{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:32:43Z","timestamp":1759969963193,"version":"build-2065373602"},"reference-count":64,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Congenital hypothyroidism\u2019s sequelae include visuomotor and intellectual developmental deficits. Visual-motor perception is a cognitive function related to academic performance. Intellect is the ability to learn and use acquired knowledge to solve and achieve goals. Our objective was to evaluate visual-motor and intellectual development in children with late initiation of treatment for congenital hypothyroidism enrolled in a developmental follow-up and intervention program.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We evaluated the visual-motor and intellectual development of 75 infants with congenital hypothyroidism, 34 with athyrosis, and 41 with ectopia using the Bender Visual-Motor Development Test and the Weschler Intelligence Scale at eight and nine years of age.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Children with ectopia had a visual-motor delay of \u22122 years and an Intelligence Quotient (IQ)\u00a0greater than 98 points. Children with athyrosis had a visual-motor delay equivalent to \u22123.2 years and an IQ below 90 points. Better performance on Bender\u2019s test was positively correlated with IQ. Attending more than 80% of Developmental Intervention Program appointments had a positive impact on intellectual development.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Timely diagnosis and early treatment with the appropriate dose of levothyroxine are determining factors; however, attendance to a development follow-up and intervention program could further support the cognitive development of children with congenital hypothyroidism.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Impact<\/jats:title>\n            <jats:p>\n              <jats:list list-type=\"bullet\">\n                <jats:list-item>\n                  <jats:p>Visuomotor development influences cognitive functions related to school performance.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>Deficits in the ability to learn and use acquired knowledge to solve problems and achieve goals are characteristic of children with congenital hypothyroidism.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>Delayed treatment is associated with more severe sequelae in both visual-motor and intellectual development.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>Here, we show that treatment with adequate doses of levothyroxine and inclusion in a follow-up and developmental program are highly recommended for patients with delayed treatment.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>A better understanding of these factors will allow clinicians to target therapeutic interventions.<\/jats:p>\n                <\/jats:list-item>\n              <\/jats:list>\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41390-025-03850-3","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T05:27:04Z","timestamp":1737523624000},"page":"1046-1055","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Congenital hypothyroidism and associated visual-motor and intellectual development"],"prefix":"10.1038","volume":"98","author":[{"given":"Esperanza","family":"Ontiveros-Mendoza","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Antonio","family":"Gonz\u00e1lez-Medrano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolando","family":"Rivera-Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla","family":"S\u00e1nchez-Huerta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerardo","family":"Barrag\u00e1n-Mej\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"3850_CR1","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1089\/thy.2020.0333","volume":"31","author":"P Van Trotsenburg","year":"2021","unstructured":"Van Trotsenburg, P. et al. Congenital Hypothyroidism: A 2020\u20132021 Consensus Guidelines Update\u2014An ENDO-European Reference Network Initiative Endorsed by the European Society for Pediatric