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Title of Paper: Developmental and nutritional status of internationally adopted children

Type of Paper: Original Article; Prospective Medical Evaluations

Purpose: To assess the relationship between nutritional status and developmental status in international adoptees at the time of arrival.

Nutrition-Related Measures:

Participants: 122 children adopted from 22 different countries between the ages of 6 week and 10. 5 years at adoption. The median age was 12 months (half of the kids were younger than 12 months and half were older than 12 months at adoption). The most frequent countries of origin were Romania, China, Korea, and Paraguay.

Methods: Children were seen in one international adoption clinic soon after arrival into the U. S. The majority (70%) were seen during the first six weeks. Medical and developmental assessments were completed. The developmental testing included several developmental assessments to measure cognitive, motor, and language functioning (Peabody Developmental Motor Scales, Early Intervention Developmental Profile, Bruininks-Oseretsky Test of Motor Proficiency, Beery Developmental Test of Visual-Motor Integration) .

Nutrition Results:

Conclusions & Clinical Implications: Poorer nutritional status, specifically physical growth, was associated with delays in motor, cognitive, and language development at the time of arrival in international adoptees. This was true for all areas of physical growth, including height, weight, and head size. The authors discuss this association in regard to previous studies on malnutrition in which malnutrition and environmental deprivation work together to delay development.

Limitations of the Nutritional Results: The authors discuss that the long-term effects of early malnutrition, specifically delayed growth, in international adoptees are unknown. This study did not address whether or not the developmental delays improved in children with lower physical growth z scores. Also, the only marker used to identify anemia was hematocrit, and it was not reported whether the anemia was due to iron deficiency or another etiology.

Reference: Miller LC, Kiernan MT, Mathers MI, Klein-Gitelman M. Developmental and nutritional status of internationally adopted children. Arch Pediatr Adolesc Med. 1995;149(1): 40-44. http://www.ncbi.nlm.nih.gov/pubmed/7827658

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