. 2020 Feb 12;16(3):e12967. doi: 10.1111/mcn.12967

Table 3.

Main results of studies evaluating the association between household food insecurity and early childhood development by domains

Study identification	ECD outcomes (% delay or x̅)	HFI prevalence	ECD (% delay, x̅ or r) by HFI	Effect size	Effect size (ORs used in the meta‐analysis)
Developmental riskd
Drennen et al. (2019) United States	11.5%	27.3% overall HFI 14.0% as HFI/child secure 13.3% as HFI/child FI	12.5% HFI/Child Secure 14.0% HFI/Child FI	<13 mo HFI/child secure OR_a 1.12 (0.85–1.47) HFI/child FI OR_a 1.49 (1.11–1.98) 13–24 months HFI/child secure OR_a 1.12 (0.90–1.39) HFI/child FI OR_a 1.22 (0.98–1.53) 25–36 months HFI/child secure OR_a 1.23 (0.98–1.54) HFI/child FI OR_a 1.35 (1.08–1.69) 37–48 months HFI/child secure OR_a 1.32 (1.02–1.72) HFI/child FI OR_a 1.44 (1.12–1.85)	25–36 months HFI/child secure OR_a 1.23 (0.98–1.54)
Black et al., (2012) United States	15.2%a	24.0%	N/R	HFI OR_a 1.22 (1.22–1.69)	HFI OR_a 1.22 (1.22–1.69)
Rose‐Jacobs et al. (2008) United States	14.0%	21.0% HFI 6.0% HFI with hunger	18.0%	HFI OR_a 1.76 (1.26–2.46) HFI without hunger OR_a1.77 (1.23–2.56)	HFI OR_a 1.76 (1.26–2.46)
Socio‐emotionald
Finch et al., (2018) Pakistan	Externalizing behaviour problems x̅ = 0.951 SD = 0.523 Prosocial behaviours x̅ = 1.529 SD = 0.363 BSID‐III social–emotional x̅ = 93.709 SD = 18.334 BSID‐III cognitive‐language x̅ = 80.5 SD = 12.793	32.8% HFI	N/R	Externalizing behaviour β 0.187 SE (0.068) Prosocial behaviours β −0.008 SE (0.061)	Externalizing behaviour OR_a 1.21 (1.06–1.38)e
Gill et al., (2018) United States	High discipline frequency 56.4%	22.7% low FS 9.7% very low FS 67.6% marginal/high FS	High discipline frequency Low FS = 60.7% Very low FS = 64.2%	High‐frequency discipline Low FS OR_a 1.27 (1.07, 1.49) Very low FS OR_a 1.41 (1.11, 1.79)	High‐frequency discipline Low and very low FS OR 1.38 (1.21–1.58)e
Hobbs & King (2018) United States	Externalizing behaviours x̅ = 9.6 Internalizing behaviours x̅ = 4.3	19.2% HFI 4.0% very low FS	N/R	Externalizing behaviours 10th β 0.02 (−0.05 to 0.10) 25th β 0.24 (0.12 to 0.36) 50th β 0.27 (0.15 to 0.39) 75th β 0.28 (0.10 to 0.46) 90th β 0.32 (0.08 to 0.57)Internalizing behaviours 10th β 0.28 (0.22 to 0.33) 25th β 0.25 (0.15 to 0.35) 50th β 0.39 (0.26 to 0.52) 75th β 0.43 (0.26 to 0.61) 90th β 0.44 (0.25 to 0.63)	Externalizing behaviours 90th OR_a 1.38 (1.08–1.77)e Internalizing behaviours 90th OR_a 1.55 (1.28–1.88)e
Johnson & Markowitz (2018) United States	Bayley behaviour score at 9 months x̅ = 5.16 SD = 0.99 Bayley behaviour score at 2 years x̅ = 3.41 SD = 0.83	Low FS at 9 months x̅ = 0.15 Very low FS at 9 months x̅ = 0.04 Low FS at 2 years x̅ = 0.11 Very low FS at 2 years x̅ = 0.03 Low FS at preschool x̅ = 0.16 Very low FS at preschool x̅ = 0.05	Bayley behaviour score at 9 months HFI at 9 months x̅ = 5.13 SD = 0.99 HFI at 2 years x̅ = 5.14 SD = 0.98 HFI at preschool x̅ = 5.13 SD = 1.00 Bayley behaviour score (2 years) HFI at 9 months x̅ = 3.41 SD = 0.84 HFI at 2 years x̅ = 3.39 SD = 0.84 HFI at 2 years x̅ = 3.38 SD = 0.83	Hyperactivity Low FS at 2 years β −0.01 SE (0.09) Very low FS at 2 years β 0.41 SE (0.15) Conduct problems Low FS at 2 years β −0.01 SE (0.09) Very low FS at 2 years β 0.41 SE (0.18)	Hyperactivity Low FS at 2 years OR_a 0.99 (0.83–1.18)e Conduct problems Low FS at 2 years OR_a 0.99 (0.83–1.18)e
