Impact of Home Stimulation on the Motor Development of Malnourished Toddlers: A Cross-sectional Study

Abstract

Objectives: The objectives of the study are to investigate the relationship between malnutrition (as measured by stunting), motor development, and early parental stimulation during the critical preschool years. Methodology: The sample comprised of 150 mother-child dyads. Children with a history of any chronic illness or disability were excluded. The StimQ (Toddler version) questionnaire was used to assess parental stimulation. Motor development was measured by the motor development scale of the Developmental Assessment Scales for Indian Infants. Stunting was measured by the height-for-age Z-score (2 standard deviation [SD] or more below the World Health Organization standard) and this was used as a proxy measure for malnutrition. Results: Among the 150 children studied, 38.7% were stunted and 36.7% were wasted. Overall, the motor development quotient was 91.11 (SD = 14.57) and one-fifth (19.3%) of the sample had a delay in the motor domain. Stunting was positively associated with delayed motor developmental status (t = 2.84, P = 0.005). The motor delayed group, relative to the normal developing preschool children, had significantly lower total StimQ scores as well as on all the subscales. Multiple stepwise linear regression analysis indicated that two variables, namely total StimQ score and extent of stunting, were significantly related to the motor quotient score and explained 23.3% variance (F = 23.68, P = 0.0001), even after controlling for socioeconomic factors. Conclusions: Primary care pediatricians are ideally suited to integrate the promotion of maternal-child responsive interactions, psychosocial stimulation, and child nutritional rehabilitation programs in their clinical practice to foster healthy child development, especially in the context of resource-poor settings.

Keywords

• home stimulation
• malnourished
• motor development
• toddlers