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Mental status examination of children with learning problems
P J Brunquell1, B S Russman, T J Lerer
1Department of Pediatrics, Newington Children's Hospital, Connecticut 06111.
Pediatric Neurology
|January 1, 1989
Summary
Child neurologists consistently examine children with learning problems but underemphasize complex cognitive functions. This suggests diagnoses may rely more on other clinical findings than the standard mental status examination.
Area of Science:
- Neuroscience
- Pediatrics
- Developmental Psychology
Background:
- Learning problems in children are a significant concern.
- The mental status examination is a key diagnostic tool.
- Assessing higher cortical functions is crucial for understanding learning difficulties.
Purpose of the Study:
- To evaluate the consistency of mental status examinations in children with learning problems among child neurologists.
- To determine if the assessment adequately covers higher and related cortical functions.
- To question the utility of the mental status examination in diagnosing learning problems.
Main Methods:
- A questionnaire was distributed to 163 board-certified/eligible child neurologists.
- Responders' testing frequencies for 6 major mental status categories were analyzed.
- Data were compared across demographic subgroups (age, sex, practice type, training completion).
Main Results:
- Testing frequency was uniform across demographic variables.
- A decline in testing frequency was observed with increasing cognitive complexity.
- Higher and related cortical functions were tested significantly less often than elementary functions.
Conclusions:
- The mental status examination approach is consistent among child neurologists but may be insufficient for learning problems.
- Underassessment of higher cortical functions raises questions about the examination's importance.
- Diagnoses for learning problems likely depend on factors beyond the mental status examination.