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Minor malformations, hyperactivity, and learning disabilities
P J Accardo1, T Tomazic, J Morrow
1Department of Pediatrics, St Louis University School of Medicine, Knights of Columbus Developmental Center, Cardinal Glennon Children's Hospital St. Louis, MO.
Insights
Standardized minor malformation scores do not predict hyperactivity or attention deficits in children. Instead, higher scores are linked to learning disabilities and higher IQs, suggesting a different diagnostic utility.
Area of Science:
- Developmental Pediatrics
- Clinical Genetics
- Neurodevelopmental Disorders
Background:
- Standardized minor malformation scores have been suggested as predictors for attention problems and hyperactivity.
- The utility of these scores for identifying specific neurodevelopmental profiles remains incompletely understood.
Purpose of the Study:
- To investigate the diagnostic correlations of minor malformation scores in children evaluated for developmental disorders.
- To determine the association between dysmorphology scores and diagnoses such as attention deficit hyperactivity disorder and learning disabilities.
Main Methods:
- Examined minor malformation scores in 1233 children undergoing multidisciplinary evaluation for developmental disorders.
- Excluded children with chromosomal disorders and recognized dysmorphic syndromes.
- Analyzed correlations between dysmorphology scores, IQ, hyperactivity, attention deficit disorder, and specific learning disabilities.
Main Results:
- No significant association was found between minor malformation scores and hyperactivity or attention deficit disorder.
- Higher dysmorphology scores were observed in children with IQs greater than 100.
- Children with specific learning disabilities exhibited significantly higher minor malformation scores.
Conclusions:
- Minor dysmorphic features do not reliably predict attentional problems or hyperactivity in referred children.
- Elevated minor malformation scores may characterize children with co-occurring attention deficit disorder and learning disabilities, or learning disabilities alone.
Abstract:
Standardized minor malformation scores have been reported to predict and identify children with attentional problems and hyperactivity. The reason why this marker works for only a subset of children with attention deficit hyperactivity disorder remains unclear. The dysmorphology scores on all children presenting for a multidisciplinary team evaluation of developmental disorders were examined for diagnostic correlations after children with chromosomal disorders and recognized dysmorphic syndromes were excluded. For 1233 subjects, the mean minor malformation score was 2.94 (SD = 2.05). A significant association between minor malformation scores and IQ (mean = 80.95, SD = 23.67) was accounted for by the group with IQs greater than 100 exhibiting the higher dysmorphology scores. An analysis of variance revealed no significant association between minor malformation scores and hyperactivity or attention deficit disorder. Indeed, the presence of an attention deficit disorder yielded lower mean dysmorphology scores. When the minor malformation scores were compared for those subgroups of children with and without specific learning disabilities, the learning-disabled subjects had significantly higher dysmorphology scores. Minor dysmorphic features do not relate to the presence or absence of attentional problems or hyperactivity in referred children. Rather they appear to characterize that subpopulation of children with attention deficit disorder and learning disabilities as well as a group of learning-disabled children without attentional disorders.