Childhood brain function differences in delinquent and non-delinquent hyperactive boys

Electroencephalography and clinical Neurophysioh)gv, 1984, 57: 199 207 Elsevier Scientific Publishers Ireland, Ltd.

199

C H I L D H O O D BRAIN F U N C T I O N DIFFERENCES IN D E L I N Q U E N T A N D N O N - D E L I N Q U E N T HYPERACTIVE BOYS t JAMES H. SATTERFIELD * and A N N E M. SCHELL **

• California Child Stuc(v Foundation, Eneino, CA 91316, and ~* Department of Po,choloy~,, Occidental College, Los Any4eles, ('A 90041 (U.S.A.) (Accepted for publication: September 21, 1983)

Many disorders of early childhood are transient and do not predict later life psychopathology (Kohlberg et al. 1972). This is not the case for the hyperactive (HA) child syndrome, which is remarkably immutable, often resulting in adolescent problems of academic failure and serious antisocial behavior. Several follow-up studies of HA children have found a substantial subgroup (25%) to be delinquent (Huessy et al. 1974; Weiss et al. 1975). We have recently reported data which indicate that previous studies may have considerably underestimated the delinquency rate among HA children as teenagers (Satterfield et al. 1982). Although many HA children become delinquent, most do not. These different outcomes are not surprising; most investigators agree that the HA child syndrome (minimal brain dysfunction, hyperkinesis, attention deficit disorder) represents a heterogeneous group in terms of etiology and prognosis. Although meaningful subgroups are believed to exist, their identification is extremely difficult. One approach to this classification problem is to study subjects as extensively as possible in childhood and follow them into adolescence, when outcome can be measured. Subgroups can be formed based upon outcome differences, then childhood attributes that may meaningfully differentiate these subgroups can be examined. This strategy was used in the present study. A major question in this study was whether delinquent hyperactive (DHA) youths differ from

non-delinquent (NDHA) youths in childhood brain function, as measured by clinical electroencephalograms (EEGs), auditory event-related potentials (AERPs) and EEG power spectral data. Reports which indicate that these childhood measures might predict teenage antisocial behavior include findings of clinical EEG abnormalities in already delinquent adults (Williams 1969), as well as the finding that EEG power spectral measures predicted later life antisocial behavior (Mednick et al. 1981). A commonly held view of the significance of EEG abnormalities is that this finding suggests a poor prognosis. Therefore, a second question we examined was whether childhood EEG and AERP data in the DHA and N D H A outcome groups when compared with similar childhood data from normal controls would reveal the DHA boys to be more abnormal than the N D H A boys. Low socioeconomic class (SES) and low intelligence (West and Farrington 1973), childhood antisocial behavior (Robins 1966) and broken families (Rutter and Hersov 1977) have been reported to be precursors of delinquency (in individuals not selected for HA). We therefore examined whether our N D H A and DHA outcome groups differed from each other on these same variables. In view of the above studies, we predicted that the D H A youths would be characterized in childhood as having more antisocial behavior, lower intelligence, more abnormal brain function and come from low SES and broken families. As reported below, only one of these 5 predictions was found to be true.

I This work was supported, in part, by N I M H Grants MH35498 and MH35497. 0013-4649/84/$03.00 :": 1984 Elsevier Scientific Publishers Ireland, Ltd.

