Background: Thyroid hormones are essential in the regulation of foetal and post-natal neurodevelopment. Despite early diagnosis and treatment of congenital hypothyroidism (CH) difficulties with language, hearing, memory and motor function persist for some children. However, comprehensive data about hearing, language and communication function in children with CH are not widely available.
Objective and hypotheses: To evaluate hearing, language and communication abilities in a cohort of children diagnosed with CH through newborn screening and treated early.
Method: Thirty-four children age 616 years took part in the study. Sixteen had CH and 18 were typically developing controls (TDCs). Those with CH were identified through newborn screening and had TSH >375 mU/l and T4 <3.9 pmol/l at diagnosis. All began thyroxine treatment within the first month of life and remained on treatment at the time of testing. Participants hearing was evaluated using pure-tone audiometry and speech-in-noise testing. The Clinical Evaluation of Language Fundamentals (CELF-4) was carried out to examine language function. The Childrens Communication Checklist (CCC-2) was completed by parents to assess communication.
Results: Pure tone audiometry revealed hearing losses in three children (19%) in the CH group. One child had a unilateral mild to moderate sensorineural hearing loss and two had bilateral mild high-frequency hearing loss. Speech-frequency pure tone average was significantly better for TDCs as were speech-in-noise results. CELF-4 core language score was poorer for the group with CH and 20% showed evidence of a language disorder. CCC-2 results indicated lower General Communication Composite and higher Social Interaction Deviance Composite scores for the CH group with 38% of children rated has having communication impairment.
Conclusion: Children with CH scored significantly more poorly on assessments of hearing, language and communication than TDCs. It is important to recognize that children with CH may continue to experience difficulties in several areas of development despite early treatment.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology