Taking Charge of ADHD

Its full title is Taking Charge of ADHD: The Complete, Authoritative Guide for Parents. The fourth edition came out from Guilford Press on 12 June 2020, 381 pages. The publisher writes that more than half a million copies of the book have been printed. The publisher's and library descriptions say the book was written for parents of children with ADHD between the ages of 6 and 18.

Its edition history is short. Guilford's editions page shows the first edition as 1996, the revised edition as 2000 and the third edition as 2013. Library records show the first edition as 1995 and give 294 pages, which means the book grew by about ninety pages over twenty-five years.

There is a Turkish edition. Palme Yayınevi published it under the title Dikkat Eksikliği ve Hiperaktivite Bozukluğu (DEHB) ile Baş Edebilme, translated by Şebnem Sevinç and Ülkü Pişkin Abidoğlu, 362 pages. I saw this on the publisher's own page and at Nobel Kitabevi, and the Amazon Turkey record gives the date 8 October 2021. I could not verify which English edition it was translated from. If you are buying it for the new material in the fourth edition, I recommend checking the table of contents.

This review is based on the book's table of contents, the publisher's description and published reviews. I do not claim to have read it page by page. I describe the chapters only as far as the titles and the publisher's text support.

The author

Russell Barkley was born in 1949 and did his doctorate in clinical psychology at Bowling Green State University. In 1977 he founded the neuropsychology service at the Medical College of Wisconsin, from 1985 to 2000 he directed psychology at the University of Massachusetts Medical School, and then worked at the Medical University of South Carolina and Virginia Commonwealth University. He founded the journal The ADHD Report, which runs to thirty volumes, and led the first international consensus statement on ADHD.

This researcher identity sets the tone of the book. Barkley approaches the parent not with good wishes but with evidence. In his own disclosures he also states that he receives royalties and speaking fees from publishers and pharmaceutical companies. Readers have a right to know this while reading the medication chapters; this information does not make those chapters wrong.

The starting idea: the real problem is not attention

The name of the second chapter in the table of contents carries the book's whole framework: it asks, "What is the real problem with my child?" and gives the answer in two words, poor self-regulation. The translation of the title is mine.

This is Barkley's theory in parents' language. He sees ADHD less as a deficit of attention than as a problem of being able to use what one knows at the right moment and to steer behavior toward a goal. The academic name for this framework is executive functions. On the site I also reviewed ADHD and the Nature of Self-Control, which works through the same theory across a whole book.

The practical consequence for the parent is this: instead of thinking the child "won't do it," thinking the child "can't do it at that moment." All of the book's later suggestions are built on this sentence.

Inside the book: the introduction and part one

The book opens with an introduction titled "A guiding philosophy for parents," followed by part one, six chapters on understanding ADHD.

In order, they cover: what ADHD is, poor self-regulation, what causes ADHD, what does not, the developmental course of the disorder, and the family context of a child with ADHD. Devoting a whole chapter to what does not cause it is, I think, the book's most compassionate decision. A large part of parental guilt can be untangled here. The heredity chapter helps with this too: Faraone and Larsson's 2019 review gives the heritability rate as about 74 percent.

The question parents ask most often is whether the child will grow out of it. I cannot see from the table of contents what answer the chapter on developmental course gives to this. Its title says "what to expect." Among the additions the publisher lists for the new edition are up-to-date information on causes, sibling issues and advice for parents who may have ADHD themselves. I cannot say for certain from the table of contents which chapters these went into.

Part two: the executive parent

Four chapters: deciding to have the child evaluated, preparing for the evaluation, coping with the diagnosis, and looking after yourself under the heading "for parents only." The title of the part is Taking Charge: How to Be a Successful Executive Parent. I translate "executive parent" as yönetici ebeveyn.

The reading I draw from the title and from Barkley's theory is this: for a while, the parent takes on from the outside the executive functions the child is missing; the parent builds the structure, the reminders and the plan. As someone who was diagnosed at 22, I look at this idea with sympathy, because I think it would have made a big difference if the outside structure I try to build for myself in adulthood had been built deliberately by someone in my childhood. This is not a memory but an interpretation.

I do not look down on the chapters devoted to coping with the diagnosis and to the parent looking after themselves. Most books devote zero pages to the parent's own feelings after the diagnosis. Here there are two chapters.

Part three: at home and at school

This is the heart of the book, its longest part with eight chapters. In order: better behavior in eight steps, the art of problem solving at home, peer problems, adolescence (with Arthur L. Robin), a healthy lifestyle, getting off to a good start at school and enhancing education at school and at home (both chapters with Linda J. Pfiffner), and keeping school performance on track.

I could not verify what each of the eight steps is. The publisher describes the plan with the phrases "using rewards and incentives effectively," "parenting techniques that improve behavior" and "restoring peace at home." I will not list the steps myself, because listing them wrongly would mislead a parent. I know the plan's family: parent behavior management training. On the site I described this family of methods in the parent training programs article, and the reward side in the reward system article.

The subtitle of chapter seventeen says "kindergarten to grade 12"; this is a framework built on American school levels. For a parent in Turkey, the classroom suggestions carry over, but legal rights and planning processes do not. I do not know whether the Turkish edition adapted these.

