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This paper outlines a program designed to help the educational, medical, and parent sectors of the greater Omaha area to better understand the problems of specific learning disabilities and the minimal brain dysfunction syndrome. The evolution of the project and its various components are described. The program is presented as a series of guidelines for other communities interested in dealing with the multifaceted needs of children with these problems, guidelines which may enable a community to avoid some obstacles and pitfalls in implementing such a program. The Omaha Project is in its fourth year, is gaining momentum rapidly, and is spreading statewide. Improved attitudes and a better spirit of cooperation between the educational, medical, and parent sectors of the community are increasingly evident. [ABSTRACT FROM AUTHOR]

The literature on hyperkinesis contains considerable disagreement regarding the disorder's terminology, etiology, behavioral correlates, and treatment techniques. This paper explores the possibility that two distinct patterns of hyperkinesis exist and that the failure to delineate these has resulted in the conflicting reports evidenced throughout the literature. [ABSTRACT FROM AUTHOR]

This paper describes the development and use of standard score profile programs based on psychological tests for evaluating the patterns of abilities and deficits in children with various types of brain damage or dysfunction. The test profile is described and comments made on: the collection of normative data, standard score characteristics, standard deviation limits, age change problems, and the use of a summary score. Two cases are presented on one child with a brain tumor and one with a history of learning problems. The technique of profile interpretation is illustrated and the test scores are related to the medical history. A second computer program which selects the test profiles most similar to any criterion case, from all the previous cases, in an effort to develop a technique for improved classification, is described. [ABSTRACT FROM AUTHOR]

We are increasingly aware of the harm, both actual and potential, done to patient and parents from the designation of children with delayed and irregular maturation as "brain-damaged" or "suffering from brain dysfunction". The terror and anxiety wrought by such diagnosis, despite the fact that they are based on no current evidence of actual brain disease, is the topic of this paper. [ABSTRACT FROM AUTHOR]

Performance on the Canter Background interference Procedure (BIP) of 40 hyperkinetic boys was compared with that of 38 male control subjects. While the groups did not differ on the Bender-Gestalt Test (with IQ partialled out), the hyperkinetic group showed a significantly greater decrement in performance under Canter-BIP conditions. However, the magnitude of the differences found was too small to yield reliable classification of the individual child. The results indicate the necessity of caution in clinical use of the technique with children. [ABSTRACT FROM AUTHOR]

This paper focuses on the symptom picture called "hyperkinetic impulse disorder" and its effect upon learning and behavior in children and adolescents. Clinical experience has indicated that there may be a specific, beneficial, controlling effect from the use of psychic energizers and cerebral stimulants, all characterized by causing an increase in available norepinephrine at cell surfaces in the central nervous system. It has also been found that the symptom picture may be worsened by medications which reduce the level of available norepinephrine at cell surfaces. The medications in use are quite potent ones and concerns as to how they may best be administered are discussed. Possible side effects and long-term outcomes of their use are described. A method is given for determining proper dosage, listing and controlling side effects. Other concurrent necessary kinds of help are described. Means of recognizing the eventual outgrowing of the hyperkinetic impulse disorder are indicated. Last, results of a follow-up study are presented: a group of private patients were followed up for varying periods after medication had been terminated. The study shows the current levels of functioning and presence or absence of persisting toxic effects from long-term use of these medications. [ABSTRACT FROM AUTHOR]

A brief overview is given of recent controlled studies of the effects of stimulant drugs on general behavior, motor organization, cognition and learning, physiological responsiveness and attention in hyperkinetic children Emphasis is objective methods of assessment of drug effects which have began to allow long-standing clinical lore to become documented and to contribute to the understanding of basic psychological and physiological processes involved in the heterogeneous disorders lumped under the label of "hyperkinetic syndrome". [ABSTRACT FROM AUTHOR]

The article presents a study that identifies the type of educational program for children with minimal brain dysfunction in the U.S. The author constructed a language arts developmental program for three boys diagnosed as having minimal brain dysfunction. The Look, Learn and Listen Program, a core reading material published by Educational Developmental Laboratories, adopted because it employed various filmstrips for use with the tachistoscope that will possibly be a great help in the educational development of children with minimal brain dysfunction.