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Methods

Subject selection The present study is part of a follow-up of 110 HA and 75 normal control subjects extensively evaluated in childhood (ages 6-12 years) and followed up in their teens (ages 14-20 years). All HA children were originally referred between 1970 and 1972 for learning a n d / o r behavioral problems to an outpatient clinic for HA children. Informed consent was obtained from all subjects, and from their parents, after the experimental procedures were fully explained. To be selected for the HA group, a child had to be male, attending school, tested normal vision and hearing, at or above 80 in IQ on the Wechsler Intelligence Scale for Children (WISC full scale) and diagnosed by a child psychiatrist using behavioral criteria which required evidence of a chronic (6 months or longer) symptom pattern of hyperactivity, inattention and impulsivity as reported by parents a n d / o r teachers. Subjects were selected for this study before the diagnostic category of attention deficit disorder was in use. Nevertheless, the HA children in this study were selected by criteria that are similar to DSM-III criteria for attention deficit disorder with hyperactivity. Normal control children were paid subjects selected from public school classes and matched to the HA group for age, sex, and as closely as possible, for race and WISC full scale IQ. Teacher and parent rating scales described below were used to screen out normal children who evidenced hyperactive behavior. Comparisons between HA and normal subjects on the teacher rating scale have been reported elsewhere (Satterfield et al. 1982). Initial childhood evaluations and treatment All HA subjects were evaluated from several points of view: behavioral, psychological, psychiatric, neurological and neurophysiological. Control subjects were similarly evaluated except that they did not receive psychiatric or neurological evaluations. The Satterfield Teacher and Parent Rating Scales were obtained on most subjects. The Teacher Rating Scale consists of 36 behavioral items which are rated with respect to their descriptiveness of

J.H. SATTERFIELD, A.M. SCHELL

the child from 0 to 3: 0 = not at all, 1 = j u s t a little, 2 = pretty much, and 3 = very much. A maximum-likelihood factor analysis was performed on the individual item scores of this scale, and 5 orthogonal factors were extracted. An item was retained in a factor only if it loaded 0.5 or greater on that factor. If an item loaded 0.5 or greater on more than one factor, it was retained only in the factor on which it loaded the highest. Factor scores were obtained by averaging the item scores of those items selected for each factor. These 5 factors were labeled: hyperactive, antisocial, impulsive, inattentive and withdrawn. The Satterfield Parent Rating Scale is similar to the teacher scale and consists of 45 behavioral items rated from 1 to 3 : 1 = not at all, 2 = sometimes true. and 3-definitely true. Factor scores were computed in a manner similar to that described above for the Teacher Rating Scale. The following factors were obtained: hyperactive, inattentive, impulsive, antisocial and irritable. AERP, EEG and power spectral data were obtained on most subjects. Subjects were seated in an easy chair in a soundproof, electrically shielded room. The EEG was recorded using gold disk electrodes from two leads located 2.5 cm from the midline at the vertex and referred to the ipsilateral earlobe. In an attempt to improve the signal-tonoise ratio, an average of the EEG in these two channels was computed on-line and stored on digital tape. A ground electrode was placed on the forehead. The eyeblink potential was recorded from electrodes placed below and above the orbit. Any evoked potentials that were sampled during an eyeblink were automatically excluded by the computer from the averaging process. Approximately 20 50% of AERPs were excluded from the averaging process due to the presence of eyeblink potentials. The following operational definition was used for identification of the AERP components: the highest positive peak in the interval 50-110 msec following the stimulus was designated as P1, the highest positive peak in the interval 110 225 msec was designated as P2, the largest negative trough between these two positive peaks was designated as N1, and the largest negative trough following P2 in the interval 200-330 msec was designated as N2 (Satterfield and Braley 1977).

BRAIN FUNCTION DIFFERENCES IN HYPERACTIVEBOYS Subjects were instructed to watch a videotaped cartoon show on a television monitor and to ignore clicks being presented over two loudspeakers which were placed 45 ° to the left and right of the subject. Auditory stimuli were clicks lasting 0.1 msec with an intensity of 90 dB sound pressure level; the television sound was 50 dB sound pressure level throughout the experiment. Stimuli were presented in blocks at two regular rates; 400 stimuli were delivered at a slow rate of one stimulus every 2.5 sec and 1600 stimuli were delivered at a fast rate of two stimuli per second. At the fast stimulus rate some of the individual component peaks of the A E R P were difficult to identify, and for this reason only data from the slow stimulus rate were used for analysis. During the slow stimulus interval, the EEG was sampled every 2 msec for two 500 msec epochs for each stimulus and was recorded on digital tape. Data from the first 500 msec epoch, which began 100 msec before the onset of the stimulus, were averaged in order to obtain AERPs. Zero baseline was defined as the average of the EEG sample obtained during the pre-stimulus interval. Data from the second 500 msec epoch, which began 1 sec after the onset of the stimulus (at which time the evoked potential was over), were used to obtain EEG power spectral information. Only artifact-free epochs were averaged. The individual artifact-free non-signal epochs were first transformed by power spectral analysis, and then average power spectral values were computed. The averaged AERP and power spectral data were used for further analysis. The absolute spectral measures (delta = 1.5-3.5 c/sec, theta = 3.5-7.5 c/sec, a l p h a = 7.5 12,5 c/sec, beta 1 = 12-20 c/sec, and beta 2 = 20-30 c/sec) were also transformed for study to relative power, as a percentage of total power, by dividing by total power (1.5-30 c/see) and multiplying by 100. Clinical EEGs were obtained for 20 HA subjects. EEG records were classified as normal, borderline, or abnormal. Details of the method of classification and results have been reported previously (Satterfield et al. 1974). Before follow-up, most HA children had received stimulant drug treatment (methylphenidate) and brief counseling. The mean treatment period was 25.1 months

