Foreword Reviews

The Silent Epidemic

A Child Psychiatrist’s Journey Beyond Death Row

Clarion Rating: 3 out of 5

The Silent Epidemic is a thought-provoking introduction to ND-PAE.

Susan D. Rich’s The Silent Epidemic concerns a medical condition with an alarming reach.

The book draws on Rich’s background as a psychiatrist to explain neurodevelopmental disorder associated with prenatal alcohol exposure (ND-PAE), a condition that can profoundly impact a person’s cognitive and emotional development throughout their life. Rich explores how prevalent, yet unknown, this condition is: although the effects of drinking during pregnancy have been discussed by medical professionals for decades, the term ND-PAE was only assigned a diagnostic code in 2013, when it was included in the Diagnostic and Statistical Manual of Mental Disorders.

Rich seeks to find solutions to the problem, which is both medical and social in scope. The work is split into three parts: “Illuminating the Problem,” “Shifting Social Paradigms,” and “Professional and Parent Guide to ND-PAE.” The first two are comprised of several chapters each, while the third includes three appendixes focused on actionable steps for parents and caretakers of children diagnosed with the disorder. This structure breaks down a complex topic into manageable fragments.

Rich advocates for campaigns of awareness, so that sexually active women who drink regularly know to take measures to avoid pregnancy, and so that women who are trying to get pregnant stop drinking. Several other courses of action are also suggested, but the promotion of public awareness and knowledge is at the heart of the book’s propositions. Such arguments are backed up by statistics, case studies, and books by other medical professionals who focus on ND-PAE.

However, some of the book’s hypotheses are underdeveloped and underclarified, as with an attempt to establish a connection between recent victims of police brutality and ND-PAE that is insufficiently supported. Likewise, not all the sources are scientifically rigorous: the book often uses the Bible and Aldous Huxley’s Brave New World as comparison points. And on top of the case studies about formally diagnosed patients, the manuscript suggests diagnoses for people like Adam Lanza, the mass murderer responsible for the Sandy Hook massacre, of ND-PAE, but does so without sufficient evidence; it also outlines a hypothetical treatment plan for him based on that possibility.

Misused words are frequent, as are typographical errors, while the book’s uneven writing style impedes its flow. It is academic and clear in some sections, flowery and sentimental in others. Personal asides and ableist value judgments are also recurrent, as when the book compares adoptive parents and disabled foreign children to, respectively, the pharaoh’s daughter and Moses. Still, the book closes with actionable steps for those who are curious.

In some places a thought-provoking introduction to ND-PAE, The Silent Epidemic covers a condition that affects countless people around the world.

Reviewed by Carolina Ciucci

Disclosure: This article is not an endorsement, but a review. The publisher of this book provided free copies of the book and paid a small fee to have their book reviewed by a professional reviewer. Foreword Reviews and Clarion Reviews make no guarantee that the publisher will receive a positive review. Foreword Magazine, Inc. is disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255.

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