Relationship between child development and nutritional status of under-five Nigerian children

Evaluation of apparently healthy Egyptian infants and toddlers on the bayley-III scales according to age and sex

BACKGROUND

Child development is shaped throughout the first years of life through the interaction of genetics and the environment. Bayley-III is valuably used to determine early developmental delay (DD). The aim of this study was to detect the differences in performance of a sample of apparently healthy Egyptian infants and toddlers on the Bayley-III scales in relation to their age and gender.

METHODS

This was a cross-sectional study. Bayley scales were applied to 270 of the 300 recruited children following the inclusion criteria; to avoid potential risk factors affecting development. Assessment included cognitive, language and motor skills. Engaged children aged 18-42 months were divided into 4 age groups with six-month intervals.

RESULTS

Approximately 78.4%, 76.2%, and 72% of the participants had average and above average scores in the cognitive, motor, and language domains, respectively. The language domain was characteristically impacted. The oldest age group (36-42 months) scored the highest means composite scores, while the 2nd group aged 24 - <30 months, scored the lowest means in the three evaluated domains. In general, girls had non-significantly higher composite scores than boys, with a small effect size (d = 0.2-0.4). In the language domain, girls aged 30 to < 36 months scored significantly higher composite scores than boys (p < 0.05), with a medium effect size (d = 0.73).

CONCLUSION

The study indicates that the performance of apparently healthy Egyptian children on the Bayley III evaluation differs in relation to age and sex. The most vulnerable age group at potential risk of DD was children aged 24-30 months. Efforts must be directed to investigate the nutritional, physical, psychological and safety needs of this group. Attention must be paid to early childhood intervention programs that stimulate development, especially language development, and they must be tailored on the basis of age and gender. Gender-specific norms may be needed in the evaluation of language development.

What matters most for early childhood development? Evidence from Malda district, India

BACKGROUND

The early period of a child's life is considered to be the most important developmental stage throughout the lifespan. Around 250 million children of age below five years in low-and middle- income countries (LMICs) are at risk of not attaining their developmental potential. A cross-sectional case study was conducted to assess the early childhood developmental (ECD) status and to investigate the factors influencing the same in Malda, India.

METHODS

Information on 731 pre-school children aged 36 to 59 months was collected in 2018 using a structured questionnaire following a multi-stage, stratified simple random sampling procedure. ECD was measured following the UNICEF's Multiple Indicator Cluster Survey, which monitors early child development in LMICs. A path analysis using structural equation modelling was carried out to examine the relationship between possible associated factors and ECD status.

RESULTS

It has been found that only about 25% of children are developmentally on track of literacy-numeracy domain of ECD. Although, in the other domains, the situation is better. Results of the path analysis revealed that there are certain proximal factors, i.e., home environment, mother's time for care, having home tuition and attending private pre-school, which are influenced by certain distal factors and subsequently affecting ECD. The total effects revealed that place of residence (urban or rural) affects ECD mostly (Coef. -0.87, p = <0.001) directly or via mothers' time for stimulating activities, home environment and having home tuition for children. Further, it revealed that private pre-schools (Coef. 0.76, p = <0.001) and home tuition (Coef. 0.43, p = <0.001) also play a significant role in ECD.

CONCLUSION

Urgent attention from policymakers or other stakeholders is needed to promote ECD for the betterment of children and society of Malda district. In addition to that, special attention needs to be given to the children who belong to Muslim families, socially deprived communities and living in rural areas.

Determinants of Infant Growth and Development Based on the Health Promotion Model

