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Minimal Brain Dysfunction and Hyperkinesis: A Clinical Viewpoint

Minimal Brain Dysfunction and Hyperkinesis: A Clinical Viewpoint Abstract During the last 20 years much attention has been given in the medical and psychological literature to the syndrome of minimal brain dysfunction (MBD) or hyperkinesis (hyperactivity), the terms generally being used interchangeably. Experts have emphasized the high frequency and clinical importance of this condition and have warned clinicians about the necessity of early detection and proper treatment. The conscientious clinician cannot fail to be impressed by the magnitude of this literature and its sense of urgency. However, when the clinician inspects these reports closely, the concept is found to be so poorly described that deciding whether a particular case fits the definition adequately is difficult. The expert consultant, who is presented with a child with clear evidence of academic or behavioral problems, may label such a case as MBD with little hesitation, but the primary care clinician is often perplexed. The purposes of this communication are to review critically References 1. Strauss AA, Lehtinen L: Psychopathology and Education of the Brain Injured Child . New York, Grune & Stratton Inc, 1947. 2. Clements SD: Minimal Brain Dysfunction in Children . Washington, DC, Dept of Health, Education, and Welfare, 1966. 3. DSM-II: Diagnostic and Statistical Manual of Mental Disorders , ed 2. Washington, DC, American Psychiatric Association, 1968. 4. DSM-III: Diagnostic and Statistical Manual of Mental Disorders, ed 3. Washington, DC, American Psychiatric Association, to be published. 5. Thomas A, Chess S, Birch HG, et al: Behavioral Individuality in Early Childhood . New York, New York University Press, 1963. 6. Thomas A, Chess S, Birch HG: Temperament and Behavior Disorders in Children . New York, New York University Press, 1968. 7. Carey WB, Fox M, McDevitt SC: Temperament as a factor in early school adjustment . Pediatrics 60( (suppl) ):621-624, 1977. 8. Bugental DB, Collins S, Collins L, et al: Attributional and behavioral changes following two behavior management interventions with hyperactive boys: A follow-up study . Child Dev 49:247-250, 1978.Crossref 9. Swanson JM, Kinsbourne M: Stimulant-related state-dependent learning in hyperactive children . Science 192:1354-1357, 1976.Crossref 10. Firestone P, Peters S, Rivier M, et al: Minor physical anomalies in hyperactive, retarded and normal children and their families . J Child Psychol Psychiatr 19:155-160, 1978.Crossref 11. O'Leary SG, Pelham WE: Behavior therapy and withdrawal of stimulant medication in hyperactive children . Pediatrics 61:211-217, 1978. 12. Dalby JT, Kinsbourne M, Swanson JM, et al: Hyperactive children's underuse of learning time: Correction by stimulant treatment . Child Dev 48:1448-1453, 1977.Crossref 13. Harley JP, Matthews CG, Eichman P: Synthetic food colors and hyperactivity in children: A double-blind challenge experiment . Pediatrics 62:975-983, 1978. 