Optimizing Early Child Development in the Primary Care Practice Setting: Pragmatic Randomized Trial of Iron Treatment for Young Children with Non-Anemic Iron Deficiency
Dr. Patricia Parkin, Hospital for Sick Children
The pre-school years are critical years for children to acquire early learning skills such as language, fine motor and social skills; this is termed early child development. Iron deficiency (low blood iron levels) peaks in early childhood, between 1 and 3 years of age, and is mostly due to inadequate iron in the child’s diet. Research has shown that iron deficiency may result in delays in early child development which may be irreversible and long lasting. Primary care doctors (family doctors and pediatricians) are in a unique position to identify children with health or developmental problems. Screening is the process of testing healthy people for the earliest signs of health problems, followed by treatment, with the expectation that screening will improve the health of those screened. The focus of this research is screening young children for the earliest signs of iron deficiency followed by treatment with oral iron and diet advice. Early detection of iron deficiency presents an important opportunity to provide effective interventions and improve child developmental outcomes. Physicians in primary care settings are ideally suited to provide this screening.
Objective and Trial Procedure
The objective of the OptEC trial is to screen at least 1,500 young children (1 to 3½ years of age) with blood tests to determine their iron level. Children with low iron levels will receive oral iron treatment and/or diet advice. Children with all ranges of iron levels (all children with low iron levels and some children with healthy iron levels) will receive a detailed assessment of their development by a trained psychometrist. The developmental assessment will be completed at baseline, 4 months and 12 months later. We hope to follow all children participating in the OptEC trial into school age and adolescence with their consent.
Importance of the Trial
Currently in Canada, children are not routinely screened for iron deficiency. If our trial shows that screening followed by treatment improves the health and development of children, this finding would support a recommendation for regular screening when children attend their primary care doctor visits.
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