerous, and it is not the label, but the intervention that is important, but I also think that this book is a little cavalier with the way it tries to get that point across.
September 22, 2013
I have been studying education for over 30 yrs. I also taught in the public schools and have enough children to do a virtual case study in my own home. If I could give this book ten stars, I would. It is written on a level that anyone can understand, but he backs everything up with case studies. Gnaulati also gives plenty of examples and approaches to various behaviors. Everything is presented in a positive manner, with no finger pointing, just real solutions. His love for children is obvious. He has consolidated so many different subjects, which I have read in other sources including: diet, discipline, classrooms, doctors/drug manufacturers, etc. This book should be required reading for every future educator, pediatrician, or counselor and any parent is sure to learn from it.
I won this book in a goodreads contest with the expectation of a fair/unbiased review.
I won this book in a goodreads contest with the expectation of a fair/unbiased review.
January 5, 2014
I wish the book had focused more on two areas. First, differences between kids with legitimate cases of each disorder and who benefit from medication, and the kids he primarily focus on who do not belong on drugs and may not even have a disorder. Second, practical dialogue advice for parents of healthy children whose schools confront them about their children's behavior. Aside from telling the teacher/administrators to read this book, I'm still not sure how to handle such a scenario.
January 18, 2015
Back to Normal, Dr. Enrico Gnaulati's new book about the critical over-diagnosis of mental health disorders in children is a powerful, informative, and shocking indictment of many aspects of our society. Dr. Gnaulati addresses the many players involved, including parents, teachers, pharmaceutical companies, insurance agencies, and health care professionals. While I questioned some of his conclusions as tweaking a variety of data to fit his needs, he does bring to light the larger issues, and from this a discussion should ensue, at the very least.
The numbers are staggering; America is by far the most prescribed nation in the world, and children are not exempt. There are powerful forces at play, namely insurance companies and pharmaceutical companies, those with the power, money, and wherewithal to carpet bomb our nation with their particular message. One can't watch thirty minutes of television without encountering a handful of drug commercials promising cures for everything from heartburn to depression to bladder control and penile dysfunction. While I believe from my experience that certain diagnoses are more obvious than others, particularly those on the more severe end of the autism spectrum, there is a still a rush to label and prescribe instead of strategizing and applying non-medical, non-drug interventions. To that end, the author has some sensible solutions and strategies to ameliorate the problem. Furthermore, he reminds the reader often that what is thought of as problematic or unusual in our society is merely normal behavior that needs harnessed, not deadened. His research is thorough and his style is very readable, despite the clinical nature of the subject matter.
This book is highly recommended for all stakeholders in the educational arena, as well as any parent who thinks they may have a child with special needs. Forewarned is forearmed, and that first trip to the pediatrician, child psychologist, or parent-teacher conference should be done with some knowledge so as to avoid being steamrolled into having your child become yet another statistic in the exploding special needs population. Read this book beforehand and make drugs a last resort, not the first.
The numbers are staggering; America is by far the most prescribed nation in the world, and children are not exempt. There are powerful forces at play, namely insurance companies and pharmaceutical companies, those with the power, money, and wherewithal to carpet bomb our nation with their particular message. One can't watch thirty minutes of television without encountering a handful of drug commercials promising cures for everything from heartburn to depression to bladder control and penile dysfunction. While I believe from my experience that certain diagnoses are more obvious than others, particularly those on the more severe end of the autism spectrum, there is a still a rush to label and prescribe instead of strategizing and applying non-medical, non-drug interventions. To that end, the author has some sensible solutions and strategies to ameliorate the problem. Furthermore, he reminds the reader often that what is thought of as problematic or unusual in our society is merely normal behavior that needs harnessed, not deadened. His research is thorough and his style is very readable, despite the clinical nature of the subject matter.
This book is highly recommended for all stakeholders in the educational arena, as well as any parent who thinks they may have a child with special needs. Forewarned is forearmed, and that first trip to the pediatrician, child psychologist, or parent-teacher conference should be done with some knowledge so as to avoid being steamrolled into having your child become yet another statistic in the exploding special needs population. Read this book beforehand and make drugs a last resort, not the first.
