Mental status examination of children with learning problems

Questionnaires were submitted to 163 board-certified/eligible child neurologists to determine whether they employed a consistent approach to the mental status examination of children with learning problems and whether this approach appropriately emphasized the assessment of higher and related cortical functions. The responders' frequency of testing in 6 major categories of mental status function was independent of their age, sex, board-certified/eligible status, type of practice, and years elapsed since completion of training. The results of the entire study group and comparisons among demographic subgroups demonstrated a progressive decline in testing frequency with increasing complexity of mental status function. Child neurologists' approach to the mental status examination was remarkably uniform across a wide range of demographic variables. Higher and related cortical functions are tested significantly less often in children with learning problems than are other more elementary categories of mental status function; therefore, the importance of the mental status examination in this context must be questioned. It is likely that the diagnosis ascribed to a child with learning problems is based on findings other than those provided by the mental status examination.