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Minor Neurological Dysfunction Is More Closely Related to Learning Difficulties than to Behavioral Problems

Mijna Hadders-Algra, MD, PhD, is a neuroscientist with special training in developmental neurology. She works at the University of Groningen, the Netherlands. Her main interests are the development of normal and abnormal motor behavior in early infancy and the significance of minor neurological dysfunction in the development of learning problems and behavioral difficulties.

Bert C.L. Touwen

Bert C.L. Touwen, MD, PhD, is professor of developmental neurology at the University of Groningen. His major research involves the elucidation of the mechanisms involved in normal and abnormal neurological development. One of his main interests is the significance of mild dysfunctions of the brain for adaptation to environmental constraints. Address: Mijna Hadders-Algra, Department of Developmental Neurology, Oostersingel 59/31, 9713 EZ Groningen, the Netherlands.

In a group of 570 nine-year-old children (315 boys and 255 girls) without an overtly handicapping neurological condition, relationships were studied between the presence of minor neurological dysfunction (MND) on the one hand and cognitive and behavioral problems on the other hand. The aim of the study was to investigate whether MND was more closely related to learning problems than to behavioral difficulties. The group was a subpopulation of the birth cohort of the Groningen Perinatal Project in the Netherlands, in which perinatal developmental relationships are studied. The age-specific and standardized neurological examination technique of Touwen (1979) was used, resulting in a description of the neurological condition in terms of the number of deviant clusters. The absence of deviant clusters indicated a normal neurological condition (n=418); children with one or two deviant clusters were classified as MND-1 (n=86) and those with more than two deviant clusters as MND-2 (n=66). The presence and severity of MND was significantly related to poor performance on standardized reading, spelling, and arithmetic tests. MND was also related to ratings of distractible behavior on parent and teacher questionnaires, but to a lesser extent than the cognitive problems. Ratings of so-called "troublesome" and "timid" behavior were not related to MND. Our conclusion is that learning problems are more closely related to MND than are behavioral difficulties. This has implications for prevention and intervention: In the former the focus should be more on biological hazards, in the latter on environment and rearing attitudes.

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