December 28, 2016
As a graduate student studying pediatric occupational therapy, going through IEP's on a daily basis, I found this book extremely relevant and objective.
It should be required reading for pediatricians, concerned parents, and therapists of ANY kind. I can honestly say this is one of the ONLY works I've read that advises what I believe to be appropriate caution- not in treatment- but in labeling children, in order that they do get what they need. Identifying the problem accurately (and understanding how the definition of the problem is changing over time, and what other factors might influence the experts) is the first step to any solution.
This is not a self-help book. It is not meant to provide tips, strategies for daily living, or conclusive ways to diagnose disorders- only to explain why sometimes diagnoses might be suspect; especially when you're already doing everything recommended but nothing is getting better. If you are going to find those strategies and treatment options, you must first know what you are dealing with, and consider all the options. Rushing headlong into repair without proper diagnostics is ill advised. I can't tell you the emotional and financial resources I see expended without gain becasue a path is chosen and people are unwilling to deviate despite evidence it isn't really addressing the problem.
The book is objective (although as one would expect, he does favor psychoanalysis- and I can't argue with the in-depth discussions necessary to gain true insight into underlying causes of atypical behavior) and describes very well some of the pitfalls along the way.
Its nice to see a professional work through some of the (best intention-ed) hysteria that my vocation (and yes, industry, among others) thrives on, but isn't in the best interest of the families or children I hope to help. He raises legitimate concerns, and will hopefully empower parents, teachers and doctors to carefully weigh their observations, become aware of unconscious biases and fully consider the difficulties their child is experiencing.
It should be required reading for pediatricians, concerned parents, and therapists of ANY kind. I can honestly say this is one of the ONLY works I've read that advises what I believe to be appropriate caution- not in treatment- but in labeling children, in order that they do get what they need. Identifying the problem accurately (and understanding how the definition of the problem is changing over time, and what other factors might influence the experts) is the first step to any solution.
This is not a self-help book. It is not meant to provide tips, strategies for daily living, or conclusive ways to diagnose disorders- only to explain why sometimes diagnoses might be suspect; especially when you're already doing everything recommended but nothing is getting better. If you are going to find those strategies and treatment options, you must first know what you are dealing with, and consider all the options. Rushing headlong into repair without proper diagnostics is ill advised. I can't tell you the emotional and financial resources I see expended without gain becasue a path is chosen and people are unwilling to deviate despite evidence it isn't really addressing the problem.
The book is objective (although as one would expect, he does favor psychoanalysis- and I can't argue with the in-depth discussions necessary to gain true insight into underlying causes of atypical behavior) and describes very well some of the pitfalls along the way.
Its nice to see a professional work through some of the (best intention-ed) hysteria that my vocation (and yes, industry, among others) thrives on, but isn't in the best interest of the families or children I hope to help. He raises legitimate concerns, and will hopefully empower parents, teachers and doctors to carefully weigh their observations, become aware of unconscious biases and fully consider the difficulties their child is experiencing.
June 24, 2015
This book may be controversial for some - just a forewarning. Back to Normal is a nonfiction book about how the big pharmaceutical companies push medications meant for adults onto children, and the way doctors go along with it. This generation of children is more medicated than any other, and the author questions if disorders like ADHD and autism may be overdiagnosed. The drugs most often given to children for disorders like these are usually expensive and have a variety of side effects. He argues that many times, children are medicated for "just being children." (His words, not mine.) This book will be unpopular for a lot of people, I can imagine. But it really made me think.
