A developmental view of the undernourished child: background and purpose of the study in Pangalengan, Indonesia

Abstract

Objectives: This is the ®rst of a series of reports published in this supplement of an experimental study to test the validity of a conceptual model about the intellectual delay of undernourished children. This paper describes the model and outlines its empirical and theoretical basis. The model provides a conceptual framework for the multiple relationships among growth and developmental domains presumably affected by malnutrition. It allows for a statistical statement regarding the goodness of ®t between data and theory. The model also identi®es particular hypotheses regarding multiple distinct pathways of human development. The following questions were addressed: (1) what are the effects of early supplementary feeding on the physical growth, motor development and activity, mental development and behavior of infants and toddlers who are nutritionally at risk? (2) What are the effects of a micronutrient supplement in the presence and absence of a high-energy supplement? (3) What are the moderating effects of developmental level and timing of the intervention. Design: The study was a randomized clinical trial involving two cohorts (12 and 18 months old) of nutritionallyat-risk children living in Pangalengan, West Java, Indonesia and three types of supplements: condensed milk micronutrients; skimmed milk micronutrients; and skimmed milk. The children were tested every 2 months for a period of 12 months.

Effects of an energy and micronutrient supplement on play behavior in undernourished children in Indonesia

“…The present study on play behavior utilized a subsample of 55 children recruited for a larger experimental study (Pollitt, 2000;Pollitt et al, 2000a). Play observations began later in the data collection period of the larger study.…”

Determinants of early cognitive development: hierarchical analysis of a longitudinal study

“…Lucas et al 18 stress that malnourished children are from poor population groups with high child mortality and parents who are less equipped to care for and stimulate their children. Major improvements in child development have been evidenced in settings with adequate health, nutrition, and stimulation 39,40,41 .…”

Effects of an energy and micronutrient supplement on mental development and behavior under natural conditions in undernourished children in Indonesia

“…Nutritional rehabilitation in early life has nearly always produced salutary changes with the exception of those children who had experienced iron de®ciency anemia (IDA) during infancy and the toddler years. Many studies have shown that the delay in mental development observed among children having suffered from IDA during the ®rst two years of life was not corrected by iron repletion therapy (Lozoff, 1991;Pollitt, 2000). In addition, early IDA with and without iron treatment has been associated with later mental retardation and learning disabilities (Hurtado et al, 1999;Pollitt, 1999) and with poor performance in tests of intelligence, andaor speci®c cognitive processes later in school (Lozoff et al, 2000).…”