title: Associations between physical growth and general cognitive functioning in international adoptees from Eastern Europe at 30 months post-arrival.
abstract: BACKGROUND
  Internationally adopted children have often experienced early adversity and growth suppression as a consequence of institutional care. Furthermore, these children are at risk for impaired cognitive development due to their early adverse experiences. This study examined the association between physical growth, the growth hormone (GH) system, and general cognitive functioning post-adoption. Based on previous research, we expected to find that a child's initial physical growth status and normalization of the growth hormone-insulin-like growth factor 1 (GH-IGF-1) axis would be positive predictors of general cognitive functioning.
  
  
  METHODS
  Post-institutionalized children (n = 46) adopted from Eastern Europe were seen approximately 1 month after their arrival into the USA to determine baseline measurements. They were seen again 6 and 30 months later for two follow-up sessions. Measures included anthropometry, insulin-like growth factor-1 (IGF-1), IGF binding protein-3 (IGFBP-3), Mullen Scales of Early Learning, and Stanford-Binet Intelligence Scales. Information about parental education was also collected.
  
  
  RESULTS
  We found that a child's general cognitive functioning at 30 months post-adoption was predicted by their general developmental scores at 6 months post-adoption, their initial height status, and markers of the growth hormone system. Children with lower initial IGFBP-3 standard deviation (SD) scores had higher verbal IQ scores at 30 months. Furthermore, a child's initial height was found to be a significant positive predictor of non-verbal IQ.
  
  
  CONCLUSIONS
  These results suggest an association between a child's suppressed physical growth in response to early adversity and alterations in GH system functioning and subsequent recovery in cognitive functioning.
authors.affiliation: Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 55454 USA ; Center for Neurobehavioral Development, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 55454 USA ; Present address: University of Minnesota, 717 Delaware Street SE, Room 361, Minneapolis, MN 55414 USA.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Kroupina
authors.affiliation: Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 55454 USA ; Center for Neurobehavioral Development, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 55454 USA.
authors.forename: Judith K
authors.initials: JK
authors.lastname: Eckerle
authors.affiliation: Department of Psychology, University of North Florida, Jacksonville, FL 32224 USA.
authors.forename: Anita J
authors.initials: AJ
authors.lastname: Fuglestad
authors.affiliation: Maastricht University, Maastricht, The Netherlands.
authors.forename: Liza
authors.initials: L
authors.lastname: Toemen
authors.affiliation: Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 55454 USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Moberg
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454 USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Himes
authors.affiliation: Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 55454 USA ; Center for Neurobehavioral Development, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 55454 USA.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Miller
authors.affiliation: Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 55454 USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Petryk
authors.affiliation: Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 55454 USA ; Center for Neurobehavioral Development, University of Minnesota Masonic Children's Hospital, Minneapolis, MN 55454 USA.
authors.forename: Dana E
authors.initials: DE
authors.lastname: Johnson
keywords: Cognitive functioning; Early adversity; Growth hormone system; International adoption; Physical growth