SUMMARY This prospective 20‐year follow‐up study contrasts the development of a group of 20 children grossly undernourished during infancy (index group) with that of a matched control group. There were significant differences between two groups in head circumference, height, weight, full‐scale IQ, verbal quotient, non‐verbal quotient and in visuo‐motor perceptual function. Despite their disadvantages, the index group have integrated effectively into the community, and their children have not experienced the nutritional deprivation they suffered during their own childhoods. RÉSUMÉ Etude de développement sur vingt ans du devenir psychosocial et des données de tomodensitométrie cérébrale de sujets sévérement sous‐nutrits durant la premiére enfance Cette étude longitudinale prospective sur 20 ans oppose le développement d'un groupe de 20 enfants sévérement sous‐nutrits durant la premiére enfance (groupe index) avec celui d'un groupe contrôle apparié. Les différences significatives entre les groupes index et contrôle en tour de tête, taille, poids, quotients intellectuels généraux, verbaux et non verbaux, en fonction perceptive visuomotrice mesurée au test de Bender et au dessin du Bonhomme sont discutées. L'étude montre qu'en dépit de leurs désavantages, les sujets du groupe index se sont intégrés plus efficacement dans la communauté et que leurs enfants n'ont pas eu á souffrir de la déprivation nutritionnelle qu'ils avaient subie durant leur propre enfance. ZUSAMMENFASSUNG Eine zwanzigjährige Entwicklungsstudie über die psychosozialen Ergebnisse und Befunde der Hirntomogramme von Patienten, die in ihrer Kindheit schwer unterernährt waren Diese zwanzigjährige Verlaufsstudie stellt die Entwicklung einer Gruppe von 20 in ihrer Kindheit schwer unterernährten Kindern (Index‐Gruppe) der einer entsprechenden Kontrollgruppe gegenüber. Die signifikanten Unterschiede zwischen der Index‐Gruppe und der Kontrollgruppe hinsichtlich Kopfumfang, Größe, Gewicht, Gesamtquotients, Verbalquotient, Nicht‐Verbal‐quotient und visuell motorischem Perzeptionsvermögen, was anhand des Bender Tests und anhand von Zeichnungen von Menschen beurteilt wurde, werden diskutiert. Die Studie zeigt, daß die Index‐Gruppe sich trotz ihrer Nachteile besser in die Gesellschaft integriert hat und daß ihre Kinder keine Unterernährung erfahren, die sie in ihrer eigenen Kindheit erlitten haben. RESUMEN Estudio del desarrollo en veinte anos de la situacion psicosocial conseguida y los hallazgos con la TAC en sujetos que habian sufrido una desnutricion importante en la lactancia Este estudio prospectivo de 20 años compara el desarrollo de un grupo de 20 niños con marcada desnutricion durante su lactancia (grupo indice) con el de un grupo control. Se discuten las diferencias significativas entre los dos grupos en el perimetro craneal, peso, estatura, cocientes verbal y no verbal y función perseptiva viso‐motora en el test de Bender y en los dibujos de figura humana. El estudio muestra que, a pesar de sus desventajas, el grupo indice se habia integrado más efectiv...
Stoch, M. B., and Smythe, P. M. (1976). Archives of Disease in Childhood, 51, 327. 15-year developmental study on effects of severe undernutrition during infancy on subsequent physical growth and intellectual functioning. This third 5-year follow-up on the effects of severe undernutrition during infancy on subsequent brain growth and intellectual development confirms the level of gross retardation of intellect in the undernourished group when compared with the controls. A.s the subjects are now 15-18 years ofagethis mustbepermanent. All but 5 oftheundernourished group are now living in conditions comparable to the controls. Improved nutrition is manifest by catch-up in height, in that the mean difference between undernourished subjects andcontrols has decreased by2 *73cm. Remarkably,thedifferencein head circumference has increased by 0 * 5 cm, the mean head circumference of the undernourished now being 2 *8 cm less than that of the controls. The Bender Gestalt and Human Figure Drawing tests did not correlate with the intelligence tests, indicating a separate deficit of a marked disturbance of visual-motor perception in 17 of the undernourished subjects, in 9 of whom these tests were highly significant of minimal brain dysfunction (5 of the controls). In retrospect there is much evidence to suggest the controls were also suboptimal; 8 controls had abnormal electroencephalograms as did 6 of the undernourished group.This study was started in 1955, based on the hypothesis that the ill effects of undernutrition are determined firstly by its occurrence during the period of maximum growth and, secondly, by the duration of undernutrition relative to the total period of growth. As brain growth in the human is very rapid during the first year of life and almost complete by the end of the second year it seemed possible that undernutrition during this critical period might inhibit brain growth and that this could result in a permanent reduction in brain size and impaired intellectual development.To test this hypothesis a group of subjects grossly undernourished during early infancy was compared with a control group. Two previous reports on this study were published in 1963 and1967 (Stoch andSmythe). This third 5-year study is of particular value as little further develop-
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