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Minor physical anomalies and neurologic status in hyperactive boys.

The "hyperactivity" syndrome or "minimal brain dysfunction" has received considerable attention from teachers, psychologists and pediatricians over the past decade. The varied symptoms of restlessness, irritability, short attention span, impulsivity, motor incoordination and perceptual-cognitive disability may be prevalent in from 4% to 10% of grade school children.
 Several etiologic factors for this disorder have been proposed. In 1956 Rogers and Pasamanick found a higher rate of pregnancy complications for cases of behavior disorder compared to controls. Several replications of these findings have supported the postulate of a continuum of reproductive casualty in which disability varies with extent of damage. However, some recent studies of behavior disorders have not found a clear relationship among perinatal difficulties, neurologic signs, cognitive abnormalities and behavior problems.
 The evidence for genetic transmission of hyperactivity has also been examined; family clustering and sib half-sib studies have supported a genetic model. In addition, parents of hyperactive children have been noted to have a higher incidence of psychiatric disturbances not seen in their adoptive counterparts.
 The heterogeneity of this population and the variety of the theoretical models for the condition suggest that further clinical subclassification for hyperactive children is needed.
 In 1960 Daryn, examining 86 children with "diffuse brain damage," noted the frequent occurrence of minor physical anomalies for this group. Waldrop used the presence of minor physical anomalies to predict hyperactive behavior in a nursery school population. Waidrop and co-workers have reported four replications of this study with preschool populations, children with speech and hearing disorders, and an elementary school population. Rosenberg and Weller found that high ratings of minor physical anomalies were associated with school failure for an unselected population of 99 first-grade children.