PDF(Pubmed)
Abstract：
Stunting (low height-for-age) is a marker of cumulative developmental disadvantage that can also contribute to impaired cognitive development and poor psychological wellbeing. Several interventions designed to preserve stunted children\'s developmental potential through increasing their cognitive stimulation have proven to be effective. However, their resource-intensive nature limits their sustainability and scalability in the low-and middle-income countries in which 98% of stunted children live. The current study had three aims: to identify the domains of developmental disadvantage associated with stunting at 5 years of age in the Vietnamese context; to examine the relationship between Vietnamese children\'s stunting status at 5 years of age, the dose of the national preschool program they received, and their cognitive skills and psychological well-being at 4 ages; and to determine whether some doses of the national preschool program were associated with the mitigation of adverse cognitive and wellbeing outcomes among stunted children.
The Young Lives Study in Vietnam (n = 2,000; 31 sites) provided archival data that allowed calculation of the approximate dose (in hours) of the preschool program received by children, and longitudinal data on children\'s growth (1, 5, 8, 12, and 15 years), receptive vocabulary (5, 8, 12 and 15 years), reading skills, mathematics skills and life satisfaction (each at 8, 12, and 15 years).
Stunting at 5 years of age was associated with diverse aspects of financial and social disadvantage, greater exposure to health risks, lower preventive health care, and constraints on maternal care. Scores for all cognitive variables at all ages were positively associated with preschool dose and negatively associated with stunted growth at 5 years of age. That is, effects associated with stunting and preschool dose at 5 years of age continued to be found during the subsequent 10 years. High doses of preschool education (3,000 h or more) were associated with the mitigation of adverse outcomes for most cognitive variables at most ages.
The current findings raise the possibility that generic preschool programs delivered at high dose may provide a scalable and sustainable intervention to support the life opportunities of children who experience early stunting.
The Young Lives Study in Vietnam (n = 2,000; 31 sites) provided archival data that allowed calculation of the approximate dose (in hours) of the preschool program received by children, and longitudinal data on children\'s growth (1, 5, 8, 12, and 15 years), receptive vocabulary (5, 8, 12 and 15 years), reading skills, mathematics skills and life satisfaction (each at 8, 12, and 15 years).
Stunting at 5 years of age was associated with diverse aspects of financial and social disadvantage, greater exposure to health risks, lower preventive health care, and constraints on maternal care. Scores for all cognitive variables at all ages were positively associated with preschool dose and negatively associated with stunted growth at 5 years of age. That is, effects associated with stunting and preschool dose at 5 years of age continued to be found during the subsequent 10 years. High doses of preschool education (3,000 h or more) were associated with the mitigation of adverse outcomes for most cognitive variables at most ages.
The current findings raise the possibility that generic preschool programs delivered at high dose may provide a scalable and sustainable intervention to support the life opportunities of children who experience early stunting.
摘要：
■发育迟缓（低身高年龄）是累积发育劣势的标志，也可能导致认知发育受损和心理健康不良。一些旨在通过增加发育迟缓儿童的认知刺激来保持其发育潜能的干预措施已被证明是有效的。然而,它们的资源密集型性质限制了它们在低收入和中等收入国家的可持续性和可扩展性，其中98%的发育迟缓儿童生活在这些国家。目前的研究有三个目的：在越南的背景下，确定与5岁发育迟缓相关的发育劣势领域;检查越南儿童5岁发育迟缓状态之间的关系，他们接受的国家学前教育计划的剂量，以及他们4岁时的认知技能和心理健康;并确定某些剂量的国家学前教育计划是否与缓解发育不良儿童的不良认知和健康结局相关。
■越南的年轻生命研究（n=2,000；31个站点）提供了档案数据，可以计算儿童接受的学龄前计划的大致剂量（以小时为单位），和儿童成长的纵向数据(1、5、8、12和15岁)，接受词汇（5、8、12和15年），阅读技巧,数学技能和生活满意度(分别为8、12和15年)。
■5岁时发育迟缓与财务和社会劣势的各个方面有关，更多的健康风险，预防保健较低，以及对产妇护理的限制。所有年龄段的所有认知变量的得分与学龄前剂量呈正相关，而与5岁时的发育迟缓呈负相关。也就是说,在随后的10年中，继续发现与5岁时的发育迟缓和学龄前剂量相关的影响。在大多数年龄段，高剂量的学前教育（3,000小时或更长时间）与缓解大多数认知变量的不良后果有关。
■当前的研究结果提出了这样一种可能性，即高剂量提供的通用学前计划可能提供可扩展和可持续的干预措施，以支持早期发育迟缓的儿童的生活机会。
■越南的年轻生命研究（n=2,000；31个站点）提供了档案数据，可以计算儿童接受的学龄前计划的大致剂量（以小时为单位），和儿童成长的纵向数据(1、5、8、12和15岁)，接受词汇（5、8、12和15年），阅读技巧,数学技能和生活满意度(分别为8、12和15年)。
■5岁时发育迟缓与财务和社会劣势的各个方面有关，更多的健康风险，预防保健较低，以及对产妇护理的限制。所有年龄段的所有认知变量的得分与学龄前剂量呈正相关，而与5岁时的发育迟缓呈负相关。也就是说,在随后的10年中，继续发现与5岁时的发育迟缓和学龄前剂量相关的影响。在大多数年龄段，高剂量的学前教育（3,000小时或更长时间）与缓解大多数认知变量的不良后果有关。
■当前的研究结果提出了这样一种可能性，即高剂量提供的通用学前计划可能提供可扩展和可持续的干预措施，以支持早期发育迟缓的儿童的生活机会。
