ESPE Abstracts

Background: Despite neonatal screening, children with congenital hypothyroidism (CH) may still display behavioural problems such as inattention, distractibility, hyperactivity and restlessness.

Objective and hypotheses: The aim of present study was to evaluate attention and sluggish cognitive tempo (SCT) symptoms in 32 children with CH compared to 32 matched healthy controls.

Method: The study population consisted of 32 CH children aged 9–14 years. CH children were diagnosed by neonatal screening and treated at a mean age of 19.34±4.5 days with mean starting Levothyroxine (LT₄) dose of 11.8±1.4 μg/kg per die (range 10–15 μg/kg per die). 32 healthy subjects, comparable for age, sex and socioeconomic status were enrolled as control. CH patients and controls underwent Child and Adolescent Disruptive Behaviour Inventory-Plus (CADBI-plus) to evaluate attention and SCT symptoms. Cooperation from both parents and from teacher of enrolled subject was required to enter the study. SCT is a newly defined childhood disorder associated with a slow cognitive processing, sluggishness, daydreaming, drowsiness, lethargy and under-activeness.

Results: CH children scored significantly higher than controls in: attention problems referred by both mothers (M) (5.29±5.01 vs 3.17±2.54; P 0.04), and teachers (T) (7.2±8.49 vs 2.69±3.28, P<0.01) and SCT symptoms referred by both parents (F 9.61±7.04 vs 5.41±4.77, P<0.01; M 10.63±9.57 vs 4.9±4.68, P<0.01) and teachers (T 13.2±13.01 vs 4.28±5.63, P<0.01). No significant differences were found in hyperactivity or oppositional behaviors. Concerning academic performance, teachers report lower scores in mathematics in CH children compared to controls (6.25±2.13 vs 7.1±1.13, P 0.05).

Conclusion: The results of our study suggest that CH children may have ADs, SCT symptoms and impaired mathematical abilities, despite early replacement therapy and high starting LT₄ doses.