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Although the presence of minor physical malformations in children is often considered to be associated with attentional problems, hyperactivity, and other syndromes, many children with these disorders do not have detectable structural malformations (dysmorphisms). To learn more about the association between these factors, a study was carried out of 1,233 children who underwent evaluation at one developmental center during a six-year period. The children were routinely assessed for minor dysmorphic features, such as hairwhorl abnormality, low-set ears, abnormally large head circumference, or other characteristics (which are listed in a table). IQ scores and diagnoses of attention deficit disorder (ADD) or learning disability (LD) were noted. The average dysmorphology score for the group was 2.94. The average score for 251 children with IQs higher than 100 was 3.24, a value that was higher than for subjects with IQs lower than 101. No difference was seen between the dysmorphology scores of children with and without ADD, nor between the scores of children with ADD with or without hyperactivity. However, the dysmorphology scores of children without LD were significantly lower than the scores of children with LD. Higher dysmorphology scores were associated with LD as well as with the absence of attention deficit hyperactivity disorder (ADHD). Minor dysmorphic features are commonly evaluated in screening for ADHD, an association that is not supported by the results in this study. It appears that LD, rather than ADHD, is associated with the presence of these abnormalities. Minor dysmorphic features can be considered a nonspecific and nondiagnostic sign of LD in a population of children referred for more extensive evaluation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hyperactivity and attention deficit disorder (ADD) are related, but distinct problems affecting the learning ability and behavior of children. Children referred to a child development center for evaluation of inattentive and hyperactive behavior were studied in order to relate their diagnosis to various emotional and learning problems. Of the 614 children evaluated during a six-year period, 422 (68.7 percent) were diagnosed with ADD and 192 (31.3 percent) were not diagnosed with this disorder. These two groups were then compared; it was noted that 66.8 percent of the ADD children were also diagnosed as hyperactive. Children with ADD had significantly higher IQs (intelligence quotients) and verbal test scores, and their parents had achieved a higher educational level. The ADD group also had more specific learning disabilities. There were significant differences between the two groups of children. Subjects in the group without ADD were more likely to have suffered child abuse or neglect and exhibit intellectual limitations. Their parents were more likely to show evidence of severe psychiatric illness. Factors that did not differ between the groups were depression in the children or parents, motor skill problems, language disorders, conduct disorders, and psychosomatic complaints. The previous use of medications to treat behavior problems in all the children was also investigated. Twenty-nine of the children without a diagnosis of ADD (4.7 percent) had been treated inappropriately with stimulant medication in the past, but in most of these cases the drug was discontinued as soon as it was noted to be ineffective. This does not suggest that stimulant drugs are being prescribed irresponsibly for a large number of children, as some critics of treatment for ADD and hyperactivity have claimed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mentally retarded adults are marrying and having children at the same rate as people with normal cognitive abilities. The degree of retardation is considerable in some cases, with mothers having IQs in the 35 to 69 range. Maternal mental retardation is associated with an increased risk of child abuse and neglect. In one study, 45 percent of the children of retarded mothers had been removed from the home by the authorities. In another study, 66.4 percent of children were shown to have suffered child abuse, sexual abuse and/or neglect; 31 percent of these children were also diagnosed as mentally retarded. However, retarded children with one or two retarded parents had a lower risk of abuse than the normal children of retarded parents. The risk of abuse was lower in the more severe cases of parental retardation. This may be a result of the ability of less retarded parents to conceal abuse more easily. Incidents of abuse increased with increased family size. Training retarded adults to be responsible parents has had mixed results. Greater success has been achieved with parents with less severe retardation (IQs in the range of 70). More seriously retarded parents have difficulty mastering the routines of daily life necessary to raise a family. Future efforts should be devoted to family support, expanded group-home settings, foster-care placement, and other alternative living arrangements. Children should be protected from the adverse effects that may result from being reared by retarded parents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Toe walking has been associated with language disorders and autism. To better understand the association between persistent toe walking and sensory and motor variables in children with autism, the degree of toe walking was compared with an estimate of the severity of sensory integration dysfunction symptoms and the presence of residual components of the tonic labyrinthine in supine reflex pattern in 61 children younger than 37 months of age with newly diagnosed autism. There was no association between the presence of toe walking and sensory symptoms (P = .5298) or language age (P = .6142), but there was an association between toe walking and the presence of components of the tonic labyrinthine reflex (P = .04222). These preliminary results support the contribution of subtle motor deficits to the evolution of some behaviors associated with autism. [ABSTRACT FROM PUBLISHER]