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. 2001 Nov;85(5):371–374. doi: 10.1136/adc.85.5.371

Neurological soft signs in mainstream pupils

J Fellick 1, A Thomson 1, J Sills 1, C Hart 1, P STEPHENSON 1
PMCID: PMC1718960  PMID: 11668095

Abstract

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.
METHODS—A 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).
RESULTS—Children 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 15.3v 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.
CONCLUSION—In 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.



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Selected References

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  1. Adams R. M., Kocsis J. J., Estes R. E. Soft neurological signs in learning- disabled children and controls. Am J Dis Child. 1974 Nov;128(5):614–618. doi: 10.1001/archpedi.1974.02110300024004. [DOI] [PubMed] [Google Scholar]
  2. Blondis T. A., Snow J. H., Accardo P. J. Integration of soft signs in academically normal and academically at-risk children. Pediatrics. 1990 Mar;85(3 Pt 2):421–425. [PubMed] [Google Scholar]
  3. Camp J. A., Bialer I., Press M., Winsberg B. G. The physical and neurological examination for soft signs (PANESS): pediatric norms and comparisons between normal and deviant boys [proceedings]. Psychopharmacol Bull. 1977 Apr;13(2):39–41. [PubMed] [Google Scholar]
  4. Galler J. R., Ramsey F., Solimano G. A follow-up study of the effects of early malnutrition on subsequent development. II. Fine motor skills in adolescence. Pediatr Res. 1985 Jun;19(6):524–527. doi: 10.1203/00006450-198506000-00004. [DOI] [PubMed] [Google Scholar]
  5. Galler J. R., Ramsey F., Solimano G., Kucharski L. T., Harrison R. The influence of early malnutrition on subsequent behavioral development. IV. Soft neurologic signs. Pediatr Res. 1984 Sep;18(9):826–832. doi: 10.1203/00006450-198409000-00004. [DOI] [PubMed] [Google Scholar]
  6. Grimwood K., Anderson V. A., Bond L., Catroppa C., Hore R. L., Keir E. H., Nolan T., Roberton D. M. Adverse outcomes of bacterial meningitis in school-age survivors. Pediatrics. 1995 May;95(5):646–656. [PubMed] [Google Scholar]
  7. Henderson S. E., Hall D. Concomitants of clumsiness in young schoolchildren. Dev Med Child Neurol. 1982 Aug;24(4):448–460. doi: 10.1111/j.1469-8749.1982.tb13649.x. [DOI] [PubMed] [Google Scholar]
  8. Hertzig M. E. Neurological 'soft' signs in low-birthweight children. Dev Med Child Neurol. 1981 Dec;23(6):778–791. doi: 10.1111/j.1469-8749.1981.tb02066.x. [DOI] [PubMed] [Google Scholar]
  9. Holden E. W., Tarnowski K. J., Prinz R. J. Reliability of neurological soft signs in children: reevaluation of the PANESS. J Abnorm Child Psychol. 1982 Jun;10(2):163–172. doi: 10.1007/BF00915938. [DOI] [PubMed] [Google Scholar]
  10. Jongmans M., Mercuri E., de Vries L., Dubowitz L., Henderson S. E. Minor neurological signs and perceptual-motor difficulties in prematurely born children. Arch Dis Child Fetal Neonatal Ed. 1997 Jan;76(1):F9–14. doi: 10.1136/fn.76.1.f9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pine D. S., Scott M. R., Busner C., Davies M., Fried J. A., Parides M., Shaffer D. Psychometrics of neurological soft signs. J Am Acad Child Adolesc Psychiatry. 1996 Apr;35(4):509–515. doi: 10.1097/00004583-199604000-00017. [DOI] [PubMed] [Google Scholar]
  12. Pine D. S., Wasserman G. A., Fried J. E., Parides M., Shaffer D. Neurological soft signs: one-year stability and relationship to psychiatric symptoms in boys. J Am Acad Child Adolesc Psychiatry. 1997 Nov;36(11):1579–1586. doi: 10.1016/S0890-8567(09)66568-0. [DOI] [PubMed] [Google Scholar]
  13. Shafer S. Q., Stokman C. J., Shaffer D., Ng S. K., O'Connor P. A., Schonfeld I. S. Ten-year consistency in neurological test performance of children without focal neurological deficit. Dev Med Child Neurol. 1986 Aug;28(4):417–427. doi: 10.1111/j.1469-8749.1986.tb14279.x. [DOI] [PubMed] [Google Scholar]
  14. Steele J. C. Progressive supranuclear palsy. Historical notes. J Neural Transm Suppl. 1994;42:3–14. [PubMed] [Google Scholar]
  15. Stephenson J. B. Neonatal presentation of Prader-Willi syndrome. Am J Dis Child. 1992 Feb;146(2):151–152. doi: 10.1001/archpedi.1992.02160140017010. [DOI] [PubMed] [Google Scholar]
  16. Stokman C. J., Shafer S. Q., Shaffer D., Ng S. K., O'Connor P. A., Wolff R. R. Assessment of neurological 'soft signs' in adolescents: reliability studies. Dev Med Child Neurol. 1986 Aug;28(4):428–439. [PubMed] [Google Scholar]

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