Dissertation/Thesis Abstract

The interaction of iron deficiency and psychosocial care on child behavior and cognitive outcomes: A longitudinal study of Senegalese children
by Ortolano, Stephanie, Ph.D., Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, 2012, 228; 3542018
Abstract (Summary)

The purpose of this thesis is to explore the relationships among child cognitive development, provision of care to the child, and the child's iron status through the use of quantitative and qualitative data. Iron deficiency and iron deficiency anemia remain widespread problems throughout much of the world and have potentially serious consequences for child development and learning outcomes. Cognitive development is influenced both through physiological and psychological mechanisms. Provision of care is a factor that can influence both nutritional status and cognitive development. This longitudinal study addresses the three concurrent relationships between iron status and cognitive development, iron status and interaction with the physical environment, and interaction and provision of care.

The first hypothesis is that children between 24 and 42 months with low hemoglobin levels (as defined by Hb ≤ 10.5 g/dl) have lower activity levels, and lower focused activity levels, than the children with higher hemoglobin levels, when observed in the home setting. This was tested using a test of means for two groups, dividing the children into anemic (Hb < 10.5 g/dl) and non-anemic (Hb ≥ 10.5 g/dl).</p>

The second set of hypotheses test the relative importance of certain feeding practices on child anemia status, including the age of introduction of fish and the provision and quality of the late afternoon meal, the diogonal. Multiple regressions and ANOVA were used to determine the strength of the association between these practices and iron status, controlling for socio-economic status and age of child.

The third set of hypotheses tests the complex relationships between good care practices and activity, attentiveness and learning achievements of the anemic child, with the goal of assessing the degree to which good home care serves to mitigate the negative impacts of iron deficiency on child development. Children with lower iron status but higher levels of maternal interaction and cognitive stimulation will have better cognitive development that children with lower iron status who do not receive as much stimulation. This protective effect will persist beyond early childhood, leading to differences in school performance at age 10-11 years. Multiple regression was used to determine immediate impact of iron status and care on picture vocabulary score (at age 24-42 months) and later impact on school performance (at age 10-11 years).

Lower physical activity and lower focused activity that are present in the anemic child have implications for the child's cognitive development. We expect that more attentive mothers will have children with better iron status, but there is also an iterative relationship here where the child with better iron status will attract more maternal interaction and attention. The tests for cognitive outcomes were administered at two different points in time and have implications for the short- and long-term impacts of iron deficiency in early childhood. While the data are specific to the population and culture where the study was conducted, there will be conclusions drawn that will have a more general relevance. This information can be used both to design interventions and to influence policy decisions for early childhood nutrition and education programs.

Indexing (document details)
Advisor: Rogers, Beatrice
Commitee: Hyatt, Raymond, Zeitlin, Marian
School: Tufts University, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy
Department: Food Policy and Applied Nutrition
School Location: United States -- Massachusetts
Source: DAI-B 74/03(E), Dissertation Abstracts International
Source Type: DISSERTATION
Subjects: Behavioral psychology, Early childhood education, Nutrition
Keywords: Anemia, Care interactions, Child behavior, Iron deficiency, Observation, Senegal
Publication Number: 3542018
ISBN: 978-1-267-69262-7
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