title: Early childhood stimulation benefits adult competence and reduces violent behavior.
abstract: OBJECTIVE
  An estimated 178 million children younger than 5 years in developing countries experience linear growth retardation and are unlikely to attain their developmental potential. We aimed to evaluate adult benefits from early childhood stimulation and/or nutritional supplementation in growth-retarded children.
  
  
  METHODS
  In Kingston, Jamaica, 129 growth-retarded children aged 9 to 24 months took part in a 2-year trial of nutritional supplementation (1 kg milk-based formula per week) and/or psychosocial stimulation (weekly play sessions to improve mother-child interaction). We assessed IQ, educational attainment, and behavior at 22 years old in 105 participants. We used multivariate regressions, weighted to adjust for loss to follow-up, to determine treatment benefits.
  
  
  RESULTS
  We found no significant benefits from supplementation. Participants who received stimulation reported less involvement in fights (odds ratio: 0.36 [95% confidence interval (CI) 0.12-1.06]) and in serious violent behavior (odds ratio: 0.33 [95% CI: 0.11-0.93]) than did participants with no stimulation. They also had higher adult IQ (coefficient: 6.3 [95% CI: 2.2-10.4]), higher educational attainment (achievement, grade level attained, and secondary examinations), better general knowledge, and fewer symptoms of depression and social inhibition.
  
  
  CONCLUSIONS
  Early psychosocial intervention had wide-ranging benefits in adulthood that are likely to facilitate functioning in everyday life. The reductions in violent behavior are extremely important given the high levels of violence in many developing countries. The study provides critical evidence that early intervention can lead to gains in adult functioning.
authors.affiliation: Epidemiology Research Unit, University of the West Indies, Mona Campus, 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: Marcos
authors.initials: M
authors.lastname: Vera-Hernández
authors.forename: Sally
authors.initials: S
authors.lastname: Grantham-McGregor
mesh_terms: D000124:Achievement; D000328:Adult; D000367:Age Factors; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D003906:Developing Countries; D002658:Developmental Disabilities / Q000175:diagnosis / Q000534:rehabilitation*; D019587:Dietary Supplements; D018479:Early Intervention, Educational; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007563:Jamaica; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D016743:Mental Competency; D015999:Multivariate Analysis; D016017:Odds Ratio; D011203:Poverty; D012044:Regression Analysis; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors