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We agree with Dr. Oettinger that considerations of etiology are highly important. We regard the etiology of hyperactivity as a "chain of events" with at least primary and secondary sources of the symptom behavior.
As primary factors we include characteristics of normal individual genetic differences in reactivity and arousability, plus intra-uterine, birth and postbirth introduced pathology.
However, we think these basic characteristics constitute only a partial explanation for the hyperactive child's typical or atypical development.