King (2018) United States	N/R	19.0% HFI 7.0% child HFI	HFI Externalizing behaviours at 5 year x̅ = 11.9 Internalizing behaviours at 5 year x̅ = 5.9 Child HFI Externalizing behaviours at 5 year x̅ = 12.3 Internalizing behaviours at 5 year x̅ = 5.9	Externalizing behaviours Child HFI SD 0.07 CSE (0.02) HFI SD 0.02 CSE (0.01) Internalizing behaviours Child HFI SD 0.06 CSE (0.03) HFI SD = 0.03 CSE (0.01)	Not possible to calculate OR
Milner et al. (2018) Kenya	N/R	HFI timing Round 1 x̅= 0.94 SD = 0.51 Round 2 x̅= 0.88 SD = 0.46 Round 3 x̅= 0.81 SD = 0.44 Round 4 x̅=0.83 SD = 0.40 Round 5 x̅= 0.83 SD = 0.43 Round 6 x̅=0.80 SD = 0.45 Round 7 x̅=0.80 SD = 0.41 Round 8 x̅=0.80 SD = 0.44 Round 9 x̅=0.84 SD = 0.47 HFI intensity Cumulative 24 months x̅=7.54 SD = 2.98 HFI duration Never 35.0% 1–2 times 33.0% 3–4 times 15.0% 5–6 times 9.0% ≥7 times 7.0%	N/R	Personal social HFI 3 months ago β −0.16 (−0.29, −0.031) HFI current β 0.032 (−0.11, 0.18) HFI intensity β −0.021 (−0.054, 0.012) HFI duration β −0.015 (−0.055, 0.026)	Personal social HFI 3 months ago OR_a 0.85 (0.75–0.97)e
Nagata et al. (2018) United States	6.0% affective score 5.4% anxiety score 5.4% oppositional defiant score 3.6% attention deficit/hyperactivity score 7.1% pervasive developmental problems	8.6% marginal FS 28.2% low FS 4.9% very low FS	N/R	Affective score β 0.13 SE (0.07) Pervasive developmental score β 0.21 SE (0.10) Oppositional defiant score β 0.06 SE (0.08) Anxiety OR_a 1.02 (0.81–1.28) Attention deficit/hyperactivity OR_a 0.91 (0.65–1.29)	Affective score OR_a 1.14 (0.99–1.31)e Oppositional defiant score OR_a 1.06 (0.91–1.24)e Anxiety OR_a 1.02 (0.81–1.28) Attention deficit/hyperactivity OR_a 0.91 (0.65–1.29)
Greder et al. (2017) United States	Internalizing behaviours T score = 50.25, SD = 11.03 CI 29.00–79.00 Externalizing behaviours T score = 51.34, SD = 11.54 CI 28.00–92.00	Score 1.55, SD = 2.04 CI 0.00–6.00	Internalizing child behaviour r = .23 Externalizing child behaviour r = .35	Externalizing behaviour β 0.236 p < .05	Not possible to calculate OR
Zaslow et al. (2009) United States	38.7% insecurely attached	2.6% very low FS 9.9% low FS	N/R	Insecure attachment β 0.013	Not possible to calculate OR
