Neurophysiologic disorders that impair normal learning as well as social and emotional development afflict at least 5-8 percent of the school-aged children in this country. Significant symptoms often persist into adulthood and many people struggle for a lifetime, never understanding what continues to hamper their functioning. Brainstorms examines questions surrounding the possible neurobiological underpinnings of the emotionally hyperactive and hyperreactive components of A.D.H.D. and related disorders. These "pre-psychological" substrata may, for example, be fundamental to what we think of as temperament. Here is where the regulation of selective attention and the filtration of noise reside, along with the neurosystems behind energy, sleep/wakefulness, and emotional intensity. The "firecracker temperament" often associated with certain subtypes of A.D.H.D. is quick to heat up and just as quick to cool down. Episodes of dyscontrol, involving anger or any other strong emotion, can present the most challenging aspects of managing A.D.H.D. in people of all ages; on the other hand, what takes shape in one person as a handicap may be a welcome burst of creativity and inspired vision in others-such as Mozart, Edison, Hemingway. Exploration of the many paradoxes of these brainstorms is the business of Dr. Horacek's very different, very necessary book.
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H. Joseph Horacek, Jr., M.D. , is president and medical director of the Center for Neurological Health in Learning in Charlotte, North Carolina.
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