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The association of early linear growth and haemoglobin concentration with later cognitive, motor, and social-emotional development at preschool age in Ghana.

ABSTRACT: It is important to identify the periods during childhood when exposure to environmental risk factors results in long-term neurodevelopmental deficits. Stunting and anaemia may be sensitive indicators of exposure to such risks. In a prospective cohort enrolled before birth, we investigated the association of developmental scores at 4-6 years with (a) birth length and linear growth during three postnatal periods and (2) haemoglobin (Hb) concentration at three time points. Children were participants in a follow-up study of a randomized controlled trial of nutritional supplementation in Ghana. At 4-6 years, cognitive, motor, and social-emotional developments were assessed using standard tests adapted for this population. We estimated the associations of length-for-age z-score (LAZ) at birth and postnatal linear growth (n = 710) and Hb (n = 617) with developmental scores in regression models, using multistage least squares analysis to calculate uncorrelated residuals for postnatal growth. Cognitive development at 4-6 years was significantly associated with LAZ at birth (? = 0.12, 95% CI = 0.05, 0.19), ?LAZ from 6 to 18 months (? = 0.16, 95% CI = 0.04, 0.28), and Hb at 18 months (? = 0.13, 95% CI = 0.06, 0.20), but not with ?LAZ during 0-6 months, ?LAZ from 18 months to 4-6 years, Hb at 6 months, or Hb at 4-6 years. No evidence of associations with motor or social-emotional development were found. These results suggest that in similar contexts, the earlier periods prior to birth and up to 18 months are more sensitive to risk factors for long-term cognitive development associated with LAZ and Hb compared with later childhood. This may inform the optimal timing of interventions targeting improved cognitive development.

SUBMITTER: Ocansey ME

PROVIDER: S-EPMC6852555 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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The association of early linear growth and haemoglobin concentration with later cognitive, motor, and social-emotional development at preschool age in Ghana.

Ocansey Maku E ME Adu-Afarwuah Seth S Kumordzie Sika M SM Okronipa Harriet H Young Rebecca R RR Tamakloe Solace M SM Oaks Brietta M BM Arimond Mary M Dewey Kathryn G KG Prado Elizabeth L EL

Maternal & child nutrition 20190613 4

It is important to identify the periods during childhood when exposure to environmental risk factors results in long-term neurodevelopmental deficits. Stunting and anaemia may be sensitive indicators of exposure to such risks. In a prospective cohort enrolled before birth, we investigated the association of developmental scores at 4-6 years with (a) birth length and linear growth during three postnatal periods and (2) haemoglobin (Hb) concentration at three time points. Children were participant ...[more]

PMID: 31042813

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Project description:Background:Adequate nutrition is necessary for brain development during pregnancy and infancy. Few randomized controlled trials of supplementation during these periods have measured later developmental outcomes. Objective:Our objective was to investigate the effects of provision of prenatal and postnatal lipid-based nutrient supplements (LNS) on child development at preschool age. Methods:We conducted a follow-up study of 966 children aged 4-6 y in 2016, born to women who participated in the International Lipid-Based Nutrient Supplements-DYAD trial conducted in Ghana in 2009-2014, representing 79% of eligible children. Women ?20 weeks of gestation were randomized to daily LNS or multiple micronutrient (MMN) capsules during pregnancy through 6 mo postpartum or iron and folic acid (IFA) capsules during pregnancy and calcium placebo capsules during 6 mo postpartum. Children in the LNS group received LNS from 6 to 18 mo. Primary outcomes of this follow-up study were (1) a cognitive factor score based on a test battery adapted from several standard tests, 2) fine motor score (9-hole pegboard test), and (3) social-emotional difficulties (Strengths and Difficulties Questionnaire; SDQ). Eight secondary outcomes were calculated in specific domains (e.g., language, SDQ prosocial). Analysis was by a complete case intention to treat in a 2-group comparison: LNS compared with non-LNS (MMN + IFA). Results:Children in the LNS group had significantly lower social-emotional difficulties z-scores than children in the non-LNS group (adjusted for child age ? = -0.12, 95% CI: -0.25, 0.02, P = 0.087; fully adjusted ? = -0.16, 95% CI: -0.29, -0.03, P = 0.013). The effect of LNS on social-emotional difficulties score was larger among children living in households with lower home environment scores (P-interaction = 0.081). No other outcomes differed between the 2 intervention groups. Conclusions:Provision of LNS during the first 1000 d of development improved behavioral function, particularly for children from low nurturing and stimulation households, but did not affect cognition at preschool age in this setting. Trial Registration: clinicaltrials.gov, Identifier NCT00970866.

