The effect of psychosocial stimulation on cognition and behaviour at 6 years in a cohort of term,low‐birthweight Jamaican children

Aim The aim of this study was to determine whether psychosocial stimulation up to the age of 2 years benefits cognition and behaviour at age 6 years in low‐birthweight, term‐born (LBW‐T) children (gestational age ≥37wk, birthweight <2500g), and to compare LBW‐T and normal‐birthweight (NBW) children. Method LBW‐T Jamaican infants were randomized at birth to a control group or an intervention group. Children in the intervention group received psychosocial stimulation for 2 years. LBW‐T infants were also compared with NBW infants born in the same hospital. IQ, cognitive function, and behaviour were measured at age 6 years in 109 LBW‐T infants. The LBW‐T group were divided into the intervention group (55 out of 70 enrolled, 32 females, 23 males; mean birthweight 2190g, SD 200g; and the control group (54 out of 70 enrolled, 33 females, 21 males; birthweight 2240g, SD 180g]. These were compared with 73 out of 94 enrolled NBW infants (38 females 35 males; birthweight 3130g, SD 330g). Results Among the LBW‐T children performance IQ scores were higher in the intervention group than in the control group (regression coefficient [B] 4.06, 95% confidence interval [CI] 0.01–7.98) as were visual–spatial memory scores (B 1.12, 95% CI 0.45–1.87). Children in the intervention group also exhibited fewer behavioural difficulties (B ?2.21, 95% CI ?4.13 to ?0.10) than children in the control group. Compared with NBW children, LBW‐T children in the control group had poorer selective attention (B=?3.35, 95% CI ?5.59 to ?1.26) and visual–spatial memory (B=?0.76, 95% CI ?1.54 to 0.00), but there were no differences in IQ, language, or behaviour. Interpretation Stimulation had sustained benefits in LBW‐T infants. Finding few differences between LBW‐T and NBW school‐aged children concurs with results from other developing countries.