The epidemiology, co-morbidity and overlap of attention deficit hyperactivity disorder (ADHD) and deficits in attention, motor control and perception (DAMP), as defined in Scandinavia, were assessed in a total population of 589 6-year-old children screened for neurodevelopmental and neuropsychiatric disorders at the Skovde Central Hospital, and the University of Goteborg, Sweden. Among 63 children (10.7%) with identified disorders, the prevalence rates for ADHD and DAMP were 2.4-4% and 5.3-6.9%, respectively. One in four to three in four of children with DAMP had ADHD. Attention problems were more pronounced in the ADHD group, but overactivity and impulsivity did not distinguish ADHD from DAMP. Children with DAMP had, by definition, more deficits in perception and motor function. [1]

COMMENT. The Scandinavian syndrome of DAMP emphasizes the association of neurological signs of motor dysfunction, perceptual dysfunction, and attention deficits, whereas the current American DSM criteria for ADHD include only symptoms of inattentiveness, hyperactivity, and impulsivity, excluding reference to tests for neurological and perceptual dysfunction. The overlap of these syndromes and the higher prevalence of DAMP compared to ADHD suggests that the neurological examination and tests for perceptual dysfunction should form an integral part of the criteria for diagnosis of the attention deficit disorders (ADHD). A return to the former minimal brain dysfunction (MBD) criteria, in addition to symptoms of ADHD, would allow a more objective diagnosis and earlier recognition and remediation of associated motor incoordination and perceptual deficits.

Conflicting parent and teacher reports of problem behaviors were noted in children with reading disabilities and/or ADHD in a study at the University of Houston [2]. In evaluating a child for ADHD, it is important to obtain both teacher and parent reports.