FRAGILE-X, IRON, AND NEURODEVELOPMENTAL SCREENING IN 8-YEAR-OLD CHILDREN WITH MILD-TO-MODERATE LEARNING-DIFFICULTIES

Objective-To examine the value of neurodevelopmental examination, frag ile X testing, iron studies, and other screening procedures in childre n with mild to moderate learning difficulties. Design-A cross sectiona l case-control study. Subjects-A 34% random sample (n = 130) of childr en with mild to moderate learning difficulties born between 01/07/83 a nd 30/06/84 and resident in North and West Belfast. Controls were 130 children without learning difficulties matched for age and geographica l area. Results-The prevalence of mild to moderate learning difficulti es in North and West Belfast was 16%; 115 (89%) of the learning diffic ulties group and 80 (58%) of the control group consented to participat e. Children in the learning difficulties group scored significantly lo wer in neurodevelopmental testing and were more likely to fail their a udiometry assessment than controls. Children in the learning difficult ies group were also more likely to be anaemic and had lower serum iron and transferrin saturation than controls. No cases of fragile X were identified. Thyroid function tests and urinary amino acids were all wi thin normal limits There were no significant differences in anthropome try, head circumference, or formal neurological examinations. Conclusi ons-Children with learning difficulties are more likely to be neurodev elopmentally immature and iron depleted than controls. Iron depletion should be aggressively sought and treated. The role for routine assess ment for fragile X, thyroid function tests, and amino acid chromatogra phy is doubtful.