Early childhood stunting and later behaviour and school achievement

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Abstract
Background: Stunting in early childhood is common in developing countries and is associated with poorer cognition and school achievement in later childhood. The effect of stunting on children's behaviours is not as well established and is examined here. Method: Children who were stunted at age 9 to 24 months and had taken part in a 2‐year intervention programme of psychosocial stimulation with or without nutritional supplementation were reexamined at age 11–12 years and compared with non‐stunted children from the same neighbourhoods. Their school and home behaviours were assessed using the Rutter Teacher and Parent Scales and school achievement was measured using the Wide Range Achievement Test (WRAT) and the Suffolk Reading Scales. Results: No significant intervention effects were found among the stunted groups. Thus data from the four intervention groups were aggregated for subsequent analyses, comparing all 116 stunted children with 80 non‐stunted children. Controlling for social background variables, the stunted group had more conduct difficulties (p < .05) as rated by their parents. They also had significantly lower scores in arithmetic, spelling, word reading and reading comprehension than the non‐stunted children (all p < .001). Conduct difficulties and hyperactivity were related to poorer school achievement. Controlling for the children's IQ, the stunted children's arithmetic scores remained significantly lower than those of the non‐stunted children, but reading and spelling scores were not different. Conclusions: Previously stunted children had more conduct difficulties at home, regardless of their social background, than non‐stunted children. Their educational attainment was also poorer than non‐stunted children and these results are suggestive of a specific arithmetic difficulty. Children with behaviour problems performed less well at school.