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“A” is for Alexithymia

January 14, 2012

Thanks for entertaining my relative silence here this week. Between RSV going through the family and a grant application due yesterday, I haven’t done much else. But the goop is lifting, the grant is submitted, and about 8:00 PM last night I sat down with a book that has been waiting for me: Kieran D. O’Malley, Ed. ADHD and Fetal Alcohol Spectrum Disorders (Nova Biomedical, 2007).

Warning: the least expensive copy is $120. Used copies start at $999. And before we all flock to our library websites to request what we can’t afford: there are only two copies in Minnesota (I have one of them) –which is pretty good considering that there are only 81 copies owned by libraries in the entire world.

It is not like ADHD and FASD are orphan diseases. O’Malley cites incidence statistics of about 9.1 per 1,000 live births in Seattle and 40 per 1,000 in South Africa (p.3).  You’d think this book would be in wider circulation. But I digress.

O’Malley summarizes the book this way in his Preface.  “This book has a beginning, a middle, and an end.  It starts with a general overview of FASD, and then moves on to infancy and early childhood. Along the way, professionals from varied disciplines attest to the multi-faceted complexity of FASD. Parent/child support, sensory integration, language therapy, neuropsychology all have their critical roles to play. FASD are not ‘doc in a box’ conditions. They subscribe to the well recognized wisdom of generations of the management of of developmental disability, and it is only through a marriage of different professionals adequate care can be provided. The meat of the book involves dealing with uncomfortable behaviors such as aggression and ADHD when underlying brain damage makes medication unpredictable, or sexually inappropriate impulsive behaviors, or again the inability to express emotions in acceptable verbal language (alexithymia). The book ends with a review of multi-modal management strategies, offering a panoply of ideas and techniques which are often needed to approach such a patient population.

This book has no pretensions to academia. The authors are all well qualified and recognized in their fields. They command years of collective, varied clinical experience, and it was my hope that they would offer a template for management in the context of the reluctance of government agencies in the U.S. (NIH) or the UK (MRC) to become involved in outcome studies of the practical management of FASD. Sometimes it seemed that FASD patients were not just orphans in their own right but also from modern medicine. Their challenges seen as too vague, too complex.

So here is a book that analyses the ins and outs of ADHD as it appears in FASD, and offers a range of insights into understanding and management.” (p. viii)

Since there is no Look Inside feature, I will paraphrase the chapter titles to give you some idea of the scope:

Chapter 1: an overview of  FASD

Chapter 2: caring for infants and toddlers with FASD

Chapter 3: sensory integration differences in FASD

Chapter 4: the unique presentation of ADHD and medication management for it in FASD

Chapter 5: preventing FASD by reaching out to birthmothers

Chapter 6: neuropsychological characteristics of children and teens with FASD and ADHD

Chapter 7: neuropsychological characteristics of adults with FASD

Chapter 8: sexually inappropriate behavior in FASD

Chapter 9: social communication deficits in school-aged kids with FASD

Change 10: diagnosing and treating FASD and ADHD in the real world

Chapter 11: multidisciplinary management of FASD across the lifespan

Chapter 12: psychodynamic management of FASD in adults

The post title? I have  a thing for beautiful, awful words. Parasomnia keeps us awake at night. Melt-downs come from Alexithymia.

More to come from O’Malley’s book this week  –after I pay some serious attention to our house, which looks like I just got back from a vacation where everyone else stayed home :).

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3 Comments leave one →
  1. Karla (Mom2MissK) permalink
    January 14, 2012 11:20 am

    Sounds very interesting! I , for one, will be looking forward to your review!

  2. January 14, 2012 11:24 am

    humm….can I borrow it if you finish it before it’s due? I have Fatal Link for you Sunday. 🙂

  3. mabiclark permalink
    January 14, 2012 12:23 pm

    OH, I have been wanting to read that book forever too!!!!!! Where did you get it from?

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