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Abstract Neurological soft signs are minimal and difficult-to-assess impairments of neurological functions. Historically, they have been described as indicators of mini mal brain damage (MBD) in children with a variety of different problems of behavior, emotion, and learning. The term was discarded in response to various investigations that showed that actual brain damage could not be demonstrated in a majority of these children (MacKeith and Bax 1963). However, the substitute term “minimal brain dysfunction” still survives; hundreds of publications on the subject, many of them critical, appear almost every year. The term has been used to refer to a syndrome that includes behavioral manifestations, such as fluctuations in behavior, intellect, attention, activity level, impulse control, and affect. Both the unitary nature and the meaningfulness of such a syndrome have been questioned seriously. Whether or not the term MBD is used, the significance of soft signs remains a major issue in child neuropsychology. This chapter reviews the concept of minimal brain dysfunction, the nature of soft neurological signs, the subgrouping of such signs, their possible etiology and measurement, and their meaning in the context of the neuropsychological evaluation of the child.
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