Problems in the Diagnosis of Minimal Brain Dysfunction and the Hyperkinetic Syndrome

Long-Term Outcome of Hyperactive Children: A Review

“…Indeed , in many cases, symptoms are reported only by some, not all informants (Klein and Gittelman-Klein, 1975). This inconsistent reporting causes diagnostic dilemmas since the significance of the pervasiveness of hyperactivity, or lack thereof, is poorly understood.…”

A Naturalistic Assessment of the Motor Activity of Hyperactive Boys

“…Inclusion criteria for hyperactivity were (1) at least 2 SDs above published age-matched, sex-matched norms on factor IV (hyperactivity) of the Conners' Teacher Rating Scale19 and (2) evidence of restlessness or inattention on observation or from history in at least one other situation (home, psychiatric interview, or psychological testing). Exclusion criteria were (1) "hard" neurological disease, ie, clinical seizure disorder or other medical disorder, (2) major psychiatric disorder such as psychosis or depression, but not conduct disorder or developmental disorder, (3) full-scale IQ less than 80 on the Wechsler Intelligence Scale for Children-Revised (WISC-R), and (4) special class placement (classmates were used as controls to match school schedules). Twelve boys met the criteria and were included in the study.…”

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

“…In their thoughtful review of diagnostic issues in hyperkinesis, Klein and Gittelman-Klein (1975) suggest that validation be sought through an examination of responses to drug treatment, Wliilst it is clear that a majority of children diagnosed as hyperactive respond favourably to stimulant drugs (Barkley, 1977), it is by no means certain that drug induced improvements are confined to hyperactive children.…”

“…(b) That the presence of these behaviours discriminates between chnical entities which differ in respects other than through their defining or "necessary" symptoms. This does not mean that all children who are overactive or inattentive should resemble all others (Klein and Gittelman-Klein, 1975) but the presence ofthe cardinal symptoms should allow some wider generalization to be made about clinical state (concurrent validity). (c) That the syndrome-regardless of aetiology-enables predictions to be made about natural history or response to treatment (predictive validity).…”