201 (S.D. = 24.1 months). The socioeconomic status of all families was measured using the Duncan scale (Duncan 1961), a 6-category scale based upon the occupation of the head of the household. This scale was divided into 3 social class categories (lower, middle and upper) by combining adjoining categories. Family type was determined for all subjects, based upon who the child lived with: two biological parents, one biological parent, one biological parent and step parent, and one or two step parents. At follow-up subjects were classified into delinquency groups based on official arrest data. The Los Angeles County Probation Department maintains a central juvenile index of all reported arrests from childhood to 18 years of age for persons living in the county. This information includes type and frequency of offense. Official arrest information was available for all 110 HA and 75 normal subjects. We classified offenses into two types, felony or minor. Minor offenses included status crimes, alcohol intoxication, possession of less than an ounce of marijuana, vandalism, and petty theft. Felony offenses included robbery, burglary, grand theft, grand theft automobile, and assault with a deadly weapon. For purposes of this study HA youths were classified on the basis of their arrest histories into 2 groups: (1) a group of 31 delinquent hyperactive (DHA) youths, who had a history of multiple (2 14) arrests for felony offenses, and (2) a group of 45 non-delinquent hyperactive ( N D H A ) youths, with no history of arrest including arrests for minor offenses. Normal youths were also classified into 2 groups: (1) a group of 65 non-delinquent normal (NDN) youths, with no history of arrests, and (2) all others (N = 10). A group of 34 HA youths with either minor or single felony offenses fell in between the two extreme outcome groups but their data were not used for comparison purposes. A delinquent normal group was not available for study, because no normal subject had a history of multiple arrests for felony offenses.

Results

Comparisons of normals with hyperactive subjects We first compared 3 groups, the DHA, N D H A ,

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J.H. SATTERFIELD, A.M. S('HELL

TABLE 1 Delinquent and non-delinquent hyperactives compared with non-delinquent normals on childhood log power spectral measures. Measures

NDN

DHA

NDHA

N Mean age (months)

65 101.2 (16.7)

31 96.0 (15.2)

45 101.3 (12.2)

E E G absolute power

Total Delta Theta Alpha Beta I Beta 2 Beta 3

4.41 (0.36) 3.26 (0.40) 3.30 (0.38) 2.79 (0.44) 1.55 (0.32) 1.06 (0.40) 1.32 (0.34)

4.40 (0.30) 3.19 (0.35) 3.23 (0.30) 2.90 (0.43) 1.59 (0.42) 1.14 (0.36) 1.33 (0.31)

4.57 * (0.32) 3.34 (0.40) 3.39 (0.30) 3.13 ** (0.49) 1.65 (0.37) 1.31 ** (0.41) 1.43 (0.29)

3.46 (0.20) 3.49 (0.11) 2.99 (0.23) 1.75 (0.22) 1.26 (0.20) 1.52 (0.15)

3.40 (0.18) 3.44 (0.10) 3.11 (0.27) 1.68 (0.26) 1.34 (0.22) 1.47 (0.19)

