Soft Neurological Signs and Impulsivity in Children

Department of Psychiatry, Medical College of Pennsylvania, Philadelphia.
Journal of Developmental & Behavioral Pediatrics (Impact Factor: 2.13). 07/1990; 11(3):112-5. DOI: 10.1097/00004703-199006000-00003
Source: PubMed


To evaluate the relationship between soft neurological signs and various proposed dimensions of impulsivity (behavioral and cognitive), 31 boys (6-13 years, mean +/- SD 10.1 +/- 1.8) with disruptive behavior disorders, and 45 age-matched boys without DSM-III-R pathology, were independently assessed on clinical ratings of impulsivity, a battery of cognitive tests intended to score impulsive responding, and a neurological examination for soft signs. After being corrected for age, neurological soft signs correlated positively with impulsive responding on the Matching Familiar Figures Test (inpatients and normals) and the Continuous Performance Test (in normals), but not with IQ or clinical impulsivity rating scores. These findings suggest a relationship between neurological dysfunction/immaturity and performance on specific tasks requiring response inhibition, thus adding value to the cognitive assessment of impulsivity.

11 Reads
  • Source
    • "The lack of a group difference in relation to digit span, digit symbol test scores, and PANESS impersistence scores might be due to the their occurrence in both disorders and this is consistent with the previous findings of attention problems and imbalance in ADHD and ANXs (Ghanizadeh, 2011; Jarrett & Ollendick, 2008; Jarrett et al., 2012; Konicarova, Bob, & Raboch, 2014). Consistent with the previous studies (Pasini & D'agati, 2009; Vitiello et al., 1990; Mostofsky & Simmonds, 2008), only the tasks requiring inhibitory control produced significant differences among groups, confirming the suggestions that ADHD is best characterized as a disorder of reduced inhibition control (Barkley, 1990; Nigg, 2001) and ANXs are associated with increased control of inhibition (Degnan & Fox, 2007; Oosterlaan & Sergeant, 1998), and leading to the idea that imbalance and inattentiveness may not be sensitive enough to capture diminished capacity in these patient groups. Similar to Manassis, Tannock, Young, & Francis-John's study (2007), we did not replicate earlier findings of greater impairment in ANX + ADHD than in " pure " ADHD (Pliszka, 1989, 1992), and we found that pure ADHD was the most impaired group. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To compare the neuro-cognitive profiles among initial clinic referred medication naive sample of children with anxiety disorders (ANXs) and ADHD in a youth sample. Three groups of patients, ANX (n = 40), ADHD (n = 48), and ANX + ADHD (n = 33), aged 7 to 12 years, were compared with respect to their Physical and Neurological Examination for Subtle Signs (PANESS) and cognitive measures (digit span, digit symbol, Trail Making Test [TMT]-A and TMT-B, Stroop test). ADHD group performed worse than the other two groups with regard to soft signs and cognitive test performance; ANX + ADHD were impaired relative to ANX but better than ADHD. Significant differences were found for gait and station problems, overflows and timed movements, TMT error points, and Stroop interference scores. ADHD patients had more difficulty in warding off irrelevant responses and lower speed of time-limited movements. This clinical evaluation study suggested that ANX and ADHD seem to have significantly different neuro-cognitive features: Poorest outcomes were observed among children with ADHD; rather than problems of attention, inhibitory control deficits were the most prominent differences between ANX and ADHD; and the presence of ANX appears to have mitigating effect on ADHD-related impairments. © 2015 SAGE Publications.
    Journal of Attention Disorders 06/2015; DOI:10.1177/1087054715578003 · 3.78 Impact Factor
    • "Thus, there was a high incidence of maturational delay. This delay has been reported in many earlier studies.[14252930] Similarly decreasing incidence of soft signs with age has also been reported.[31] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with wide repercussions. Since it is etiologically related to delayed maturation, neurological soft signs (NSS) could be a tool to assess this. Further the correlation of NSS with severity and type of ADHD and presence of Specific Learning Disability (SLD) would give further insight into it. To study neurological soft signs and risk factors (type, mode of delivery, and milestones) in children with ADHD and to correlate NSS with type and severity of ADHD and with co-morbid Specific Learning Disability. The study was carried out in Child care services of a tertiary teaching urban hospital. It was a cross-sectional single interview study. 52 consecutive children diagnosed as having ADHD were assessed for the presence of neurological soft signs using Revised Physical and Neurological Examination soft Signs scale (PANESS). The ADHD was rated by parents using ADHD parent rating scale. The data was analyzed using the chi-squared test and Pearson's co-relational analysis. Neurological soft signs are present in 84% of children. They are equally present in both the inattentive-hyperactive and impulsive-hyperactive types of ADHD. The presence of neurological soft signs in ADHD are independent of the presence of co-morbid SLD. Dysrrhythmias and overflow with gait were typically seen for impulsive-hyperactive type and higher severity of ADHD is related to more errors.
    Indian Journal of Psychiatry 04/2012; 54(2):159-65. DOI:10.4103/0019-5545.99540
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The present study aimed to examine whether neurological soft signs identified in children with attention deficit hyperactivity disorder (ADHD), learning disorders (LD), comorbid ADHD-LD and children with no known disorders could be grouped and whether these groups of soft signs would differentiate between the clinical groups and the non-clinical group. A total of 148 children (114 boys, 34 girls) participated in the study, with a mean age of 8.84. The exploratory factor analysis for Neurological Examination for Subtle Signs (NESS) items revealed five factors, explaining 81.7% of the variation. Multivariate analysis of variance showed that these factors of NESS were significantly different between the clinical groups and the non-clinical group. The discriminant functional analysis also yielded significant canonical discriminant functions, correctly classifying 85% of the clinical and non-clinical groups of children. Certain factors of NESS such as speed of movement, dysrhythmia and overflow with timed movements, provide important information that may enhance our understanding of the neurobiological bases of ADHD and LD and the clinical implications of neurological soft signs.
    The Turkish journal of pediatrics 01/2007; 49(3):263-9. · 0.43 Impact Factor
Show more