Abstract
Twenty-one children, mean age of 8 years, were each examined on separate occasions by two pediatric residents, blind to diagnosis, using the neurological examination (PANESS) included in the group of instruments recommended by the National Institute of Mental Health for psychotropic drug studies in children. Half the children were hyperactive/aggressive, one quarter were normal, and one quarter had histories or signs strongly presumptive of brain damage. Many of the signs, though reliable, did not occur in the majority of children. Examiners did achieve a high level of agreement about global neurological status. It was concluded that the neurological examination probably contains a substantial number of non-contributory items and should be regarded as experimental rather than definitive.
Similar content being viewed by others
References
Camp, J. A., Bialer, I., Press, M., and Winsberg, B. G. (in press). The physical and neurological examination for soft signs (PANESS): Pediatric norms and comparisons between normal and deviant boys.Psychopharmacology Bulletin.
Close, J. Scored neurological examination in pharmacotherapy of children.Psychopharmacology Bulletin, Special Issue—Pharmacotherapy of Children, 1973, 142–148.
Conners, C. K. A teacher rating scale for use in drug studies with children.American Journal of Psychiatry, 1969,6, 152–156.
Conners, C. K. Pharmacotherapy of psychopathology in children. In H. C. Quay & J. S. Werry (Eds.),Psychopathological disorders of childhood. New York: Wiley, 1972.
Fleiss, J. L., Spitzer, R. L., Endicott, J., & Cohen, J. Quantification of agreement in multiple psychiatric diagnosis.Archives of General Psychiatry, 1972,26, 169–171.
Kendall, M. G., & Stuart, A.The advanced theory of statistics (Vol. 2). London: Charles Griffin & Company Limited, 1961.
Kornetsky, C. Psychoactive drugs in the immature organism.Psychopharmacologia, 1970,17, 105–136.
Ozer, M. N. The neurological evaluation of school age children.Journal of Learning Disabilities, 1969,1, 87–84.
Paine, R. S., & Oppe, T. E. Neurological examination of children.Clinics in developmental medicine (#20/21). London: Heinemann, 1966.
Psychopharmacology Bulletin Pharmacotherapy of children. Special issue, 1973 (No volume #).
Reitan, R., & Heinemann, C. Interactions of neurological deficits and emotional disturbances in children with learning disorders. Method for differential assessment. InLearning disorders III. Seattle: Special Child Publication, 1969. Pp. 93–136.
Rutter, M., Graham, P., & Yule, W. A neuropsychiatric study in childhood.Clinics in developmental medicine. (#35/36). London: Heinemann, 1970.
Satterfield, J. H., Cantwell, D. P., Saul, R. E., Lesser, L. I., & Podosin, R. L. Response to stimulant drug treatment in hyperactive children: Prediction from EEG and Neurological findings.Journal of Autism and Childhood Schizophrenia, 1973,3, 36–48.
Sprague, R., Christensen, D., & Werry, J. Experimental psychology and stimulant drugs. In C. K. Conners (Ed.),Clinical use of stimulant drugs in children. Amsterdam: Excerpta Medica, 1974.
Wender, P.Minimal brain dysfunction in children, New York: Wiley, 1971.
Werry, J. S. Studies on the hyperactive child IV—an empirical analysis of the syndrome of minimal brain dysfunction.Archives of General Psychiatry, 1968,19, 9–16.
Werry, J. S. Organic factors in psychopathology. In H. C. Quay, & J. S. Werry (Eds.),Psychopathological disorders of childhood. New York: Wiley, 1972.
Werry, J. S., & Aman, M. G. Methylphenidate and haloperidol in children. Effects on attention, memory, and activity.Archives of General Psychiatry, 1975,32, 790–795.
Werry, J. S., Minde, K., Guzman, A., Weiss, G., Dogan, K., & Hoy, E. Studies on the hyperactive child VII: Neurological status compared with neurotic and normal children.American Journal of Orthopsychiatry, 1970,42, 441–451.
Author information
Authors and Affiliations
Additional information
This study was supported in part by a grant to Professor Werry from the Medical Research Council of New Zealand and USPHS grant #MH 18909 from the National Institute of Health to R. L. Sprague, Ph.D. Drs. M. Hudson and M. Morris performed the examinations. We should like to pay particular tribute to Dr. Thelma Becroft, a school doctor in Auckland, who supplied the normal and neurological subjects.
Rights and permissions
About this article
Cite this article
Werry, J.S., Aman, M.G. The reliability and diagnostic validity of the physical and neurological examination for soft signs (PANESS). J Autism Dev Disord 6, 253–262 (1976). https://doi.org/10.1007/BF01543465
Issue Date:
DOI: https://doi.org/10.1007/BF01543465