Early Hormonal Influences on Cognitive Functioning in Congenital Adrenal Hyperplasia

A battery of cognitive tests and a measure of early childhood activities were administered to 17 females and 8 males with congenital adrenal hyperplasia (CAH), an autosomal recessive disorder associated with elevated prenatal adrenal androgen levels. CAH females, as compared with unaffected female relatives, showed significantly enhanced performance on three tests of spatial ability - Hidden Patterns, Card Rotations, and Mental Rotations; no reliable differences in spatial ability were observed between male patients and controls. On the Early Life Activities Questionnaire (ELAQ), male patient and control groups did not differ significantly on any activity scales. In contrast, CAH females, relative to female control subjects, showed significantly lower frequencies of participation in activities involving verbal expression and a trend toward greater participation in spatial manipulation activities. Nevertheless, differences between female patient and control groups in early childhood activities did not account for observed differences in spatial ability, given the absence of a significant correlation between the spatial manipulation activity scale and spatial ability. These results are consistent with an effect of pre- and perinatal androgenizing hormones on the development of spatial ability.