J. Gordon Millichap THE HYPERACTIVE CHILD WITH MINIMAL BRAIN DYSFUNCTION Chicago: Year Book Medical Publishers, 1975, 169 pp., $10.95.
Addressed to a broad audience, this book, by a questionand-answer format, discusses diagnosis and treatment of the hyperactive child with MBD. Quoting unspecified sources, the author states that MBD affects between 4 and 20 per cent of school-age children. Etiology, symptoms, signs, and syndromes are delineated with "no obvious cause . . . apparent in 50% of cases." The two longest chapters describe diagnostic evaluation, detailed neurologic examination, EEG, and neurophysiologic tests. Among the latter are intelligence and perceptual tests. Intelligence tests, such as the WISC, are considered culturally determined and hence of questionable value. Use of visual perceptual tests and EEGs as indicators of MBD would be unsatisfactory to many investigators.
Minimal brain dysfunction is not a well-accepted, -defined, and -researched clinical entity. The opinions of the author are not supported by facts (see Satterfield, 1973, re EEG issues with MBD and Cantwell, 1975, re hyperactivity). The present trend is toward making the diagnosis more exclusive. The author defines MBD as "a term applied to children of normal intelligence who exhibit learning and behavioral disabilities associated with neurologic abnormalities. Hyperactive behavior is the most common [symptom], occurring in 75% of children affected by MBD." Unfortunately, no references or bibliography is included, which may trouble the careful, compulsive reader.
Literature on MBD suffers because writers on the subject have not resolved two basic issues: first, the nature of child development, particularly development of body regulation and cognitive functions, and, second, the disagreement regarding criteria for valid proof in behavioral sciences.