This book sounds like it could be dry, I know, but it really wasn't. I found it to be super interesting, and it really gave a lot of useful information that I wasn't aware of before. I have seen ADHD and severe autism up-close and personal, so I know that they are definitely not "fake conditions." However, the doctor did make some good points. I will also vouch for the fact that conditions like anxiety and depression can be misdiagnosed or overdiagnosed: I was diagnosed with anxiety and prescribed Xanax after no testing and only a few questions (I don't have anxiety; I have a heart condition), and after telling my doctor I thought I was depressed, I was prescribed Effexor with zero questions asked. I really do have depression, and the Effexor has helped me very much - I just thought there would be more to the appointment in order to walk out with a prescription in hand. (I apologize for the medicine cabinet reveal - this is the kind of stuff I find really interesting :) )
This book sounds like it could be dry, I know, but it really wasn't. I found it to be super interesting, and it really gave a lot of useful information that I wasn't aware of before. I have seen ADHD and severe autism up-close and personal, so I know that they are definitely not "fake conditions." However, the doctor did make some good points. I will also vouch for the fact that conditions like anxiety and depression can be misdiagnosed or overdiagnosed: I was diagnosed with anxiety and prescribed Xanax after no testing and only a few questions (I don't have anxiety; I have a heart condition), and after telling my doctor I thought I was depressed, I was prescribed Effexor with zero questions asked. I really do have depression, and the Effexor has helped me very much - I just thought there would be more to the appointment in order to walk out with a prescription in hand. (I apologize for the medicine cabinet reveal - this is the kind of stuff I find really interesting :) )
February 28, 2018
I want to shout this book across the airwaves, I want to thrust it into the hands of every parent who has come out of a psychiatric or medical professional’s office with a diagnosis that just didn’t sit quite right, but unsettled about questioning the expert and uncertain where to turn.
Enrico Gnaulati has done a magnificent job of explaining how accurately diagnosing a child with ADHD, bipolar disorder, or autism requires not only an evaluation of the child’s symptoms in isolation, but a thorough understanding of the family context from which they spring. He clearly describes the differences between these real, treatable disorders, and similar behaviors that arise from normal teen emotions and reactions. The author clearly understands the variety of different personalities among kids and teens, and his great affection for his patients emanates from every page.
Brilliantly laid out, wonderfully readable, refreshingly honest.
Enrico Gnaulati has done a magnificent job of explaining how accurately diagnosing a child with ADHD, bipolar disorder, or autism requires not only an evaluation of the child’s symptoms in isolation, but a thorough understanding of the family context from which they spring. He clearly describes the differences between these real, treatable disorders, and similar behaviors that arise from normal teen emotions and reactions. The author clearly understands the variety of different personalities among kids and teens, and his great affection for his patients emanates from every page.
Brilliantly laid out, wonderfully readable, refreshingly honest.
September 20, 2017
I wish I could give this book 6 stars. Or 10. Some reviewers have complained that the book focuses too much on the behavior of young boys, but young boys are more likely to be diagnosed with these disorders and often incorrectly. As a former high school teacher and the mother of a "difficult" son with no diagnosis, I cannot recommend this book highly enough to parents and teachers who want to truly understand their child's behavior. Dr. Gnaulati presents parents with a well-researched book and writes with honesty and a hefty, much-appreciated dose of reality. It is highly informative and yet extremely readable.
June 20, 2021
I like the book overall. It communicates well how some of the normal behaviour of a difficult child is so easily placed into ASD nowadays. This book has a lot of social perspective, while I was looking for specific information regarding a child I know. In this context too, many case studies are mentioned. It must be mentioned that this book appears to be more suitable for the kids between 5 and late teens. This has little about the kids that are diagnosed too early (<3 years).
The book has a lot of American politico-economic context, that I was not really interested in knowing. But since the USA is considered a superpower, you see similar behaviour trickling down into other countries (like India). Therefore, I got some value from understanding that part too.
Another big problem was that the author does not always define the "age" when he talks of the "age-appropriate". So, if there is an example, it gets a bit difficult to imagine the age of the kid.
The book has a lot of American politico-economic context, that I was not really interested in knowing. But since the USA is considered a superpower, you see similar behaviour trickling down into other countries (like India). Therefore, I got some value from understanding that part too.
Another big problem was that the author does not always define the "age" when he talks of the "age-appropriate". So, if there is an example, it gets a bit difficult to imagine the age of the kid.