BACKGROUND: The quality of future generations is largely determined by the growth and development of toddlers. All parents want their children to grow and develop optimally. AIM: The purpose of this study was to identify the determinants of growth and development of infants aged 3–12 months based on the Health Promotion Model (HPM). METHODS: The study used a cross-sectional study design, which was conducted at the Banyuwangi District Health Center. Respondents in this study were mothers who had infants aged 3–12 months as many as 217. The sampling technique used was random sampling. The independent variables using the components of the HPM theory are mother’s motivation, infant’s gestational age, perceived benefit, perceived barrier, perceived self-efficacy, and activity-related affect. The dependent variable is growth and development. Growth assessment is obtained from the BB/U value and compared with the z-score table. Developmental assessment was done using Pre-screening Development Questionnaire. The relationship between each independent variable and the dependent variable was analyzed using the Chi-square test. Determinants of growth and development of children under five were analyzed using multiple logistic regression. RESULTS: The results of the independent variable logistic regression test with growth showed that the variable with p < 0.05 was the mother’s perceived self-efficacy with p = 0.013. While the independent variable logistic regression test with development showed that the variable with p < 0.05 was the mother’s perceived barrier with a p = 0.000. CONCLUSION: Based on the HPM approach, it was found that the determinant of infant growth was the mother’s perceived self-efficacy, while the determinant of infant development was the mother’s perceived barrier. The growth and development of toddlers can be achieved optimally through efforts to increase the mother’s perceived self-efficacy and reduce the mother’s perceived barrier.

A self-reported cross-sectional study on the oral function and the quality of life in children with stunted growth

BACKGROUND

Failure to catch up with growth in toddlerhood will stunt elementary school children, which continues to cognitive decline and oral motor coordination. Verbal motor skills play an essential role in the oral function of the stomatognathic system, which includes mastication, swallowing, and speech. Therefore, early attention to oral function disorders of the stomatognathic system can avoid complications in children's nutritional status and quality of life.

OBJECTIVE

The objective of this study was to analyze the correlation of oral function of the stomatognathic system with Oral Health-Related Quality of Life (OHRQoL) in stunting children.

METHODS

This cross-sectional study correlates with 58 children aged 7-12 years with a history of stunting in toddlerhood from the Pasir Jambu District, Bandung Regency. The oral function of the stomatognathic system was evaluated by Adapted Orofacial Myofunctional Assessment Protocol and OHRQoL with Child Oral Health Impact Profile Short Form (COHIP-SF 19).

RESULTS

The results were statistically analyzed using Spearman's rank correlation and Kendall's coefficient of concordance correlation tests. The results showed that the research subjects had a significant relationship in each variable and the three variables of the oral function of the stomatognathic system (chewing, swallowing, and speech) with OHRQoL with a p-value <0.05. The study concluded that the oral function of the stomatognathic system (chewing, swallowing, and speech) is related to OHRQoL in children with stunted growth.

Systematic review and meta-analysis found that malnutrition was associated with poor cognitive development

AIM

Malnutrition is a major public health issue that has been associated with high susceptibility for impaired brain development and mental functioning. However, to date studies on this topic have not been collated and appraised. This systematic review and meta-analysis investigated the association between malnutrition and cognitive development.

METHODS

We searched the MEDLINE, Scopus, CINAHL, Embase PsycINFO and Cochrane Library databases in English up to 8 December 2020. All studies reporting an association between nutritional status and cognitive development were included. p values of less than 0.05 were considered statistically significant and the results are reported as standardised mean differences (SMD), 95% confidence intervals (95%) and I² statistics.

RESULTS

We included 12 studies comprising 7,607 participants aged 1 to 12 years. Children with malnutrition had worse scores than controls for the Wechsler Intelligence Scale (SMD -0.40; 95% CI -0.60 to -0.20; p < 0.0001; I² 77.1%), the Raven's Coloured Progressive Matrices (SMD -3.75; 95% CI -5.68 to -1.83; p < 0.0001; I² 99.2%), visual processing (SMD -0.85; 95% CI -1.23 to -0.46; p 0.009; I² 11.0%) and short memory (SMD 0.85; 95% CI -1.21 to -0.49; p < 0.0001; I² 0%) tests.

CONCLUSION

Normal cognitive development requires access to good and safe nutrition.