3.38 (0.25) 3.42 * (0.16) 3.17 ** (0.30) 1.80 (0.27) 1.35 * (0.16) 1.54 (0.15)

E E G relative power

Delta Theta Alpha Beta~ Beta 2 Beta 3

Note: Standard deviation in parentheses. * P < 0.05, D u n n e n ' s test. ** P < 0.01, Dunnett's test.

and the N D normal group, on EEG power spectral measures. In order to normalize distributions and achieve homogeneity of variance, natural log transformations were done on the EEG absolute power values and the relative power values in each frequency band. Analyses of variance revealed a significant group effect in the absolute power alpha band ( F = 7.46, df= 2, 138, P < 0.001), the absolute power beta 2 band ( F = 5.39, df= 2, 138, P < 0.01), total absolute power ( F = 3.80, dr= 2,

138, P < 0.05), the relative power theta band ( F = 4.18, df=2, 138, P < 0 . 0 2 ) , the relative power alpha band ( F = 6.51, df=2, 138, P <0.01), and the relative power beta 2 band ( F = 3.27, dr= 2, 138, P < 0.05). Dunnett's t test, which is appropriate for testing several group means against one control group (Kirk 1969), was then performed for all variables found to be significant by the analysis of variance. The degrees of freedom for each of these tests was 138, the df associated with the analysis of variance terms. The Dunnett's tests results are indicated in Table I, where asterisks indicate significant differences between means of hyperactive groups and the normal control group. As can be seen, the N D H A group had significantly higher total power, higher absolute power in the alpha and beta, bands, higher relative power in the alpha and beta 2 bands and lower relative power in the theta band than did the normal controls. Conversely, the DHAs did not differ from the normal group on any power spectral measure. We next compared the 3 groups on the auditory evoked potential measures. Analyses of variance on the amplitudes and latencies of the P1, N1, P2 and N2 components revealed a significant difference only for N2 amplitude ( F = 4.91, dr= 2, 98, P < 0.01). Dunnett's tests (dr= 98) indicated TABLE I1 Delinquent and non-delinquent hyperactives compared with non-delinquent normals on childhood evoked potential measures. Measures

NDN

DHA

NDHA

N Mean age in months

40 102.8 (17.5)

26 101.8 (12.6)

35 97.0 (14.3)

4.5 (2.4) 0.9 (3.6) 7.7 (3.9) -6.4 (3.7)

4.1 (1.8) 0.9 (2.4) 6.6 (3.3) 5.6 (2.3)

A E R P amplitude (tLV)

P1 N1 P2 N2

* P < 0.01, Dunnen's test.

4.1 (2.1) 0.7 (2.5) 6.0 (3.5) 4.3 * (2.3)

BRAIN FUNCTION

DIFFERENCES

IN H Y P E R A C T I V E

203

BOYS

T A B L E Ill

T A B L E IV

A E R P c o m p o n e n t c o r r e l a t i o n s with a g e in h y p e r a c t i v e s t h a t d i f f e r s i g n i f i c a n t l y f r o m n o r m a l A E R P a g e c o r r e l a t i o n s ~'

Delinquent and non-delinquent hyperactives compared childhood EEG and AERP measures.

Measures

Measures

DHA

N M e a n age in m o n t h s

31 ~' 101

N

NDN

DHA

40

26

NDHA 35

A E R P measures

N1 lat (reset) P2 a m p (ttV) N2 amp

0.26 -0.18 -0.42

0.12 0.21 -0.06

0.28 * 0.52 ** -0.04 *

* P < 0.05. ** P < 0.01. " Twenty-one corrrelations were obtained between age and neurophysiological measures.