April 5, 2018
Gnaulati has a lot of valid points. He argues for more acceptance of "normal" kid behavior, (particularly, in the vein of Christina Hoff Sommers, for boys, who don't always demonstrate the behaviors valued by classroom teachers).
I just wish there was a bit more substance to this book. I understand that it can be a fine line when it comes to behavior disorders, that we don't fully understand what causes them or what they look like (if anything) in the brain--hence the difficulty in diagnosing them. Still, I'd like to know more about how kids that present with ADHD-like behaviors are different from kids who actually have ADHD, for example. He addresses that issue somewhat, but I confess to having finished this book hungry for more.
Heading off to explore more books like this. If anyone can recommend any good (recent) ones (like within the last, say 3 years or so), please comment.
I just wish there was a bit more substance to this book. I understand that it can be a fine line when it comes to behavior disorders, that we don't fully understand what causes them or what they look like (if anything) in the brain--hence the difficulty in diagnosing them. Still, I'd like to know more about how kids that present with ADHD-like behaviors are different from kids who actually have ADHD, for example. He addresses that issue somewhat, but I confess to having finished this book hungry for more.
Heading off to explore more books like this. If anyone can recommend any good (recent) ones (like within the last, say 3 years or so), please comment.
July 4, 2017
Excellent book written by clinical psychologist about the urge to "denormalize" children's behavior and diagnose them with ADHD, Bipolar Disorder and Autism. The book doesn't read like an angry treatise or an author with an agenda but more like honest concern for how children are treated educationally and medically in this country. With a narrowing of an idea what normal is and a lack of acceptance for others, the USA seems to be heading towards an idea that everyone is somehow sick. I won't go into all the details and insight the author has, one could read the book, but this an important book.
January 8, 2019
Some good stuff, mostly not. 2.5 stars. The author kept taking about backing his comments up with research, but mostly used examples from his practice. This book was also focused 95% on boys and how they are different from girls without diving into the societal expectations of girls and why these things might show up. There were great nuggets of insight spread around, but I think a lot could have been taken out or reworked to make this book more effective at normalizing some of these behaviors.
April 1, 2021
Un livre intéressant à lire en cette ère de surdiagnostics et de surmédicamentation des enfants qui ne fitte pas dans le moule. Certaines affirmations de l'auteur m'ont laissée un peu perplexe. Comme celles sur les garçons un peu clichées et stéréotypées à mon goût. Avec quelques bons conseils (un peu remâchés toute fois pour les personnes qui ont déjà lu des livres sur ce sujet) pour les parents qui vivent avec un enfant à comportements "problématiques".
to-read-medium
December 16, 2019JMRL: 618.9289 Gnaulati
September 25, 2020
I found this book to be very well-written and made me feel better about being a parent. This book helps you understand how other things can be addressed to help deal with difficult behavior.
August 29, 2024
A must read for anyone who cares about education
March 29, 2025
Much like a Uni course, I learned a lot but it's not very readable. And let's just say that now I'm even more sure that I will never want kids...
March 10, 2017
Świetna książka pokazująca, że wiele zachowań dzieci to nie choroba psychiczna czy ADHD, ale próby poradzenia sobie z emocjami, stresem, oczekiwaniami. Autor nie zaprzecza, że część dzieci ma chorobę dwubiegunową czy ADHD, ale zwraca uwagę, że w ostatnich latach u dużo większej liczby dzieci diagnozuje się choroby psychiczne. Książka też nie jest przeamerykanizowana jak wiele poradników.
June 7, 2014
The crux of psychotherapist Gnaulati's thesis is this: "It can be empowering for parents to look a their children's difficulties with the knowledge that the causes are a blend of biological, social and psychological factors. It absolves them of the inaccurate and unfair charge that their child's (disproportionately boys') troubles are due solely to parental faults and failings." That being said, the effects of labels and neuro-pharmaceuticals are long lasting, detrimental, and above all, fail to address the root of the problematic behaviors, which can often be corrected with enlightened appropriate action.
