A study on comparison of neurological soft signs and minor physical anomalies between siblings of attention deficit hyperactivity disorder and normal controls

Jayendra Seetharaman, Karthikeyan Muthumani, Sivaraman Thirumalaikumarasamy


Background: The objective of the study was to compare the neurological soft signs and minor physical anomalies between ADHD siblings and normal controls, to observe the correlations among these parameters with sex and socioeconomic status of the subjects and to find out the interrelationship between neurological soft signs (NSS) and minor physical anomalies (MPAs) in both groups if at all there is a correlation.

Methods: This case control study was conducted in children of diagnosed ADHD and normal of age group 8-13 years at Institute of Child Health and Hospital for Children, Egmore, Chennai, during the period February 2013 to October 2014. The number of subjects from both case and control group were 57 each. All the patients were assessed for NSS by PANESS and MPAs by using Waldrop scale.

Results: Total number of children included in the study is 114. Male dominance was noted in the study (64.9%). Most of the patients belong to upper lower class (39.5%). ADHD siblings showed a significant increase in NSS especially in the field of overflow, gaits and stations, and timed when compared with the normal children (P<0.05). In both the groups, the difference in sex was not statistically significant in overflow, gait and stations, total timed, total PANESS and MPA scale (p>0.05). In case group parameters like gait and total time were significantly correlated with MPA scale. In control group, significant correlations were noted only between total PANESS and MPA scale. No positive correlation was observed between NSS and MPAs with socioeconomic status of the study participants in both the groups (p>0.05).

Conclusion: The current findings indicate that no significant correlation was existed between sex and socioeconomic status with NSS and MPAs in both the groups. ADHD siblings failed to show a significant increase in MPAs but showed a significant increase in NSS. However more number of studies is warranted for minor physical anomalies in ADHD siblings as early diagnosis of ADHD could be a possibility in children born with minor physical anomalies even before 3 years.


ADHD, Minor physical anomalies, Neurological soft signs

Full Text:



Kaplan and Sadock's. Attention Deficit Disorders. In: Sadock BJ, Sadock VA, editors. Comprehensive Textbook of Psychiatry. 9th edition. Philadelphia: Wolters Kulwer; 2009:3560-3561.

Barkley RA, Cunningham CE. The effects of methylphenidate on the mother. Child interactions of hyperactive children. Arch Gen Psychiatry. 1979;36:201-8.

Sergeant J. DSM-III attentional deficit disorder to functional defects. In: Bloomingdale L, Sergeant J, editors. Attention deficit disorder: Criteria, cognition, and intervention. New York: Pergamon; 1988:183-198.

Birth injury guide. Available at: Accessed on 20 January 2016.

Hill SY, Lowers L, Locke-Wellman J, Shen SA. Maternal smoking and drinking during pregnancy and the risk for child and adolescent psychiatric disorders. J Stud Alcohol. 2000;61(5):661-8.

Scahill L, Schwab-Stone M, Merikangas KR, Leckmaz JF, Zhang H, Kasl S. Psychosocial and clinical correlates of ADHD in a community sample of school-age children. J Am Acad Child Adolesc Psychiatry. 1999;38:976-84.

Biederman J, Mick E, Faraone SV, Braaten E, Doyle A, Spencer T, et al. Influence of gender on attention deficit hyperactivity disorder in children referred to a psychiatric clinic. Am J Psychiatry. 2002;159:36-42.

Martins I, Lauterbach M, Slade P, Luis H, De Rouen T, Martin M, et al. A longitudinal study of neurological soft signs from late childhood into early adulthood. Dev Med Child Neurol. 2008;50:602-7.

Bartol CR, Bartol AM. Juvenile Delinquency and Antisocial Behavior, A Developmental Perspective. 3rd edition. Pearson Publisher; 2008.

Denckla MB. Revised physical and neurological examination for subtle signs. Psychopharmacol Bull. 1985;21:773-800.

Waldrop MF, Halverson CF. Minor physical anomalies and hyperactive behaviour in young children. Exceptional Infant. 1971;2:343-80.

Malhotra S, Borade PB, Sharma P, Satija Y, Gunjan. A qualitative study of neurological soft signs in obsessive compulsive disorder and effect of comorbid psychotic spectrum disorders and familiality on its expression in Indian population. Asian J Psychiatry. 2017;25:6-12.

Gershon J. An overview of research. In: Quinn PO, Nadeau KG, Eds. Gender issues and AD/HD: Research diagnosis and treatment. Silver Spring, MD: Advantage Books; 2002:23-38.

Rucklidge JJ, Tannock R. Neuropsychological profiles of adolescents with ADHD: Effects of reading difficulties and gender. J Child Psychol Psychiatry. 2002;43:988-1003.

Newcorn JH, Halperin JM, Jensen PS, Abikoff HB, Arnold LE, Cantwell DP. Symptom profile in children with ADHD: Effects of comorbidity and gender. J Am Academy Child Adolescent Psych. 2001;40:137-46.

Semrud-Clikeman M, Biederman J, Sprich-Buckminster S, Lehman BK, Faraone SV, Norman D. Comorbidity between Attention Deficit Hyperactive Disorder and learning disability: A review and report in a clinically referred sample. J Am Acad Child Adolesc Psychiatry. 1992;31:439-48.

Holden EW, Tarnowski KJ, Prinz RJ. Reliability of neurological soft signs in children: reevaluation of the PANESS. J Abnorm Child Psychol. 1982;10(2):163-72.