A preliminary test of a developmental model for the study of undernourished children in Indonesia

Abstract

Objectives: Structural equation modeling of an abbreviated version of the conceptual model of the effects of micronutrient and energy supplementation on growth and development of undernourished children in West Java. The study focused on the baseline data from the Pangalengan longitudinal project. Design: This trial included two cohorts of children classi®ed as nutritionally-at-risk who were randomly assigned to three treatments (condensed milk micronutrients (E ); skimmed milk micronutrients (M); skimmed milk (S )). Supplements were given for a period of up to 12 months. Setting: The sites were six tea plantations in Pangalengan. Subjects: A 12-month-old (n 53) and an 18-month-old (n 83) cohort were recruited from 24 day care centers. Twenty children that received the S supplement were part of the 12-and 18-month-old cohorts. Criteria for inclusion were: no chronic disease; length-for-age À1 standard deviation (s.d.) and weight-for-length between À1 and À2 s.d. of the median of the reference of the World Health Organization. Variables: Indicators of socioeconomic status were economic and educational resources; length-for-age and weight-for-length were used as indicators of nutritional status; motor development and motor activity were measured with custom-made procedures; and carrying by caretaker and manipulation of objects were used as indicators of caretaking and exploratory behavior. Results: The model ®tted the data of the older but not of the younger cohort (w 2 statistic and three other indices of goodness to ®t). However, there were no differences between cohorts in the estimation of the models.

A developmental view of the effects of an energy and micronutrient supplement in undernourished children in Indonesia

“…This conclusion was based on the results of the chi-square, and three other goodness of ®t indices (Walka & Pollitt, 2000). This result was true when the change in adipose factor was calculated for either 2 or 4 months after the beginning of the intervention.…”

“…This technique was used in our preliminary analysis (Walka & Pollitt, 2000) to test the goodness-of-®t between the model and cross-sectional data from our baseline evaluation. That test required some adjustments of the conceptual model because of the limitations inherent in cross-sectional data.…”

Socioeconomic status, anthropometric status, and psychomotor development of Kenyan children from resource-limited settings: A path-analytic study

“…More recently, Walka and Pollitt [16], working in Indonesia, presented a preliminary model for studying the relationship between the three variables. We extend their model and showed that the relationship between SES and outcome is fully mediated by WAZ and HAZ.…”

“…The studies that were mentioned only addressed the correlation between the variables and did not investigate the potential pathways to poor developmental outcome. In the only path-analytic study of the relationship between socioeconomic status (SES), height-for-age (HAZ), and Motor Skills we identified, Pollitt and Walka [16] present a preliminary model of the relationship between the 3 variables among 12 and 18 month-old children in Indonesia. They report a significant relationship between SES and HAZ, and between HAZ and Motor Skills.…”

Parental IQ and cognitive development of malnourished Indonesian children

“…When parental IQ was included in a multivariable analysis the association between malnutrition and IQ was no longer significant. While the current study is limited in its sample size, it suggests the need for a re-evaluation of studies that have shown an association between malnutrition and cognitive development but have not considered parental IQ as a critical covariate (Freeman et al, 1980;Galler et al, 1983Galler et al, , 1990Rose, 1994;Mendez & Adair, 1999;Walka and Pollitt, 2000;Berkman et al, 2002, Jianghong et al, 2003. Poor parental cognitive skills were associated with lower IQs in their children, more malnutrition and less schooling.…”