Gnaulati presents significant evidence for the egregious overdiagnosis of ADD and ADHD and makes a compelling case that the presenting behaviors are not due to brain abnormality, but rather "deficits in working memory are also due to overconfident kids rejecting the sort of practice that makes basic knowledge automatic" (c.f. Twenge and Campbell's The Narcissism Epidemic, 2009). Amusingly, he draws on the alternate label Deficit in Attention Disorder (DAD), for "it is from Dad that pride and recognition are really needed." Children require appropriate appreciation for their "enthusiastic displays of mastery [especially physical in the case of boys]" and problems arise when such actions "have been regularly met with rejection, indifference, or [conversely] overindulgence." Echoing Twenge and Campbell, Gnaulati warns of the ever increasing threat not of "too little self esteem, but too much of it," and emphasizes the need for children to be "connecting to people, places, and things outside of their own narrow comfort zones."
Gnaulati then points to the 4000% increase in the number of children diagnosed with bipolar disorder since the mid-1990s who no longer meet the criteria as adults. He asserts that emotional meltdowns are "expectable reactions to teens encountering conditions where they have to 'show the goods,'" when they have developed extraordinarily inflated self-concepts or perceptions of their abilities.
Perhaps the weakest chapter that finds the author a bit off the rails deals with children on the autistic spectrum. "Brainy, willful, and introspective" may apply to some or even many of those diagnosed, but certainly not the ones I know.
"Parenting With Authority" is the most compelling section of this book and is worth the price of the book on its own. The author affirms the cultivation of self-discipline and mastery by children managing their own time and activities. He underscores the smothering effect of parents attending every sports event and performance. With respect to technology, Gnaulati is emphatic: no TV, computer, smartphone or game consoles in the bedroom (for better monitoring of content and time) and no screen time within an hour of bedtime (c.f. Steiner-Adair's The Big Disconnect: Protecting Childhood and Family Relationships In the Digital Age, 2013). Parents must ensure that children get sufficient sleep (a key factor for health, achievement, and behavior that is too often ignored). Finally, Gnaulati provides excellent communication techniques to help the most beleaguered parent to gain control and lead all concerned to [unmedicated] domestic tranquility.
Highly recommended for educators and parents.
Gnaulati presents significant evidence for the egregious overdiagnosis of ADD and ADHD and makes a compelling case that the presenting behaviors are not due to brain abnormality, but rather "deficits in working memory are also due to overconfident kids rejecting the sort of practice that makes basic knowledge automatic" (c.f. Twenge and Campbell's The Narcissism Epidemic, 2009). Amusingly, he draws on the alternate label Deficit in Attention Disorder (DAD), for "it is from Dad that pride and recognition are really needed." Children require appropriate appreciation for their "enthusiastic displays of mastery [especially physical in the case of boys]" and problems arise when such actions "have been regularly met with rejection, indifference, or [conversely] overindulgence." Echoing Twenge and Campbell, Gnaulati warns of the ever increasing threat not of "too little self esteem, but too much of it," and emphasizes the need for children to be "connecting to people, places, and things outside of their own narrow comfort zones."
Gnaulati then points to the 4000% increase in the number of children diagnosed with bipolar disorder since the mid-1990s who no longer meet the criteria as adults. He asserts that emotional meltdowns are "expectable reactions to teens encountering conditions where they have to 'show the goods,'" when they have developed extraordinarily inflated self-concepts or perceptions of their abilities.
Perhaps the weakest chapter that finds the author a bit off the rails deals with children on the autistic spectrum. "Brainy, willful, and introspective" may apply to some or even many of those diagnosed, but certainly not the ones I know.
"Parenting With Authority" is the most compelling section of this book and is worth the price of the book on its own. The author affirms the cultivation of self-discipline and mastery by children managing their own time and activities. He underscores the smothering effect of parents attending every sports event and performance. With respect to technology, Gnaulati is emphatic: no TV, computer, smartphone or game consoles in the bedroom (for better monitoring of content and time) and no screen time within an hour of bedtime (c.f. Steiner-Adair's The Big Disconnect: Protecting Childhood and Family Relationships In the Digital Age, 2013). Parents must ensure that children get sufficient sleep (a key factor for health, achievement, and behavior that is too often ignored). Finally, Gnaulati provides excellent communication techniques to help the most beleaguered parent to gain control and lead all concerned to [unmedicated] domestic tranquility.