Effectiveness of Ready-to-Use Therapeutic Food in Improving the Developmental Potential and Weight of Children Aged under Five with Severe Acute Malnourishment in Pakistan: A Pretest-Posttest Study

The objective of this study was to assess whether the standard therapy of ready-to-use therapeutic food in the treatment of uncomplicated severe acute malnutrition (SAM) is effective in improving developmental potential and weight gain in children aged under five years. A multicenter pretest-posttest study was conducted among 91 children aged under five with uncomplicated SAM in Pakistan. Study participants completed their eight weeks’ therapy of ready-to-use therapeutic food according to the World Health Organization’s (WHO) standard guidelines. The study outcome was the proportion of children with improved developmental potential in all domains in comparison with the pretreatment status and children gaining >15% of their baseline weight; mean weight-for-height/length z-score after completing eight weeks’ therapy of ready-to-use therapeutic food. The Denver Development Screening Tool II was used for developmental screening. Significant changes (p < 0.05) were observed for developmental status milestones in terms of gross motor, fine motor, and personal/social milestones, as well as language and global development milestones. There was a strong positive correlation (r = 0.961) between initial weight and weight at the last visit (p < 0.001). Ready-to-use therapeutic food is effective in improving development potential as well as promoting weight gain in children aged under five with uncomplicated SAM if provided according to WHO guidelines.

Comparative analysis of developmental profile between normal and severe acute malnourished under-five children in Pakistan: a multicentre cross-sectional study

OBJECTIVES

This study aims to compare the developmental profile of severe acute malnourished (SAM) and normal under-five children and to find sociodemographic determinants accountable for their developmental disabilities.

SETTING

We conducted a multi-centre cross-sectional study in three basic health units and one rural health centre in Pakistan.

PARTICIPANTS

200 children (SAM and healthy) aged 6-59 months.

PRIMARY AND SECONDARY MEASURES

We screened for nutritional status and clinical complications. Children underwent for developmental assessment by Denver Development Screening Tool II. A pretested structured questionnaire on sociodemographic characteristics and nutrition was used for collecting data about determinants of developmental delay.

RESULTS

We observed statistically significant differences in anthropometric measurements among SAM compared with normal nourished in weight, height, mid-upper arm circumference and weight-for-height z-scores. SAM serves as a significant risk factors (p<0.001) for delayed personal or social development (69% vs 11%; OR (95% CI)=18.01 (8.45 to 38.37)), delayed fine motor development (39% vs 8%; OR (95% CI)=7.35 (3.22 to 16.81)), delayed language development (32% vs 8%; OR (95% CI)=5.41 (2.35 to 12.48)), delayed gross motor development (34% vs 10%; OR (95% CI)=4.64 (2.14 to 10.05)) and delayed global development (66% vs 20%; OR (95% CI)=7.77 (4.09 to 14.74)). Applying logistic regression, personal or social development (p<0.001) and language development (p<0.05), under-five siblings was a risk factor, while among gross motor development, mother's educational status (p<0.05) was a significant risk factor for developmental delay.

CONCLUSIONS

Our analysis indicates that children with malnutrition have a high frequency of developmental delays. Missing maternal education and a higher number of under-five siblings are also potential risk factors for developmental delay.

The Association Between Nutritional Status and Risk of Developmental Disorder in Children in Denpasar Bali Indonesia

BACKGROUND: Preschool age is an important period for growth and development. Malnutrition that occurs during this period can have negative impacts on growth, cognitive development, and academic performance in children. AIM: The objective of the study is to know the association between nutritional status and the risk of developmental disorder in preschool children in Denpasar. METHODS: An observational analytic study with a cross-sectional design and cluster sampling method was conducted on children under 5 years old who attended Early Childhood Education in Denpasar Bali in 2019. RESULTS: From 468 samples, the median age was 5 years old (range, 1–5), the majority of children were well-nourished (52.6%), and caretaken by parents (82.9%). Child development was prescreened using an Indonesian child development pre-screening questionnaire/Kuesioner Pra Skrining Perkembangan (KPSP) that had 75% sensitivity, 99.16% specificity, 85.71% positive predictive value,and 98.33% negative predictive value compared to Capute Scale test as a gold standard. It showed that the majority of participants had an appropriate developmental stage (91.3%), followed by doubtful (5.3%) and possible deviations (3.4%). The results of the bivariate analysis showed that malnutrition was significantly related to the risk of developmental delay (PR 2; confidence interval [CI] 95%, 1.05-3.97). The result of multivariate analysis for variables that were considered to be significant as a risk for developmental disorder showed that malnutrition was related to the possibility of developmental disorder (PR 2; CI 95%, 1.04–3.95). Caretakers other than parents and lack of physical activity were not significantly related to the risk of developmental disorder. CONCLUSION: Malnutrition was found to be significantly associated with the risk of developmental disorder in preschool children. Further prospective study by standard assessment tools is required to evaluate the association between nutritional status and developmental level in children.

