The effect of psychosocial stimulation on cognition and behaviour at 6 years in a cohort of term, low-birthweight Jamaican children.
OBJECTIVE
The aim of this study was to determine whether psychosocial stimulation up to the age of 2 years benefits cognition and behaviour at age 6 years in low-birthweight, term-born (LBW-T) children (gestational age > or =37 wk, birthweight <2500g), and to compare LBW-T and normal-birthweight (NBW) children.


METHODS
LBW-T Jamaican infants were randomized at birth to a control group or an intervention group. Children in the intervention group received psychosocial stimulation for 2 years. LBW-T infants were also compared with NBW infants born in the same hospital. IQ, cognitive function, and behaviour were measured at age 6 years in 109 LBW-T infants. The LBW-T group were divided into the intervention group (55 out of 70 enrolled, 32 females, 23 males; mean birthweight 2190g, SD 200g; and the control group (54 out of 70 enrolled, 33 females, 21 males; birthweight 2240g, SD 180g]. These were compared with 73 out of 94 enrolled NBW infants (38 females 35 males; birthweight 3130g, SD 330g).


RESULTS
Among the LBW-T children performance IQ scores were higher in the intervention group than in the control group (regression coefficient [B] 4.06, 95% confidence interval [CI] 0.01-7.98) as were visual-spatial memory scores (B 1.12, 95% CI 0.45-1.87). Children in the intervention group also exhibited fewer behavioural difficulties (B -2.21, 95% CI -4.13 to -0.10) than children in the control group. Compared with NBW children, LBW-T children in the control group had poorer selective attention (B=-3.35, 95% CI -5.59 to -1.26) and visual-spatial memory (B=-0.76, 95% CI -1.54 to 0.00), but there were no differences in IQ, language, or behaviour.


CONCLUSIONS
Stimulation had sustained benefits in LBW-T infants. Finding few differences between LBW-T and NBW school-aged children concurs with results from other developing countries.
Walker
Susan P
SP
Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston 7, Jamaica. susan.walker@uwimona.edu.jm
Chang
Susan M
SM
Younger
Novie
N
Grantham-McGregor
Sally M
SM
D001519:Behavior; D002648:Child; D003071:Cognition; D003072:Cognition Disorders / Q000517:prevention & control*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007360:Intelligence; D007361:Intelligence Tests; D007563:Jamaica; D008297:Male; D001523:Mental Disorders / Q000517:prevention & control*; D009034:Mother-Child Relations; D010988:Play and Playthings; D011581:Psychological Tests; D012056:Reinforcement, Social; D016896:Treatment Outcome