Abstract
The cognitive functioning, motor skills and behaviour of 5-year-old children with early-treated congenital hypothyroidism was assessed. The study group was 57 children with congenital hypothyroidism (CH) diagnosed by neonatal screening in N.E. and N.W. Thames regions between 1978 and 1981 along with 51 non-affected controls matched for age, sex, social class and language background. Small differences in I.Q. and behaviour between the patients and the controls were not statistically significant. However, children with CH showed significant deficits in motor skills (M 79.9 SE 3.7) compared to the controls (M 99.8 SE 4.0) (P=0.0003). Deficits were particularly marked for balance. In addition, children with more severe hypothyroidism at diagnosis (Plasma thyroxine <20 nmol/l) did significantly less well in respect to I.Q. and motor skills than those with less severe hypothyroidism (plasma thyroxine >60 nmol/l). These findings provide further evidence for the importance of the severity of hypothyroidism in determining the outcome for intelligence and motor skills in children with early-treated congenital hypothyroidism. Deficits in motor skills, particularly in relation to balance, suggest that early impairment of the vestibular system may occur despite early treatment.
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Abbreviations
- CH:
-
congenital hypothyroidism
- T4 :
-
thyroxine
References
Barnes ND (1985) Screening for congenital hypothyroidism: the first decade. Arch Dis Child 60:587–592
Bruinincks RH (1978) Bruinincks-Oseretsky test of motor proficiency. American Guidance Service, Minnesota
Dememes D, Dechesne C, Legrand C, Sans A (1986) Effects of hypothyroidism on postnatal development in the peripheral vestibular system. Brain Res 90:147–152
Flynn JR (1987) Massive I.Q. gains in 14 nations. What I.Q. tests really measure. Psychol Bull 101:171–191
Glorieux J, Dussault JH, Morrisette J, Desjardins M, Letarte J, Guyda H (1985) Follow up at ages 5 and 7 years on mental development in children with hypothyroidism detected by the Quebec screening program. J Pediatr 107:913–915
Glorieux J, Desjardins M, Letarte J, Morrisette J, Dussault JH (1988) Useful parameters to predict the eventual mental outcome of hypothyroid children. Pediatr Res 24:6–8
Grant DB, Smith I (1988) Survey of neonatal screening for primary hypothyroidism in England, Wales and Northern Ireland, 1982–1984. Br Med J 296:1355–1358
Horak FB, Shumway-Cook A, Crowe TK, Owen Black F (1988) Vestibular function and motor proficiency of children with impaired hearing, or with learning disability and motor impairments. Dev Med Child Neurol 30:64–79
Hulse JA (1984) Outcome for congenital hypothyroidism. Arch Dis Child 59:23–30
Hulse JA, Grant DB, Jackson D, Clayton BE (1982) Growth, development and reassessment of hypothyroid infants diagnosed by screening. Br Med J 284:1435–1437
MacFaul R, Dorner S, Brett EM, Grant DB (1978) Neurological abnormalities in patients treated for hypothyroidism from early life. Arch Dis Child 53:611–617
Meyerhoff WL (1987) Hypothyroidism and the ear: electrophysiological, morphological and chemical considerations. Laryngoscope [Supple 19] 89:10, Part 2
Murphy GH, Hulse JA, Jackson D, Tyrer P, Glossop J, Smith I, Grant DB (1986) Early treated hypothyroidism: development at three years. Arch Dis Child 61:671–675
Murphy GH, Hulse JA, Smith I, Grant DB (1990) Congenital hypothyroidism: physiological and psychological factors in early development. J Child Psychol Psychiatry 31:711–725
New England Congenital Hypothyroidism Collaborative (1985) Neonatal hypothyroidism screening: status of patients at 6 years. J Pediatr 107:915–919
Richman N (1977) Is a behavioural checklist for pre-school children useful? In: Graham P (ed) Epidemiological approaches in child psychiatry. Academic Press, London, pp 125–137
Richman N (1988) Overview of behaviour and emotional problems. In: Richman N, Lansdown R (eds) Problems of preschool children. Wiley, Chichester, pp 111–130
Rickards A, Coakley J, Francis I, Armstrong S, Medson H, Connelly J (1989) Results of follow up at five years in a group of hypothyroid Australian children detected by newborn screening. In: Delange F, Fisher DA, Glinoer D (eds), Research in congenital hypothyroidism. Plenum, New York, p. 341
Rovet JF, Ehrlich RM, Sorbara DL (1986) Factors predicting the intellectual outcome of children with congenital hypothyroidism. Pediatr Res 20:221A
Rovet J, Ehrlich R, Sorbara D (1987) Intellectual outcome in children with fetal hypothyroidism. J Pediatr 110:700–704
Sato T, Ishiguro C, Watanabe Y, Mizokoshi K (1987) Quantitative analysis of cerebello-vestibular function in congenital hypothyroidism. Acta Paediatr Jpn 29:121–129
Wechsler Pre-school and Primary Scale of Intelligence (1966) The Psychological Corporation, New York
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Fuggle, P.W., Grant, D.B., Smith, I. et al. Intelligence, motor skills and behaviour at 5 years in early-treated congenital hypothyroidism. Eur J Pediatr 150, 570–574 (1991). https://doi.org/10.1007/BF02072209
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DOI: https://doi.org/10.1007/BF02072209