Comparisons of non-delinquent (NDHA) and delinquent (DHA) hyperactive subjects When D H A s and N D t t A s were compared on E E G power spectral and AERP measures, several significant differences emerged (Table IV). The D H A group had significantly lower total power in the EEG than the N D H A group (t = 2.39, df= 74, P < 0.05), and lower absolute power in the theta (t = 2.20, df= 74, P < 0.05) and alpha (t = 2.14, df=74, P < 0 . 0 5 ) frequency bands. They had marginally lower power in the beta 2 band, as well (," = 1.92, df~- 74, P < 0.06). The D H A group also

NDHA 45 96

A bsotute power

(log/xV) Total Theta Alpha Beta 2

that the N D H A group had significantly smaller N2 amplitudes than did the controls (Table II). Since the age range of the HA and normal children was 6 12 years, we were able to examine the effects of age on our evoked potential measures in all 3 groups. Correlations between age and A E R P measures revealed that 3 correlations with age in the N D H A group differed significantly from normal, but no correlations with age were different from normal in the D H A group (Table Ill). P2 and N2 amplitudes decreased with age in normals and increased or remained constant in N D H A subjects. N1 latency increased in normals and decreased in the N D H A subjects. During our initial chilhood evaluation we obtained clinical EEGs on 20 HA children. We found a lower rate (1 of 8 subjects, or 12%) of clinical EEG abnormal findings in the D H A group than in the N D H A group (6 of 12 subjects, or 50%) (X 2 with d r = 1 marginally significant at P < 0.1).

on

4.40 * (0.311 3.23 * (0.30) 2.90 * (0.43) 1.14 (0.36)

4.57 (0.32) 3.39 ~0.30) 3.13 4'0.49) 1.31 (0.41)

AERP

N2 amp

5.6 (2.3)

*

-

4.3 ,',2.3)

* P < 0.05. 1 N ' s for A E R P are 26 for D H A a n d 35 for N I ) H A .

had significantly higher N2 amplitudes (t = 2.25, df = 59, P < 0.05). Comparison of factor scores from parent and teacher rating scales obtained during initial evaluations revealed that the D H A s had significantly higher scores on the hyperactive: and antisocial factors on the parent rating scale, and a significantly higher score on the antisocial factor on the teacher rating scale than did the N D H A group. The N D H A and D H A groups did not differ significantly on the Wechsler Intelligence Scale (WISC) full scale IQ, WISC Performance IQ and W1SC Verbal IQ, social class and family type. There was a statistically non-significant trend for HA children from the middle class, and from two biological parent families, to have a good outcome. Other analyses (unpublished data) revealed an extraordinarily low offender rate for normal children from families with two biological parents. This suggested that environmental and social factors in such families work against the development of antisocial behavior. Therefore, the development of antisocial behavior in HA children from two biological parent families may be more heavily influenced by biological factors than by environmental and social ones. HA children from intact

204

J.H. SATTERFIELD, A.M. SCHELL

TABLE V Comparison of outcome for youths from two parent families: upper third and lower two-thirds of N2 amplitude. Outcome type

Total

N2 amplitude third

sample

Upper one

Lower two

Delinquent Non-delinquent Other

12 (32%) 17 (46%) 8 (22%)

6 2 4

6 15 4

Total

37 (100%)

12

25

families may be an ideal population for studying the biological factors underlying antisocial behavior. Since we found that EEG total power, absolute power in the theta and alpha bands, and N2 amplitude differed significantly between N D H A and D H A subjects, we did a discriminant function analysis using these variables in an attempt to separate the HA youths from two biological parent families into N D H A and H D A groups. As N2 amplitude was the first variable selected, we examined its predictive power by rank ordering the N2 amplitudes of the HA youths from two biological parent families (from largest negative value to smallest). The percentage of the delinquent subjects who fell into the upper third of the amplitude distribution was significantly larger (6/12 or 50% versus 2 / 1 7 or 12%) than the percentage of nondelinquent subjects falling in the upper third (Fisher's Exact Test, P < 0.05). The HA diagnosis in children from all two biological parent families resulted in a delinquent outcome in 32% and a non-delinquent outcome in 46% of cases (Table V). However, when these HAs were divided into two groups on the basis of their N2 amplitudes, the delinquency outcome was markedly different, with delinquency present in 6 / 1 2 or 50% of the cases in the upper third group, and for only 6/25 or 24% of cases in the lower two-thirds group.

