Intellectual development at 10 years in early treated congenital hypothyroidism.

Simons, W F; Fuggle, Peter; Grant, D B; Smith, I.

doi:10.1136/adc.71.3.232

Cited by 71 publications

(39 citation statements)

References 10 publications

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“…Although in our (18,40) and others' (14,15,17,41,42) experience, a low neonatal T 4 level is a risk factor for a defective neuropsychological development, in the present study the degree of neonatal thyroid hormone deficiency was not found to be a major variable influencing school learning. In this regard, our results do not completely agree with the recent observation that a low neonatal T 4 is associated with less satisfactory scores for educational attainments (21).…”

Section: Discussioncontrasting

confidence: 66%

“…In some follow-up programmes for CH, global IQs of children treated early in life do not differ from those of control children (1, 3). Other follow-up studies report a mild decrease in global IQs compared with controls (10)(11)(12)(13)(14)(15)(16)(17)(18). Differences in motor and psychometric subtests have also been reported.…”

Section: Discussionmentioning

confidence: 95%

“…However, some of these CH children have subtle impairments in language abilities (3)(4)(5), neuromotor skills (5-7), behaviour (8,9) and cognitive performances (4,(10)(11)(12)(13)(14)(15)(16)(17)(18). Such impairments might adversely affect school learning.…”

Section: Introductionmentioning

confidence: 99%

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School attainments in children with congenital hypothyroidism detected by neonatal screening and treated early in life

Bargagna

Dinetti

Pinchera

et al. 1999

European Journal of Endocrinology

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Objective: Evaluation of school attainments in children with congenital hypothyroidism (CH) detected by neonatal screening and treated early in life. Patients and methods:Text comprehension, mathematics, reading, writing and verbal and spatial memory, as indices of school learning, were evaluated in nineteen 5-to 10-year-old children with CH attending nursery or elementary school. L-Thyroxine substitution (starting dose 8-10 mg/kg body weight per day) was initiated at a mean age of 30 Ϯ 10 days of life. The control group included 298 unaffected children matched with the CH children for age and school grade. Thirty per cent of controls were classmates of CH children. Intelligence quotients (IQ), language performances and motor development were evaluated in CH children at age 5 years, and were related to their school attainments. School performances of CH children were also compared with their neonatal serum thyroxine (T 4 ) concentration, and with the social-cultural level of the family. Results: Four out of 19 (21%) children with CH, 3 in the nursery and 1 in the elementary school, displayed a generalized learning disorder. Symbol copy, geometric copy, phrase repetition, dictation writing and spontaneous writing were particularly defective in nursery school CH children, while orthographic error recognition was defective in elementary school CH children. School learning disorders in CH children were significantly correlated with a borderline-low IQ, poor language performances and a low social-cultural level of the family, but not with motor skills or neonatal T 4 concentration. Conclusion: School attainments of early treated CH children were within the normal range in most affected cases. However, about 20% of CH children, most of them attending nursery school, showed a generalized learning disorder. Low IQ scores and poor language performances at age 5 years were associated with defective learning, mainly in CH children living in a poor social-cultural environment. In this subset of CH children, prompt initiation of speech and psychomotor rehabilitation therapy is recommended in order to prevent subsequent school learning disorders.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 95%

See 1 more Smart Citation

School attainments in children with congenital hypothyroidism detected by neonatal screening and treated early in life

Bargagna

Dinetti

Pinchera

et al. 1999

European Journal of Endocrinology

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show abstract

“…Although neuropsychological follow-up studies in general have been favourable, slightly lower IQs compared with unaffected controls have been reported, particularly in the most severely affected infants (1,2). Some follow-up programmes report good psychometric outcomes, with IQs similar to controls (3)(4)(5) and no apparent impediment in school performances (3). Other reports indicate a mild decrease in IQs of CH infants in spite of early substitution treatment (6)(7)(8)(9).…”

mentioning

confidence: 99%

“…These include: (i) pretreatment serum T 4 concentration; (ii) neonatal skeletal maturation; (iii) aetiology of CH; (iv) age at start of treatment; (v) starting L-T 4 dose; (vi) adequacy of substitution treatment in the first 2 years of life and even afterwards; (vii) socio-economic class of the family. Most follow-up studies found a significant correlation between cognitive development and pretreatment serum T 4 (4,6,(8)(9)(10)16). In a multicentre survey in the UK (16), the relationship between IQ and serum T 4 level at diagnosis was discontinuous with a threshold of 3.3 mg/dl (42.8 nmol/l).…”

mentioning

confidence: 99%