Endocrinology and the European Society for Endocrinology. Thyroid 31, 387\u2013419 (2021).","journal-title":"Thyroid"},{"key":"3850_CR2","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1590\/S0036-36342004000200008","volume":"46","author":"M Vela-Amieva","year":"2004","unstructured":"Vela-Amieva, M. et al. Epidemiolog\u00eda del hipotiroidismo cong\u00e9nito en M\u00e9xico. Salud P\u00fablica de. M\u00e9xico 46, 211\u2013224 (2004).","journal-title":"Salud P\u00fablica de. M\u00e9xico"},{"key":"3850_CR3","doi-asserted-by":"publisher","first-page":"5S","DOI":"10.18233\/APM39No6pp5S-13S1717","volume":"39","author":"MA Hinojosa-Trejo","year":"2018","unstructured":"Hinojosa-Trejo, M. A. et al. Prevalencia al nacimiento de hipotiroidismo cong\u00e9nito. Acta Pedi\u00e1tri. de. M\u00e9xico 39, 5S\u201313S (2018).","journal-title":"Acta Pedi\u00e1tri. de. M\u00e9xico"},{"key":"3850_CR4","first-page":"204","volume":"84","author":"A Rivera-Hern\u00e1ndez","year":"2017","unstructured":"Rivera-Hern\u00e1ndez, A., Huerta-Mart\u00ednez, H., Centeno-Navarrete, Y., Flores-Escamilla, R. & Zurita-Cruz, J. N. Actualizaci\u00f3n En Hipotiroidismo Cong\u00e9nito: Definici\u00f3n, Epidemiolog\u00eda, Embriolog\u00eda y Fisiolog\u00eda. Prim. Parte Rev. Mex. Pediatr. 84, 204\u2013209 (2017).","journal-title":"Prim. Parte Rev. Mex. Pediatr."},{"key":"3850_CR5","first-page":"A6564","volume":"158","author":"PH Verkerk","year":"2014","unstructured":"Verkerk, P. H. et al. [Neonatal screening for congenital hypothyroidism: more than 30 years of experience in the Netherlands]. Ned. Tijdschr. Geneeskd. 158, A6564 (2014).","journal-title":"Ned. Tijdschr. Geneeskd."},{"key":"3850_CR6","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1053\/j.semperi.2015.03.002","volume":"39","author":"BL Therrell","year":"2015","unstructured":"Therrell, B. L. et al. Current status of newborn screening worldwide: 2015. Semin Perinatol. 39, 171\u2013187 (2015).","journal-title":"Semin Perinatol."},{"key":"3850_CR7","doi-asserted-by":"publisher","first-page":"3427","DOI":"10.3390\/jcm11123427","volume":"11","author":"KC Raz\u00f3n-Hern\u00e1ndez","year":"2022","unstructured":"Raz\u00f3n-Hern\u00e1ndez, K. C. et al. Neuropsychological alterations in patients with congenital hypothyroidism treated with levothyroxine: linked factors and thyroid hormone hyposensitivity. J. Clin. Med. 11, 3427 (2022).","journal-title":"J. Clin. Med."},{"key":"3850_CR8","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1016\/S0022-3476(05)82194-8","volume":"118","author":"S Heyerdahl","year":"1991","unstructured":"Heyerdahl, S., Kase, B. F. & Lie, S. O. Intellectual development in children with congenital hypothyroidism in relation to recommended thyroxine treatment. J. Pediatr. 118, 850\u2013857 (1991).","journal-title":"J. Pediatr."},{"key":"3850_CR9","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1016\/S0022-3476(05)83178-6","volume":"124","author":"L Kooistra","year":"1994","unstructured":"Kooistra, L. et al. Motor and cognitive development in children with congenital hypothyroidism: a long-term evaluation of the effects of neonatal treatment. J. Pediatr. 124, 903\u2013909 (1994).","journal-title":"J. Pediatr."},{"key":"3850_CR10","doi-asserted-by":"publisher","first-page":"e52","DOI":"10.1542\/peds.2004-1492","volume":"115","author":"JF Rovet","year":"2005","unstructured":"Rovet, J. F. Children with congenital hypothyroidism and their siblings: do they really differ? Pediatrics 115, e52\u2013e57 (2005).","journal-title":"Pediatrics"},{"key":"3850_CR11","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1210\/jc.2005-1209","volume":"91","author":"MJE Kempers","year":"2006","unstructured":"Kempers, M. J. E. et al. Intellectual and motor development of young adults with congenital hypothyroidism diagnosed by neonatal screening. J. Clin. Endocrinol. Metab. 91, 418\u2013424 (2006).","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"3850_CR12","doi-asserted-by":"publisher","first-page":"E1427","DOI":"10.1210\/jc.2011-0119","volume":"96","author":"SM Wheeler","year":"2011","unstructured":"Wheeler, S. M., Willoughby, K. A., McAndrews, M. P. & Rovet, J. F. Hippocampal size and memory functioning in children and adolescents with congenital hypothyroidism. J. Clin. Endocrinol. Metab. 