Over the last 30 years, a number of behavioural and learning disorders have been lumped together under the uninformative label of ‘minimal brain dysfunction’ (MBD). Even long before that, MBD was used as a blanket term to cover children with hyperactivity and learning problems who, it was often taken for granted, had ‘minimal brain damage’. The roots of this unfortunate diagnostic etiquette are to be found at the beginning of this century, when, on the basis of studies of children with encephalitis, it was surmised that a characteristic syndrome of over-activity often developed as a consequence of brain damage sustained in utero or in early childhood. Reciprocally, the notion gradually emerged that over-activity was in itself a sign that the child was brain damaged. Subsequent empirical study has shown that (a) over-activity is usually not a sign of brain damage and (b) brain damage does not usually lead to over-activity (Rutter, 1982).

Synonyms

A comprehensive survey of all the many synonyms and partly overlapping concepts used in this field is beyond the scope of this book. However, a list of some of the most common diagnostic labels is appropriate, as an introduction to a description of the symptom profiles encountered in children who have been given the, often inappropriate, label of minimal brain dysfunction (MBD) over the last 30 years (see Table 8.1).

The array of labels outlined in the table testify to the confusion in the field. Unfortunately, it does not appear that it is yet time for consensus.