Whitaker et al. (2006) United States	10.4% aggressive 12.6% anxious/depressed 10.2% inattention/hyperactivity 21.9% any behaviour problem	17.1% mothers marginally FS 12.2% mothers HFI 3.5% mothers HFI with hunger. Mothers HFI = 27.4% children HFI Mothers marginally FS = 0.6% children HFI	Aggressive 14.5% marginally FS 20.8% HFI Anxious/depressed 18.9% marginally FS 24.6% HFI Inattention/hyperactivity 13.6% marginally FS 18.6% HFI Any behaviour problem 29.9% marginally FS 38.6% HFI	Aggressive Marginally FS OR_a 1.5 (1.1–2.1) HFI OR_a 1.9 (1.4–2.7) Anxious/depressed Marginally FS OR_a 1.8 (1.4–2.4) HFI OR_a 2.2 (1.6–3.1) Inattention/hyperactivity Marginally FS OR_a 1.6 (1.1–2.2) HFI OR_a 1.9 (1.4–2.8) Any behaviour problem Marginally FS OR_a 1.6 (1.3–2.1) HFI OR_a 2.1 (1.6–2.7)	Aggressive HFI OR_a 1.90 (1.40–2.70) Anxious/depressed HFI OR_a 2.20 (1.60–3.10) Inattention/hyperactivity HFI OR_a 1.90 (1.40–2.80)
Fuller et al. (2002) United States	Aggression Girls x̅ = 13.8, SD = 8.4 Boys x̅ = 15.4 SD = 8.6 Inattentiveness Girls x̅ = 6.8, SD = 3.9 Boys x̅ = 7.5, SD = 3.4	N/R	N/R	Aggression β 0.07 p > .05cInattentiveness β 0.03 p > .05c	Not possible to calculate OR
Cognitived
Mickens et al. (2019) United States	Battelle Developmental Inventory Overall sample x̅: 8.99 SD = 4.58 English sample x̅: 9.92 SD = 4.74 Spanish sample x̅: 7.98 SD = 4.17 English TEMA x̅: 86.51 SD = 11.83 Spanish TEMA x̅: 75.94 SD = 12.72	31.3%	N/R	TEMA English Low FS β −0.02 (−3.30, 2.44) TEMA Spanish Low FS β −0.07 (−5.77, 2.15)	TEMA English Low FS OR_a 0.98 (0.04–11.47)e
Hobbs & King (2018) United States	Peabody Picture Vocabulary Test x̅ = 86.2 Woodcock–Johnson letter–word identification x̅ = 99.9	19.2% HFI 4.0% very low FS	N/R	Peabody vocabulary 10th β −0.01 (−0.20 to 0.19) 25th β −0.11 (−0.26 to 0.05) 50th β −0.16 (−0.29 to −0.02) 75th β −0.19 (−0.33 to −0.04) 90th β −0.14 (−0.24 to −0.04) Woodcock−Johnson letter–word 10th β −0.16 (−0.30 to −0.01) 25th β −0.01 (−0.16 to 0.14) 50th β −0.07 (−0.18 to 0.05) 75th β −0.03 (−0.16 to 0.10) 90th β −0.03 (−0.08 to 0.14)	Peabody vocabulary 10th OR_a 0.99 (0.82–1.21)e Woodcock−Johnson letter–word 10th OR_a 0.85 (0.74–0.99)e
Huang et al. (2018) United States	N/R	11.7% HFI_US 15.4% HFI_IMM	Children HFI_US Math test score x̅ = 24.95 Reading test score x̅ = 21.36 Children HFI_IMM Math test score x̅ = .45 Reading test score x̅ = 19.92	Reading assessment score HFI_US β 0.39 SE (1.23) Math assessment score HFI_US β −0.17 SE (1.11)	Reading assessment score HFI_IMM OR_a 0.44 (0.10–1.97)e Math assessment score HFI_IMM OR_a 0.47 (0.09–2.38)e
Johnson & Markowitz, 2018 UnitedStates	Bayley cognitive score at 9 months x̅ = 76.57 SD = 10.00 Bayley cognitive score at 2 years x̅ = 124.78 SD = 10.12	Low FS at 9 months x̅ =0.15 Very low FS at 9 months x̅ =0.04 Low FS at 2 years x̅ = 0.11 Very low FS at 2 years x̅ = 0.03 Low FS at preschool x̅ =0.16 Very low FS at preschool x̅ =0.05	Bayley cognitive score at 9 months HFI at 9 months x̅ = 76.39 SD = 10.10 HFI at 2 years x̅ = 76.42 SD = 9.90 HFI at preschool x̅ = 76.38 SD = 9.75Bayley cognitive score (2 years) HFI at 9 months x̅ = 124.58 SD = 9.98 HFI at 2 years x̅ = 124.52 SD = 10.32 HFI at preschool x̅ = 124.32 SD = 10.20	Approaches to learning Low FS at 2 years β −0.10 SE (0.08)very low FS at 2 years β −0.34 SE (0.12)Reading Low FS at 2 years β −0.13 SE (0.06)very low FS at 2 years β −0.07 SE (0.11)Math Low FS at 2 years β −0.18 SE (0.07) very low FS at 2 years β −0.27 SE (0.12)	Reading Low FS at 2 years eORa 0.88 (0.78–0.99)Math Low FS at 2 years eORa 0.84 (0.73–0.96)
