Neurocognitive function in children with compensated hypothyroidism: lack of short term effects on or off thyroxin.

BACKGROUND: Although thyroxin therapy clearly is beneficial to children with frank hypothyroidism there is little data on the effects of thyroxin in children with compensated or subclinical hypothyroidism. The objective of this study was to determine the effect of thyroxin therapy on cognitive function in children with compensated hypothyroidism. The hypothesis was that thyroxin therapy would change neuropsychological function. METHODS: Eleven patients with a history of sub clinical hypothyroidism entered the study. At the start of the study, six out of the 11 were on thyroxin therapy, while 5 were off therapy. All patients underwent a battery of neuropsychological testing and thyroid function tests at the start of study. Based on the results of thyroid function tests, two of the 5 patients who were off thyroxin were started back on thyroxin. All of the 6 patients who were on thyroxin were taken off thyroxin. All patients then underwent repeat neuropsychological testing and thyroid functions after an average of 91 days. RESULTS: Thyroxin therapy could not be shown to have an effect on neuropsychological function in this short term study. Our patients had attention problems as compared to the normal population. No significant differences were found between our subjects and normal population standards in verbal processing, visual processing, motor speed/coordination and achievement. CONCLUSION: In this small, short term study, thyroxin therapy could not be shown to affect neuropsychological function in children with compensated hypothyroidism. These children may have attention problems but appear to have normal verbal and visual processing, motor speed/coordination and achievement.

The role of oral language revisited: a comment on the NICHD Early Child Care Research Network (2005).

This article comments on the discussion of S. A. Storch and G. J. Whitehurst's literacy development model in the article by the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network (ECCRN). Specifically, this comment focuses on concerns raised by the NICHD ECCRN that Storch and Whitehurst's model does not afford an important role to oral language in the development of early reading skill. Four important issues are presented that provide a serious and careful challenge to the model and conclusions of the NICHD ECCRN's report.

Predicting improvement after first-grade reading difficulties: the effects of oral language, emergent literacy, and behavior skills.

This study investigated the role of early literacy and behavioral skills in predicting the improvement of children who have experienced reading difficulties in 1st grade. The progress of 146 low-income children whose reading scores in 1st grade were below the 30th percentile was examined to determine (a) how the poorest readers in 1st grade progressed in reading achievement through 4th grade and (b) which emergent literacy and behavioral skills measured in kindergarten predicted differential 4th grade outcomes. Results indicated that the divergence between children who improved and those who did not was established by the end of 2nd grade. Further, individual linguistic skills and behavioral attributes measured in kindergarten contributed substantively to this difference. Implications for intervention timing and educational policy are discussed.