96, E1427\u2013E1434 (2011).","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"3850_CR13","first-page":"395","volume":"18","author":"SB Najmi","year":"2013","unstructured":"Najmi, S. B., Hashemipour, M., Maracy, M. R., Hovsepian, S. & Ghasemi, M. Intelligence quotient in children with congenital hypothyroidism: the effect of diagnostic and treatment variables. J. Res. Med. Sci. 18, 395\u2013399 (2013).","journal-title":"J. Res. Med. Sci."},{"key":"3850_CR14","first-page":"28","volume":"8","author":"M Ordooei","year":"2014","unstructured":"Ordooei, M., Mottaghipisheh, H., Fallah, R. & Rabiee, A. Cognitive outcomes for congenital hypothyroid and healthy children: a comparative study. Iran. J. Child Neurol. 8, 28\u201332 (2014).","journal-title":"Iran. J. Child Neurol."},{"key":"3850_CR15","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/s13312-018-1243-2","volume":"55","author":"K Rahmani","year":"2018","unstructured":"Rahmani, K. et al. Intelligence quotient at the age of six years of iranian children with congenital Hypothyroidism. Indian Pediatr. 55, 121\u2013124 (2018).","journal-title":"Indian Pediatr."},{"key":"3850_CR16","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1038\/pr.2015.93","volume":"78","author":"H Clairman","year":"2015","unstructured":"Clairman, H., Skocic, J., Lischinsky, J. E. & Rovet, J. Do children with congenital hypothyroidism exhibit abnormal cortical morphology? Pediatr. Res. 78, 286\u2013297 (2015).","journal-title":"Pediatr. Res."},{"key":"3850_CR17","doi-asserted-by":"publisher","first-page":"396","DOI":"10.13181\/mji.v28i4.3473","volume":"28","author":"AB Pulungan","year":"2019","unstructured":"Pulungan, A. B., Oldenkamp, M. E., van Trotsenburg, A. S. P., Windarti, W. & Gunardi, H. Effect of delayed diagnosis and treatment of congenital hypothyroidism on intelligence and quality of life: an observational study. Med. J. Indones. 28, 396\u2013401 (2019).","journal-title":"Med. J. Indones."},{"key":"3850_CR18","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1089\/thy.2000.10.243","volume":"10","author":"S Bargagna","year":"2000","unstructured":"Bargagna, S. et al. Neuropsychological follow-up in early-treated congenital hypothyroidism: a problem-oriented approach. Thyroid 10, 243\u2013249 (2000).","journal-title":"Thyroid"},{"key":"3850_CR19","doi-asserted-by":"publisher","DOI":"10.1590\/2317-1782\/20192019017","volume":"32","author":"DAC Lam\u00f4nica","year":"2020","unstructured":"Lam\u00f4nica, D. A. C., Anast\u00e1cio-Pessan, F. D. L., Ferraz, P. M. D. P. & Ribeiro, C. D. C. Performance in motor, communicative and cognitive skills of girls with congenital hypothyroidism treated from the neonatal period. CoDAS 32, e20190017 (2020).","journal-title":"CoDAS"},{"key":"3850_CR20","doi-asserted-by":"crossref","DOI":"10.1590\/2317-1782\/20172016064","volume":"29","author":"RC Frezzato","year":"2017","unstructured":"Frezzato, R. C. et al. Fine motor skills and expressive language: A study with children with congenital hypotyreoidism. CoDAS 29, e20160064 (2017).","journal-title":"CoDAS"},{"key":"3850_CR21","first-page":"12","volume":"115","author":"ML Pardo Campos","year":"2017","unstructured":"Pardo Campos, M. L. et al. Cognitive profiles of patients with early detected and treated congenital hypothyroidism. Arch. Argent. Pediatr. 115, 12\u201317 (2017).","journal-title":"Arch. Argent. Pediatr."},{"key":"3850_CR22","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1159\/000151397","volume":"89","author":"V Blasi","year":"2009","unstructured":"Blasi, V. et al. Decreased parietal cortex activity during mental rotation in children with congenital hypothyroidism. Neuroendocrinology 89, 56\u201365 (2009).","journal-title":"Neuroendocrinology"},{"key":"3850_CR23","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1007\/s12519-019-00230-w","volume":"15","author":"AKC Leung","year":"2019","unstructured":"Leung, A. K. C. & Leung, A. A. C. Evaluation and management of the child with hypothyroidism. World J. Pediatr. 