In a rural cohort of 625 children registered from 1981 to 1983 in 10 villages of K.V. Block, Varanasi, 196 children were assessed for physical growth, development, intelligence and concept development between 1 and 3 years of age. Home environment was also assessed using Caldwell Home inventory. These rural children remained below 3rd centile of NCHS standard for weight, height, skull and mid-arm circumferences throughout the study. Malnourished children scored poorly in all the areas of development, i.e., motor, adaptive, language and personal social, 9% in Grade I and 16.6% children in Grade II + III had IQ less than 79 (inferior). Concept for color shape and size was poorly developed in malnourished children. Maternal involvement and stimulation was strongly associated with better behavior development and intelligence. Multiple regression analysis showed that the effect of home environment on development and intelligence was of a higher magnitude as compared to status and family variables and nutritional status during 1-3 years of age.
PIP: The effects of nutrition and home environment on behavior development and intelligence of mild, moderate, and severely malnourished children are examined for a sample population of 196 children born in 1981-83 from 10 villages of Kashi Vidyapeeth Block of Varanasi district, India. Development was followed from the 1st year of life until 3 years of age. Children were grouped by degree of malnutrition at 18, 24, 30, and 36 months using the National Center for Health Statistics 50th centile weight for age as a reference point. Gesell's developmental schedule was also administered at the aforementioned ages. Some of the Caldwell Home Inventory and socioeconomic measures were used to measure home environment. The general characteristics of the villages mirror the larger rural population of 112 villages in the area. The developmental quotient (DQ) for motor, adaptive, language, and personal social areas was determined for the Gesell inventory, and the Binet Kulshrestha Intelligence Scale was used to determine level of cognitive ability at 36 months. Concept development was measured with the Block-Sort test. The findings indicate that all children were below the 3rd percentile for height and weight at all ages. Head and chest circumference mean values were statistically significantly below the average for affluent Varanasi children at all ages. The mid-arm circumference was below the 3rd centile, which indicates moderate to severe undernutrition. 50-60% of children were malnourished at Grade II and III. DQ decreased with the severity of malnutrition; scores for all except personal social development were below average for children with Grade III malnutrition. Significant differences in language and social development scores were found between Grade II and III malnourished and normal children, even with increases at 36 months for motor, language, and social behavior scores. Inferior IQ scores were found for 9% of Grade I malnourished and 16.6% of Grade II and III malnourished children. There were significant differences in scores between the normal, Grade I, and Grade II and III scores. The most critical period for delays is 10-12 months, when home environment vitally influences physical growth and mental development.