Twenty-one experimental studies of attention deficits in children with learning disabilities were reviewed. Included in the review were studies of distractibility, hyperactivity, impulsivity, vigilance, and intersensory integration. From the accumulated evidence, the following conclusions were drawn: (1) Children with learning disabilities exhibit more distractibility than controls on tasks involving embedded contexts (figure-ground perception tasks) and on tests of incidental vs. central learning. They are not differentially distracted by other types of distractors such as flashing lights and extraneous color cues. (2) Hyperactivity of children with learning disabilities may be situational-specific, with higher levels of activity being exhibited in the structured situation. (3) Children with learning disabilities are more impulsive, i. e. less reflective, than controls. (4) Children with learning disabilities are deficient in their ability to maintain attention over prolonged periods of time. Studies of attention within a standardized testing framework were also discussed. [ABSTRACT FROM AUTHOR]

A variety of characteristics, primarily negative in nature, have been associated with learning disabilities. A review of the empirical research which has compared learning disabled children with the academically successful finds little data to support these notions. Behaviors which discriminate groups do not appear to include simple perception and discrimination, hyperactivity, nor neurological deficits, and there is some question about the intelligence level of sampled children. Behaviors which do discriminate groups include ability to pay attention, difficulty with complex tasks, and tasks which make heavy demands on language skills and information organization. It is hoped that professionals in this field will not become frozen in inappropriate stereotypes regarding learning disabled children, but will be sensitive to and supportive of research efforts on their behalf. [ABSTRACT FROM AUTHOR]

The use of a psychophysiological method for training children in the control of hyperactive behavior is explored. The method involved attention training through breathing control, incorporating biofeedback and operant conditioning principles to help the child develop self-control over excessive and distracting motor behaviors and to maintain attention in learning situations. Six children (age 6-8 years old), from a private school for children with learning disabilities, participated in the study, three assigned to a group given the breathing control and attention training and three assigned to a control group. Measures obtained before, during, and after training included respiration indices, attention and vigilance test performance scores, and teacher ratings of classroom behaviors. The findings supported the feasibility of the training approach and provided important information relevant for future refinements in training and evaluation procedures. [ABSTRACT FROM AUTHOR]

The Influences of Methylphenidate on Heart Rate and Behavioral Measures of Attention in Hyperactive Children. CHILD DEVELOPMENT, 1975, 46, 727-733. Reaction-time performance and heart-rate responses associated with attention were used to assess the hyperactive child's attentional deficit and his response to methylphenidate. Attentional deficits shown by long response latencies were reflected in heart-rate responses theoretically incompatible with sustained attention. Subjects exhibiting the greatest attentional deficit displayed the most favorable response to methylphenidate in both reaction-time performance and physiological measures. However, subjects who showed the greatest improvement in social behavior were those who showed the least improvement in reaction-time performance. [ABSTRACT FROM AUTHOR]

This article explores the conflicting views as to electroencephalography's (EEG) diagnostic value in minimal brain dysfunction (MBD). Some of the values and limitations of EEG findings for diagnosis, prognosis, and follow-up study of MBD individuals are described. The issue of EEG unreliability in the assessment of the presence of behavior disorders and MBD has been stressed correctly by several authors. Many EEGs fail to include sleep recording despite the unquestioned existence of abnormalities whose appearance is confined almost entirely to one or two stages of somnolence.

