[The importance of nonverbal motor examination methods in screening for minimal brain dysfunction]

During screening of disorders of activities ascribed among others to the effect of minimal brain dysfunction (MBD) by means of indirect, questionnaire methods the influence of social conditioning, e.g. overprotection by parents or neglected education, cannot be ruled out. Because in screening of this type the testing part of the diagnostic process is lacking, it is desirable to assess not only disorders of acquired mental functions in school children but to check the course of learning. In order to eliminate verbal transfer and to restrict the influence of previously acquired cognitive strategies which are also socially conditioned, it is expedient to select for tests of learning new unequivocally defined motor patterns. The advantage of motor learning is the possibility to follow up readily observable movements in the course of learning. Contrary to gross cerebral lesions where there are usually disorders of various mental functions, depending on the affection of the right or left hemisphere, in subclinical compensated cerebral affections, e.g. in MBD, it is rather a problem of more difficult cooperation of the two cerebral hemispheres when the demands on attention and integrated activity are increased. In this connection we may also reflect on the relationship with the diffuse polymodal non-specific sensory system. In this respect the difference in performance of learned activities and in tests of motor learning in subjects with MBD is important. It may be assumed that after learning an activity the demands on attention are reduced and thus the differences between healthy children and children with MBD are masked.