Useful parameters to predict the eventual mental outcome of hypothyroid children

The Quebec Network for Genetic Medicine has followed the development of some 100 hypothyroid children treated by 1 month of age and evaluated at 18 months, 3 and 5 yr and the Griffiths Mental Development Scales, then at 7 and 9 yr with the Wechsler Intelligence Scale for Children Revised. Results show that the children as a group reach scores within the normal range of the tests. However, a few patients have low scores at each evaluation. Previously, we showed a correlation between a low serum thyroxine concentration, or a relatively retarded bone maturation before treatment, and low mental scores. To better characterize the significance of this relationship we correlated these pretreatment factors and the Wechsler Intelligence Scale for Children Revised results of 43 subjects reaching the age of 7 yr. Again, the same correlation was observed. Calculating a predictive factor (low thyroxine, less than 2 micrograms/dl and retarded bone surface, less than 0.05 cm2) from data recorded before therapy initiation, 10 of 13 children were correctly predicted to have I.Q. values less than 90. The use of these parameters might permit early intervention, and allow specific guidance of the more affected subjects.