Article
Neurological soft signs in mainstream pupils
J M Fellicka, A P J Thomsona, J Sillsb, C A Hartc
a Institute of
Child Health, Royal Liverpool Children's Hospital NHS Trust, Eaton
Road, Liverpool L12 2AP, UK, b Department of Paediatrics, Royal
Liverpool Children's Hospital, c Department of Medical Microbiology, University
of Liverpool
Correspondence to: Dr Fellick jfellick{at}liv.ac.uk
Accepted 6 July 2001
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.
METHODSA 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).
RESULTSChildren 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.
CONCLUSIONIn 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.
Keywords: neurological soft signs; ADHD; learning difficulties; developmental coordination disorder
© 2001 by Archives of Disease in Childhood
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