A Critical Note on the Predictive Validity of “The Hyperkinetic Syndrome”

Abstract

SUMMARY It is argued that the diagnosis of “Hyperactivity Syndrome” tells little about aetiology and does not permit generalizations to be made about clinical state. Its usefulness in predicting response to drug or other forms of treatment has yet to be demonstrated. A series of follow‐up studies have been reviewed in order to determine whether a diagnosis of hyperactivity syndrome will allow predictions to be made about natural history. The literature reveals widely differing outcome in different samples. It may be that this inconsistency simply reflects methodological variation between the studies. However, it can also be taken that the lack of consistency further weakens the validity or clinical usefulness of this diagnostic concept.

Childhood Hyperactivity

“…Shaffer & Greenhill, 1979). Hyperactivity is associated with lower tested intelligence, poorer academic attainment, greater attention deficit, and neurodevelopmental impairment.…”

Effects of event rate and display time on sustained attention in hyperactive, normal, and control children

“…Typically, diagnosis has been based on the results of various questionnaires, clinical interviews, or direct observations that are not clearly described or may be of questionable validity (Schachar, Sandberg, & Rutter, 1986;Sergeant, 1981;Shaffer & Greenhill, 1979). A related difficulty arises from the existence of two sets of criteria for diagnosing hyperactivity: DSM-III (American Psychiatric Association, 1980) and ICD-9 (World Health Organization, 1978).…”

“Early detection of learning difficulties”

“…This proportion fluctuates from country to country depending on the the language (written or verbal), the educational system, and the social and cultural conditions (Waltzer and Richmond, i973,MinskofT, ig83,Tarnopol&Tarnopol, i976,Vellutino, 1981). Frequently but not always learning difficulties coexist with hyperkinesis, lack of concentration, behaviour disorder and or soft neurological signs (Cantwell, 1977 hyperactivity, the delay in language development, the behaviour disorder or the environment (Rutter & Yule, 1975;Schachar, Rutter & Smith, 1981;Shaffer et al, 1979;Sturge, 1982;Gillberg et al, 1982;McGee et al, 1984;Jorm et al, 1986). However, the results of the different studies are rather contradictory.…”