Obradovíc, Yousafzai, Finch, & Rasheed (2016) Pakistan	N/R	33.0%	N/R	EF β 0.022 SE (0.026)c Verbal IQ β 0.048 SE (0.025)c Performance IQ β 0.042 SE (0.026)c	Verbal IQ OR 0.95 (0.91–1.00)e
Hernandez & Jacknowitz, (2009) United States	N/R	HIF at 24 months x̅ = 24.54, SEM = 0.09 HIF persistent x̅ = 24.58, SEM = 0.10	Cognitive scores at 24 months HFI at 9 months x̅ = 125.66, SEM = 0.55 HFI at 24 months x̅ = 123.93, SEM = 0.70 HFI persistent x̅ = 123.93, SEM = 0.77	Cognitive scores at 24 months Adult HIF persistent β −0.87 SE (0.81) Adult HFI at 9 months β 0.41 SE (0.54) Adult HFI at 24 months β −1.50 SE (0.69)
Zaslow et al., (2009) United States High income	Mental development score x̅ = 34.7 SD = 22.4	2.6% very low FS 9.9% low FS	N/R	3−level FI and mental development β = 0.015	Not possible to calculate OR
Motord
Milner et al., (2018) Kenya	N/R	HFI timing Round 1 x̅ = 0.94 SD = 0.51 Round 2 x̅ = 0.88 SD = 0.46 Round 3 x̅ = 0.81 SD = 0.44 Round 4 x̅ = 0.83 SD = 0.40 Round 5 x̅ = 0.83 SD = 0.43 Round 6 x̅ = 0.80 SD = 0.45 Round 7 x̅ = 0.80 SD = 0.41 Round 8 x̅ = 0.80 SD = 0.44 Round 9 x̅ = 0.84 SD = 0.47 HFI intensity Cumulative 24 months x̅ = 7.54 SD = 2.98 HFI duration Never 35% 1–2 times 33.0% 3–4 times 15.0% 5–6 times 9.0% ≥7 times 7.0%	N/R	Gross motor HFI 3 months ago β −0.097 (−0.23, 0.036) HFI current β −0.050 (−0.18, 0.079) HFI intensity β −0.028 (−0.058, 0.0019) HFI duration β −0.029 (−0.066, 0.0075)	Gross motor HFI 3 months ago OR_a 0.91 (0.79–1.03)e
Hernandez & Jacknowitz, (2009) United States	N/R	HIF at 24 months x̅ = 24.54, SEM = 0.09 HIF persistent x̅ = 24.58, SEM = 0.10	Motor scores at 24 months HFI at 9 months x̅ = 81.65, SEM = 0.29 HFI at 24 months x̅ = 81.48, SEM = 0.36 HFI persistent x̅ = 80.86, SEM = 0.39	Motor scores at 24 months Adult HIF persistent β −0.58 SE (0.40) Adult HFI at 9 months β 0.10 SE (0.29) Adult HFI at 24 months β 0.05 SE (0.35)	Motor scores at 24 months Adult HFI at 24 months OR_a 1.05 (0.53–2.09)e
Languaged
Milner et al. (2018) Kenya	N/R	HFI timing Round 1 x̅ = 0.94 SD = 0.51 Round 2 x̅ = 0.88 SD = 0.46 Round 3 x̅ = 0.81 SD = 0.44 Round 4 x̅ = 0.83 SD = 0.40 Round 5 x̅ = 0.83 SD = 0.43 Round 6 x̅ = 0.80 SD = 0.45 Round 7 x̅ = 0.80 SD = 0.41 Round 8 x̅ = 0.80 SD = 0.44 Round 9 x̅ = 0.84 SD = 0.47 HFI intensity Cumulative 24 months x̅ = 7.54 SD = 2.98 HFI duration Never 35% 1–2 times 33.0% 3–4 times 15.0% 5–6 times 9.0% ≥7 times 7.0%	N/R	Communication HFI 3 months ago β −0.12 (−0.26, 0.019) HFI current β −0.0070 (−0.14, 0.13) HFI intensity β −0.022 (−0.057, 0.014) HFI duration β −0.020 (−0.063, 0.024)
Saha et al. (2010) Bangladesh	Language expression M 10.0 IQR (7.0, 15.0) Language comprehension M 37.4 SD (7.80)	N/R	N/R	Language comprehension OR_a 0.83 (0.92–0.74)b Language expression OR_a 0.36 (0.37–0.36)b

