[Concentration of lead in the blood of children with hyperkinesis]

The concentration of lead in bloods of 25 hyperkinetic children was compared to that found in a corresponding number of healthy children of the same age group. It was found that 3 hyperkinetic children showed levels above 40 mug/100 ml. The findings are discussed and the importance of substances containing this element bears on the child's environment are pointed out. Besides, stress is placed on the consequence that a high concentration of lead in the blood may show on mental development and it is suggested that through studies be carried out in every child with the habit of pica added to hyperkinesia.

[The Restless Child (author's transl)]

Physiological unrest of children seems to originate from a basic need for activity in humans. It becomes apparent as "enjoyment of action" during age-specific periods, particularly during emotional phases of development. Apart from clearly neurological diseases, psychomotoric unrest as a pathological symptom can be observed in three forms different in artiology and psychodynamics: as cerebral unrest, psycho-vegetative unrest, and neurotic unrest. Causes, psychodynamics and appearances of the unrest as mentioned before are discussed and illustrated by details of case histories. Basically, the psychomotoric unrest is an expression of frustrated emotion, preventing the child from adjustment to reality, thereby causing a deficit of experience, which inturn is the reason for a secondary lack of success, to which the child reacts again with psychomotoric unrest. Therapy has to interrupt this vicious circle by three recommended approaches: drug therapy, child guidance, and psycho-therapy. Sociological aspects of the "restless child" are mentioned.

Minimal brain dysfunction

The syndrome of minimal brain dysfunction is found in at least 5% of South African schoolchildren. The aetiology and pathology of this entity are uncertain. Presenting features include hyperactive behaviour, problems of fine motor co-ordination, learning disabilities and certain 'soft' neurological signs. Skilled remedial teaching is the mainstay of successful management.

Organic factors in hyperkinesis: a critical evaluation

The role of organic factors in childhood hyperkinesis is evaluated, with a focus on electroencephalographic, neurological, biochemical, pregnancy and birth, and genetic research. Evidence that the majority of hyperkinetic children suffer from organic dysfunction is found to be minimal. This conclusion is discussed, and guidelines for future research are offered.

Hyperactive children and the efficacy of psychoactive drugs as a treatment intervention

Characteristics of hyperactive children, including speculation in regard to etiology, are reviewed. Drug effects studies and drug treatment of hyperactive behavior are examined, and unresolved issues are discussed. Conclusions indicate that individual differences in hyperative children should form the basis for treatment planning, rather than simply treating groups of children under the rubric "hyperactivity."

Hyperactivity and physical anomalies

Hyperactive elementary school boys were matched for age and IQ to a group of normal control children, and the frequency of minor physical anomalies in each group was recorded. Although hyperactives had more of these anomalies than the control children there was not a significant correlation between the degree of hyperactivity and the frequency of anomalies.

Standardized playroom measures as indices of hyperactivity

A group of 16 children from a normal community population was compared with two groups of 16 children referred for clinical evaluation of hyperactivity. These three groups were matched on age, sex, and race. One of the clinic groups was matched with the community sample on IQ and social class as well, while the children in the other clinic group were mentally retarded and of somewhat lower social class. All children were observed in a standardized playroom for two 15-minute sessions, one under free play instructions and the other under instructions restricting activity and toy-changing behavior. The two groups of children referred for evaluation of hyperactivity had significantly higher playroom activity scores than controls under both instructional conditions and significantly higher toy-change scores under restrictive instructions. Parental ratings of activity were also significantly higher in both clinic groups than in the community group. The mentally retarded clinic sample did not differ from the other clinic sample on any of the measures of activity or toy switching.

Medication for hyperkinetic children

The hyperkinetic syndrome is a symptom complex of hyperactivity, short attention span, distractibility, impulsivity, learning difficulties, other behaviour problems and 'equivocal' neurological signs. However, none of these terms has ever been objectively defined and at present diagnosis is largely a matter of clinical judgement. In the management of the disorder, drugs do have a place but the decision to use medication is a complex procedure diagnostically and therapeutically calling for the highest in clinical skill and medical supervision. The most useful medication at present is the stimulant group of drugs, particularly dextroamphetamine and methylphenidate. Antipsychotic drugs are sometimes useful but carry the risk of depressing higher CNS functions such as attention and cognition. Other drugs which have been shown to be of value include tricyclic antidepressants (although their effect is less predictable and less striking than that of the stimulants) and pemoline.

[Severe psychomotor instability in child psychiatry. Hyperkinetic states or psychomotor incontinence]

The pedopsychiatric problem of severe psycho-motoric instabilities of hyperkinetic states, that we prefer to designate as psychomotoric incontinence, is at the origin of great amount of publications of inequal value. After having delimitated the concept of severe psycho-motoric instability (hyperkinetic syndrome or motoric incontinence) and a critical historic review of the problem, the author relates the various clinical aspects with twenty personal cases as example. The clinical and therapeutic experience of the author, the etiology, pathologic antecedents, neuro-psychological and electro-encephalographic data concerning this clinical condition, show that only ameliorations (in 40% of the cases), and not recoveries, are to be expeected.

Sex differences in the activity level of preschool children as a possible precursor of hyperactivity

The major objective of the present study was to determine whether or not preschool age boys had a higher activity level than girls. While it is a widely known fact that more boys than girls are referred to specialists for being hyperactive, the question of whether a sex-linked pattern of hyperactivity is observable in the general population remains unanswered. To investigate this issue, the activity levels of preschool children from a "normal" sample were measured randomly by an observation technique as they took part in a nursery school program. The results not only indicated that boys were more active than girls, but that the boy's behavioral activity was manifested in patterns that were similar in nature to those often included as part of the various definitions of hyperactivity. The implication of the results were discussed, and future research needs were delineated.

Teachers' causal attributions for a child's hyperactivity: race, socioeconomic status, and typicalness

80 teachers and teachers-in-training responded to paragraphs describing a child as hyperactive. The race, socioeconomic status of the child, and the typicalness of the child's hyperactivity were systematically varied. Responses were affected by the described typicalness but not by the described race or sex.

Hyperkinesis and maternal smoking

Mothers of methylphenidate-sensitive hyperkinetic children reported smoking two to three times as many cigarettes as the mothers of dyslexic and normal controls; the reported cigarette consumptions of the fathers showed no significant differences. These findings are consistent with the hypothesis that smoking during pregnancy is an important cause of the hyperkinetic syndrome.