Developmental delay and its predictors among children under five years of age with uncomplicated severe acute malnutrition: a cross-sectional study in rural Pakistan

Background

In developing countries, malnutrition in children and developmental delays are two major challenges for public health. To achieve the vision of the Sustainable Development Goals from the broader perspective of child health, early identification of developmental delays and timely intervention are crucial. The aim of this study is to assess the prevalence of suspected developmental delay and their predictors in children under the age of 5 years with uncomplicated severe acute malnutrition in rural areas of Pakistan.

Methods

A multicentre cross-sectional study was conducted among 185 children with uncomplicated severe acute malnutrition. We screened children aged 6–59 months for their nutritional status and clinical complications. Children fulfilling the inclusion criteria underwent the Denver Development Screening Tool II (DDST-II). The children’s global developmental profile was calculated according to the established protocols of DDST-II, which are based on four important domains of development: personal and social behaviour, language, gross motor adaptive skills and fine motor adaptive skills. A pretested questionnaire was used to collect data on socio-demographic and nutritional factors for assessing predictors of developmental delay, which were analysed using a multivariate logistic regression model.

Results

Out of 177 children with severe acute malnutrition, 69 (38.9%) had normal global development and 108 (61.1%) had delayed global development. Significant associations were found between global developmental delay and younger children (6–24 months vs. 25–59 months; AOR = 4.53, 95% CI: 1.56–13.10, p < 0.01), children who were not exclusively breastfed (AOR = 3.07, 95% CI: 1.24–7.56, p = 0.01), and a history of contact with a tuberculosis smear-positive adult (AOR = 2.67, 95% CI: 1.30–5.49, p < 0.01).

Conclusion

About two thirds of the study participants showed delayed or unstable global development. Thus, according to DDST-II-established protocols, there is a high prevalence of suspected developmental delay among children under the age of five years with uncomplicated severe acute malnutrition in rural areas of Pakistan. Children in their first 2 years of life were at particularly high risk due to insufficient breastfeeding. This emphasizes the need to provide adequate infrastructure and information to parents for the prevention of developmental delay in remote areas.

Physical Discipline, Deprivation, and Differential Risk of Developmental Delay Across 17 Countries

OBJECTIVE

Parenting behaviors have been studied largely in isolation with regard to child development in cross-national contexts. We examine and compare the relative strength of association between physical discipline and deprivation with risk of children's socioemotional and cognitive developmental delay in a cross-national sample.

METHOD

The sample was drawn from the UNICEF Multiple Indicator Cluster Survey. Analyses used observations with data on parental physical discipline, parenting behaviors associated with deprivation, and child developmental outcomes. The present analysis included 29,792 children aged 36-59 months across 17 countries. Using the Early Child Development Index, risk for cognitive or socioemotional developmental delay was indicated if a child could not accomplish 2 or more items within that specific subdomain. Overall risk for delay was indicated if a child was at risk in either subdomain. Associations among discipline, deprivation, and delay were assessed using multivariable logistic regression.

RESULTS

Five of the 7 exposures were associated with risk of overall developmental delay. Physical discipline (odds ratio [OR] = 1.49 [95% CI = 1.39, 1.59]; p < .001) had the largest association with risk for socioemotional delay. Not having books (OR = 1.62 [95% CI = 1.42, 1.84]; p < .001) and not counting with the child (OR = 1.47 [95% CI = 1.32, 1.64]; p < .001) had the largest associations with risk of cognitive delay.

CONCLUSION

The exposures of physical discipline and deprivation measured here have distinct associations with risk of socioemotional and cognitive delay cross-nationally. Programmatic and clinical interventions should seek to act on adversities that are relevant to the targeted delay.