Discussion

These findings suggest that there may be two distinct subgroups of HA children. The D H A

group, defined in terms of multiple arrests for serious offenses in their teens, was further characterized in childhood by having normal EEG power spectral and A E R P measures and normal changes with age of these measures. They also had a lower incidence of clinical EEG abnormalities and more antisocial and hyperactive behavior than did the N D H A group. The N D H A group, defined in terms of absence of arrests for teenage antisocial behavior, was further characterized in childhood by having abnormal EEG power spectral values, abnormal AERPs and abnormal changes with age of these measures. They also had a higher incidence of abnormal clinical EEGs and less antisocial and hyperactive behavior. Our data clearly indicated that the traditional medical interpretation of clinical and power spectral EEG abnormalities and of A E R P abnormalities did not apply to our HA children. Of the 42 comparisons made between the hyperactive and normal groups, of either average values of electrophysiological variables or correlations of those variables with age, none were significant between the D H A and normal subjects. The N D H A s did differ from the normals on 10 of the 42 comparisons (Tables I II1). Brain function measures that de~,iate from normal control data are usually interpreted as indicating a poor prognosis. Such an inference is not supported by our data, which suggest just the opposite, i.e., abnormal EEG and AERP findings indicate a good prognosis. We conjecture that the N D H A children with abnormal EEG and AERP findings may have their childhood disorder secondary to an underlying brain dysfunction, while the D H A children with normal EEG and AERP findings have their childhood disorder secondary to environmental-social factors. If true, then underlying social-environmental factors as a cause of this childhood disorder suggest a poorer prognosis than the same clinical picture secondary to brain dysfunction. This viewpoint is directly contrary to the prevailing belief that abnormal behavior stemming from neurophysiological pathology suggests a poorer prognosis than behavioral abnormalities with a social-environmental etiology. Our data did reveal a statistically non-significant trend for DHA children to come from lower SES and broken families, which is consistent with this interpreta-

BRAIN F U N C T I O N D I F F E R E N C E S IN HYPERACTIVE BOYS

tion. However interesting, this is a weak speculation. An alternative, apparently contradictory thesis is that D H A children with ' n o r m a l ' EEG and A E R P findings may, in fact, suffer from a brain dysfunction. The finding that a large childhood N2 amplitude characterizes HA children who become multiple offenders has both clinical and theoretical implications. Adding information about a HA child's AERP N2 amplitude to the clinical diagnostic information considerably enhanced our ability to select HA children at risk for delinquency (Table V). From a clinical point of view, selection of subgroups of HA children, most of whom can be predicted to develop delinquency, would be useful for delinquency prevention because it is more economical to treat only those children who can reasonably be expected to become delinquent without treatment. The theoretical implications of this finding are discussed below. The amplitude of the N2 component of the A E R P has been found to increase markedly with decreasing levels of arousal (Wilkinson et al. 1966), to decrease with increased alertness produced by shock or by stimulation of the mesencephalic reticular formation (Guerrero-Figueroa and Heath, 1964; Tecce 1976), and to be unaffected by changes in attention (Picton and Hillyard 1974). In summary, N2 appears to reflect the state of general alertness or arousal but to be insensitive to changes in selective attention. N2 amplitudes for D H A s were not different from normal but were significantly larger than N2 amplitudes for N D H A s (Tables II and IV). This suggests that our D H A children had low arousal levels as compared to N D H A children, but normal arousal levels compared to age-matched normals. We conjecture that the optimal arousal level for HAs is different than that for normals. As noted above a given arousal level may at the same time be indicative of a n o r m a l arousal level for a normal child, and an a b n o r m a l arousal level for a HA child. Few' prospective studies of EEG and other nervous system measures as predictors of delinquency have been reported in either normal or HA children. However, the 'arousal' interpretation of the large N2 amplitudes found in our predelin-

205

quent HA children is supported by Mednick et al. (1981), who found that EEG alpha slowing in normal individuals predicted delinquency. The 'arousal' interpretation of our findings is also supported by the fact that 3 other prospective studies have reported reduced autonomic nervous system responsiveness in subjects who later evidenced antisocial behavior (Wadsworth 1976; Loeb and Mednick 1977; Hare 1978). This is the first prospective study that has collected childhood data on a variety of variables in HA and normal subjects, who were then followed to determine teenage delinquency outcome status, and which compared outcome groups on childhood neurophysiological, cognitive, social, familial and behavioral variables. Although the findings, if valid, are of considerable theoretical and clinical importance, replication is necessary to determine their validity. We hope to be able to validate these findings by a follow-up study of a different cohort of 100 HA subjects, who have reached the correct age for a cross-validation study.

