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Sir.—Dr. Newton's comments are well thought out and obviously based on experience. Our article was not intended to imply, as he suggests, "that we do not need to do a neurological examination of the child involved." Rather it suggests that a de-emphasis may be in order, ie, that a neurological examination need not be in the first phase of the evaluative process in a nonresearch setting. Certainly a multidisciplinary approach to underachieving children is desirable; unfortunately the supply of "knowledgeable physicians" (primarily neurologists and selected pediatricians) is not plentiful in most areas. Those who are available often lack either the time or inclination to assimilate and explain the psychoeducational data to parents. Most school districts have the option of dealing with the primary physician or employing neurological consultants. The going rate for neurological evaluation ranges from $45 to $60. In terms of educational outcome for the child,
ADAMS RM. Neurological Examination of the Child-Reply. Am J Dis Child. 1975;129(6):748. doi:10.1001/archpedi.1975.02120430079025
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