Study identification

ECD outcomes (% delay or x̅)

HFI prevalence

ECD (% delay, x̅ or r) by HFI

Effect size

Effect size (ORs used in the meta‐analysis)

Developmental riskd

Drennen et al. (2019)

United States

11.5%

27.3% overall HFI

14.0% as HFI/child secure

13.3% as HFI/child FI

12.5% HFI/Child Secure 14.0% HFI/Child FI

<13 mo

HFI/child secure OR_a 1.12 (0.85–1.47)

HFI/child FI OR_a 1.49 (1.11–1.98)

13–24 months

HFI/child secure OR_a 1.12 (0.90–1.39)

HFI/child FI OR_a 1.22 (0.98–1.53)

25–36 months

HFI/child secure OR_a 1.23 (0.98–1.54)

HFI/child FI OR_a 1.35 (1.08–1.69)

37–48 months

HFI/child secure OR_a 1.32 (1.02–1.72)

HFI/child FI OR_a 1.44 (1.12–1.85)

25–36 months

HFI/child secure OR_a 1.23 (0.98–1.54)

Black et al., (2012)

United States

15.2%a

24.0%

N/R

HFI OR_a 1.22 (1.22–1.69)

Rose‐Jacobs et al. (2008)

United States

14.0%

21.0% HFI

6.0% HFI with hunger

18.0%

HFI OR_a 1.76 (1.26–2.46)

HFI without hunger OR_a1.77 (1.23–2.56)

HFI OR_a 1.76 (1.26–2.46)

Socio‐emotionald

Finch et al., (2018)

Pakistan

Externalizing behaviour problems x̅ = 0.951 SD = 0.523

Prosocial behaviours x̅ = 1.529 SD = 0.363

BSID‐III social–emotional x̅ = 93.709 SD = 18.334

BSID‐III cognitive‐language x̅ = 80.5 SD = 12.793

32.8% HFI

N/R

Externalizing behaviour

β 0.187 SE (0.068) Prosocial behaviours

β −0.008 SE (0.061)

Externalizing behaviour OR_a 1.21 (1.06–1.38)e

Gill et al., (2018)

United States

High discipline frequency 56.4%

22.7% low FS

9.7% very low FS

67.6% marginal/high FS

High discipline frequency

Low FS = 60.7%

Very low FS = 64.2%

High‐frequency discipline Low FS

OR_a 1.27 (1.07, 1.49)

Very low FS

OR_a 1.41 (1.11, 1.79)

High‐frequency discipline Low and very low FS

OR 1.38 (1.21–1.58)e

Hobbs & King (2018)

United States

Externalizing behaviours x̅ = 9.6

Internalizing behaviours x̅ = 4.3

19.2% HFI

4.0% very low FS

N/R

Externalizing behaviours 10th β 0.02 (−0.05 to 0.10)

25th β 0.24 (0.12 to 0.36)

50th β 0.27 (0.15 to 0.39)

75th β 0.28 (0.10 to 0.46)

90th β 0.32 (0.08 to 0.57)Internalizing behaviours 10th β 0.28 (0.22 to 0.33)

25th β 0.25 (0.15 to 0.35)

50th β 0.39 (0.26 to 0.52)

75th β 0.43 (0.26 to 0.61)

90th β 0.44 (0.25 to 0.63)

Externalizing behaviours 90th OR_a 1.38 (1.08–1.77)e

Internalizing behaviours 90th OR_a 1.55 (1.28–1.88)e

Johnson & Markowitz (2018)

United States

Bayley behaviour score at 9 months x̅ = 5.16 SD = 0.99

Bayley behaviour score at 2 years x̅ = 3.41 SD = 0.83

Low FS at 9 months x̅ = 0.15

Very low FS at 9 months x̅ = 0.04

Low FS at 2 years x̅ = 0.11

Very low FS at 2 years x̅ = 0.03

Low FS at preschool x̅ = 0.16

Very low FS at preschool x̅ = 0.05

Bayley behaviour score at 9 months

HFI at 9 months x̅ = 5.13 SD = 0.99

HFI at 2 years x̅ = 5.14 SD = 0.98

HFI at preschool x̅ = 5.13 SD = 1.00

Bayley behaviour score (2 years)

HFI at 9 months x̅ = 3.41 SD = 0.84

HFI at 2 years x̅ = 3.39 SD = 0.84

HFI at 2 years x̅ = 3.38 SD = 0.83

Hyperactivity

Low FS at 2 years

β −0.01 SE (0.09)

Very low FS at 2 years

β 0.41 SE (0.15)

Conduct problems

Low FS at 2 years

β −0.01 SE (0.09)

Very low FS at 2 years

β 0.41 SE (0.18)

Hyperactivity

Low FS at 2 years

OR_a 0.99 (0.83–1.18)e

Conduct problems

Low FS at 2 years

OR_a 0.99 (0.83–1.18)e

King (2018)