The term "minimal brain damage" (MBD) is evaluated in the light of several experiments: "no treatment" in a democratic existential children `s community; the effect of psychic energizers on skills thought to be deficient due to MBD; electrosleep; biofeedback training for alpha wave desynchronization; deconditioning of phobias; and nutritional/medical treatment. These experiments showed statistically significant improvement in skills related to MBD. It is suggested that MBD may be a diagnosis which directs attention to symptoms and that treatment of underlying functions may be superior to present practice. [ABSTRACT FROM AUTHOR]

To avoid emotional and learning difficulties in children with minimal brain dysfunction (MBD) early detection is desirable, and a battery of tests has been devised to achieve this. The battery was administered to 228 children at the start of their kindergarten year. Of 49 children who failed the battery, 25 were matched with 25 controls and were examined in detail neurologically and psychologically. The battery distinguished normal children (who passed) from those who failed. In the latter group, two types of children were found: (1) children clinically diagnosed as having MBD, (2) children thought to be immature, some of whom improved on readministration of the test battery eight months later and who are expected to show continued improvement but will likely have difficulty in Grade I. However, three false positives and one false negative were found. On 11 of the 12 tests the mean scores of the immature were better than those of the MBD. [ABSTRACT FROM AUTHOR]

Utilizing objective scales for rating characteristics in the hyperkinetic syndrome, teachers' ratings revealed favorable effects of dextroamphetamine in 27 of a group of 42 children with hyperkinetic impulse disorder and learning difficulties. Statistical comparisons of ratings received under pretest, placebo, and drug conditions showed significant differences on the scales measuring hyperactivity, short attention span, and impulsivity. Teachers can preselect hyperkinetic children who will respond to medication with the questionnaire-rating scale technique. Other objective measures have been discussed which can be incorporated into the evaluative procedure. [ABSTRACT FROM AUTHOR]

Research on hyperactive children was reviewed in order to define and clarify relationships and interactions between hyperactivity and learning disorders. Despite agreement on maladaptive social and behavioral characteristics associated with hyperactivity, findings specifying the nature of educational deficits are inconsistent and inconclusive. Three hypotheses are proposed to explain learning problems of hyperactive children. The first represents the medical-neurological syndrome explanation: the second suggests that activity disrupts attention and the information acquisition stages of learning; the third implicates impulsivity in decsion making. Although neither exhaustive nor mutually exclusive, the hypotheses differ in remedial and treatment implications. Evidence is reviewed under each hypothesis. [ABSTRACT FROM AUTHOR]

This article describes the various successes and failures encountered in a year long sociorecreation program for conduct disorder children. The experience indicated that the conduct disorder child can be helped to achieve greater satisfaction in a recreation setting if the setting is structurally conducive to the control of his deviant behavior. The traditional models of free play and socially centered programing were tried first but failed. They could only be effectively utilized once the requisite social, physical, and behavioral skills bad been acquired in a structured setting. A description is provided of the program's staff, structure, and content as well as certain leadership principles which emerged throughout the year. [ABSTRACT FROM AUTHOR]

Studies dealing with the sociometry of handicapped children have not shown the presence of any single handicapping condition to be an absolute criterion for predicting rejection. Since brain damage is associated with many handicapping conditions, the relationship of brain damage associated characteristics and social acceptance in EMR classes was investigated. Those characteristics commonly associated with brain damage were found to be closely and cumulatively associated with rejection among the subjects studied. The mast frequently found characteristics among the most often rejected subjects were short attention span, hyperkinesis, emotional lability, and impulsivity. [ABSTRACT FROM AUTHOR]

To assess the idea that mild neurological dysfunction, as evidenced by crossed eye hand preference patterns, interferes with the learning of reading skills, comparisons were made of reading readiness test results for 89 first grade children. Comparisons on the basis of sex and of eye hand preference patterns yielded no significant differences in levels of reading readiness. Findings suggest that minimal brain dysfunction theories may be unsuitable for explaining reading disability. [ABSTRACT FROM AUTHOR]

The equating of minimal neurological signs with minimal brain (neuropathological) damage is shown to be untenable in the present state of our knowledge. It is demonstrated that for the neurological examination to be of importance, it must encompass complex behavioral phenomena, as well as study of the classical motor and sensory functions. in the treatment of disturbed communication function, the accent must be away from correction, and directed toward continual development and growth through the available, relatively intact address systems. [ABSTRACT FROM AUTHOR]

Investigates whether unilateral dominance is not related to neuropsychological integrity in children. Absence of strong linear predictive relationships between LA and SLP; Limited significance of LA and SLP for human behavior.

