Behavioural measures of nutrition related cognitive development in rural Gambia: studies from birth to 24 months of age (389.1)

Abstract

The Mullen Scales of Early Learning is a developmental assessment battery which can be administered from birth to five years of age to separately assess gross motor, fine motor, receptive language, expressive language, and visual receptive abilities. Scores for each subscale as well as an overall composite score are typically computed based on a comparison to Western norms. The aim of this work was to adapt the Mullen Scales for use at a field station in rural Africa as an assessment tool for cognitive function in nutrition based studies. We also examine associations between behavioural performance and anthropometric growth indices in young infants.A committee of native, dual‐language speakers and trained Mullen administrators reviewed and adapted the Mullen assessment for use in The Gambia. Adaptations included the linguistic translation of the item‐by‐item verbal prompts and the substitution of culturally inappropriate stimuli.We studied infants longitudinally at two time points between the age of 9‐17 months, and a separate group of toddlers at 18‐24 months of age. In addition to behavioural assessment, we collected anthropometric measurements and generated z‐scores based on WHO standards. An analysis of the relationship between growth and cognitive development revealed several significant associations over the first two years of life; in particular there were significant correlations with the language subscales. These results suggest that early language development is associated with growth markers in Gambian infants. The trajectories of several growth measures appear to decline steadily across the first 2 years of life, with associations to impaired behavioural performance already apparent from around the first year. These associations are difficult to examine in earlier infancy as the efficacy of behavioural measures at this age is limited. Optical imaging may be a viable solution to this problem, by providing an objective measure of cognitive function from birth.Grant Funding Source: Bill and Melinda Gates Foundation