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Predictors of Developmental Status in Young Children Living in Institutional Care in Kazakhstan

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Abstract

The main objective of this study was to assess the developmental status of children living in the severely adverse environment of institutional care and the examination of risk factors with regard to developmental status, including degree of stunting and emotional–behavioral and anemia status. The Bayley Scales of Infant Development were used to assess development status in 103 children aged 14.9 months (SD = 6.8) in six Kazakh institutions. The Behavioral Rating Scales were used to assess emotional–behavioral regulation. Physical growth measures were converted to z scores using World Health Organization growth charts. Venous blood was collected for assessment of anemia. Our findings indicated that young children in institutions were developmentally compromised, with duration of institutional care correlated with the severity of delay. Negative predictors of developmental status included: Poor emotional–behavioral regulation, degree of stunting and age at assessment. A particularly large percentage of children were found to be anemic. Additionally, low birth weight was found to be a significant negative predictor of development. Our findings indicate that institutional care has a detrimental impact on the development and emotional regulation of young children. Time in institutional care is a negative predictor for cognitive status for children placed at birth. Moreover stunting was found to be a useful indicator of the degree of impact of early adversity on cognitive development. Particular attention is needed for special-needs children such as those with low birth weight, since their development was found to be more sensitive to early adversity than that of normal birth weight children.

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References

  1. Gunnar, M. R., Bruce, J., & Grotevant, H. D. (2000). International adoption of institutionally reared children: Research and policy. Development and Psychopathology, 12(4), 677–693.

    Article  CAS  PubMed  Google Scholar 

  2. McCall, R. B., IJzendoorn, M Hv, Juffer, F., Groark, C. J., & Groza, V. K. (2011). Background to this monograph. Monographs of the Society for Research in Child Development, 76(4), 1–7.

    Article  Google Scholar 

  3. Nelson, C. A., Zeanah, C. H., Fox, N. A., Marshall, P. J., Smyke, A. T., & Guthrie, D. (2007). Cognitive recovery in socially deprived young children: The bucharest early intervention project. Science, 318(5858), 1937–1940.

    Article  CAS  PubMed  Google Scholar 

  4. Petersburg S. BabyHomes in the Russian Federation. (2009). The Effects of early social-emotional and relationship experience on the development of young orphanage children (pp. 16–29). New Jersy: Wiley-Blackwell.

    Google Scholar 

  5. Smyke, A. T., Koga, S. F., Johnson, D. E., Fox, N. A., Marshall, P. J., Nelson, C. A., et al. (2007). The caregiving context in institution-reared and family-reared infants and toddlers in Romania. Journal of Child Psychology and Psychiatry, 48(2), 210–218.

    Article  PubMed  Google Scholar 

  6. Johnson, D. E., & Gunnar, M. R. (2011). Growth failure in institutionalized children. Monographs of the Society for Research in Child Development, 76(4), 92–126.

    Article  PubMed Central  PubMed  Google Scholar 

  7. van IJzendoorn, M. H., Palacios, J., Sonuga-Barke, E. J., Gunnar, M. R., Vorria, P., McCall, R. B., et al. (2011). I. Children in institutional care: Delayed development and resilience. Monographs of the Society for Research in Child Development, 76(4), 8–30.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Johnson, D. E., Guthrie, D., Smyke, A. T., Koga, S. F., Fox, N. A., Zeanah, C. H., et al. (2010). Growth and associations between auxology, caregiving environment, and cognition in socially deprived romanian children randomized to foster vs ongoing institutional care. Archives of Pediatrics and Adolescent Medicine, 164(6), 507–516.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Juffer, F., Palacios, J., Le Mare, L., Sonuga-Barke, E. J., Tieman, W., Bakermans-Kranenburg, M. J., et al. (2011). II. Development of adopted children with histories of early adversity. Monographs of the Society for Research in Child Development, 76(4), 31–61.

    Article  Google Scholar 

  10. Taneja, V., Aggarwal, R., Beri, R. S., & Puliyel, J. M. (2005). Not by bread alone project: A 2-year follow-up report. Child: Care, Health and Development, 31(6), 703–706.

