Catch-up growth assessment in long-term physically neglected and emotionally abused preschool age male children.
OBJECTIVE
To assess the catch-up growth of long-term physically neglected and emotionally abused preschool male children who have entered foster residential care and remained 1 year after initial placement.


METHODS
Longitudinal study over a 7-year period (1994-2001). So that a child was eligible for the study, three selection criteria were included: (1) aged between 24 and 48 months at the time of entry into residential facility, (2) having suffered both long-term (more than 6 months) physically neglected and emotionally abused, and (3) having stayed in foster care for 1 year after initial placement. Weight, height, and head circumference were established upon entry and re-assessed 1 year after initial placement, calculating the annual growth velocity. Results were compared with normal regional longitudinal standards of reference (Z score). Student's t test was used to assess statistically significant differences.


RESULTS
During the study period, 87 children aged between 24 and 48 months (54 male/33 female) were admitted to residential facility after having suffered both long-term physical neglect and emotional abuse. Nevertheless, only 20 children (23% of the total admissions) met the third selection criteria (having remained 1 year after initial placement). Of these children, all were males and at placement they were between the ages of 30 and 42 months, with an average age of 36 months (1.9 SD). At placement, the analyzed parameters were below the normal standards, showing a statistically significant difference for height (Z score = -1.29; p = .008) and weight (Z score = -.75; p = .038). The annual growth velocity for all parameters was above the normal standards showing a statistically significant difference for height (Z score = +1.43; p = .009). One year after initial placement, the significant differences for height (Z score = -.68; p = .102) and weight (Z score = -.31; p = .435) with respect to the normal standards disappeared, though still remained below, showing a significant catch-up growth for height (improvement height Z = +.61 SD).


CONCLUSIONS
At placement, the both long-term physically neglected and emotionally abused preschool age male children showed a mild form of chronic malnutrition with growth failure. Growth failure was reversible after the first year of stay, which demonstrates that this delay in growth was secondary to nutritional and psychosocial factors. Placement in foster residential care was beneficial for the catch-up growth of these patients.
Oliván
Gonzalo
G
Division of Pediatrics and Adolescent Medicine, Social Services Institute of Aragón, Department of Health, Consumption and Social Services, Government of Aragón, Avda de las Torres 93, 1F, 50007 Zaragoza, Spain.
D002648:Child; D002649:Child Abuse; D002675:Child, Preschool; D005500:Follow-Up Studies; D005581:Foster Home Care; D006130:Growth Disorders / Q000209:etiology* / Q000534:rehabilitation; D006801:Humans; D007223:Infant; D008297:Male; D009748:Nutrition Disorders / Q000209:etiology* / Q000534:rehabilitation