14. Connors CK: A teacher rating scale for use in drug studies with children . Am J Psychiatr 126:884-888, 1969. 15. Kenny TJ, Clemmens RL, Hudson BW, et al: Characteristics of children referred because of hyperactivity . J Pediatr 79:618-622, 1971.Crossref 16. Lambert NM, Sandoval J, Sassone D: Prevalence of hyperactivity in elementary schoolchildren as a function of social system definers . Am J Orthopsychiatr 48:446-463, 1978.Crossref 17. Johnson CF, Prinz R: Hyperactivity is in the eyes of the beholder . Clin Pediatr 15:222-238, 1976.Crossref 18. Sandoval J, Lambert NM, Yandell W: Current medical practice and hyperactive children . Am J Orthopsychiatr 46:323-334, 1976.Crossref 19. Wender E: Food additives and hyperkinesis . Am J Dis Child 131:1204-1206, 1977. 20. Barclay RA: Recent developments in research on hyperactive children . J Pediatr Psychol 3:158-163, 1978.Crossref 21. Carey WB, Sibinga MS: Avoiding pediatric pathogenesis in the management of acute minor illness . Pediatrics 49:553-562, 1972. 22. Rapoport JL, Buchsbaum MS, Zahn TP, et al: Dextroamphetamine: Cognitive and behavioral effects in normal prepubertal boys . Science 199:560-563, 1978.Crossref 23. Weiss G, Hechtman L, Perlman T: Hyperactives as young adults: School, employer and self-rating scales obtained during ten-year follow-up evaluation . Am J Orthopsychiatr 48:438-445, 1978.Crossref 24. Eisenberg L: Hyperkinesis revisited . Pediatrics 61:319-321, 1978. 25. Riddle KD, Rapoport JL: A two-year follow-up of 72 hyperactive boys: Classroom behavior and peer acceptance . J Nerv Ment Dis 162:126-134, 1976.Crossref 26. Jones TD: Diagnosis of rheumatic fever . JAMA 126:481, 1944.Crossref 27. Rutter M: Brain damage syndromes in childhood: Concepts and findings . J Child Psychol Psychiatr 18:1-21, 1977.Crossref 28. Sandberg ST, Rutter M, Taylor E: Hyperkinetic disorder in psychiatric clinic attenders . Dev Med Child Neurol 20:279-299, 1978.Crossref 29. Shaffer D, Greenhill L: A critical note on the predictive validity of 'the hyperkinetic syndrome .' J Child Psychol Psychiatr 20:61-72, 1979.Crossref 30. Schmitt BD: The minimal brain dysfunction myth . Am J Dis Child 129:1313-1318, 1975. 31. Saravia-Campos J: 'Minimal brain dysfunction': An oversimplification? Dev Med Child Neurol 18:246-248, 1976.Crossref 32. Ingram TTS: Soft signs . Dev Med Child Neurol 15:527-530, 1973.Crossref 33. Carey WB, McDevitt SC, Baker D: Differentiating minimal brain dysfunction and temperament . Dev Med Child Neurol 21:765-772, 1979.Crossref 34. McMahon S, Greenberg LM: Serial neurologic examination of hyperactive children . Pediatrics 59:584-587, 1977. 35. Shaffer D: 'Soft' neurological signs and later psychiatric disorder: A review . J Child Psychol Psychiatr 19:63-65, 1978.Crossref 36. Touwen BCL, Sporrel T: Soft signs and MBD . Dev Med Child Neurol 21:528-529, 1979.Crossref 37. Barlow CF: 'Soft signs' in children with learning disorders . Am J Dis Child 128:605-606, 1974. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Minimal Brain Dysfunction and Hyperkinesis: A Clinical Viewpoint

