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Long-term sequelae of hearing impairment in congenital hypothyroidism
1Department of Psychology and Communication Disorders, Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Congenital hypothyroidism in children can lead to significant hearing loss, impacting speech and reading skills. Early treatment onset is crucial for mitigating these developmental effects.
Area of Science:
- Pediatrics
- Audiology
- Endocrinology
Background:
- Congenital hypothyroidism (CH) is a condition detectable through newborn screening.
- Hearing impairment is a potential complication of CH, affecting child development.
Purpose of the Study:
- To evaluate hearing loss and its functional consequences in children with CH.
- To assess the impact of hearing impairment on language and reading abilities in this cohort.
Main Methods:
- Retrospective analysis of 101 children with CH, with hearing tests on 75.
- Audiological assessments, language, and auditory processing evaluations at ages 3, 5, and 7.
- Comparison of reading skills at grade 3 between hearing-impaired children, normally hearing children with CH, and matched controls.
Main Results:
- 15% of children with CH experienced hearing problems, including sensorineural and conductive loss.
- Hearing-impaired children had a delayed age of treatment onset (22 vs. 14 days).
- Deficits in early speech, receptive language, auditory discrimination, and phonologic processing skills were observed in hearing-impaired children, affecting reading ability.
Conclusions:
- Hearing loss is a significant concern in children with CH, often linked to delayed treatment.
- Functional consequences include persistent language and auditory processing deficits, leading to poorer reading skills.
- Early detection and intervention for hearing issues in CH are critical for optimal developmental outcomes.
Abstract:
Hearing loss and its functional consequences were evaluated retrospectively in children with congenital hypothyroidism. From a cohort of 101 children followed longitudinally to evaluate newborn screening, 75 with previous hearing tests were studied. Fifteen (20%) were found to have hearing problems. Of these, nine had unilateral or sensorineural loss mostly at high frequencies, five had a conductive loss, and one had both problems. Hearing impaired children differed from children with normal hearing in age of treatment onset (22 vs 14 days) but not disease severity or duration. A comparison of language and auditory processing skills at ages 3, 5, and 7 years revealed that early speech was delayed in hearing impaired children, whereas deficits persisted in later receptive language and auditory discrimination skills. Comparing hearing impaired children and children with normal hearing with matched control subjects at grade 3 showed that hearing impaired children were poorer readers because of less adequate phonologic processing skills.