Neurological soft signs in mainstream pupils

Abstract

Aims-(1) To examine the relation between neurological soft signs and measures of cognition, coordination, and behaviour in mainstream schoolchildren. (2) To determine whether high soft sign scores may predict children with significant problems in other areas. Methods-A total of 169 children aged between 8 and 13 years from mainstream schools were assessed. They form part of a larger study into the outcome of meningococcal disease in childhood. Half had previous meningococcal disease and half were controls. Assessment involved measurement of six soft signs followed by assessment of motor skills (movement ABC), cognitive function (WISC-III), and behaviour (Conners' Rating Scales). Results-Children having an age corrected soft sign score above the 90th centile were considered to have an excess of soft signs. When compared to the other children they had significantly worse scores on the other three measures. Median movement ABC score was 15.3 v 7. Mean total IQ scores were lower by 10.3 points. Median behaviour scores were significantly higher on both parental and teacher questionnaires. A soft sign score above the 90th centile had a sensitivity of 38% for detecting cognitive impairment, 42% for detecting coordination problems, and 25% for detecting possible attention deficit hyperactivity disorder. Conclusion-In this group of children higher scores on the soft sign battery were related to significantly worse performance on measures of cognition, coordination, and behaviour. However, although soft sign assessment may be of interest it cannot accurately predict which children are likely to have impairment in other areas. (Arch Dis Child 2001;85:371-374)

Motor performance and dyslexia in a national cohort of 10‐year‐old children

“…In paediatrics, failure on a graphaesthesia test and poor motor speed can be regarded as neurological 'soft signs' (NSS); that is, minor abnormalities identified in a neurological examination in the absence of other features of transient neurological disorder (Shaffer, Connor, & Shafer, 1983). A graphaesthesia and a motor speed test formed part of a battery of six NSS signs in an assessment of 169 mainstream pupils aged 8-13 years by Fellick, Thomson, Sills, and Hart (2001). They found NSSs were lower in older children; a result that gives support to the view that NSSs represent a developmental phenomenon.…”

Clinical and psychoeducational profile of children with borderline intellectual functioning

“…Although soft neurologic signs are known to be associated with children having behavior, coordination, and learning difficulties they are not diagnostic of any particular condition and give pediatricians little information to guide for further management. 18 ADHD-combined type, a known co-morbidity in slow learners, was diagnosed in only 2 (3.6%) cases, although 16-18% had displayed hyperactivity / inattentiveness in the classroom. 19 These two children were started on methylphenidate therapy.…”

Clinical and psychoeducational profile of children with specific learning disability and co-occurring attention-deficit hyperactivity disorder

“…[1,3,22] Although these Þ ndings in a child with poor school performance are of some importance, they are not diagnostic of either SpLD or ADHD. [3,4,18,23] In the present study, difficulties in writing, inattentiveness and difÞ culties in mathematics were noted in 74-96% of children by the classroom teacher [ Table 5]. It is known that children with SpLD/ ADHD have 'more severe' learning problems than children who have SpLD but no ADHD, and also 'more severe' attention problems than children who have ADHD but no SpLD.…”