Neurological soft signs and school achievement: The mediating effects of sustained attention

A group of 115 black male adolescents drawn from a clinically unselected birth cohort, half of whom were known to have had neurological soft signs at age 7, were examined at age 17 to determine the relation between soft signs and performance on standard tests of school achievement and sustained attention. Three signs measured at age 17-dysgraphesthesia, difficulties with rapid alternating movements (dysdiadochokinesis), and motor slowness—were related to lower concurrent and past IQ and to impaired performance on laboratory and paper-and-pencil measures of sustained attention. The relation between signs and the attentional measures remained significant after IQ was statistically controlled. The three age 17 soft signs as well as age 7 signs were related to impaired performance on standardized tests (age 17) of school achievement. Most of the relation between signs and school achievement could be accounted for by the variance signs shared with sustained attention. One sign, mirror movements, was unrelated to all other attentional and cognitive measures.The study was supported by center grant MH 306906 and research training grant 5 T32 MH 13043-13 from the National Institute of Mental Health, as well as by the City College and the City University Computing Centers. We thank Lillian Belmont and two reviewers for their critical comments on an earlier version of the paper. We dedicate this paper to the memory of Joseph Barmack.