United States

N/R

19.0% HFI

7.0% child HFI

HFI

Externalizing behaviours at 5 year x̅ = 11.9

Internalizing behaviours at 5 year x̅ = 5.9

Child HFI Externalizing behaviours at 5 year x̅ = 12.3

Internalizing behaviours at 5 year x̅ = 5.9

Externalizing behaviours

Child HFI SD 0.07 CSE (0.02)

HFI SD 0.02 CSE (0.01)

Internalizing behaviours

Child HFI SD 0.06 CSE (0.03)

HFI SD = 0.03 CSE (0.01)

Not possible to calculate OR

Milner et al. (2018)

Kenya

N/R

HFI timing

Round 1 x̅= 0.94 SD = 0.51

Round 2 x̅= 0.88 SD = 0.46

Round 3 x̅= 0.81 SD = 0.44

Round 4 x̅=0.83 SD = 0.40

Round 5 x̅= 0.83 SD = 0.43

Round 6 x̅=0.80 SD = 0.45

Round 7 x̅=0.80 SD = 0.41

Round 8 x̅=0.80 SD = 0.44

Round 9 x̅=0.84 SD = 0.47

HFI intensity

Cumulative 24 months x̅=7.54 SD = 2.98

HFI duration

Never 35.0%

1–2 times 33.0%

3–4 times 15.0%

5–6 times 9.0%

≥7 times 7.0%

N/R

Personal social

HFI 3 months ago

β −0.16 (−0.29, −0.031)

HFI current

β 0.032 (−0.11, 0.18)

HFI intensity

β −0.021 (−0.054, 0.012)

HFI duration

β −0.015 (−0.055, 0.026)

Personal social

HFI 3 months ago

OR_a 0.85 (0.75–0.97)e

Nagata et al. (2018)

United States

6.0% affective score

5.4% anxiety score

5.4% oppositional defiant score

3.6% attention deficit/hyperactivity score

7.1% pervasive developmental problems

8.6% marginal FS

28.2% low FS

4.9% very low FS

N/R

Affective score

β 0.13 SE (0.07)

Pervasive developmental score

β 0.21 SE (0.10)

Oppositional defiant score

β 0.06 SE (0.08)

Anxiety

OR_a 1.02 (0.81–1.28)

Attention deficit/hyperactivity

OR_a 0.91 (0.65–1.29)

Affective score

OR_a 1.14 (0.99–1.31)e

Oppositional defiant score

OR_a 1.06 (0.91–1.24)e

Anxiety

OR_a 1.02 (0.81–1.28)

Attention deficit/hyperactivity

OR_a 0.91 (0.65–1.29)

Greder et al. (2017)

United States

Internalizing behaviours

T score = 50.25, SD = 11.03 CI 29.00–79.00

Externalizing behaviours T score = 51.34, SD = 11.54 CI 28.00–92.00

Score 1.55, SD = 2.04 CI 0.00–6.00

Internalizing child behaviour r = .23 Externalizing child behaviour r = .35

Externalizing behaviour

β 0.236 p < .05

Not possible to calculate OR

Zaslow et al. (2009)

United States

38.7% insecurely attached

2.6% very low FS

9.9% low FS

N/R

Insecure attachment

β 0.013

Not possible to calculate OR

Whitaker et al. (2006)

United States

10.4% aggressive

12.6% anxious/depressed

10.2% inattention/hyperactivity

21.9% any behaviour problem

17.1% mothers marginally FS

12.2% mothers HFI

3.5% mothers HFI with hunger.

Mothers HFI = 27.4% children HFI

Mothers marginally FS = 0.6% children HFI

Aggressive

14.5% marginally FS

20.8% HFI

Anxious/depressed

18.9% marginally FS

24.6% HFI

Inattention/hyperactivity

13.6% marginally FS

18.6% HFI

Any behaviour problem

29.9% marginally FS

38.6% HFI

Aggressive

Marginally FS

OR_a 1.5 (1.1–2.1)

HFI OR_a 1.9 (1.4–2.7)

Anxious/depressed

Marginally FS

OR_a 1.8 (1.4–2.4)

HFI OR_a 2.2 (1.6–3.1)

Inattention/hyperactivity Marginally FS

OR_a 1.6 (1.1–2.2)

HFI OR_a 1.9 (1.4–2.8)

Any behaviour problem Marginally FS

OR_a 1.6 (1.3–2.1)

HFI OR_a 2.1 (1.6–2.7)

Aggressive

HFI OR_a 1.90 (1.40–2.70)

Anxious/depressed

HFI OR_a 2.20 (1.60–3.10)

Inattention/hyperactivity HFI OR_a 1.90 (1.40–2.80)

Fuller et al. (2002)

