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ADHD: Attention Deficit Hyperactivity Disorder
Childhood Mental Disorders and Illnesses

by Echo R. Fling
Jessica Kingsley, 2000
Review by Monique Thornton, M.S.W. with Kendell Thornton, Ph.D. on Feb 26th 2002

Eating an Artichoke

            When the author’s son was a preschooler his teacher expressed concerned that his social skills were different compared to the other children, that he seemed to use dialogue from videos/movies to communicate with others and that he often seemed overstimulated by auditory stimuli.  The author first went to her son’s pediatrician for an evaluation and he referred her to a social-skills therapist.  Although Jimmy did not receive the diagnosis of Asperger at that time (only some vague possible diagnostic suggestions) he began to receive appropriate therapy with a skilled therapist.  More evaluations followed after Jimmy entered school.  In first grade, Jimmy was diagnosed with ADHD and started on Ritalin, which he stayed on for over a year.  Finally, after seeing a pediatric neurologist her son was diagnosed with Asperger Syndrome at the age of 9.  

            Asperger Syndrome has 5 diagnostic criteria categories according to the Diagnostic and Statistical Manual of Mental Disorders-IV: 1) qualitative impairment in social interaction as manifested by at least two of four behaviors listed.  2) failure to develop peer relationships appropriate to developmental level.  3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people.  4) lack of social or emotional reciprocity.

            Some may criticize the importance this author places on getting a diagnosis.  However, without a diagnosis it is difficult to get appropriate and necessary treatment for a child.  Parents need a diagnosis not only to get services for a child in the school system, but also they need a diagnosis to help make sense of the sometimes challenging and/or confusing behaviors they see in their child.  Once an accurate diagnosis is received, it is as if parents are often able to move on, accept that their child has special needs and begin the process of meeting those needs through appropriate services and parenting skills.  All of this is done with the hope that the child and family will be able to reach their full potential.

            Fling’s book is readable and at times quite funny.   It fills a void in the Asperger’s literature.   Many parents of children with Asperger’s want to read about how other parents have struggled with similar issues and share vicariously their successes and failures. As a clinician and as a parent of a child with Asperger Syndrome, I know how incredibly therapeutic and reassuring it can be to hear that I am not the only one who has experienced some of these same issues.  The author has significant insight into how having a child with Asperger’s affects the family dynamics. 

            This book is a useful resource for parents, teachers and professionals working with children with Asperger Syndrome.  It supports families in realizing they are not alone and that others have been through very similar experiences.  Fling also does a service for parents in that she reinforces how important it is for parents to listen to their intuition.  She describes that her intuition guided her to keep searching for an appropriate therapist, school placement for her son, an appropriate diagnosis and style of parenting that meets the needs of the family.

            Fling does an impressive job exemplifying characteristics sometimes associated with Asperger Syndrome.  She describes her son’s sensory integration difficulties, his need for sameness and consistency, difficulty with transitions, lack of common sense, and at times her son’s overwhelming fear and worry, in a way that makes it obvious these are not your typical childhood behaviors. 

            Fling indicates that others have accused her of being an overindulgent mother when she makes allowances for her son’s needs, like finding just the right pair of socks (due to his tactile defensiveness) or modifying the family’s schedule in order to prevent difficulties, when in fact she is listening to her intuition and using her past experience to successfully navigate the present.  For example, Fling describes how her son’s condition has impacted the family’s celebrations and special occasions.  She says, “sure, we celebrate just like everyone else does.  But with special considerations and modifications...Yet, when you think about all the little things where Jimmy’s quirks had to be accommodated, it’s quite exhausting.”  Fling has learned from past experience how important it is to listen to her son, her family and her intuition to truly understand what it will take to meet Jimmy’s needs in the context of family and society.

            What is most meaningful is that the author never loses sight of her son’s strengths.  I think it is easy to focus on the challenges and become discouraged when a child struggles with situations that other children do not. However, to focus on a child’s strengths is to have hope and confidence that his potential can be realized.

            I think the book is a useful reference for parents and other family members of those affected by Asperger’s.  The author’s metaphor for the title of the book is quite different from what I expected when I first picked up the book. The title of the book refers to the author’s perception of how eating an artichoke is similar to the process it took in getting an accurate diagnosis for her son.  Fling describes, “My five year journey for an answer finally came to an end.  After years of peeling back thorny leaves, I finally had the heart of my artichoke”. 

            I like the author’s metaphor; that the outer, tough leaves of the artichoke are like the challenge in advocating for a child by navigating the complex system of doctors, therapists and the school system.  If parents are persistent, they often get to the heart, an accurate diagnosis and the support and guidance he needs.  However, with my son in mind, I also understood the title as a reference to how in Asperger’s, there are confusing and challenging behaviors, but if you peel away some of those layers you get to the really rich and tender heart. 


© 2002 Monique Thorton and Kendell Thornton


Kendell C. Thornton, Ph.D. is currently an Assistant Professor in Psychology at Dowling College, Long Island, NY. He earned his B.S. in Psychology from the University of Idaho, M.S. in Social Psychology from the University of Montana, and Ph.D. in Social Psychology from the University of Kansas. His current research interests include interpersonal relationships, with a focus on emotions, motivations, and self-concept.  Monique Thornton earned her MSW in 1993 from the University of Kansas. Kendell and Monique are the parents of a 5-year-old with Asperger Syndrome.