The Influence of Early Malnutrition on Subsequent Behavioral Development: I. Degree of Impairment in Intellectual Performance

Galler, Janina R.; Ramsey, Frank; Solimano, Giorgio; Lowell, Walter E.; Mason, Elaine

doi:10.1097/00004583-198301000-00002

Cited by 118 publications

(91 citation statements)

References 6 publications

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“…6,[21][22][23][24][39][40][41] In other populations, growth and cognitive performance in early life are related to later development. [42][43][44][45][46][47][48][49][50] Our results suggest that adoption professionals, governments, and other regulatory agencies should coordinate efforts to promote early placement of children who are identified for international adoption.…”

Section: E714mentioning

confidence: 81%

Health of Children Adopted From Guatemala: Comparison of Orphanage and Foster Care

et al. 2005

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ABSTRACT. Objective. Since 1986, American parents have adopted >17 300 children from Guatemala. This study assessed the health, growth, and developmental status of 103 Guatemalan adopted children (48 girls; 55 boys) after arrival in the United States. Physical evidence suggestive of prenatal alcohol exposure and adequacy of vaccinations administered were also reviewed.Methods. Retrospective chart review was conducted of 103 children who were evaluated after arrival in the United States in an international adoption specialty clinic, and a case-matched study was conducted of a subgroup of 50 children who resided in either an orphanage or foster care before adoption. Mean age at arrival was 16 ؎ 19 months. Before adoption, 25 children resided in orphanages, 56 resided in foster care, and 22 resided in mixed-care settings. The 25 children who had resided in orphanages before adoption were matched for age at arrival, interval from arrival to clinic visit, and gender with a child adopted from foster care. Health and developmental status of these matched pairs were compared, allowing the first direct comparison of children raised in orphanages or foster care before adoption.Results. Mild growth delays were frequent among the children. Mean z scores for weight, height, and head circumference were, respectively, ؊1.00, ؊1.04, and ؊1.08. Children from foster care had significantly better z scores for height, weight, and head circumference than those from orphanage or mixed care. Among children who were younger than 2 years at arrival, growth measurements correlated inversely with age at arrival. Infectious diseases included intestinal parasites (8%) and latent tuberculosis infection (7%). Other medical conditions included anemia (30%), elevated lead levels (3%), and (using strict criteria) phenotypic facial features suggestive of prenatal alcohol exposure (28%). Adequacy of vaccine records from Guatemala was assessed: 28% met American Academy of Pediatrics standards for vaccine administration. Unsuspected significant medical diagnoses, including congenital anomalies and ocular, neurologic, and orthopedic problems, were found in 14%. Most children were doing well developmentally (80 -92% of expected performance), but 14% had global developmental delays. Cognition, expressive and receptive language, and activities of daily living skills correlated inversely with age at arrival for children who were younger than 2 years at adoption. Among the 50 matched children, those who resided in foster care before adoption had better measurements for height, weight, and head circumference at arrival to the United States. Moreover, those who resided in foster care scored significantly better for cognitive skills than those who had previously resided in orphanages (96.3% of age-expected compared with 88.3% of age-expected); other skills did not differ between the 2 groups. No differences were found between the 2 groups of children related to prevalence of medical diagnoses or phenotypic evidence suggesting prenatal alcohol exposure.Conclu...

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Section: E714mentioning

confidence: 81%

Health of Children Adopted From Guatemala: Comparison of Orphanage and Foster Care

et al. 2005

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“…We examined the 1 1-plus scores in relationship to cognitive and behavioral performance measured when the children were 5 to 11 y of age. The IQ measure was a modified version of the Wechsler Intelligence Scale for Children, which has been described elsewhere (9). To make tests relevant for Barbadian school children, items were altered to include local exemplars.…”

Section: Methodsmentioning

confidence: 99%

The Long-Term Effects of Early Kwashiorkor Compared with Marasmus. IV. Performance on the National High School Entrance Examination

et al. 1990

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ABSTRACT. This is one of a series of studies on the longterm effects of early childhood malnutrition in Barbadian school children. This is the first report of the relationship between early malnutrition and later performance on a national examination administered to all 11-y-old children in Barbados to assign high school seats. We compared scores achieved on the 11-plus examination by 103 boys and girls with histories of marasmus or kwashiorkor with those obtained by 63 healthy comparison children and also with scores obtained by the total island population of children during the same years. We report that children with histories of either type of malnutrition confined to infancy had significantly lower scores on the national high school examination than healthy comparison children. Reduced 11-plus scores were closely associated with teacher reports of attention deficits in the classroom documented when the children were as young as 5 to 8 y of age and also with IQ and academic performance. Early malnutrition had independent effects on performance on the 11-plus examination even when home environmental conditions were controlled for. In a series of studies in Barbados (1-3), we have followed the growth and behavioral development up to 18 y of age of boys and girls with histories of marasmus and kwashiorkor in the first year of life and have compared the findings with those obtained from healthy Barbadian control children matched by age, sex, and socioeconomic group. There was no evidence of continuing malnutrition in this group and follow-up after puberty of boys and girls in this category demonstrated catch-up growth that gave them the same body dimensions as the control children (1).

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“…When parental IQ was included in a multivariable analysis the association between malnutrition and IQ was no longer significant. While the current study is limited in its sample size, it suggests the need for a re-evaluation of studies that have shown an association between malnutrition and cognitive development but have not considered parental IQ as a critical covariate (Freeman et al, 1980;Galler et al, 1983Galler et al, , 1990Rose, 1994;Mendez & Adair, 1999;Walka and Pollitt, 2000;Berkman et al, 2002, Jianghong et al, 2003. Poor parental cognitive skills were associated with lower IQs in their children, more malnutrition and less schooling.…”

Section: Discussionmentioning

confidence: 93%

“…Elucidating the effect of malnutrition on cognitive development has remained difficult, due to covarying risk factors and the inability to perform randomized controlled studies (Grantham-McGregor, 1995). A number of studies have shown a small long-term negative effect of malnutrition on IQ after adjusting for socioeconomic factors and education (Freeman et al, 1980;Galler et al, 1983Galler et al, , 1990Rose, 1994;Mendez & Adair, 1999;Ivanovic et al, 2000Ivanovic et al, , 2004Berkman et al, 2002;Jianghong et al, 2003). However, these studies have not controlled for parental IQ.…”

Section: Introductionmentioning

confidence: 99%

Parental IQ and cognitive development of malnourished Indonesian children

2005

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A cross-sectional study of children in West Kalimantan, Indonesia, was conducted to examine the relationship between malnutrition history, child IQ, school attendance, socioeconomic status, parental education and parental IQ. In unadjusted analyses, severely stunted children had significantly lower IQ scores than mild-moderately stunted children. This effect was significant when stunting, school attendance and parental education were included in multivariable models but was attenuated when parental IQ was included. Our research underscores the importance of accounting for parental IQ as a critical covariate when modeling the association between childhood stunting and IQ.

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The Influence of Early Malnutrition on Subsequent Behavioral Development: I. Degree of Impairment in Intellectual Performance

Cited by 118 publications

References 6 publications

Health of Children Adopted From Guatemala: Comparison of Orphanage and Foster Care

Health of Children Adopted From Guatemala: Comparison of Orphanage and Foster Care

The Long-Term Effects of Early Kwashiorkor Compared with Marasmus. IV. Performance on the National High School Entrance Examination

Parental IQ and cognitive development of malnourished Indonesian children

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