The boundaries of attention deficit disorder.

M. A. Epstein, S. E. Shaywitz, B. A. Shaywitz, J. L. Woolston

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


This report examines distinctions and interrelationships among attention deficit disorder (ADD) and two closely related conditions: learning disability (LD) and oppositional/conduct (O/C) disorder. To evaluate our hypothesis that some of the difficulty in resolving the relationship between ADD and, particularly, O/C may reflect the consequences of selective referral patterns, we studied groups of children diagnosed as ADD from different referral sources. Results suggest that referral bias does exist and that children referred to mental health settings differ from those referred to pediatricians, child neurologists, or psychologists. Because of the nature of the subjects referred to mental health services, nonrepresentative associations may emerge. Rather than being considered as prototypical of all children with attention disorder, children referred to mental health facilities may represent simply an extreme of the continuum of ADD. Evidence suggests that many children with ADD will be represented by those referred primarily for attentional deficits and learning problems, rather than those with inattention, hyperactivity, or aggression referred for child psychiatric evaluation.

Original languageEnglish (US)
Pages (from-to)78-86
Number of pages9
JournalJournal of Learning Disabilities
Issue number2
StatePublished - Feb 1991

ASJC Scopus subject areas

  • Health(social science)
  • Education
  • Health Professions(all)


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