United States

Aggression

Girls x̅ = 13.8, SD = 8.4

Boys x̅ = 15.4 SD = 8.6

Inattentiveness

Girls x̅ = 6.8, SD = 3.9 Boys x̅ = 7.5, SD = 3.4

N/R

Aggression β 0.07 p > .05cInattentiveness β 0.03 p > .05c

Not possible to calculate OR

Cognitived

Mickens et al. (2019)

United States

Battelle Developmental Inventory

Overall sample x̅: 8.99 SD = 4.58

English sample x̅: 9.92 SD = 4.74

Spanish sample x̅: 7.98 SD = 4.17

English TEMA x̅: 86.51 SD = 11.83

Spanish TEMA x̅: 75.94 SD = 12.72

31.3%

N/R

TEMA English

Low FS β −0.02 (−3.30, 2.44)

TEMA Spanish

Low FS β −0.07 (−5.77, 2.15)

TEMA English

Low FS OR_a 0.98 (0.04–11.47)e

Hobbs & King (2018)

United States

Peabody Picture Vocabulary Test x̅ = 86.2

Woodcock–Johnson letter–word identification x̅ = 99.9

19.2% HFI

4.0% very low FS

N/R

Peabody vocabulary

10th β −0.01 (−0.20 to 0.19)

25th β −0.11 (−0.26 to 0.05)

50th β −0.16 (−0.29 to −0.02)

75th β −0.19 (−0.33 to −0.04)

90th β −0.14 (−0.24 to −0.04)

Woodcock−Johnson letter–word

10th β −0.16 (−0.30 to −0.01)

25th β −0.01 (−0.16 to 0.14)

50th β −0.07 (−0.18 to 0.05)

75th β −0.03 (−0.16 to 0.10)

90th β −0.03 (−0.08 to 0.14)

Peabody vocabulary

10th OR_a 0.99 (0.82–1.21)e

Woodcock−Johnson letter–word

10th OR_a 0.85 (0.74–0.99)e

Huang et al. (2018)

United States

N/R

11.7% HFI_US

15.4% HFI_IMM

Children HFI_US

Math test score x̅ = 24.95 Reading test score x̅ = 21.36

Children HFI_IMM

Math test score x̅ = .45 Reading test score x̅ = 19.92

Reading assessment score

HFI_US β 0.39 SE (1.23)

Math assessment score

HFI_US β −0.17 SE (1.11)

Reading assessment score

HFI_IMM

OR_a 0.44 (0.10–1.97)e

Math assessment score HFI_IMM

OR_a 0.47 (0.09–2.38)e

Johnson & Markowitz, 2018 UnitedStates

Bayley cognitive score at 9 months x̅ = 76.57 SD = 10.00

Bayley cognitive score at 2 years

x̅ = 124.78 SD = 10.12

Low FS at 9 months x̅ =0.15 Very low FS at 9 months x̅ =0.04 Low FS at 2 years x̅ = 0.11 Very low FS at 2 years x̅ = 0.03 Low FS at preschool x̅ =0.16 Very low FS at preschool x̅ =0.05

Bayley cognitive score at 9 months HFI at 9 months x̅ = 76.39 SD = 10.10 HFI at 2 years x̅ = 76.42 SD = 9.90 HFI at preschool x̅ = 76.38 SD = 9.75Bayley cognitive score (2 years) HFI at 9 months x̅ = 124.58 SD = 9.98 HFI at 2 years x̅ = 124.52 SD = 10.32 HFI at preschool x̅ = 124.32 SD = 10.20

Approaches to learning Low FS at 2 years β −0.10 SE (0.08)very low FS at 2 years β −0.34 SE (0.12)Reading Low FS at 2 years β −0.13 SE (0.06)very low FS at 2 years β −0.07 SE (0.11)Math Low FS at 2 years β −0.18 SE (0.07) very low FS at 2 years β −0.27 SE (0.12)

Reading Low FS at 2 years eORa 0.88 (0.78–0.99)Math Low FS at 2 years eORa 0.84 (0.73–0.96)

Obradovíc, Yousafzai, Finch, & Rasheed (2016)

Pakistan

N/R

33.0%

N/R

EF β 0.022 SE (0.026)c

Verbal IQ β 0.048 SE (0.025)c

Performance IQ β 0.042 SE (0.026)c

Verbal IQ

OR 0.95 (0.91–1.00)e

Hernandez & Jacknowitz, (2009)

United States

N/R

HIF at 24 months

x̅ = 24.54, SEM = 0.09

HIF persistent

x̅ = 24.58, SEM = 0.10

Cognitive scores at 24 months

HFI at 9 months x̅ = 125.66, SEM = 0.55

HFI at 24 months x̅ = 123.93, SEM = 0.70

HFI persistent x̅ = 123.93, SEM = 0.77

Cognitive scores at 24 months

Adult HIF persistent

β −0.87 SE (0.81)