15, 124\u2013134 (2019).","journal-title":"World J. Pediatr."},{"key":"3850_CR24","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1067\/mpd.2002.128887","volume":"141","author":"KA Selva","year":"2002","unstructured":"Selva, K. A. et al. Initial treatment dose of L-thyroxine in congenital hypothyroidism. J. Pediatr. Dec. 141, 786\u2013792 (2002).","journal-title":"J. Pediatr. Dec."},{"key":"3850_CR25","doi-asserted-by":"publisher","first-page":"701","DOI":"10.33588\/rn.2807.98227","volume":"28","author":"MA \u00c1lvarez","year":"1999","unstructured":"\u00c1lvarez, M. A. et al. Estado neurocognitivo En Ni\u00f1os de 8 A\u00f1os Con Hipotiroidismo Cong\u00e9nito Tratado Precozmente. Rev. Neurol. 28, 701\u2013706 (1999).","journal-title":"Rev. Neurol."},{"key":"3850_CR26","doi-asserted-by":"publisher","first-page":"101980","DOI":"10.1016\/j.nicl.2019.101980","volume":"24","author":"HE Cooper","year":"2019","unstructured":"Cooper, H. E. et al. White matter microstructural abnormalities in children with severe congenital hypothyroidism. NeuroImage. Clin. 24, 101980 (2019).","journal-title":"NeuroImage. Clin."},{"key":"3850_CR27","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1203\/00006450-199506000-00011","volume":"37","author":"G Weber","year":"1995","unstructured":"Weber, G. et al. Neurophysiologic studies and cognitive function in congenital hypothyroid children. Pediatr. Res. 37, 736\u2013740 (1995).","journal-title":"Pediatr. Res."},{"key":"3850_CR28","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1055\/s-0035-1549978","volume":"227","author":"VL Ellerbroek","year":"2015","unstructured":"Ellerbroek, V. L. et al. Long-term surveillance of children with congenital hypothyroidism: data from the german registry for congenital Hypothyroidism (AQUAPE \u201cHypo Dok\u201d). Klinische P\u00e4diatr. 227, 199\u2013205 (2015).","journal-title":"Klinische P\u00e4diatr."},{"key":"3850_CR29","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1016\/j.jpeds.2005.09.031","volume":"147","author":"JJ Bongers-Schokking","year":"2005","unstructured":"Bongers-Schokking, J. J. & de Muinck Keizer-Schrama, S. M. P. F. Influence of timing and dose of thyroid hormone replacement on mental, psychomotor, and behavioral development in children with congenital Hypothyroidism. J. Pediatr. 147, 768\u2013774 (2005).","journal-title":"J. Pediatr."},{"key":"3850_CR30","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1203\/PDR.0b013e31818d2030","volume":"65","author":"A Dimitropoulos","year":"2009","unstructured":"Dimitropoulos, A. et al. Children with congenital Hypothyroidism: Long-term intellectual outcome after early high-dose treatment. Pediatr. Res. 65, 242\u2013248 (2009).","journal-title":"Pediatr. Res."},{"key":"3850_CR31","first-page":"240","volume":"66","author":"S Marti","year":"2006","unstructured":"Marti, S. et al. Effects of early high-dose levothyroxine treatment on auditory brain event-related potentials at school entry in children with congenital hypothyroidism. Horm. Res. 66, 240\u2013248 (2006).","journal-title":"Horm. Res."},{"key":"3850_CR32","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1016\/S0022-3476(95)70452-3","volume":"126","author":"JF Rovet","year":"1995","unstructured":"Rovet, J. F. & Ehrlich, R. M. Long-term effects of L-thyroxine therapy for congenital hypothyroidism. J. Pediatr. 126, 380\u2013386 (1995).","journal-title":"J. Pediatr."},{"key":"3850_CR33","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1016\/j.jpeds.2005.07.024","volume":"147","author":"KA Selva","year":"2005","unstructured":"Selva, K. A., Harper, A., Downs, A., Blasco, P. A. & Lafranchi, S. H. Neurodevelopmental outcomes in congenital hypothyroidism: comparison of initial t4 dose and time to reach target T4 and TSH. J. Pediatr. 147, 775\u2013780 (2005).","journal-title":"J. Pediatr."