Physical growth and development, neurological maturation and behavioral functioning in two Ecuadorian Andean communities in which goiter is endemic. I. Outline of the problem of endemic goiter and cretinism. Physical growth and neurological maturation in the adult population of La Esperanza

Animal experiments indicate that chronic dietary iodine deficiency can have a marked effect on neurological maturation and the consequent behavioral capacities of the individuals so affected. Goiter, enlargement of the thyroid gland, is hyperendemic throughout the Andean region of Ecuador and is associated with an insufficient dietary intake of iodine. In these populations there is also a strikingly high prevalence of gross mental and physical developmental retardation that has been classified under the rubric of “endemic cretinism.” Anthropometric measurements and Bender Gestalt productions were collected from 44 deaf‐mute “cretin” and 344 “normal” adult individuals in the parroquia of La Esperanza. The anthropometric data were generally comparable to that of other Ecuadorian Andean populations which have been studied. The deaf‐mute “cretin” group showed retardation in physical growth and marked retardation in visual motor maturation compared to the “normal” population. Seventeen percent of the “normal” population showed clear signs of neurological deficit in visual motor perception. The data suggest that in addition to the large number of grossly retarded “cretins” in these populations, many of the “normal” individuals show some degree of neurological deficit, thus forming a continuum from frankly retarded, through moderately and slightly affected, to normal individuals. The socio‐cultural adaptations to the presence of a large number of retarded individuals in the community are discussed.