15-Year developmental study on effects of severe undernutrition during infancy on subsequent physical growth and intellectual functioning.

This third 5-year follow-up on the effects of severe undernutrition during infancy on subsequent brain growth and intellectual development confirms the level of gross retardation of intellect in the undernourished group when compared with the controls. As the subjects are now 15-18 years of age this must be permanent. All but 5 of the undernourished group are now living in conditions comparable to the controls. Improved nutrition is manifest by catch-up in height, in that the mean difference between undernourished subjects and controls has decreased by 2-73 cm. Remarkably, the difference in head circumference has increased by 0-5 cm, the mean head circumference of the undernourished now being 2-8 cm less than that of the controls. The Bender Gestalt and Human Figure Drawing tests did not correlate with the intelligence tests, indicating a separate deficit of a marked disturbance of visual-motor perception in 17 of the undernourished subjects, in 9 of whom these tests were highly significant of minimal brain dysfunction (5 of the controls). In retrospect there is much evidence to suggest the controls were also suboptimal; 8 controls had abnormal electroencephalograms as did 6 of the undernourished group.