The Last Normal Child
Essays on the Intersection of Kids, Culture, and Psychiatric Drugs
by Lawrence H. Diller, M.D.
August 2006, 160pp, 6 1/8 x 9 1/4
1 volume, Praeger

Hardcover: 978-0-275-99096-1
$75, £58, 66€, A103
eBook Available: 978-0-313-08175-0
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The noted psychiatrist who brought us Running on Ritalin reveals intriguing cases from his practice that illustrate the current ethical, political and cultural issues behind the explosion in psychotropic medication use with our children, an increasing number of whom are as young as 8.

Behavioral-developmental pediatrician Lawrence Diller continues his investigation into the widespread use of psychiatric drugs for children in America, an investigation that began with his first book, Running on Ritalin. In this work at hand, Diller delves more deeply into the factors that drive the epidemic of children’s psychiatric disorders and medication use today, questioning why these medications are being sought, and why Americans use more of these drugs with children than is used in any other country in the world.

There is relentless pressure for performance and success on children as young as three, Diller acknowledges, but his analysis goes further, and his conclusion is both surprising and ironic. In the name of preserving children’s self esteem, American society has become intolerant of minor differences in children’s behavior and performance. We worry so much about how our children feel about themselves that struggles once within the realm of normal are now considered abnormal – indicative of a psychiatric or brain disorder, requiring diagnosis and treatment wth psychiatric drugs, often for years. The Last Normal Child also addresses the role of drug companies in the advertising and promotion of both disorders and drugs. The pharmaceutical industry has garnered incredible profits and power in influencing the way we view children today. Diller illustrates through vivid and poignant stories of real patients, how he, together with families, make informed decisions about using psychiatric drugs for children. Parents, educators, pediatric and mental health professionals will gain valuable insights, tips and tools for navigating what has become a truly perilous trip of childhood for children in America today.


"The author is a behavioral-developmental pediatrician with over 20 years of experience in treating problems of behavior and learning in children at home and at school. His previous books on drug use include Running on Ritalin (1998) and Should I Medicate My Child? (CH, Oct'02). In this work he identifies and discusses problems associated with the increasingly widespread use of Ritalin--not only in children with suspected attention deficit hyperactivity disorder (ADHD), but also in young adults (primarily college-age students, before taking the SAT or other tests), and even in adults who wish to improve their intellectual performance. (The Ritalin production rate has increased an astounding 1,700 percent in the US in the last 15 years; the US consumes 80 percent of the world's Ritalin.) The well-written chapters are short essays, each reflecting the author's experiences. Readers will encounter no forced preaching; Diller lets his audience draw its own conclusions....Highly recommended. All levels."—Choice, March 1, 2007

"It cannot be denied that Diller's essays provoke an existential itch....Diller has done us a favor in demonstrating how ADHD occupies a pregnant cultural moment through which psychiatrists will help define future conceptions of nothing less than what it means to be normal."—Journal of American Academy of Child and Adolescent Psychiatry, December 1, 2007

"This text maintains the same high quality of the other volumes in this set and is very readable. Diller's writing style is informal and easy to digest. His many personal accounts dealing with the families of children diagnosed with ADHD give a fresh spin on academic work....[a]nyone with an ADHD child should read this text for the clarity it brings to bear on a somewhat complicated issue. Diller has done a wonderful job of explaining pharmacotherapy for children, and many people will benefit from reading about his experiences."—PsycCRITIQUES, August 8, 2007

"The past few decades have seen both skyrocketing rates of children diagnosed with psychological disorders and a related rise in prescriptions for psychiatric drugs. In The Last Normal Child, Lawrence Diller offers a balanced perspective on these trends, focusing mostly on ADHD and its treatment by stimulant medications....[t]he humility found in the book's uncertainty is ultimately comforting in its own way, and is clearly the main reason that so many families continue coming to Diller for help."—Metapsychology, March 27, 2007

"Diller has witnessed a dramatic change in the kinds of children who are brought to him for behavioural problems by their parents. He aims a great deal of his ire at Big Pharma itself, for pathologizing childhood before offering its E-Z solution. He cites TV ads in which parents, asked if their kids are having trouble with homework, are soothingly offered Ritalin as a solution."—The Toronto Star, December 31, 2006

"The Last Normal Child, explores the root causes of the surge in psychiatric drug treatment for children and suggests different approaches."—USA Today, October 1, 2006

"This book is obligatory reading for anyone who wants to make sense out of the present confusion about medicating children to improve their behavior. Dr. Diller is a rare voice of moderation in this disputed area. He agrees that a few children are greatly improved in the short term by such medications, but he decries the excessive labeling, the unreasonable pressures from schools and parents, the aggressive advertising by the drug companies to parents and physicians, and the neglect of the essential psychosocial management of these children with such traditional techniques as effective discipline."—William B. Carey, M.D., Division of General Pediatrics, The Children's Hospital of Philadelphia, Clinical Professor of Pediatrics, University of Pennsylvania, School of Medicine, Author of Understanding Your Child's Temperament and Coping with Children's Temperament

"We are all caught in the whether-to or whether-not to medicate children who are on the ADHD spectrum. Some children profit from medication, and most don't deserve it. This book may help you sort out when and whether. I liked the stories and the approach to medication that they convey. It is a convincing book."—T. Berry Brazelton, M.D., Founder, Child Development Unit, Children's Hospital Boston, Professor of Pediatrics and Human Development, Brown University^LClinical Professor of Pediatrics Emeritus, Harvard Medical School^LAuthor, 28 books including ^ITouchpoints^R and the classic trilogy Infants and Mothers, Toddlers and Parents, and On Becoming a Family.

"This splendid set of essays provides much the most balanced discussion of the issues involved in using medication to treat children's behavioral problems. Unlike most writings on the topic, this book does not set out to defend or attack medication. Rather, it lays out the medical and ethical considerations, using the best available evidence, in an even-handed way that clearly brings out the complex mixture of risks and benefits. Very readable and very thought-provoking."—Professor Sir Michael Rutter, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London

"Dr. Diller is a sensitive, thoughtful and dedicated physician who cares deeply about his patients and their families. Drawing on his clinical experience, he shares his perspective and concerns about the contemporary treatment of children and adolescents with emotional and behavioral difficulties. Although challenging and provocative, the book is also encouraging and empowering. I'm sure it will prove to be a welcome resource for parents and teachers."—David Fassler, M.D., Clinical Professor of Psychiatry, University of Vermont

"This book is a gem. A book I can imagine both those pro and those anti pills for ADHD agreeing with enthusiastically across a range of points. I can also imagine both camps disagreeing--and disagreeing on exactly the same points. In the ADHD and Ritalin Wars, Larry Diller stands out as a voice of sanity and this book contains a great deal of illumination flooding through the shafts of insights he has driven through the ADHD edifice. In piece after piece dealing with gender or discipline, Diller strikes a note of extraordinary common sense. Extraordinary and common should not be adjectives that go together but in this area common sense is extraordinary and needs celebrating. Parents, teachers, clinicians and policy--makers will find these essays thought-provoking."—David Healy, M.D., Professor of Psychiatry, Cardiff University, Wales, Great Britain
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