},{"key":"3850_CR34","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1017\/S1355617713001136","volume":"19","author":"N Simic","year":"2013","unstructured":"Simic, N., Khan, S. & Rovet, J. Visuospatial, visuoperceptual, and visuoconstructive abilities in congenital hypothyroidism. J. Int Neuropsychol. Soc. 19, 1119\u20131127 (2013).","journal-title":"J. Int Neuropsychol. Soc."},{"key":"3850_CR35","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1093\/jpepsy\/17.2.187","volume":"17","author":"JF Rovet","year":"1992","unstructured":"Rovet, J. F., Ehrlich, R. M. & Sorbara, D. L. Neurodevelopment in infants and preschool children with congenital hypothyroidism: etiological and treatment factors affecting outcome. J. Pediatr. Psychol. 17, 187\u2013213 (1992).","journal-title":"J. Pediatr. Psychol."},{"key":"3850_CR36","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1507\/endocrj.K10E-384","volume":"58","author":"K Huo","year":"2011","unstructured":"Huo, K. et al. Risk factors for neurodevelopmental deficits in congenital hypothyroidism after early substitution treatment. Endocr. J. 58, 355\u2013361 (2011).","journal-title":"Endocr. J."},{"key":"3850_CR37","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1159\/000443958","volume":"85","author":"M Uyttendaele","year":"2016","unstructured":"Uyttendaele, M. et al. Congenital hypothyroidism: long-term experience with early and high Levothyroxine dosage. Horm. Res Paediatr. 85, 188\u2013197 (2016).","journal-title":"Horm. Res Paediatr."},{"key":"3850_CR38","doi-asserted-by":"publisher","first-page":"183","DOI":"10.5027\/psicoperspectivas-Vol12-Issue1-fulltext-201","volume":"12","author":"C Merino","year":"2013","unstructured":"Merino, C. Test gest\u00e1ltico Bender modificado y vmi-4: comparaci\u00f3n de la valid\u00e9z incremental. Psicoperspectivas 12, 183\u2013204 (2013).","journal-title":"Psicoperspectivas"},{"key":"3850_CR39","first-page":"42","volume":"37","author":"R Joseph","year":"2008","unstructured":"Joseph, R. Neuro-developmental deficits in early-treated congenital hypothyroidism. Ann. Acad. Med Singap. 37, 42\u201343 (2008).","journal-title":"Ann. Acad. Med Singap."},{"key":"3850_CR40","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1002\/nur.1038","volume":"24","author":"BM Melnyk","year":"2001","unstructured":"Melnyk, B. M. et al. Improving cognitive development of lowbirth-weight premature infants with the COPE program: a pilot studyof the benefit of early NICU interventions with mothers. Res. Nurs. Health 24, 373\u2013389 (2001).","journal-title":"Res. Nurs. Health"},{"key":"3850_CR41","doi-asserted-by":"publisher","unstructured":"Bernabe-Zu\u00f1iga, J. E. et al. Early interventions with parental participation and their implications on the neurodevelopment of premature children: a systematic review and meta-analysis. Eur. Child Adolesc. Psychiatry. https:\/\/doi.org\/10.1007\/s00787-024-02528-1 (2024).","DOI":"10.1007\/s00787-024-02528-1"},{"key":"3850_CR42","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.jped.2019.05.002","volume":"96","author":"RC Ferreira","year":"2020","unstructured":"Ferreira, R. C., Alves, C. R. L., Guimar\u00e3es, M. A. P., Menezes, K. K. P. & Magalh\u00e3es, L. C. Effects of early interventions focused on the family in the development of children born preterm and\/or at social risk: a meta-analysis. J. Pediatr. 96, 20\u201338 (2020).","journal-title":"J. Pediatr."},{"key":"3850_CR43","unstructured":"Bender, L. Test guest\u00e1ltico visomotor (B.G.) usos y aplicaciones cl\u00ednicas. (Paidos, M\u00e9xico, 1997)."},{"key":"3850_CR44","unstructured":"Wechsler, D. Escala de Inteligencia Wechsler para Ni\u00f1os - Revisada en Espa\u00f1ol WISC-R. (El Manual Moderno, M\u00e9xico, 1974)."},{"key":"3850_CR45","unstructured":"Koppitz, E. M. The Bender Gestalt kest for Young Children. (Grune & Stratton, New York, 1963)."},{"key":"3850_CR46","unstructured":"La Evaluaci\u00f3n Psicol\u00f3gica en Ni\u00f1os. T\u00e9cnicas de Screening y Diagn\u00f3stico. Alejandro Castro Solano. et-al. (Paidos, Buenos Aires, 2017)."