It is meaningful that the adolescence chapter was written with Robin. Robin is a clinician who has worked for many years with adolescents with ADHD and their families. Devoting a separate chapter to adolescents means accepting that eight steps written for a young child will not work the same way for a teenager.

Part four and the back of the book

Two chapters: approved, effective stimulant medications and other medications. Two out of twenty chapters, that is, a tenth of the book. I think this ratio shows the book's stance: medication is part of treatment, but the book's weight is on the tools in the parent's hands. The decision about medication is made with a doctor; a book does not replace that conversation. It is also worth keeping in mind that medication names and licensing status in America are not the same as in Turkey.

The book ends with parent support services, suggested reading, references and an index. The publisher's page also mentions downloadable and printable worksheets. These are provided as PDFs. I do not know whether they are in the translation too.

Its strongest points

First, scope. From the diagnosis to home, school, adolescence and medication, a chapter is devoted to most of the questions a parent will face in the first years. In the quotes on the publisher's page, Peg Dawson names the book as a reference source for clinical practice, and Edward Hallowell highlights the new scientific information in the fourth edition and Barkley's experience and kindness. These are words the publisher chose and do not count as impartial criticism.

Second, it moves the blame out of place. The "what does not cause it" chapter and the self-regulation framework together answer the sentence "if I were a good parent, this wouldn't be happening" with evidence.

Third, it has brought the parent themselves into the book. A chapter on self-care and the addition of advice for parents who may have ADHD are two of the things the publisher highlights for the fourth edition. Given that ADHD is inherited from parent to child, I think this is well placed.

Weak points and evidence

The plan comes from an evidence-based family, but the book itself has not been tested. The American Academy of Pediatrics' 2019 guideline (Wolraich et al.) recommends parent behavior training as the first step at preschool age, and together with medication at school age. This gives confidence in the method the book is based on. But it does not show that a parent who reads and applies the book alone will get the same result as from a program run with a trainer. I have not come across a study testing the book used in this way.

The evidence for behavioral interventions is narrower than expected. The 2013 meta-analysis by Sonuga-Barke et al. (54 studies out of 2,904 records) screened non-drug treatments for ADHD. When the people rating the outcomes were blinded so that they did not know about the intervention, behavioral interventions had no significant effect left on core ADHD symptoms. The 2018 review by Daley et al. arrives at the same place: with blinded measures, parenting practices and co-occurring behavior problems improve, but they cannot be supported as a first-line treatment for core symptoms. So the eight steps can reduce conflict at home, but they do not remove the attention problem. I could not see from the table of contents to what extent the book says this. This is what the reader needs to know.

Barkley's program is not the only option. The same 2018 review writes that both general and ADHD-specific parent training showed benefit. I found no evidence showing Barkley's plan to be superior to other programs.

The disorder framework. There are criticisms that Barkley describes ADHD mostly through its risks and functional impairments; I saw this in the summary of a CHADD piece. A reader review on Indigo also says they did not find much hope in the book. On the other hand, the journal of the American Academy of Child and Adolescent Psychiatry found the tone of the first edition hopeful. So this is a difference in reading. On the site I discussed the exact opposite, a strength-weighted framework, in books such as The Gift of Adult ADD. I think the two cannot be separated, but in a parenting book the balance struck between risk and hope is an important choice.

The parent who has ADHD themselves. The plan demands consistency, remembering and order. The publisher writes that advice for parents who may have ADHD was added in the fourth edition, which is good, but I cannot see how sufficient that advice is. On this subject the being a parent with ADHD article is a start.

Who it is for, and who it is not

For a parent whose child is between 6 and 18 and who has been diagnosed or is in the process of diagnosis. For those who want to separate what is evidence-based from what is myth among conflicting information. For someone who wants to prepare for school meetings, manage conflict at home and know what to ask the doctor.

A preschool-age child falls outside the age range the publisher draws. An adult reader with ADHD, on the other hand, should look at the book Barkley wrote separately.

Do not let it be the first book for someone seeking consolation. Barkley gives information and builds a plan. For a parent looking for emotional companionship, another book is more suitable.

It is not a book to read from start to finish in one go. First read part one and the chapters on the diagnosis, then go to whichever chapter covers where you are stuck.

Its place on the shelf

Barkley's books on the shelf are different doors. Taking Charge of ADHD is for the parent of a child, Taking Charge of Adult ADHD for the adult reader. In 2020 Barkley published another short parenting book with the same publisher, 12 Principles for Raising a Child with ADHD. It looks like a distilled, softer-toned version of this thick guide. If deciding which to get first feels hard, choose this one if you need the eight-step plan and the full structure, and the other one if you want a short, warm introduction.

The evidence store behind it is ADHD: A Handbook for Diagnosis and Treatment, edited by Barkley. If you wonder what research stands behind the parent guide, you can look there. For a warmer parenting read that puts the relationship first, it can be read side by side with Superparenting for ADD.

My stance

I think this book is one of the most comprehensive single-volume books written for the parent of a child with ADHD, and even its table of contents shows this. But it needs to be held not like a rulebook but like a map: the eight steps can reduce friction at home, they do not change the child's brain, and a parent who knows this from the start expects realistic things from both the book and themselves.