Early childhood growth and cognitive outcomes: Findings from the MAL‐ED study

Abstract

Although many studies around the world hope to measure or improve developmental progress in children to promote community flourishing and productivity, growth is sometimes used as a surrogate because cognitive skills are more difficult to measure. Our objective was to assess how childhood measures of anthropometry correlate with measures of child development in low-income settings with high prevalence of poor nutrition and enteric disease, to inform studies considering growth outcomes in the absence of direct child developmental skill assessment. Children from the MAL-ED study were followed from birth to 24 months of age in field sites in 8 low- and middle-income countries across 3 continents. Monthly weight, length, and head circumference measurements were performed. At 24 months, the Bayley Scales of Infant and Toddler Development was administered. We correlated cognitive measures at 24 months with anthropometric measurements from birth to 2 years comparing 3 constructs: absolute attained monthly measures, summative difference in measures from the mean growth curve, and rate of change in measures. Growth faltering at multiple time periods is related to Bayley cognitive outcomes at 24 months. Birthweight, overall growth by 18-24 months, and rate of growth in the 6- to 18-month period were most associated with 24-month developmental scores. In this study, head circumference measurements, compared with length, was more closely linked to cognitive scores at 24 months. Notably, all studies between growth and cognitive outcomes exhibited low r values (0.001-0.049). Anthropometric measures, particularly head circumference, were related to cognitive development, although explaining a low percent of variance. When feasible, direct measures of child development may be more useful.

Using functional near‐infrared spectroscopy to assess social information processing in poor urban Bangladeshi infants and toddlers

“…The child's height was assessed at the time of the study by measuring in centimetres and converted into an age referenced and standardized height‐for‐age z‐score (HAZ) using the World Health Organization's Anthro Plus software (version 3.2.2). In addition to HAZ, head circumference was also included as a risk factor that might be more specific to cognitive outcomes than HAZ (Scharf et al, ).…”

“…Organization's Anthro Plus software (version 3.2.2). In addition to HAZ, head circumference was also included as a risk factor that might be more specific to cognitive outcomes than HAZ (Scharf et al, 2018).…”

Early Life Interventions for Childhood Growth and Development in Tanzania (ELICIT): a protocol for a randomised factorial, double-blind, placebo-controlled trial of azithromycin, nitazoxanide and nicotinamide

“…This is a commonly used assessment for early childhood and has been used in many research sites around the world. 6 31 …”

“…Children in Haydom followed in MAL-ED had a prevalence of stunting of 70% at 18 months of age. 5 Data from MAL-ED also showed that linear growth deficits correlated with lower scores for cognitive development, 6 potentially through shared barriers to optimal growth and brain development. 1 7 …”

Associations between individual variations in visual attention at 9 months and behavioral competencies at 18 months in rural Malawi

“…As a secondary aim, we examined how growth and psychosocial risk factors relate to later development, as these factors have shown to be related to cognitive and sociobehavioral outcomes later in childhood (e.g. [18][19][20][21][22][23][24][25][26][27]).…”