Iron Deficiency in Infancy and Sluggish Cognitive Tempo and ADHD Symptoms in Childhood and Adolescence
Open accessAbstract
OBJECTIVE: To determine whether iron deficiency in infancy is associated with sluggish cognitive tempo (SCT) or attention-deficit/hyperactive-impulsive (AD-HI) symptoms in childhood and adolescence, and whether such behaviors contribute concurrently and predictively to lower verbal and mathematical abilities. METHOD: = 959; 50% male, of Spanish or indigenous descent from working-class backgrounds) were rated by mothers for SCT or AD-HI symptoms at ages 5, 10, and 16 years. Children completed standardized tests assessing verbal and mathematical abilities at ages 5, 10, and 16. At ages 12 and 18 months, children were assessed for iron deficiency. RESULTS: Adjusting for a comprehensive panel of covariates, greater severity of iron deficiency in infancy was associated with more frequent SCT and AD-HI symptoms at all ages studied. Most effects of iron deficiency on children's verbal and math skills were indirect, mediated through AD-HI behaviors. Children's AD-HI symptoms related to lower verbal and math test scores within age and across age. CONCLUSIONS: The long-term associations found between infant iron deficiency and SCT and AD-HI behaviors suggest that the neurodevelopmental alterations that stem from postnatal iron deficiency might play an etiological role in the development of ADHD. Screening for early-life nutritional deficiencies among children with SCT or ADHD symptoms might prove useful, and behavioral screening of children with a history of iron deficiency seems warranted. Interventions that support brain development after early nutritional deprivation also would be beneficial.
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- Authors
- East, P. L., Doom, J. R., Blanco, E., Burrows, R., Lozoff, B., & Gahagan, S.
- Affiliations
- University of California San Diego (US)
- University of Denver (US)
- Pontificia Universidad Católica de Chile (CL)
- University of Chile (CL)
- University of Michigan (US)
- Corresponding author
- East, Patricia L.
- Venue
- Journal of Clinical Child & Adolescent Psychology
- Publisher
- Informa UK Limited
- Published
- 2021-09-14
- Volume
- 52
- Issue
- 2
- Pages
- 259-270
- ISSN
- 1537-4416 (ISSN-L)
- 1537-4424
- PMC
- PMC8918441
- OpenAlex
- W3199444823
- Cited by
- 36
- References
- 65
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 9 · 2023: 7 · 2022: 3
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Child & Adolescent Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health & Human Development (R03-HD-097295, R01-HD-033487)
- National Heart, Lung, and Blood Institute (R01-HL-088530; K01-HL-143159)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01-HD033487, R03-HD097295)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- infant iron deficiency, sluggish cognitive tempo, ADHD symptoms, attention deficit hyperactivity disorder, verbal ability, mathematical ability, brain development, mediation, behavioral screening, children and adolescents
- MeSH terms
- Sluggish Cognitive Tempo, Iron Deficiencies, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Cognition, Female, Humans, Impulsive Behavior, Infant, Male, Mothers
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