The article discusses the results of a study on the learning difficulties of boys with severe behavior disorders in a special school established by the National Institute of Mental Health in Bethesda, Maryland. All the boys shared a common pathology which is commonly called as acting out. This type of behavior is justified every time an impulse or fantasy, conscious or unconscious, is acted upon whether or not is an appropriate response. The boys lack the ability to postpone, regulate, or foresee consequences. Prior to the creation of the school program for the group, their past school experience were evaluated. Acting-out boys are placed in a special class for the emotionally disturbed. Teachers on the other hand are required to treat attention-deficit-disordered children with respect and patience.

The literature related to one form of septal dysfunction - hyper-reactivity - is reviewed. The increase in reactivity following septal damage is considered in terms of its reliability and the many factors which influence its attenuation and release. Research discussed includes the topics of anatomical locus of septal damage, species and strain investigated, pre- and post-operative handling, neurochemical factors, and the relationship of hyper-reactivity to other septal dysfunctions and other anatomical structures. [ABSTRACT FROM AUTHOR]

Linguistic competence was tested and evaluated in five children who had a definitive diagnosis of minimal brain dysfunction, and in three control children whose physical, neurological, and school functions were well within normal limits. Definitive differences between the two groups were noted in sentence completion and especially in the ability to formulate sentences of negation. Repetition was found to be a useful tool for testing linguistic competence of both normal and neurologically malfunctioning children. [ABSTRACT FROM AUTHOR]

This article correlates delinquency and minimal brain dysfunction. It is hypothesized that the delinquent school dropout population from minority group ghettos should contain a greater percentage of children with minimal brain dysfunction than the total population. The term "minimal brain dysfunction" is used to designate the medical entity related to the educational term "learning disabilities" in accordance with the Terminology and Identification phase of the National Project on Minimal Brain Dysfunction in Children. The term minimal brain dysfunction covers damage as well as genetic, developmental, or other deviations of function. Many disadvantaged populations sustain a higher rate of premature births and may be expected to contain a higher rate of minimal brain dysfunction than other groups. The studies of premature infants at school age indicate that they constitute a very high risk group with respect to learning disabilities. Another source of possible neurological impairment in an impoverished population might be untreated chronic medical conditions and dietary deficiencies which could result in certain medical and dental problems.

Behavioral, psychological, and educational effects of minimal brain dysfunction are discussed with reference to the published literature. The need is outlined for the application of available knowledge leading to adequate evaluation and treatment. Methods of educating the staff, obtaining a case history, and performing psychological testing are discussed. When a central evaluation is not possible, the suggested diagnostic procedures are for pediatric neurological, developmental optometric, and speech and hearing evaluations. Specific recommendations that arise from the complete evaluation are discussed, with the necessity of reporting the results to the parents in a sensitive, meaningful manner. Recommendations include (1) special education, (2) medication, (3) developmental optometric training, (4) counseling or psychotherapy, (5) parent participation in associations, (6) recreational programs, (7) parent counseling groups. [ABSTRACT FROM AUTHOR]

Presents a discussion on hyperactivity in children. Evolution of the present concepts on hyperactivity; Description of hyperactive child currently under care; Home and family environment of the child with this condition; Management of hyperactivity in a child; Approaches to drug therapy for the condition; Treatment-oriented classification of hyperactive children.

