Endocrine Abstracts (2001) 2 SP24

Being Different - The Challenges for Turner Girls

SL King

Royal Surrey County Hospital Guildford Surrey GU2 5XX.

Being different = XO

Turner Syndrome is a chromosomal abnormality where all or part of one X chromosome is missing causing some or all of the body cells to have one inactive, an absent or only a fragment of one X chromosome. Physical manifestation of the classic features of Turner Syndrome are well described, what is not so well understood are the psychosocial aspects of Turner Syndrome.

Although intelligence is generally in the normal range, girls with Turner Syndrome are more likely to have difficulties with educational achievement and social interaction. A characteristic cognitive pattern has been described in which affected individuals show a significantly lower function in non verbal skills than verbal skills. This included a deficit in visual spatial awareness which was manifest in difficulties in being able to identify relationships of spatial objects and being able to solve problems without verbal clues.

These non verbal learning difficulties are also manifest in social development. Characteristically Turner girls have difficulty in social and emotional adjustment specifically social judgement and interaction. This maybe partly due to an inability to interpret facial expressions. Investigators report that lowered self esteem and impaired social functioning are more common in adults with Turner Syndrome. Pre and adolescent females are also believed to be more likely to experience poor peer relationships and social isolation than age matched peers.

In order to help diminish cognitive and socioemotional difficulties psychological evaluation can identify the problems associated with non verbal learning difficulties. Health professionals need to promote the need for testing and enable identification of services that provide evaluation and educational management in the hope of minimising the differences that girls with Turner Syndrome have.

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