Screening for minimal brain dysfunction (MBD/DAMP) at six years of age: results of motor test in relation to perinatal conditions, development and family situation

The aim of this study was to investigate if children aged 6 years of age, classified as having minimal brain dysfunction (MBD) or deficit in attention, motor control and perception (DAMP), exhibit special medical problems, specific developmental features or if special psychosocial conditions exist in the family. The screening program, using the psychoneurological part of the method developed by Gillberg et al., included 234 children who were followed-up prospectively from pregnancy and birth. The results were related to the physical and mental development of the children, to the psychosocial and socioeconomic conditions of the families, to pre- and postnatal conditions and to “reduced optimality score”, as defined by Prechtl. Mental development was assessed by the use of Griffiths' test at 10-14 months and at 4-5 years of age. At the second Griffiths' test, the mother was also interviewed about the presence of aggressiveness and other symptoms of childhood psychopathology in her child, as defined by the DSM-III criteria, and a psychological observation was also made. In addition to screening for MBD/DAMP, at 6 years of age the parents were asked to complete a questionnaire aimed at identifying attention deficit disorder (ADD). No medical or psychological intervention was made before this stage. Fourteen children (9M, 5F) (6%) were identified as having a positive MBD/DAMP screening result. The results of the screening procedure showed a weak correlation with those obtained using the questionnaire based on the DSM-III criteria for ADD. Compared with the rest of the children, those with a positive MBD/DAMP screening result had an increased number of complications during pregnancy but not a reduced optimality score. At 4 years of age the performance on the Griffiths' test was lower and the rate of child psychiatric symptoms such as aggressiveness and signs of the mother having difficulties in setting limits for the child were more common than among the rest of the cohort. No relation was found with the psychosocial or socioeconomic conditions of the family. We conclude that children suspected of having MBD/DAMP at the start of school may have exhibited signs of delayed psychoneurological development and symptoms of psychopathology at 4 years of age.