},{"key":"3850_CR47","first-page":"13","volume":"28","author":"A Urz\u00faa","year":"2010","unstructured":"Urz\u00faa, A., Ramos, M., Alday, C. & Alquinta, A. Madurez neuropsicol\u00f3gica en preescolares: propiedades psicom\u00e9tricas del test CUMANIN. Ter. Psicol.\u00f3gica 28, 13\u201325 (2010).","journal-title":"Ter. Psicol.\u00f3gica"},{"key":"3850_CR48","first-page":"6","volume":"27","author":"CF Rincon Lozada","year":"2022","unstructured":"Rincon Lozada, C. F. Neuropsychological maturity and soft neurological signs in preschools. Arch. Neurocien (Mex.) 27, 6\u201315 (2022).","journal-title":"Arch. Neurocien (Mex.)"},{"key":"3850_CR49","unstructured":"Heredia y Ancona, M. C., Santaella Hidalgo, G. B., Somarriba Rocha, L. A. Interpretaci\u00f3n del Test Gest\u00e1ltico Visomotor de Bender Sistema de puntuaci\u00f3n de Koppitz. Textos de Apoyo Did\u00e1ctico. (Facultad de Psicolog\u00eda, UNAM, M\u00e9xico, 2011)."},{"key":"3850_CR50","doi-asserted-by":"publisher","first-page":"2691","DOI":"10.1016\/j.neuropsychologia.2006.04.029","volume":"44","author":"M Iacoboni","year":"2006","unstructured":"Iacoboni, M. Visuo-motor integration and control in the human posterior parietal cortex: evidence from TMS and fMRI. Neuropsychologia 44, 2691\u20132699 (2006).","journal-title":"Neuropsychologia"},{"key":"3850_CR51","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1007\/s100720070068","volume":"21","author":"G Weber","year":"2000","unstructured":"Weber, G. et al. Cognitive function and neurophysiological evaluation in early-treated hypothyroid children. Neurol. Sci. 21, 307\u2013314 (2000).","journal-title":"Neurol. Sci."},{"key":"3850_CR52","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1055\/s-2008-1071283","volume":"20","author":"K Norcross-Nechay","year":"1989","unstructured":"Norcross-Nechay, K., Richards, G. E. & Cavallo, A. Evoked potentials show early and delayed abnormalities in children with congenital hypothyroidism. Neuropediatrics 20, 158\u2013163 (1989).","journal-title":"Neuropediatrics"},{"key":"3850_CR53","unstructured":"Fuentes, T. Facilito: evaluaci\u00f3n de precurrentes instrumentales para la adquisici\u00f3n de la lectoescritura. (El Manual Moderno, M\u00e9xico, 2002)."},{"key":"3850_CR54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S0104-11692010000500022","volume":"18","author":"E Zambrano-S\u00e1nchez","year":"2010","unstructured":"Zambrano-S\u00e1nchez, E., Mart\u00ednez-Wbaldo, M. C. & Poblano, A. Frequ\u00eancia de fatores de risco para dificuldade de aprendizagem em pr\u00e9-escolares com baixo n\u00edvel socioecon\u00f4mico, na Cidade do M\u00e9xico. Rev. Lat.-Am. de. Enferm. 18, 1\u20137 (2010).","journal-title":"Rev. Lat.-Am. de. Enferm."},{"key":"3850_CR55","first-page":"73","volume":"12","author":"M Cruz","year":"2001","unstructured":"Cruz, M., Garaigordobil, M. & Maganto, C. An\u00e1lisis evolutivo de la coordinaci\u00f3n visomotora y sus relaciones con inteligencia, estilo cognitivo y atenci\u00f3n. Rev. Espa\u00f1ola de. Orientaci\u00f3n Psicopedag\u00f3gica 12, 73\u201388 (2001).","journal-title":"Rev. Espa\u00f1ola de. Orientaci\u00f3n Psicopedag\u00f3gica"},{"key":"3850_CR56","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1530\/eje.0.1410105","volume":"141","author":"M Salerno","year":"1999","unstructured":"Salerno, M. et al. Intellectual outcome at 12 years of age in congenital hypothyroidism. Eur. J. Endocrinol. 141, 105\u2013110 (1999).","journal-title":"Eur. J. Endocrinol."},{"key":"3850_CR57","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1097\/00004703-200112000-00005","volume":"22","author":"SI Song","year":"2001","unstructured":"Song, S. I., Daneman, D. & Rovet, J. The influence of etiology and treatment factors on intellectual outcome in congenital hypothyroidism. J. Dev. Behav. Pediatr. 22, 376\u2013384 (2001).","journal-title":"J. Dev. Behav. Pediatr."},{"key":"3850_CR58","doi-asserted-by":"publisher","first-page":"62","DOI":"10.32641\/andespediatr.v94i1.4356","volume":"94","author":"E Ontiveros-Mendoza","year":"2023","unstructured":"Ontiveros-Mendoza, E., Gonz\u00e1lez-Medrano, JA., Rivera-Gonz\u00e1lez, R., S\u00e1nchez-P\u00e9rez, C., & Barrag\u00e1n-Mej\u00eda, G. Desempe\u00f1o cognitivo en preescolares con Hipotiroidismo Cong\u00e9nito incorporados en un programa de seguimiento. Andes pediatr. 