Abstract
To screen the global development of children with and without congenital hypothyroidism and to investigate the association between fine motor skills and expressive language development in both groups. This is a prospective study of a cohort of children diagnosed with Congenital Hypothyroidism and monitored in a reference service for congenital hypothyroidism of a public hospital and of children without this disorder. The screening was performed using the Bayley Scales of Infant Development III in the cognitive, gross and fine motor skills, and receptive and expressive language domains. The children's performance was expressed in three categories: competent, and non-competent. We screened 117 children with average age of 21 months diagnosed with Congenital Hypothyroidism at birth, with the Thyroid Stimulating Hormone (TSH) level normalized during screening, and 51 children without the condition. The children with Congenital Hypothyroidism presented lower performance in gross and fine motor skills upon comparison between the two groups, and no differences were found in the cognitive and receptive and expressive language domains. The association between fine motor skills and language persisted in the group with Hypothyroidism, demonstrating that the interrelationship of skills is present in all individuals, although this group is two times more likely to present expressive language impairment when fine motor skills are already compromised. In the development process, both skills - motor and expressive language - might be associated and/or dependent on each other in the sample assessed.
Highlights
Congenital hypothyroidism (CH) is defined as a condition of thyroid hormone (TH), thyroxine (T4), and triiodothyronine (T3) deficiency present at birth, which causes generally reduced metabolic processes
Given that the major alterations in children with CH are focused on several areas, but in motor[7] and language skills[11,12,13], the objectives of this study were to screen the global development of children with and without congenital hypothyroidism and to investigate the relationship between fine motor skills and expressive language skills in these two groups
Inclusion criteria for the CH group (CHG) were: children with congenital hypothyroidism seen at outpatient clinics, aged between 1 and 42 months, living in the areas covered by SRTN/UNICAMP (municipalities of Departamento Regional de Saúde (DRS) of Campinas, São João Boa Vista and Piracicaba), whose parents or legal guardians agreed to participate in the study and signed the Informed Consent
Summary
Congenital hypothyroidism (CH) is defined as a condition of thyroid hormone (TH), thyroxine (T4), and triiodothyronine (T3) deficiency present at birth, which causes generally reduced metabolic processes. These hormones are vital for growth, maturation and organogenesis of the central nervous system (CNS), and appropriate development depend on them for the critical period between fetal life and 2 years of age[1,2]. The absence of hormones causes impairment of different areas of the brain, affecting the posterior parietal cortex, responsible for spatial awareness; the inferior temporal lobes, responsible for identification of objects; the caudate nucleous, associated with attention; the hippocampus, associated with memory. In children with congenital hypothyroidism examined between 7 and 14 years of age, a significantly poorer performance was found in gross and fine motor functions, and the researchers concluded that problems with fine motor skills may be associated with visuomotor and visuospatial changes, besides problems with memory and attention[7]
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