July 20, 2001 | Read "Defusing the explosive child" by Lawrence H. Diller, M.D.

Dr. Greene sounds like a quack. When did children start raising themselves? I have four children, and they do not tell us what they are going to do or accept. We do. We are the adults; they are the children. Children need limits and boundaries; they need to be told, No, you can't have that. If I (or my wife) had behaved in this manner, I'd be in a body cast. We have certainly screwed up this world when we let children make their own decisions and parents pick battles that are important for a little peace and quiet now. Setting limits early on is the best gift you can give to your children so they will be adults who understand that you don't always get what you want and sometimes life just sucks. Medicating children seems to be a poor way to be a parent. -- Kevin McCreavy

As a teacher, I am sickened to see one more book come out that gives parents an excuse to allow their children's bad behavior. The sad fact is that little Johnny's "oppositional defiance disorder" or "bipolar disorder" or "ADHD" won't matter a whit when he curses a police officer or threatens others in authority. Parents do their children no favors with these permissive methods and teach the children to intrude on the rights of others. I have had meetings with students and their parents who use this jargon to excuse stealing, low grades, traffic violations, drug use, etc. Why does our society wonder that three out of five teachers quit within five years? -- Dorrie Fletcher

As the parent of a teenager diagnosed as bipolar, I have experience with an explosive child. The advice to "not sweat the small stuff" is completely wrong: It is by consistently addressing the small stuff of everyday living that the staff of the program where my daughter resides has brought about a dramatic change for the better. The challenge of the explosive child, I believe, is that he both requires and rejects externally imposed structure. It is hard to cope with this conflict, for both the child and the parents, and the difficulty is compounded by the lack of support from society in general. The approach at North Crossing involves a combination of medications, family therapy, peer group norms and consistent focus on living up to expectations. The result has been close to miraculous. -- Justin Fisher

As an advocate for children with mental illnesses, and the mother of two such children, I was horrified to read Dillard's review of "The Explosive Child," as well as his comments about medication.

Brain research has revealed more in the last decade than in all of preceding history. The discoveries, fueled by improved scanning, epidemiological and DNA research, show that childhood-onset mental illnesses are physical malfunctions of the brain more severe and debilitating than in their adult counterparts. ADHD and bipolar disorder are more heritable than juvenile-onset diabetes. Nongenetic triggers include perinatal complications, prematurity, toxins or viruses during pregnancy. Parenting practices do not cause these illnesses.

We have new hope for these children with the advent of more effective, more targeted medications and counseling therapies. Without up-to-date medical management, we condemn these children to high risk for delinquency, teen pregnancy, substance abuse, suicide and runaways.

I urge readers to study the science behind the new treatments. Medication is no picnic. The medications have worrisome, irritating and painful side effects and cost a lot of money. However, they correct the faulty imbalance of neurotransmitters, making it possible for these kids to lead nearly normal lives, and to develop socially, morally and academically. This is cause for celebration. -- Diane Weaver