Effects of psychosocial stimulation and dietary supplementation in early childhood on psychosocial functioning in late adolescence: Follow-up of randomised controlled trial
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OBJECTIVE: To determine whether dietary supplementation or psychosocial stimulation given to growth retarded (stunted) children age 9-24 months has long term benefits for their psychosocial functioning in late adolescence. DESIGN: Sixteen year follow-up study of a randomised controlled trial. SETTING: Poor neighbourhoods in Kingston, Jamaica. PARTICIPANTS: Of 129 stunted children identified at age 9-24 months, 103 adolescents aged 17-18 were followed up. INTERVENTION: Supplementation with 1 kg milk based formula each week or psychosocial stimulation (weekly play sessions with mother and child), or both, for two years. MAIN OUTCOME MEASURES: Anxiety, depression, self esteem, and antisocial behaviour assessed by questionnaires administered by interviewers; attention deficit, hyperactivity, and oppositional behaviour assessed by interviews with parents. RESULTS: Primary analysis indicated that participants who received stimulation had significantly different overall scores from those who did not (F = 2.047, P = 0.049). Supplementation had no significant effect (F = 1.505, P = 0.17). Participants who received stimulation reported less anxiety (mean difference - 2.81, 95% confidence interval - 5.02 to - 0.61), less depression (- 0.43, - 0.78 to - 0.07), and higher self esteem (1.55, 0.08 to 3.02) and parents reported fewer attention problems (- 3.34, - 6.48 to - 0.19). These differences are equivalent to effect sizes of 0.40-0.49 standard deviations. CONCLUSIONS: Stimulation in early childhood has sustained benefits to stunted children's emotional outcomes and attention.
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Early childhood development interventions are low-cost interventions delivered in home and at school.
“Evidence suggests that early childhood development (ECD) interventions including stimulation in early childhood, preschool level interventions, and ECD consultations have shown to be effective in improving health behaviors, conduct problems, and social skills and are also low-cost interventions delivered in home and at school [63], [64], [65], [66], [67].”
From Interventions for Adolescent Mental Health: An Overview of Systematic Reviews (2016) · cites this paper as [64]
Early childhood development interventions including stimulation in early childhood, preschool level interventions, and ECD consultations have shown to be effective in improving health behaviors, conduct problems, and social skills.
“Evidence suggests that early childhood development (ECD) interventions including stimulation in early childhood, preschool level interventions, and ECD consultations have shown to be effective in improving health behaviors, conduct problems, and social skills and are also low-cost interventions delivered in home and at school [63], [64], [65], [66], [67].”
From Interventions for Adolescent Mental Health: An Overview of Systematic Reviews (2016) · cites this paper as [64]
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- Authors
- Walker, S. P., Chang, S. M., Powell, C. A., Simonoff, E., & Grantham-McGregor, S. M.
- Affiliations
- University of the West Indies (JM)
- Corresponding author
- Walker, Susan P
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2006-07-28
- Volume
- 333
- Issue
- 7566
- Pages
- 472
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- OpenAlex
- W2113634771
- Cited by
- 141
- References
- 24
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 4 · 2023: 1 · 2022: 5 · 2021: 8 · 2020: 5 · 2019: 6 · 2018: 8 · 2017: 12 · 2016: 8 · 2015: 7 · 2014: 10 · 2013: 11 · 2012: 7
- FWCI
- 6.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Wellcome Trust (066088)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
- Social Sciences › Education › Early Childhood Education and Development
- Keywords
- child stunting, psychosocial stimulation, dietary supplementation, milk-based formula, early childhood intervention, long-term outcomes, adolescence, anxiety, depression, self-esteem, antisocial behavior, attention deficits, hyperactivity, oppositional behavior, low-income neighbourhoods, Jamaica
- MeSH terms
- Adolescent, Mental Disorders, Follow-Up Studies, Growth Disorders, Humans, Infant, Jamaica, Play Therapy, Self Concept, Social Behavior, Cohort Studies, Dietary Supplements
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