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The long-term follow-up of severely malnourished children who participated in an intervention program
S Grantham-McGregor1, C Powell, S Walker
1Tropical Metabolism Research Unit, University of the West Indies, Mona, St. Andrew, Jamaica.
Insights
Psychosocial intervention improved outcomes for severely malnourished children. Home visits with toy demonstrations led to intermediate cognitive and school achievement scores compared to controls, significantly better than non-intervention malnourished children.
Area of Science:
- Child Development
- Nutritional Science
- Psychosocial Intervention
Background:
- Severe malnutrition in children is linked to lower developmental levels.
- Malnourished children often exhibit deficits in cognitive and academic performance.
- Early intervention may mitigate long-term effects of malnutrition.
Purpose of the Study:
- To evaluate the long-term impact of a 3-year home-visiting psychosocial intervention program on severely malnourished children.
- To compare the school achievement and IQ of intervened malnourished children with non-intervened malnourished children and controls.
Main Methods:
- A 3-year home-visiting program with toy demonstrations was provided to 18 severely malnourished children (IM).
- Comparison groups included 17 severely malnourished children (NIM) and 19 adequately nourished controls.
- Cognitive and school achievement were assessed at 7, 8, 9, and 14 years post-hospitalization using WISC, WRAT, and PPVT.
Main Results:
- Non-intervened malnourished children (NIM) showed persistent deficits, with significantly lower scores on WISC, WRAT, and PPVT at 14-year follow-up compared to controls.
- Intervened malnourished children (IM) consistently scored intermediate between NIM and control groups.
- At 14 years, the IM group demonstrated significantly higher WISC verbal scores and approached significance in WRAT scores compared to the NIM group.
Conclusions:
- Psychosocial intervention is crucial for the comprehensive treatment of severely malnourished children.
- Home-visiting programs can positively influence long-term cognitive and academic outcomes.
- Early intervention can help reduce the lasting impact of severe malnutrition on child development.
Abstract:
18 severely malnourished children (IM) who participated in a 3-year home-visiting program were compared with 2 other comparison groups comprising 17 severely malnourished (NIM) and 19 adequately nourished children (controls). On enrollment, all the groups were in the same hospital, and both malnourished groups had lower developmental levels than the controls. The IM group received intervention for 3 years after hospitalization, consisting of weekly or 2 weekly home visits with toy demonstrations. At 7, 8, 9, and 14 years after leaving the hospital, the 3 groups were compared on tests of school achievement and IQ. The NIM group showed no sign of reducing their deficits, and at the 14-year follow-up they had markedly lower scores on the WISC verbal and performance scales, the Wide Range Achievement Test (WRAT), and the Peabody Picture Vocabulary Test (PPVT), than the controls. Throughout the follow-up the IM group's scores were intermediate between the NIM and the controls in every test. At the 14-year follow-up, their scores were significantly higher than those of the NIM group in the WISC verbal scale, and the difference approached significance in the WRAT. We conclude that psychosocial intervention should be an integral part of treatment for severely malnourished children.