About 2 to 5% of the elementary school children may suffer from some demonstrable "lagging behind" in intellect and learning abilities and alteration in behaviour. The earliest recognized disability is in reading and arithmetic.
On the whole there may be combinations of impaired memory, language, talking, understanding spoken words, reading, impulse, visual perception, conceptualization or motor function. The child is usually overactive, aggressive, excitable and impulsive. He generally fails to have reasonable social judgement and has a very short attention span. Incidence of superimposed emotional problems is high.
The cause is not precisely known though brain damage, prematurity, low-birth weight, and psychosocial and genetic factors have been blamed.
Management aims at tutoring the child to acceptable behaviour and at his training with patience and understanding. The program must involve close coordination among parents, teachers and psychologist.
In addition to the behavioural and psychological therapy aimed at the child, the parents and the school, to give structure to the child's environment, stimulant drugs such as methylphenidate, dextroamphetamine, magnesium pemoline and tricyclic antidepressants are efficacious and are strongly recommended.
Prognosis is favorable, Many children doing well in adulthood if they are properly employed. The presence of aggression in childhood is a predictive symptom of adult psychopathy, in the form of sociopathy, hysteria and alcoholism.
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