Highly recommended for educators and parents.
November 20, 2013
As a parent to a special needs child I am always searching for resources that can help me with my daughter. It is both exciting and mind boggling to see the new types of material that are being made available to both parents and community. This information has been both a blessing and a burden. It seems that with the advancement of technology there has been a trend to over diagnosis children with either autism or other cognitive/emotional disorders. I have personally experienced this with my daughter who was believed to have autism and tested 4 times. Each set of intense testing methods proved that my daughter was not autistic, but instead had severe expressive and receptive language disorder that was comorbid with ADHD. However, even with her diagnosis coming from a professional and trusted setting, we still had issues with her school. They frequently argued the diagnosis and went as far as to seek a professional center’s opinion. Once again the school was told no and we are still fighting the teachers that cannot seem to accept her diagnosis of language disorder. This book is about what other parents have gone through with their children. It is an in depth look at why there seems to be an epidemic of autism, ADHD, and other developmental disorders. It attempts to provide an alternative explanation for children’s current behavior and why some behavior is deemed strange or disturbing. The author goes into great detail on subjects such as over diagnosing, early age labeling, behavioral issues, and emotional instability.
I found this book to be very unique and refreshing. I can say that I don’t fully agree with everything, but it has really made me question some of my current beliefs. I really enjoyed how the author presented the subjects in a way that both educators, parents, and medical staff can easily read. I found his interpretation of childhood behaviors fascinating. One concept that I fully agree with is the notion of over diagnosing. I have personally experienced this and believe that it is chronic in both the school setting and medical community. This book is an important addition for any parent’s library or resource list. I think it is a wonderful book that really opens parents’ eyes on alternative views of current common childhood disorders. My hope is that those in the medical community give this book a chance and see its message and realize its importance.
I found this book to be very unique and refreshing. I can say that I don’t fully agree with everything, but it has really made me question some of my current beliefs. I really enjoyed how the author presented the subjects in a way that both educators, parents, and medical staff can easily read. I found his interpretation of childhood behaviors fascinating. One concept that I fully agree with is the notion of over diagnosing. I have personally experienced this and believe that it is chronic in both the school setting and medical community. This book is an important addition for any parent’s library or resource list. I think it is a wonderful book that really opens parents’ eyes on alternative views of current common childhood disorders. My hope is that those in the medical community give this book a chance and see its message and realize its importance.
December 12, 2016
I've been mentoring a girl (from ages 10 to 16 so far) who was diagnosed with ADHD at age 10 but was re-diagnosed a few months ago. Now we're told that she wasn't actually ADHD but is bipolar instead. I spend hours with her each week in varying circumstances, and her actions are those of a normal child who is desperate for more attention and a little slow in developing socially due to lack of social opportunities. As much sympathy as I have for her teachers and her parents, I always doubted that she really had ADHD or has bipolar or that medication has actually helped the core problems. She's used ADHD as an excuse for not trying because if she fails at anything, it's because she was ADHD. This is not the result the teachers and her parents were hoping for.
So obviously I wanted to know "why doctors, teachers, and parents incorrectly diagnose healthy American children with serious psychiatric conditions." This book did clearly explain why so many children are being diagnosed with these problems and why they are so quick to label and medicate them. He talked about various environmental aspects (like lack of sleep), emotional aspects (like need for attention), and developmental aspects (like how its normal for young children to act in certain ways) that explain some of the behaviors that can be misdiagnosed as disorders. He also explained how changes in recent years in school expectations and in the medical field may lead to misdiagnosis. He backed up his assertions with facts that you can double-check rather than expecting the reader to just take his word for it.