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Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1980.02130220004002
Publisher site
See Article on Publisher Site

Abstract

Abstract During the last 20 years much attention has been given in the medical and psychological literature to the syndrome of minimal brain dysfunction (MBD) or hyperkinesis (hyperactivity), the terms generally being used interchangeably. Experts have emphasized the high frequency and clinical importance of this condition and have warned clinicians about the necessity of early detection and proper treatment. The conscientious clinician cannot fail to be impressed by the magnitude of this literature and its sense of urgency. However, when the clinician inspects these reports closely, the concept is found to be so poorly described that deciding whether a particular case fits the definition adequately is difficult. The expert consultant, who is presented with a child with clear evidence of academic or behavioral problems, may label such a case as MBD with little hesitation, but the primary care clinician is often perplexed. The purposes of this communication are to review critically References 1. Strauss AA, Lehtinen L: Psychopathology and Education of the Brain Injured Child . New York, Grune & Stratton Inc, 1947. 2. Clements SD: Minimal Brain Dysfunction in Children . Washington, DC, Dept of Health, Education, and Welfare, 1966. 3. DSM-II: Diagnostic and Statistical Manual of Mental Disorders , ed 2. Washington, DC, American Psychiatric Association, 1968. 4. DSM-III: Diagnostic and Statistical Manual of Mental Disorders, ed 3. Washington, DC, American Psychiatric Association, to be published. 5. Thomas A, Chess S, Birch HG, et al: Behavioral Individuality in Early Childhood . New York, New York University Press, 1963. 6. Thomas A, Chess S, Birch HG: Temperament and Behavior Disorders in Children . New York, New York University Press, 1968. 7. Carey WB, Fox M, McDevitt SC: Temperament as a factor in early school adjustment . Pediatrics 60( (suppl) ):621-624, 1977. 8. Bugental DB, Collins S, Collins L, et al: Attributional and behavioral changes following two behavior management interventions with hyperactive boys: A follow-up study . Child Dev 49:247-250, 1978.Crossref 9. Swanson JM, Kinsbourne M: Stimulant-related state-dependent learning in hyperactive children . Science 192:1354-1357, 1976.Crossref 10. Firestone P, Peters S, Rivier M, et al: Minor physical anomalies in hyperactive, retarded and normal children and their families . J Child Psychol Psychiatr 19:155-160, 1978.Crossref 11. O'Leary SG, Pelham WE: Behavior therapy and withdrawal of stimulant medication in hyperactive children . Pediatrics 61:211-217, 1978. 12. Dalby JT, Kinsbourne M, Swanson JM, et al: Hyperactive children's underuse of learning time: Correction by stimulant treatment . Child Dev 48:1448-1453, 1977.Crossref 13. Harley JP, Matthews CG, Eichman P: Synthetic food colors and hyperactivity in children: A double-blind challenge experiment . Pediatrics 62:975-983, 1978. 14. Connors CK: A teacher rating scale for use in drug studies with children . Am J Psychiatr 126:884-888, 1969. 15. Kenny TJ, Clemmens RL, Hudson BW, et al: Characteristics of children referred because of hyperactivity . J Pediatr 79:618-622, 1971.Crossref 16. Lambert NM, Sandoval J, Sassone D: Prevalence of hyperactivity in elementary schoolchildren as a function of social system definers . Am J Orthopsychiatr 48:446-463, 1978.Crossref 17. Johnson CF, Prinz R: Hyperactivity is in the eyes of the beholder . Clin Pediatr 15:222-238, 1976.Crossref 18. Sandoval J, Lambert NM, Yandell W: Current medical practice and hyperactive children . Am J Orthopsychiatr 46:323-334, 1976.Crossref 19. Wender E: Food additives and hyperkinesis . Am J Dis Child 131:1204-1206, 1977. 20. Barclay RA: Recent developments in research on hyperactive children . J Pediatr Psychol 3:158-163, 1978.Crossref 21. Carey WB, Sibinga MS: Avoiding pediatric pathogenesis in the management of acute minor illness . Pediatrics 49:553-562, 1972. 22. Rapoport JL, Buchsbaum MS, Zahn TP, et al: Dextroamphetamine: Cognitive and behavioral effects in normal prepubertal boys . Science 199:560-563, 1978.Crossref 23. Weiss G, Hechtman L, Perlman T: Hyperactives as young adults: School, employer and self-rating scales obtained during ten-year follow-up evaluation . Am J Orthopsychiatr 48:438-445, 1978.Crossref 24. Eisenberg L: Hyperkinesis revisited . Pediatrics 61:319-321, 1978. 25. Riddle KD, Rapoport JL: A two-year follow-up of 72 hyperactive boys: Classroom behavior and peer acceptance . J Nerv Ment Dis 162:126-134, 1976.Crossref 26. Jones TD: Diagnosis of rheumatic fever . JAMA 126:481, 1944.Crossref 27. Rutter M: Brain damage syndromes in childhood: Concepts and findings . J Child Psychol Psychiatr 18:1-21, 1977.Crossref 28. Sandberg ST, Rutter M, Taylor E: Hyperkinetic disorder in psychiatric clinic attenders . Dev Med Child Neurol 20:279-299, 1978.Crossref 29. Shaffer D, Greenhill L: A critical note on the predictive validity of 'the hyperkinetic syndrome .' J Child Psychol Psychiatr 20:61-72, 1979.Crossref 30. Schmitt BD: The minimal brain dysfunction myth . Am J Dis Child 129:1313-1318, 1975. 31. Saravia-Campos J: 'Minimal brain dysfunction': An oversimplification? Dev Med Child Neurol 18:246-248, 1976.Crossref 32. Ingram TTS: Soft signs . Dev Med Child Neurol 15:527-530, 1973.Crossref 33. Carey WB, McDevitt SC, Baker D: Differentiating minimal brain dysfunction and temperament . Dev Med Child Neurol 21:765-772, 1979.Crossref 34. McMahon S, Greenberg LM: Serial neurologic examination of hyperactive children . Pediatrics 59:584-587, 1977. 35. Shaffer D: 'Soft' neurological signs and later psychiatric disorder: A review . J Child Psychol Psychiatr 19:63-65, 1978.Crossref 36. Touwen BCL, Sporrel T: Soft signs and MBD . Dev Med Child Neurol 21:528-529, 1979.Crossref 37. Barlow CF: 'Soft signs' in children with learning disorders . Am J Dis Child 128:605-606, 1974.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Oct 1, 1980

References

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