The events severely strain credulity - and although some young readers will have personal or familial experience with ADHD, post-partum depression, alcoholism, divorce/estrangement, blindness, and/or babysitting, they may not realize that what unfolds is totally implausible.
Let's just pretend that it really could happen. If so, then we all need to put down our novels and get busy fixing things, because this should never happen!
On the other hand, if Gantos knows that this whole giant mess never would really happen - then how does he expect young readers to recognize this is only a comedy of errors, not dark reality? Especially when the tone of the whole book is more in line with "coping-with-darkest-reality."
I strongly believe that even in the worst case scenarios, the school nurse would NOT simply hand him a replacement medical patch & not bother to phone his mother to follow up on it; the school secretary would NOT allow him to leave school without an adult after an obviously disturbing phone call from a parent in a family where very serious issues have already been observed; a parent with post-partum depression would NOT arm herself with a meat cleaver but fail to notify one single adult in her life/neighborhood/school that her ex-husband is violent & angry & a potential kidnapper, yet she would leave a 7- to 11-month old baby alone with her middle-school-age son, who she knows is prone to accidents & impulsive behavior, especially when off his meds, which she knows he is.
IF Joey's mother trusts his ability to cope with taking care of himself AND the baby -- more than she trusts doctors, nurses, teachers, & social workers, THEN why does she take every opportunity to undercut him, and set him up for failure? IF her mental illness is so severe that it provides an explanation for her decision to abandon them and her simultaneous failure to give Joey any ounce of support (money, phone number of the hospital, food, instructions, pep-talk, ADHD medication), THEN surely during her admission to the hospital the intake nurse must have asked her about her family, and discovered that she had a family depending on her. It doesn't make sense, and it is misleading to young readers to think that a young person in Joey's implausible situation could actually cope with it.
In fact, he breezes through baby-care, house-cleaning, & shopping so effortlessly & joyously, that it might be hard for a young reader to respect Joey's mother, or care about her safe return.
The story celebrates Joey's amazing capabilities and wisdom, but the unrealistic sequence of events give it an in-authenticity that negates Gantos' desire to let readers connect with the flawed characters in order to build empathy. The result could back-fire; readers may expect all kids with ADHD to have depressed or alcoholic parents (Joey repeatedly ponders the cause-effect cycle), and to be amazingly competent, gifted, & brave.
Will young people be able to switch gears fast enough that they will want to read about a boy killing cockroaches (with his bare hands and having to force himself NOT to lick his hands after) and then read about how his baby brother is such a sweet buddha and his blind girlfriend is tired of everything around her always being black? A person with ADHD might think like that, but the rest of the population (85% of kids *don't* have ADHD) may not enjoy the extreme personality shifts.
If this is an authentic representation of people with ADHD, post-partum depression, & blindness, then they need more cohesive treatment.