Project description:Background: Children and youth are facing three major challenges: (1) poor mental health, (2) physical inactivity, and (3) lack of school readiness. Fundamental movement skills (FMS) and social-emotional learning (SEL) are two developmental domains that are associated with each of these challenges. Currently, there is little focus on interventions that target both FMS and SEL. Thus, the purposes of this study were to: (1) examine the acceptability and feasibility of an FMS and SEL program (Move 2 Smile) and (2) assess the impact of Move 2 Smile on FMS and SEL in children. Methods: An exploratory, pilot study using a within-subjects design was conducted. Descriptive statistics were computed to assess the acceptability and feasibility of the Move 2 Smile program. Changes in FMS and SEL were analyzed using a paired sample t-test. A focus group was conducted with parents to gain feedback after the program ended. Results: Eleven children (four girls; M age = 50.56 months, SD = 8.63) participated, with families attending 80% of the sessions. The children and parents rated the enjoyment of the program 4.1/5 and 4.7/5, respectively. The instructor rated the children's perceived enjoyment 4.6/5 and feasibility of the sessions 4.7/5. Parents engaged in the FMS take-home activities once per week and the SEL activities three times per week. The intervention had a non-significant small to medium effect on FMS (d z = 0.42, p = 0.19), a significant large effect on social skills (d z = 1.38, p = 0.001) and emotion expressiveness (d z = 0.79, p = 0.03), and a non-significant small to medium effect on emotion knowledge (d z = 0.58, p = 0.10) and emotion regulation (d z = 0.44, p = 0.17). The results from the focus group suggest that parents and children enjoyed the program and that the program was useful and effective at impacting FMS and SEL. Conclusions: This intervention is one of the first to intentionally target both FMS and SEL. Children, parents, and instructors deemed this program as acceptable and feasible. These preliminary findings warrant future evaluations of Move 2 Smile, including a randomized controlled trial.

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Project description:Social anxiety disorder is thought to involve emotional hyperreactivity, cognitive distortions, and ineffective emotion regulation. While the neural bases of emotional reactivity to social stimuli have been described, the neural bases of emotional reactivity and cognitive regulation during social and physical threat, and their relationship to social anxiety symptom severity, have yet to be investigated.To investigate behavioral and neural correlates of emotional reactivity and cognitive regulation in patients and controls during processing of social and physical threat stimuli.Participants were trained to implement cognitive-linguistic regulation of emotional reactivity induced by social (harsh facial expressions) and physical (violent scenes) threat while undergoing functional magnetic resonance imaging and providing behavioral ratings of negative emotion experience.Academic psychology department.Fifteen adults with social anxiety disorder and 17 demographically matched healthy controls.Blood oxygen level-dependent signal and negative emotion ratings.Behaviorally, patients reported greater negative emotion than controls during social and physical threat but showed equivalent reduction in negative emotion following cognitive regulation. Neurally, viewing social threat resulted in greater emotion-related neural responses in patients than controls, with social anxiety symptom severity related to activity in a network of emotion- and attention-processing regions in patients only. Viewing physical threat produced no between-group differences. Regulation during social threat resulted in greater cognitive and attention regulation-related brain activation in controls compared with patients. Regulation during physical threat produced greater cognitive control-related response (ie, right dorsolateral prefrontal cortex) in patients compared with controls.Compared with controls, patients demonstrated exaggerated negative emotion reactivity and reduced cognitive regulation-related neural activation, specifically for social threat stimuli. These findings help to elucidate potential neural mechanisms of emotion regulation that might serve as biomarkers for interventions for social anxiety disorder.

Dataset Information

The association of early linear growth and haemoglobin concentration with later cognitive, motor, and social-emotional development at preschool age in Ghana.

Publications

The association of early linear growth and haemoglobin concentration with later cognitive, motor, and social-emotional development at preschool age in Ghana.

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