Summa~ Childhood electrophysiological and clinical measures were obtained in 110 hyperactive (HA) and 76 normal children, who were later followed up as adolescents. Official arrest data were obtained on all subjects and used to measure outcome. The usual interpretation, that the presence of a brain function abnormality suggests a poor prognosis, does not apply to the clinical EEG, EEG spectral and ERP measures obtained on these H A boys. In fact, the converse was found to be true, that is EEG and ERP abnormalities were associated with a good outcome, while normal values of these measures were associated with a poor outcome. Data were presented that suggest that there may be two distinct subgroups of HA boys. The first group was characterized by abnormalities in childhood brain function, abnormal changes in brain function with age, less antisocial and hyperactive behavior in childhood, and absence of delinquency in adolescence. The second group was characterized by normal childhood brain function, normal changes in brain

206

function with age, more antisocial and hyperactive behavior in childhood, and teenage delinquency. Childhood EEG and ERP measures were found to be significantly different in these delinquent and non-delinquent HA groups, while social, familial and cognitive attributes were not. The N2 amplitude of the A E R P in delinquent hyperactive (DHA) boys was found to be significantly larger than in the non-delinquent hyperactive ( N D H A ) boys. This N2 amplitude may prove clinically useful in selecting HA boys for delinquency prevention programs.

J.H. SATTERFIELD, A.M. SCHELL

plus hyperactif et une adolescence delinquante. Les mesures EEG et PE dans l'enfance ont ere significativement differentes entre ces deux groupes d'enfants hyperactifs delinquants ou non delinquants, alors que les influences sociales familiales et cognitives ne l'etaient pas. L'amplitude de N2 du PEA des delinquants hyperactifs s'est revelee significativement plus grande que celle des enfants hyperactifs non delinquants. L'amplitude de cette onde N2 pourrait se reveler utile pour selectionner parmi les enfants hyperactifs ceux qui doivent etre soumis/~ un programme de prevention de la delinquance.

R6sum6 References

Diffbrences enregistrbes au cours de l'enfance dans le fonctionnement cOrObral d'adolescents mgtles hyperactifs dOlinquants ou non-dblinquants Des evaluations cliniques et electrophysiologiques ont ete faites chez 110 enfants hyperactifs (HA) et 76 enfants normaux ayant ensuite ete suivis dans l'adolescence. Les rapports officiels d'arrestation ont 6te utilises pour 6valuer la conduite de ces enfants. L'interpretation habituelle, selon laquelle la detection d'une anomalie de fonctionnement cerebral appelle un pronostic negatif, ne s'est pas trouvee verifiee, lors des mesures d ' E E G cliniques, de spectres EEG et de PE obtenues chez ces enfants hyperactifs. En fait c'est plut6t l'inverse qui s'est revele exact, 'a savoir que les anomalies de I'EEG et des PE etaient associees ~ une bonne conduite, alors que des valeurs normales etaient associees b. un mauvais comportement. Les resultats suggerent la presence de deux groupes distincts de garqons ' H A ' . Le premier groupe etait caracterise par des anomalies de fonctionnement cerebral pendant l'enfance, une evolution anormale de ce fonctionnement cerebral au cours de la croissance de l'enfant, un comportement pendant l'enfance moins antisocial et moins hyperactif et une absence de delinquance au tours de l'adolescence. Le second groupe etait caracterise par un fonctionnement cerebral normal pendant l'enfance, une evolution normale du fonctionnement cerebral au cours de leur croissance, un comportement pendant l'enfance plus antisocial et

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