To the Editor.—
Dr Newton's editorial, "Minimal Brain Dysfunction" (235: 2524, 1976) emphasizes a major public health problem: evaluation of the cases of children who perform poorly in the traditional schoolroom. He is certainly correct in pointing out that the diagnostic criteria often used in evaluating these cases are "extremely confusing and in some cases, basically unscientific." It is disappointing that he then proceeds to endorse the concept of an entity called minimal brain dysfunction (MBD) and alleges that it is distinct from "hyperactivity, learning disability and behavior problems."Increasingly, workers in the field are coming to just the opposite conclusion: there is no such entity as MBD!1 It is a ragtag hodgepodge term describing children with a striking variety of problems, due (in all probability) to a number of different etiologic mechanisms. Lumping all these diverse youngsters together in one group has greatly inhibited progress in this field.
Baumann RJ. Minimal Brain Dysfunction. JAMA. 1976;236(14):1577. doi:10.1001/jama.1976.03270150015014