title: Effects of psychosocial stimulation and dietary supplementation in early childhood on psychosocial functioning in late adolescence: follow-up of randomised controlled trial.
abstract: 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.
  
  
  METHODS
  Sixteen year follow-up study of a randomised controlled trial.
  
  
  METHODS
  Poor neighbourhoods in Kingston, Jamaica.
  
  
  METHODS
  Of 129 stunted children identified at age 9-24 months, 103 adolescents aged 17-18 were followed up.
  
  
  METHODS
  Supplementation with 1 kg milk based formula each week or psychosocial stimulation (weekly play sessions with mother and child), or both, for two years.
  
  
  METHODS
  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.
authors.affiliation: Epidemiology Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston 7, Jamaica. susan.walker@uwimona.edu.jm
authors.forename: Susan P
authors.initials: SP
authors.lastname: Walker
authors.forename: Susan M
authors.initials: SM
authors.lastname: Chang
authors.forename: Christine A
authors.initials: CA
authors.lastname: Powell
authors.forename: Emily
authors.initials: E
authors.lastname: Simonoff
authors.forename: Sally M
authors.initials: SM
authors.lastname: Grantham-McGregor
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D019587:Dietary Supplements; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000628:therapy*; D006801:Humans; D007223:Infant; D007563:Jamaica; D001523:Mental Disorders / Q000517:prevention & control*; D010989:Play Therapy / Q000379:methods*; D012649:Self Concept; D012919:Social Behavior