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Malnourished Children:  Long-Term Effects of Early Malnutrition on School Performance
This table comes from Janina R. Galler (editor).  Nutrition and Behavior.  1984. Plenum Press New York. 
This book is out of print.
 
Table IIID. Studies of the Long-Term Effects of Early Malnutrition on School Performance
Reference Test Results Type of malnutrition Age studied Study design
Winick et al. (1975), Lien et al. (1977) School achievement tests Lower scores in severely malnourished children compared with moderately and well-nourished children. Children adopted at older ages did worse than those adopted at younger ages. Unspecified School age See Table IIIB.
Singh and Anand (1976), Singh et al. (1977) Class grades (teacher's grading of day-to-day performance and final exam scores Lower scores in school associated with degree of malnutrition, even when social class was controlled. Unspecified 5–9 Yr India
204 Children were divided into four groups based on weight/age deficits at the time of study (socioeconomic level differed between groups).
Evans et al. (1971)  School performance (interview completed by school principal) No differences between index children and their siblings in class grades. Lower marks in children with illness at 15–18 mo than at 10–15 mo. Kwashiorkor (10–48 mo) 11 Yr See Tables IIIA and IIIB.
Pereira et al. (1979) Class grades Lower marks, more classroom failure, and a higher drop-out rate in index children compared with siblings. Kwashiorkor (12–48 mo 6-12 Yr See Tables IIIA and IIIB
Stoch et al. (1982) Educational level Lower—11/20 index children completed primary school only as compared with 6/20 control children. Educational level associated with IQ and visual–motor perception, which was reduced in index cases. Girls had the worst progress in school Marasmus (10–24 mo) Up to 23 Yr See Tables IIA, IIIA, and IIIB. 
Galler et al. (l983b,c) Class grades
 
 
 

School behavior 

Lower marks on 8/9 subjects for index children compared with classmates. Results not accounted for by environmental features.
Index children have attention-deficit disorder, poor social relationships, and emotional lability. These characteristics are largely responsible for the lower marks in school.
Marasmus (3–8 mo) 5–11 Yr See Table IIIB
Richardson et al.
(1972, 1973)
WRAT
 
 
 
 
 
 

Class grades 

School behavior

Lower scores in index children than classmates on all three tests—reading, spelling, and arithmetic. Sibs also had lower scores than their classmates.
Lower marks in index children than either classmates or sibs. Index children had behavioral problems related to classwork—inattention, distractibility, poor social relationships, and more conduct problems than either siblings or classmates.
Mixed PEM (up to 24 mo) 6-10 Yr See Table IIIB (Hertzig et al., 1972).
Valman (1974) School progress No differences. Few details provided. Undernutrition
secondary
to ileal atresia (8) or cystic
fibrosis (13)
3-14 Yr England
21 Children compared with 26 well-nourished controls; all from high socioeconomic groups.
Ellis and Hill (1975)  WRAT No differences between index children and controls, who also had cystic fibrosis (and many of whom had stunted growth at the time of this study). Undernutrition secondary
to cystic fibrosis
7-10 Yr See Table IIIB
Klein et al. (1975) Ottawa School
Behavior
Checklist
Poorer performance in children with onset of malnutrition at 21-30 mo. These children had more immaturity, overactivity, and conduct problems compared with other index children. Undernutrition
secondary
to pyloric stenosis
5-15 Yr See Table IIIB
Beardslee at al. (1982) School progress No differences, although in some instances index children outperformed their siblings. Undernutrition
secondary
to cystic fibrosis,
ileal atresia, or severe diarrhea
Up to 22 Yr See Lloyd-Still et al. (1972, 1974) in Table IIA and IIIB.
(WRAT) Wide Range Achievement Test.
 
REFERENCES

Beardslee, W. R., Wolff, A. H., Hurwitz, I., Parikh, B., and Shwashman, 1982, The effects of infantile malnutrition on behavioral development: A follow-up study. Am. J. Clin. Nutr. 35:1437-1441.

Ellis, C. E., and Hill, D. E., 1975, Growth, intelligence and school performance in children with cystic fibrosis who have had an episode of malnutrition during infancy, J. Pediatr. 87(4): 565-568.

Evans, D. E., Moodie, A. D., and Hansen, J. D. L., 1971, Kwashiorkor and intellectual development, S. Aft.. Med. J. 45:1414-1426.

Galler, J. R., Ramsey, F., Solimano, G., and Lowell, W. E., 19836, The influence of early mal-nutrition on subsequent behavioral development. II. Classroom behavior, J. Child Psychiatry 22:16-22.

Galler, J. R., Ramsey, F., Solimano, G., and Propert, K., 1983c, Sex differences in the growth of Barbadian school children with early malnutrition, Nair. Rep. Int. 27:503-517.

Klein, P. S., Forbes, G. B., and Nadar, P. R., 1975, Effects of starvation in infancy (pyloric stenosis) on subsequent learning abilities, J. Pediatrics 87(1):8-15.

Richardson, S. A., Birch, H. G., Grabie, E., and Yoder, K., 1972, The behavior of children in school who were severely malnourished in the first two years of life, J. Health Soc. Behay. 13:276-284.

Richardson, S. A., Birch, H. G., and Hertzig, M. E., 1973, School performance of children who were severely malnourished in infancy, Am. J. Ment. Defic. 77(5):623-637.

Singh, M. V., and Anand, N. K., 1976, Scholastic performance in relation to protein calorie mal-nutrition, Indian J. Psychometry Education 7(1):5-8.

Singh, M. V., Anand, N. K., Dhingra, D. C., and Gupta, S., 1977, Scholastic performance in relation to protein calorie malnutrition, Indian J. Clin. Psycho'. 4:15-18.

Stoch, M. B., Smythe, T. M., Moodie, A. D., and Bradshaw, D., 1982, Psychosocial outcome and CT findings after growth undernourishment during infancy: A twenty-year developmental study, Dev. Med. Child Neural. 24:419-436.

Valman, H. B., 1974, Intelligence after malnutrition caused by neonatal resection in ileum, Lancet 1:425-427.

Winick, M., and Rosso, P., 1975, Malnutrition and central nervous system development, in: Brain Function and Malnutrition (]. W. Prescott, M. S. Read, and D. B. Coursin, eds.), pp. 41-51, John Wiley and Sons, Inc., New York.