The author also clearly explained the differences between normal children with problem behavior and true cases of ADHD, bipolar, and autism spectrum disorder. He used examples of real children that he's worked with in his clinic to show this distinction, which I found helpful. He also gave some examples of how parents (and other adults) can use behavior modification steps to help normal children with behavior problems.
The book was easy to follow and understand. I'd highly recommend this book to people who work with children, especially teachers, and to parents who worry that their child may have ADHD, bipolar, or autism spectrum disorder. Read it before the child is labeled and medicated so you can make an informed decision.
I received this review copy from the publisher through Amazon Vine.
So obviously I wanted to know "why doctors, teachers, and parents incorrectly diagnose healthy American children with serious psychiatric conditions." This book did clearly explain why so many children are being diagnosed with these problems and why they are so quick to label and medicate them. He talked about various environmental aspects (like lack of sleep), emotional aspects (like need for attention), and developmental aspects (like how its normal for young children to act in certain ways) that explain some of the behaviors that can be misdiagnosed as disorders. He also explained how changes in recent years in school expectations and in the medical field may lead to misdiagnosis. He backed up his assertions with facts that you can double-check rather than expecting the reader to just take his word for it.
The author also clearly explained the differences between normal children with problem behavior and true cases of ADHD, bipolar, and autism spectrum disorder. He used examples of real children that he's worked with in his clinic to show this distinction, which I found helpful. He also gave some examples of how parents (and other adults) can use behavior modification steps to help normal children with behavior problems.
The book was easy to follow and understand. I'd highly recommend this book to people who work with children, especially teachers, and to parents who worry that their child may have ADHD, bipolar, or autism spectrum disorder. Read it before the child is labeled and medicated so you can make an informed decision.
I received this review copy from the publisher through Amazon Vine.
July 5, 2021
Good book. Good points. However in some ways it leaves a lot more questions than answers.
For starters it mainly talks about ADHD and specifically ADHD in boys. Would have liked more on autism, bipolar, etc. But more importantly about girls. Pretty much a about book soley about ADHD in boys. What does a girl with bipolar, ADHD look like vs "normal" behavior. It doesn't say.
Another way this book left me confused: it says a lot about what makes a kid NOT have ADHD, autism, etc. It talks a lot about misdiagnosis. But the author makes it clear he believes ADHD does exist and is a real condition. So that leaves the question: what symptoms/traits make a kid to actually have ADHD, autism, or bipolar for real vs just "normal' childhood? Again it doesn't say.
Also like all books of this type it is a lot easier to like it if you agree with its points.
Finally this book isn't terribly exciting unless you are interested in the topic.
The last chapter was the best in the book and did a good job explaining everything as well as offering parenting tips that are really just communication tips that would work with anyone.
All in all, I do appreciate this book and giving some thought and perspective on how we go right to diagnosing kids instead of just letting being kids.
For starters it mainly talks about ADHD and specifically ADHD in boys. Would have liked more on autism, bipolar, etc. But more importantly about girls. Pretty much a about book soley about ADHD in boys. What does a girl with bipolar, ADHD look like vs "normal" behavior. It doesn't say.
Another way this book left me confused: it says a lot about what makes a kid NOT have ADHD, autism, etc. It talks a lot about misdiagnosis. But the author makes it clear he believes ADHD does exist and is a real condition. So that leaves the question: what symptoms/traits make a kid to actually have ADHD, autism, or bipolar for real vs just "normal' childhood? Again it doesn't say.
Also like all books of this type it is a lot easier to like it if you agree with its points.
Finally this book isn't terribly exciting unless you are interested in the topic.
The last chapter was the best in the book and did a good job explaining everything as well as offering parenting tips that are really just communication tips that would work with anyone.
All in all, I do appreciate this book and giving some thought and perspective on how we go right to diagnosing kids instead of just letting being kids.
July 2, 2014
Gnaulati is largely preaching to the choir here, so don't expect tons of detailed stats and studies. Yet, I wouldn't write him off. In a book world full of stats and studies, Gnaulti offers something even better- a professional clinician's explanation of his day to day job.
