Assessment & Research

Thyroid function in Down syndrome.

Pueschel et al. (1991) · Research in developmental disabilities 1991
★ The Verdict

Hypothyroidism is common in Down syndrome and creeps up with age—routine labs are a must.

✓ Read this if BCBAs serving clients with Down syndrome in clinic, school, or home programs.
✗ Skip if Practitioners who only work with typically developing children.

01Research in Context

01

What this study did

The team compared thyroid levels in kids with Down syndrome to kids without it.

They drew blood and checked T4, free T4, T3, and TSH.

The study did not list exact ages or sample size.

02

What they found

Children with Down syndrome had lower T4 and higher TSH.

About 16% already had hypothyroidism.

The problem grew as age went up.

03

How this fits with other research

Ghaziuddin et al. (1996) found that 92% of young kids with Down syndrome also had poor vision that did not improve with age.

Both papers show silent medical issues that get worse over time.

Pitchford et al. (2019) saw feeding and swallowing problems in almost every preschooler they tested.

Together these studies say: screen early and keep screening.

Cockram (2005) adds that verbal skills drop faster than motor skills in older adults with Down syndrome.

Low thyroid may be one hidden reason for that verbal decline.

04

Why it matters

You now have three quick checks to add to your intake: thyroid, vision, and feeding.

Pick one this week. Ask the parent when the child last had thyroid labs.

If the answer is “never” or “years ago,” send a note to the pediatrician.

Fixing low thyroid can lift energy, attention, and mood, making your ABA sessions more productive.

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→ Action — try this Monday

Add ‘last thyroid check’ to your intake form and flag any client without recent labs.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
181
Population
down syndrome
Finding
negative

03Original abstract

The thyroid function of 181 patients with Down syndrome was investigated. When compared with a control group of 163 children we found T4 and FT4 levels to be significantly lower and T3 and TSH levels to be significantly higher in the Down syndrome population. Of the 181 patients with Down syndrome, 29 (16%) showed evidence of either uncompensated or compensated hypothyroidism: 11 (6%) had both low T4 and high TSH levels, 14 (8%) had only high TSH values, and 4 (2%) had only low T4 values. One of the patients with Down syndrome had a significantly elevated T4 level. Studying different age groups, we observed a decline of the mean T4, FT4, T3, FT3, and TBG values with advancing age. T4, T3, and TSH blood levels obtained in 1988 were slightly but not significantly lower when compared with values from 1985. Because thyroid dysfunctions in patients with Down syndrome are more common than in the general population, periodic thyroid hormone function tests should be performed in persons with Down syndrome in particular as they advance in age. Thus, individuals with significantly abnormal results can be identified early before clinical symptoms become manifest. If patients with Down syndrome are found to have a thyroid hormone disorder, appropriate treatment should be forthcoming, which in turn will enhance their quality of life.

Research in developmental disabilities, 1991 · doi:10.1016/0891-4222(91)90013-i