Maternal and Child Health Journal

, Volume 19, Issue 6, pp 1408–1416 | Cite as

Predictors of Developmental Status in Young Children Living in Institutional Care in Kazakhstan

  • Maria G. Kroupina
  • Liza Toemen
  • Musa M. Aidjanov
  • Michael Georgieff
  • Mary O. Hearst
  • John H. Himes
  • Dana E. Johnson
  • Bradley S. Miller
  • Spoon Foundation Research team
  • Aigul M. Syzdykova
  • Toregeldy S. Sharmanov


The main objective of this study was to assess the developmental status of children living in the severely adverse environment of institutional care and the examination of risk factors with regard to developmental status, including degree of stunting and emotional–behavioral and anemia status. The Bayley Scales of Infant Development were used to assess development status in 103 children aged 14.9 months (SD = 6.8) in six Kazakh institutions. The Behavioral Rating Scales were used to assess emotional–behavioral regulation. Physical growth measures were converted to z scores using World Health Organization growth charts. Venous blood was collected for assessment of anemia. Our findings indicated that young children in institutions were developmentally compromised, with duration of institutional care correlated with the severity of delay. Negative predictors of developmental status included: Poor emotional–behavioral regulation, degree of stunting and age at assessment. A particularly large percentage of children were found to be anemic. Additionally, low birth weight was found to be a significant negative predictor of development. Our findings indicate that institutional care has a detrimental impact on the development and emotional regulation of young children. Time in institutional care is a negative predictor for cognitive status for children placed at birth. Moreover stunting was found to be a useful indicator of the degree of impact of early adversity on cognitive development. Particular attention is needed for special-needs children such as those with low birth weight, since their development was found to be more sensitive to early adversity than that of normal birth weight children.


Institutional care Development Orphans Children Nutrition 



The authors would like to thank the partnership with the Kazakh Academy of Nutrition. In addition, we would like to thank the SPOON Foundation data collection team and the baby house directors for allowing this important work to occur. Funding for this project was provided by the SPOON Foundation through grants received by Nestle Food Kazakhstan LLP, Ferrosan A/S, Chevron Munaigas Inc, Hillblom Foundation, the International Foundation and the General Mills Foundation.

Conflict of interest

None to report.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Maria G. Kroupina
    • 1
    • 2
    • 3
  • Liza Toemen
    • 1
    • 4
  • Musa M. Aidjanov
    • 5
  • Michael Georgieff
    • 2
    • 3
  • Mary O. Hearst
    • 6
  • John H. Himes
    • 7
  • Dana E. Johnson
    • 1
    • 2
    • 3
  • Bradley S. Miller
    • 3
  • Spoon Foundation Research team
    • 8
  • Aigul M. Syzdykova
    • 5
  • Toregeldy S. Sharmanov
    • 5
  1. 1.International Adoption MedicineUniversity of MinnesotaMinneapolisUSA
  2. 2.Center for Neurobehavioral DevelopmentUniversity of MinnesotaMinneapolisUSA
  3. 3.Department of PediatricsUniversity of MinnesotaMinneapolisUSA
  4. 4.Maastricht UniversityMaastrichtThe Netherlands
  5. 5.Kazakh Academy of NutritionAlmatyKazakhstan
  6. 6.Henrietta Schmoll School of HealthSt. Catherine UniversitySt. PaulUSA
  7. 7.Division of Epidemiology and Community HealthUniversity of MinnesotaMinneapolisUSA
  8. 8.SPOON FoundationPortlandUSA

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