TY - JOUR
T1 - Losses of children’s cognitive potential over time
T2 - A South African example
AU - Rotheram-Borus, M. J.
AU - Christodoulou, J.
AU - Rotheram-Fuller, E.
AU - Tomlinson, M.
N1 - Publisher Copyright:
© 2023, South African Medical Association. All rights reserved.
PY - 2023/10/19
Y1 - 2023/10/19
N2 - About 250 million children under the age of 5 years in low-and middle-income countries (LMICs) lose lifelong cognitive potential. However, the primary focus of interventions has been to increase survival and promote growth. All pregnant women in 24 non-contiguous, low-income areas in Cape Town, South Africa (N=1 238) were recruited between 2009 and 2010 and reassessed six times over 8 years post birth. Mothers in half of the 24 areas were randomised to receive home visits by community health workers, concentrated during the pregnancy and the first 6 months of life. At 18 months, the children’s cognitive development was at the global norm, i.e a mean standard deviation (SD) value of 100 (15). By 5 years of age, the mean cognitive development fell to one SD below the global norm (<85; mean = 83) and 60% of children had scores below the global mean. By 8 years of age, cognitive development scores significantly fell again (mean = 73; 88% of children <85). The magnitude of the loss was substantial and warrants sustained interventions throughout childhood that support children’s cognitive development in LMICs. The first 1 000 days of life are important, but insufficient to inoculate children against the negative consequences of poverty and coping with multiple, chronic community challenges (e.g. HIV, alcohol abuse, interpersonal violence).
AB - About 250 million children under the age of 5 years in low-and middle-income countries (LMICs) lose lifelong cognitive potential. However, the primary focus of interventions has been to increase survival and promote growth. All pregnant women in 24 non-contiguous, low-income areas in Cape Town, South Africa (N=1 238) were recruited between 2009 and 2010 and reassessed six times over 8 years post birth. Mothers in half of the 24 areas were randomised to receive home visits by community health workers, concentrated during the pregnancy and the first 6 months of life. At 18 months, the children’s cognitive development was at the global norm, i.e a mean standard deviation (SD) value of 100 (15). By 5 years of age, the mean cognitive development fell to one SD below the global norm (<85; mean = 83) and 60% of children had scores below the global mean. By 8 years of age, cognitive development scores significantly fell again (mean = 73; 88% of children <85). The magnitude of the loss was substantial and warrants sustained interventions throughout childhood that support children’s cognitive development in LMICs. The first 1 000 days of life are important, but insufficient to inoculate children against the negative consequences of poverty and coping with multiple, chronic community challenges (e.g. HIV, alcohol abuse, interpersonal violence).
UR - http://www.scopus.com/inward/record.url?scp=85177228639&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85177228639&partnerID=8YFLogxK
U2 - 10.7196/SAJCH.2023.v17i3.2002
DO - 10.7196/SAJCH.2023.v17i3.2002
M3 - Article
AN - SCOPUS:85177228639
SN - 1994-3032
VL - 17
SP - 104
EP - 106
JO - SAJCH South African Journal of Child Health
JF - SAJCH South African Journal of Child Health
IS - 3
M1 - e2002
ER -