Abstract
Early childhood nutritional interventions typically combine nutritional and psychosocial stimulation. Such combined interventions result in long-lasting improvements of cognitive abilities in children who are malnourished. Here, we investigated potential cognitive abilities in normally developing children in Indonesia who were, however, at risk for suboptimal cognitive development due to little psychosocial stimulation in their home environment. In a randomized controlled intervention, children of the experimental group received nutritional supplementation combined with cognitive stimulation. Pre- and post-intervention measurements included cognitive development and functioning, behavior, and mother–child interaction. The experimental and control group received nutritional supplementation in the form of a fortified or unfortified milk powder, respectively. Additionally, the children and parents of the experimental group jointly engaged in daily learning activities at home and performed iPad-based tasks designed to foster cognitive abilities. The experimental group compared to the control group displayed a significantly higher increase in intelligence quotient as well as a significantly larger reduction in attentional problems after the intervention. These results indicate that low-level cognitive stimulation in combination with nutritional supplementation during early childhood can be an effective intervention that improves global cognitive functioning in healthy developing children. ClinicalTrials.gov Identifier: NCT02359669.
Highlights
The development of a child depends on a range of mutually interacting factors including genetic, individual, biological, environmental, and cultural influences
(43%) in cognitive development in 3–5-year-old children (n = 58) coming from a heterogeneous socioeconomic background in Indonesia can be explained by psychosocial stimulation, education, Nutrients 2018, 10, 1394; doi:10.3390/nu10101394
In a study in Bangladesh, a nutritional supplementation by means of a balanced meal combined with advice on child development and mother–child interaction in 6–24-month-old children (n = 193) resulted in improved mental development [10]
Summary
The development of a child depends on a range of mutually interacting factors including genetic, individual (e.g., temperament and personality), biological (e.g., health and nutritional status), environmental (e.g., stimulation, quality of mother–child interaction), and cultural (access to education) influences. Healthy cognitive development draws, among other factors, on psychosocial stimulation and sufficient nutrition (for a review, see [1]). Childhood intervention programs comprising an educational or stimulation component typically show larger effects on cognition than nutritional interventions alone [5,6]. A series of intervention studies in developing countries that report benefits on cognition combined a nutritional intervention with psychosocial stimulation (for reviews and meta-analyses, see [7,8,9]). A study in Mozambique paired psychosocial stimulation with nutritional advice given to parents and demonstrated positive effects in cognitive, motor, and emotional domains in the intervention group (n = 107) compared to the control group (n = 107) [11]. Successful intervention programs focusing on cognitive development often combine psychosocial with nutritional stimulation
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