Few CT Scan Abnormalities Found Even in Neurologically Impaired Learning Disabled Children

Abstract

Computerized tomography (CT) scans without enhancement were performed on 32 children attending a learning disabilities clinic. These 32 were selected because they had subtle lateralizing neurological hemisyndromes (16 right, 16 left). Clinical readings of 25 scans by two independent radiologists “blind” to neurological or historical facts yielded only 5 (20%) concordant abnormal readings. Measurements of ventricular size in all 32 scans yielded even fewer (only 1) judged abnormal. Meaningful hemispheric asymmetries were difficult to define in the present study.

Dyslexia and brain morphology.

“…A second approach, typical of the Haslam, Dalby, Johns, and Rademaker (1981) and Denckla, LeMay, and Chapman (1985) studies, was to examine CT findings in relation to clinically defined subgroups. In the Haslam et al (1981) study, Boder's (1973) dysphonetic, dyseidetic, and nonspecific subtypes were used, whereas in Denckla et al's (1985) study, the subjects were chosen to represent children with left or right hemisyndromes (based primarily on lateralizing motor signs). In these studies, the relation between subgroups on measures of cerebral asymmetry or symmetry and other variables including intelligence and birth history were examined.…”

“…Of even more serious concern, however, is the fact that reading achievement, or delays in reading achievement, are not documented in several studies (e.g., Denckla et al, 1985; Leisman & Ashkenazi, 1980; Rosenberger & Hier, 1980). Furthermore, in opposition to recommendations made by pertinent professional organizations (e.g., National Council on Measurement in Education, International Reading Association), who oppose the reporting and analysis of grade equivalent scores because of their derived psychometric properties and misrepresentation of actual levels of achievement (Hynd & Cohen, 1983), a number of studies report reading achievement in grade equivalent (GE) scores (Haslam et al, 1981; Hier et al, 1978; Rumsey et al, 1986).…”

“…A number of studies did include and assess for the presence of soft neurological signs (Denckla et al, 1985; Haslam et al, 1981; Rosenberger & Hier, 1980; Rumsey et al, 1986). It seems that only in the Denckla et al (1985) and Rumsey et al (1986) studies was an effort made to use a standardized clinical neurodiagnostic examination, and both studies used the examination developed by Denckla (1985).…”

“…On the basis of the review provided to this point, it appears that some of the studies are so poorly controlled or reported (e.g., Leisman & Ashkenazi, 1980; LeMay, 1981) that the results, though of interest, cannot possibly be taken as important contributions to this literature. The Denckla et al (1985), Hier et al (1978), and Rosenberger and Hier (1980) studies appear to provide adequate diagnostic or clinical information, but in each case, essential data are omitted. In the Hier et al (1978) study, FSIQs are not reported, and in the Denckla et al (1985) and Rosenberger and Hier (1980) studies, adequate achievement data are not provided.…”

The Assessment of Hyperactivity in Preschool Populations

“…The components of the traditional neurological assessment include an electroencephalogram (EEG), a brain scan, and skull x-rays. Unfortunately, there is a lack of conclusive research indicating that hyperactive children can be reliably identified using these assessment techniques (Denckla, LeMay, & Chapman, 1985;Satterfield, Lesser, Saul, & Cantwell, 1973). Nonetheless, current research in neuroradiological techniques such as nuclear magnetic resonance indicate that traditional neurological assessments may soon be more effective in the identification of hyperactivity (Johnston, 1987).…”