    CAS  Google Scholar 

  11. Vorria, P., Papaligoura, Z., Dunn, J., Van IJzendoorn, M. H., Steele, H., Kontopoulou, A., et al. (2003). Early experiences and attachment relationships of Greek infants raised in residential group care. Journal of Child Psychology and Psychiatry, 44(8), 1208–1220.

    Article  PubMed  Google Scholar 

  12. van IJzendoorn MH, Luijk MP, Juffer F. (1982). IQ of Children Growing Up in Children’s Homes: A Meta-Analysis on IQ Delays in Orphanages. Merrill-Palmer Quarterly, 54(3), 341–366.

  13. The LeidenConference on the Development and Care of Children without Permanent Parents. (2012). The development and care of institutionally reared children. Child Development Perspectives, 6(2), 174–180.

    Article  Google Scholar 

  14. Crockenberg, S. C., Rutter, M., Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., Juffer, F., Collins, W. A., et al. (2008). The effects of early social-emotional and relationship experience on the development of young orphanage children. Monographs of the Society for Research in Child Development, i–298.

  15. Beckett, C., Castle, J., Rutter, M., & Sonuga-Barke, E. J. (2010). VI. Institutional deprivation, specific cognitive functions, and scholastic achievement: English and Romanian Adoptee (ERA) study findings. Monographs of the Society for Research in Child Development, 75(1), 125–142.

    Article  PubMed  Google Scholar 

  16. Fox, N. A., Almas, A. N., Degnan, K. A., Nelson, C. A., & Zeanah, C. H. (2011). The effects of severe psychosocial deprivation and foster care intervention on cognitive development at 8 years of age: findings from the Bucharest Early Intervention Project. Journal of Child Psychology and Psychiatry, 52(9), 919–928.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Loman, M. M., Wiik, K. L., Frenn, K. A., Pollak, S. D., & Gunnar, M. R. (2009). Postinstitutionalized children’s development: Growth, cognitive, and language outcomes. Journal of Developmental and Behavioral Pediatrics, 30(5), 426–434.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Miller, L. C., Kiernan, M. T., Mathers, M. I., & Klein-Gitelman, M. (1995). Developmental and nutritional status of internationally adopted children. Archives of Pediatrics and Adolescent Medicine, 149(1), 40.

    Article  CAS  PubMed  Google Scholar 

  19. Miller BS, Kroupina MG, Mason P, Iverson SL, Narad C, Himes JH, et al. (2010). Determinants of catch-up growth in international adoptees from Eastern Europe. International Journal of Pediatric Endocrinology, 2010, 107252. doi:10.1155/2010/107252.

  20. Hearst, M. O., Himes, J. H., Johnson, D. E., Kroupina, M., Syzdykova, A., Aidjanov, M., et al. (2014). Growth, nutritional, and developmental status of young children living in orphanages in Kazakhstan. Infant Mental Health Journal, 35(2), 94–101.

    Article  PubMed  Google Scholar 

  21. Gustafson KL, Eckerle JK, Howard CR, Andrews B, Polgreen LE. (2013). Prevalence of Vitamin D Deficiency in International Adoptees Within the First 6 Months After Adoption. Clinical Pediatrics, 52(12), 1149–1153.

  22. Fuglestad AJ, Georgieff MK, Iverson SL, Miller BS, Petryk A, Johnson DE, et al. (2012). Iron Deficiency After Arrival is Associated with General Cognitive and Behavioral Impairment in Post-Institutionalized Children Adopted from Eastern Europe. Matern and Child Health Journal, 17(6), 1080–1087.

  23. Georgieff, M. K. (2011). Long-term brain and behavioral consequences of early iron deficiency. Nutrition Reviews, 69(s1), S43–S48.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Bandstra, E. S., Morrow, C. E., Mansoor, E., & Accornero, V. H. (2010). Prenatal drug exposure: Infant and toddler outcomes. Journal of Addictive Diseases, 29(2), 245–258.