Adult HFI at 9 months

β 0.41 SE (0.54)

Adult HFI at 24 months

β −1.50 SE (0.69)

Zaslow et al., (2009)

United States

High income

Mental development score

x̅ = 34.7 SD = 22.4

2.6% very low FS

9.9% low FS

N/R

3−level FI and mental development

β = 0.015

Not possible to calculate OR

Motord

Milner et al., (2018)

Kenya

N/R

HFI timing

Round 1 x̅ = 0.94 SD = 0.51

Round 2 x̅ = 0.88 SD = 0.46

Round 3 x̅ = 0.81 SD = 0.44

Round 4 x̅ = 0.83 SD = 0.40

Round 5 x̅ = 0.83 SD = 0.43

Round 6 x̅ = 0.80 SD = 0.45

Round 7 x̅ = 0.80 SD = 0.41

Round 8 x̅ = 0.80 SD = 0.44

Round 9 x̅ = 0.84 SD = 0.47

HFI intensity

Cumulative 24 months x̅ = 7.54 SD = 2.98

HFI duration

Never 35%

1–2 times 33.0%

3–4 times 15.0%

5–6 times 9.0%

≥7 times 7.0%

N/R

Gross motor

HFI 3 months ago

β −0.097 (−0.23, 0.036)

HFI current

β −0.050 (−0.18, 0.079)

HFI intensity

β −0.028 (−0.058, 0.0019)

HFI duration

β −0.029 (−0.066, 0.0075)

Gross motor

HFI 3 months ago

OR_a 0.91 (0.79–1.03)e

Hernandez & Jacknowitz, (2009)

United States

N/R

HIF at 24 months

x̅ = 24.54, SEM = 0.09

HIF persistent

x̅ = 24.58, SEM = 0.10

Motor scores at 24 months

HFI at 9 months x̅ = 81.65, SEM = 0.29

HFI at 24 months x̅ = 81.48, SEM = 0.36

HFI persistent x̅ = 80.86, SEM = 0.39

Motor scores at 24 months

Adult HIF persistent

β −0.58 SE (0.40)

Adult HFI at 9 months

β 0.10 SE (0.29)

Adult HFI at 24 months

β 0.05 SE (0.35)

Motor scores at 24 months

Adult HFI at 24 months

OR_a 1.05 (0.53–2.09)e

Languaged

Milner et al. (2018)

Kenya

N/R

HFI timing

Round 1 x̅ = 0.94 SD = 0.51

Round 2 x̅ = 0.88 SD = 0.46

Round 3 x̅ = 0.81 SD = 0.44

Round 4 x̅ = 0.83 SD = 0.40

Round 5 x̅ = 0.83 SD = 0.43

Round 6 x̅ = 0.80 SD = 0.45

Round 7 x̅ = 0.80 SD = 0.41

Round 8 x̅ = 0.80 SD = 0.44

Round 9 x̅ = 0.84 SD = 0.47

HFI intensity

Cumulative 24 months

x̅ = 7.54 SD = 2.98

HFI duration Never 35%

1–2 times 33.0%

3–4 times 15.0%

5–6 times 9.0%

≥7 times 7.0%

N/R

Communication

HFI 3 months ago

β −0.12 (−0.26, 0.019)

HFI current

β −0.0070 (−0.14, 0.13)

HFI intensity

β −0.022 (−0.057, 0.014)

HFI duration

β −0.020 (−0.063, 0.024)

Saha et al. (2010) Bangladesh

Language expression

M 10.0 IQR (7.0, 15.0)

Language comprehension

M 37.4 SD (7.80)

N/R

Language comprehension

OR_a 0.83 (0.92–0.74)b

Language expression

OR_a 0.36 (0.37–0.36)b

Abbreviations: CI, confidence intervals; CSE, clustered standard errors; ECD, early childhood development; EF, executive function; FS, Food Security; HFI, Household Food Insecurity; IMM, immigrant; IQ, intelligence quotient; IQR, interquartile range; M, median; N/R, not reported; OR, odds ratio; SD, standard deviation; SE: standard error; TEMA: Test of Early Mathematics Ability; US: United States; x̅: mean.

Percentage of ECD outcome calculated by data provided by the study.

Effect size calculated per data provided by the study.

Effect size not adjusted.

Reported as ECD description adopted in this review.

Calculated by the authors as recommended by Deeks, Altman, & Bradburn (2001) and Altman (1991).