ABSTRACT
As early as Orton's (1925) description of the "motor incoordinate" type of child with normal intelligence, it was recognized that abnormalities of motor performance commonly accompanied what would now be called specific reading and other academic skill disorders. It has since been frequently documented that not only children with specific learning disabilities, but also those with Attention Deficit-Hyperactivity Disorder (ADHD) and more pervasive developmental disorders, such as mental retardation and autism, may have difficulties with motor learning and motor execution (Bakwin, 1968; Barlow, 1974; Bender, 1970; Nichols & Chen, 1981), and some individuals suffer from motor incoordination without any other symptoms (Ford, 1960). The fact that these groups of children differ from their "normal" age mates on various measures of motor performance has been solidly established (Clinton & Boyce, 1975; Denckla & Rudel, 1978; Deuel, Feeley & Bonskowski, 1984; Hertzig, 1981; Keogh, 1986; Paine, Werry, & Quay, 1968; Peters, Romine, & Dykman, 1975; Strauss & Lehtinen, 1947; Wolff & Hurwitz, 1966), but whether there are specific patterns of motor learning and execution deficits that accompany specific developmental neuropsychiatric disorders and thus have significance for neuropsychiatric syndrome diagnosis remains somewhat controversial (Deuel & Robinson, 1987; Yule & Taylor, 1987). Other current, related issues are: (a) whether mild and moderate motor performance deficits contribute
HISTORICAL PERSPECTIVE
Although discovery of soft signs, used as indicators of organic brain dysfunction, served to relieve the parents of the guilt of poor management and the children of ineffectual extended psychotherapy (Peters, 1987), it seems that the actual data used to support brain dysfunction is tenuous (Shaffer et al., 1985; Shafer, Shaffer, O'Connor, & Stokman, 1983). In fact, work by Rutter shows that, whereas severe brain damage is much more likely than mild brain damage to be accompanied by a variety of neuropsychiatric disturbances, the only specific neuropsychiatric symptom of severe brain damage that can be isolated as a true "sequela" (i.e., as related to the damage per se) is social disinhibition (Rutter, 1981, 1982, 1983). Therefore, the conclusion that, even if the motor performance deficits were to denote brain damage or fixed brain dysfunction, they would not have discriminating diagnostic significance for neuropsychiatric disorders is hard to avoid. Currently, many authorities would not assign any significance to neurological findings of motor performance deficits in syndrome diagnosis (Bigler, 1988), and some would even dispense with the neurological examination altogether in certain instances (Peters, 1987).