Discusses the possible etiology of a clumsy child. Common complaints of parents of clumsy children; Associated learning disorders of clumsiness; Psychosomatic symptoms of clumsiness; Factors to be consider in the evaluation of clumsiness; Neurologic examination is performed for the diagnosis of clumsy child.

The article presents a report on two conferences related to reading disabilities. The Medical Horizons Conference on Minimal Cerebral Dysfunction (MBD) was held in Seattle, Washington. Certain realities regarding the MBD came into light at the Medical Horizons Conference held in Seattle on November 1 and 2, 1973. The stage was set for the dual emphasis on physical findings and educational treatment in the opening speeches of physicians Keith Conners, Norris Haring and Alfred Skinner. Physician Gilbert Omenn spoke on genetics and epidemiology, giving the protocol for genetic studies of MBD at the Child Development and Mental Retardation Center of the University of Washington. The role of the ophthalmologist in learning disabilities was well covered by physician Robert Kalina. The application of drugs in MBD was treated by physician J. Gordon Millichap. He emphasized that medication is an adjunct treatment; if teachers do not provide appropriate classroom intervention, the child won't improve in academic work. Both days of the conference ended with informal discussions. At their 24th annual conference in Baltimore, Maryland, the Orton Society created nine action task forces to help promote the study, treatment and prevention of the problems of specific language disability.

The background, development, and preliminary appraisal of rating scales for assessing characteristics of the hyperkinetic syndrome are presented. The main purpose of this report is to make the instrument available to other investigators who are conducting studies on the diagnosis and treatment of hyperkinesis. [ABSTRACT FROM AUTHOR]

The article focuses on the factors that influence the emotional and psychological development of the neurologically handicapped child. According to the author, the components that contribute to the disability of the child include: heredity, environment, organic brain dysfunction, sensory deprivation, and psychological factors. A study found that defective growth and development are more influenced by genetic mutations than by early fetal anoxia. Personality and emotional stability of the child may also be influenced before, during and after birth by environmental factors. There is also evidence that mental retardation is not the result of a general defect of intelligence but may be due to structural damage or malfunction of the cerebral systems of vision and audition.

Discusses the relationship between learning disabilities, minimal brain dysfunction and hyperactivity. Definition of hyperactivity; Observations made over 13 years of experience in an interdisciplinary diagnostic and evaluation clinic where physicians have had the opportunity to study exceptional children, many of whom were suspected of having learning disabilities, minimal brain dysfunction and being hyperactive; Importance of a collective approach to all aspects of a child's maturation.

The article focuses on the lateral dominance in retarded readers with brain dysfunction. The study selects retarded readers who have signs of brain dysfunction. The examination consists of the Gray Oral Reading Paragraphs, the Peabody Picture Vocabulary Test, and the Harris Tests of Lateral Dominance. A table signifies the characteristics of the retarded readers with brain dysfunction. A pediatric neurologist also examines the subjects. The high incidence of crossed dominance appears to be a function of left-eyedness.

The article focuses on the temperamental characteristics as predicators of behavior disorders in children. The prevention of childhood psychiatric disorders is a matter of increasing concern, resulting in a corresponding rise of interest in those factors likely to predict such disorders. The New York longitudinal study suggests that a wide range of personality characteristics--high and low activity, irregularity, nonadaptability, intensity, persistence and distractibility--may predict behavior disorders. There is evidence that organic brain dysfunction is associated with an increased risk of psychiatric disorder and it may be that in a few children organic brain dysfunction has an influence on adverse temperamental characteristics. The results of the study suggests that there is a link between adverse temperament and adverse family attitudes and (possibly) relationships. The clinician should now be aware that a growing body of evidence supports the notion that a child, by virtue of his personality structure, requires handling geared to his individuality if he is to stand the best chance of avoiding the development of a psychiatric disorder.

Focuses on hyperactivity of apartment bound children in New York. Interphases between physical, social and mental health; Lack of available recreational opportunities.