First, Gnaulti gives you an understanding of what normal childhood development looks like, especially in boys. Then he breaks down what is supposed to happen when a diagnosis of ADHD, Autism, or Bipolar is made (for example, the situation must exist in two locations: home AND school), and what exactly the criteria for these technically are. Finally, Gnaulti lets you know exactly what kind of training and background various mental health professionals bring to the table (who can proscribe drugs, who has the most childhood development coursework, etc.). In the myriad of books on the subject, Gnaulti is radical by simply describing two of his patients and showing why one has (in his professional opinion) ADHD and the other does not. This kind of information is invaluable for those looking for a more complete picture of childhood mental health.
First, Gnaulti gives you an understanding of what normal childhood development looks like, especially in boys. Then he breaks down what is supposed to happen when a diagnosis of ADHD, Autism, or Bipolar is made (for example, the situation must exist in two locations: home AND school), and what exactly the criteria for these technically are. Finally, Gnaulti lets you know exactly what kind of training and background various mental health professionals bring to the table (who can proscribe drugs, who has the most childhood development coursework, etc.). In the myriad of books on the subject, Gnaulti is radical by simply describing two of his patients and showing why one has (in his professional opinion) ADHD and the other does not. This kind of information is invaluable for those looking for a more complete picture of childhood mental health.
November 16, 2015
Intelligent, thoughtful, respectful book which considers the enormous rise in psychiatric diagnoses in children.
The first part is quite interesting. He offers an array of shifts that he thinks are driving the rise in diagnoses or referrals to child behavioral health services. Gnaulati backs up his claims with statistics and anecdotes. He also argues that the focus on chemical imbalances makes us neglect environmental/nurture issues and lobbies for rebalancing with traditional psychotherapy.
The second part teases apart the stated symptoms for a disorder and other causes. He includes a lot of case studies and explains why he thinks child A has a major disorder while similar-behaving child doesn't. This section can come off as overconfident or conceited, but he backs up each diagnosis with solid reasoning.
There is a short section at the end offering general parenting advice, how to find good child therapists, and telling parents to trust their guts about whether or not to seek professional help for their children.
The book is easy to read without being dumb, and is an excellent read.
The first part is quite interesting. He offers an array of shifts that he thinks are driving the rise in diagnoses or referrals to child behavioral health services. Gnaulati backs up his claims with statistics and anecdotes. He also argues that the focus on chemical imbalances makes us neglect environmental/nurture issues and lobbies for rebalancing with traditional psychotherapy.
The second part teases apart the stated symptoms for a disorder and other causes. He includes a lot of case studies and explains why he thinks child A has a major disorder while similar-behaving child doesn't. This section can come off as overconfident or conceited, but he backs up each diagnosis with solid reasoning.
There is a short section at the end offering general parenting advice, how to find good child therapists, and telling parents to trust their guts about whether or not to seek professional help for their children.
The book is easy to read without being dumb, and is an excellent read.
October 1, 2013
I got this book for free through the Amazon Vine program. As we were having a great deal of difficulty in getting our youngest child into school because he has some undiagnosed special need, I was ecstatic to find this book. Personally, in my degree program, I had studied ADHD and Autism. It is fascinating to see how they have both exploded in diagnoses in the past 20-30 years. Is it because of something in the water or, more likely, is it because the diagnostic criteria have broadened.
Dr. Gnaulati explores the idea that not only have the diagnostic criteria been broadened, but schools and parents are searching for their children to be "normal". But, as he discusses in the book, often these are just different learning styles and we are trying to fit the children into a box. Educators, in particular, want the "perfect student".
While we still don't know what's "wrong" with our son, I am still very glad to have read this book. I think it's very helpful for those struggling with a potential diagnosis.
Dr. Gnaulati explores the idea that not only have the diagnostic criteria been broadened, but schools and parents are searching for their children to be "normal". But, as he discusses in the book, often these are just different learning styles and we are trying to fit the children into a box. Educators, in particular, want the "perfect student".
While we still don't know what's "wrong" with our son, I am still very glad to have read this book. I think it's very helpful for those struggling with a potential diagnosis.
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