    Article  PubMed  Google Scholar 

  25. Gray, R., Mukherjee, R. A. S., & Rutter, M. (2009). Alcohol consumption during pregnancy and its effects on neurodevelopment: What is known and what remains uncertain. Addiction, 104(8), 1270–1273.

    Article  PubMed  Google Scholar 

  26. Salt, A., & Redshaw, M. (2006). Neurodevelopmental follow-up after preterm birth: Follow up after two years. Early Human Development, 82(3), 185–197.

    Article  PubMed  Google Scholar 

  27. UNICEF. Second Child Protection Forum. (2009) “Building and Reforming Child Care Systems in Central Asia, Azerbaijan and Turkey.” Kazakhstan Fact Sheet. Bishkek, Kyrgyz Republic. Accessed August 05, 2013, from http://www.unicef.org/ceecis/KA_fact_sheet_eng.pdf.

  28. Bayley, Bayley N. (1993). Scales of infant development (2nd ed.). San Antonia: The Psychological Corp.

    Google Scholar 

  29. van den Dries, L., Juffer, F., van IJzendoorn, M. H., & Bakermans-Kranenburg, M. J. (2010). Infants’ physical and cognitive development after international adoption from foster care or institutions in China. Journal of Developmental and Behavioral Pediatrics, 31(2), 144–150.

    Article  PubMed  Google Scholar 

  30. Onis, M. (2006). WHO child growth standards based on length/height, weight and age. Acta Paediatrica, 95(S450), 76–85.

    Google Scholar 

  31. Ritchie, R. F., Palomaki, G. E., Neveux, L. M., Navolotskaia, O., Ledue, T. B., & Craig, W. Y. (1999). Reference distributions for the negative acute-phase serum proteins, albumin, transferrin and transthyretin: A practical, simple and clinically relevant approach in a large cohort. Journal of Clinical Laboratory Analysis, 13(6), 273–279.

    Article  CAS  PubMed  Google Scholar 

  32. Boyd, L. A. C., Msall, M. E., O’Shea, T. M., Allred, E. N., Hounshell, G., & Leviton, A. (2013). Social–emotional delays at 2 years in extremely low gestational age survivors: Correlates of impaired orientation/engagement and emotional regulation. Early Human Development, 89(12), 925–930.

    Article  PubMed  Google Scholar 

  33. Janssen, A. J. W. M., der Nijhuis-van, M. W. G., Akkermans, R. P., Oostendorp, R. A. B., & Kollée, L. A. A. (2008). Influence of behaviour and risk factors on motor performance in preterm infants at age 2 to 3 years. Developmental Medicine and Child Neurology, 50(12), 926–931.

    Article  CAS  PubMed  Google Scholar 

  34. Matheny, A. P., Dolan, A. B., & Wilson, R. S. (1974). Bayley’s infant behavior record: relations between behaviors and mental test scores. Developmental Psychology, 10(5), 696.

    Article  Google Scholar 

  35. UNICEF.(2012). Kazakhstan country profile: Maternal, Newborn and Child Survival. Accessed August 01, 2013, from http://www.childinfo.org/files/maternal/DI%20Profile%20-%20Kazakhstan.pdf.

  36. Messinger, D., Lambert, B., Bauer, C. R., Bann, C. M., Hamlin-Smith, K., & Das, A. (2010). The relationship between behavior ratings and concurrent and subsequent mental and motor performance in toddlers born at extremely low birth weight. Journal of early intervention, 32(3), 214–233.

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank the partnership with the Kazakh Academy of Nutrition. In addition, we would like to thank the SPOON Foundation data collection team and the baby house directors for allowing this important work to occur. Funding for this project was provided by the SPOON Foundation through grants received by Nestle Food Kazakhstan LLP, Ferrosan A/S, Chevron Munaigas Inc, Hillblom Foundation, the International Foundation and the General Mills Foundation.

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Correspondence to Maria G. Kroupina.

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Kroupina, M.G., Toemen, L., Aidjanov, M.M. et al. Predictors of Developmental Status in Young Children Living in Institutional Care in Kazakhstan. Matern Child Health J 19, 1408–1416 (2015). https://doi.org/10.1007/s10995-014-1647-0

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