Soft Signs in Early
David E. Tupper
Hennepin County Medical Center, Minneapolis
It is well known that children and adults who suffer brain dysfunction demonstrate psychological or neurological characteristics that reflect in some manner the nature of their neural insults. Although the inferences made about brain dysfunction in cases of severe brain injuries are rather direct, minor degrees of brain pathology may be less likely to produce consistent and clear patterns of neurobehavioral abnormality and therefore may require more inferences than most clinicians would normally like to make. Neurological soft signs may not always be accompanied by disorders of the central nervous system and do not have a specific relationship to any particular disorder. The topic of soft signs of neurological dysfunction has been a controversial one that touches on brain-behavior issues that are difficult to address directly ( Taylor, 1983; Tupper, 1987).
This chapter reviews much of the research relating soft indicators of neurobehavioral functioning to early developmental risk factors. First, the conceptual and methodological issues concerning soft signs are reviewed. The relationship among soft signs, clinical disorders, and early neurological risk factors is then addressed with particular attention paid to the few follow-up studies that have been performed. Finally, an attempt is made to relate the information gained from studying soft signs and early risk factors to broader neuropsychological mechanisms in development. Appropriate critical hypotheses about soft signs are reviewed in this context.