94, 62\u201369 (2023).","journal-title":"Andes pediatr."},{"key":"3850_CR59","doi-asserted-by":"publisher","first-page":"4499","DOI":"10.1210\/jc.2013-2175","volume":"98","author":"JJ Bongers-Schokking","year":"2013","unstructured":"Bongers-Schokking, J. J. et al. Cognitive development in congenital hypothyroidism: is overtreatment a greater threat than undertreatment? J. Clin. Endocrinol. Metab. 98, 4499\u20134506 (2013).","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"3850_CR60","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1038\/pr.2016.159","volume":"80","author":"JJ Bongers-Schokking","year":"2016","unstructured":"Bongers-Schokking, J. J., Resing, W. C. M., Oostdijk, W., de Rijke, Y. B. & de Muinck Keizer-Schrama, S. M. P. F. Individualized treatment to optimize eventual cognitive outcome in congenital hypothyroidism. Pediatr. Res. 80, 816\u2013823 (2016).","journal-title":"Pediatr. Res."},{"key":"3850_CR61","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-022-01061-z","volume":"22","author":"S He","year":"2022","unstructured":"He, S., Ma, X., Yang, J. & Li, L. Levothyroxine treatment for congenital hypothyroidism based on thyroid function: a 10-year clinical retrospective study. BMC Endocr. Disord. 22, 142 (2022).","journal-title":"BMC Endocr. Disord."},{"key":"3850_CR62","doi-asserted-by":"publisher","first-page":"269","DOI":"10.4274\/jcrpe.galenos.2020.2020.0194","volume":"13","author":"C G\u00fcnbey","year":"2021","unstructured":"G\u00fcnbey, C. et al. Basal serum thyroxine level should guide initial thyroxine replacement dose in neonates with congenital hypothyroidism. J. Clin. Res Pediatr. Endocrinol. 13, 269\u2013275 (2021).","journal-title":"J. Clin. Res Pediatr. Endocrinol."},{"key":"3850_CR63","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/s12098-013-1154-0","volume":"81","author":"P Malhi","year":"2014","unstructured":"Malhi, P., Sidhu, M. & Bharti, B. Early stimulation and language development of economically disadvantaged young children. Indian J. Pediatr. 81, 333\u2013338 (2014).","journal-title":"Indian J. Pediatr."},{"key":"3850_CR64","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1080\/09297049.2021.1876010","volume":"27","author":"JE de Andrade","year":"2021","unstructured":"de Andrade, J. E. et al. Socioeconomic aspects are crucial to better intellectual outcome in early-treated adolescents with congenital hypothyroidism. Child Neuropsychol. 27, 587\u2013600 (2021).","journal-title":"Child Neuropsychol."}],"container-title":["Pediatric Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-03850-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-03850-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-03850-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T09:11:58Z","timestamp":1759914718000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-03850-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,22]]},"references-count":64,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["3850"],"URL":"https:\/\/doi.org\/10.1038\/s41390-025-03850-3","relation":{},"ISSN":["0031-3998","1530-0447"],"issn-type":[{"type":"print","value":"0031-3998"},{"type":"electronic","value":"1530-0447"}],"subject":[],"published":{"date-parts":[[2025,1,22]]},"assertion":[{"value":"28 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 October 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Before joining the study, the parents of the children provided informed consent in writing. All the procedures performed in this study were approved by the research and ethics committees of the National Institute of Pediatrics (Reg. INP 059\/2014) and were performed in accordance with the standards of the Declaration of Helsinki of 1964 and its subsequent amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All parents provided written signed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent statement"}}]}}