A longitudinal study of the mental development of severly malnourished Jamaican children - abstract

ABSTRACT

A longitudinal study of the mental development of seventeen children admitted to hospital with severe protein energy malnutrition (PEM) was commenced in 1975. They were compared with fourteen adequately nourished children hospitalized for other reasons. Throughout the three years after leaving hospital all children had regular developmental assessments on the Griffiths Mental Development Scales, and anthropomentric measurements. When they left hospital the developmental level (DQ) of the malnourished group was markedly behind that of the comparisons. During the following three years the deficit was reduced, but the malnourished group remained significantly behind. (Malnourished mean = 86.1, SD = 11.8 comparison mean = 99.7, SD = 8.2, p<01). The malnourished group was significantly behind the comparisons in each subscale of the Griffiths test. Since leaving hospital the malnourished children had reduced their deficit in "performance" and "hand and eye' subscales but not in "locomotor" or "hearing and speech" subscales. All children were given the School Achievement Test (SAT) and Peabody Picture Vocabulary Test (PPVT) between one and six months after their 36-month test. These tests have been modified for Jamaica and are used to assess children's progress in Basic School. In both tests the malnourished children were behind the well nourished. (PPVT mean comparison = 27.5, SD = 10.9, malnourished = 19.7, SD = 9.4; p<0.5 SAT mean comparison = 34.3, SD = 19.0, malnourished = 26.8, SD = 10.6, p<.05). The malnourished children caught up to the comparison in percentage expected weight for age, but remained significantly more stunted, with smaller head circumferences and lighter. It was concluded that Jamaican children who suffer from severe PEM in early childhood have a persistent lag in mental development and retarded physical growth for several years. It is apparent that more comprehensive care is required to ensure full rehabilitation (AU)