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  • Title: Delayed motor development in relation to nutritional status among children under two years of age in two districts of Simbu Province.
    Author: Groos AD.
    Journal: P N G Med J; 1991 Dec; 34(4):238-45. PubMed ID: 1724715.
    Abstract:
    The median ages of attainment of independent sitting, crawling, standing and walking were investigated in relation to nutritional status in 866 children aged under 24 months in Gumine District and 270 children in the same age range in Karimui District of Simbu Province. Sitting ability in these children was found to be comparable to western children of the same age but subsequent development was delayed in relation to western standards. This is particularly the case for Karimui children, who are almost 18 months old before they walk independently. Growth retardation, particularly the manifestation of chronic undernutrition in terms of length, is associated with the delay of important motor skills and hence delays the child's opportunities for actions independent of caregivers. In both districts solid food is introduced early and before the median age at which children sit independently, that is, at an age when motor development should still be conforming to western standards. In Gumine District dietary supplements initially consist mainly of fruit and other soft foods while in Karimui there is a more rapid transition to an adult-type diet of sweet potato and green vegetables as the daily staples. Researchers analyzed anthropometric data and interview data on 412 2 year old children from Karimui District (August-October 1987) and 906 like children from Gumine District (February 1988) to categorize children into broad developmental stages. Both districts were in Simbu Province in Papua New Guinea. The ability of children in Gumine to sit alone (6.9 months) was similar to Western standards and that of children in Karimui was only somewhat delayed (7.5 months). Yet as age increased, development slowed. In fact, by the time Karimui and Gumine children could walk alone (17.7 and 15.8 months) they were 6 and 4 months respectively behind Western standards. Length for age (L/A) rather than weight for age (W/A) was the nutritional status indicator which was most strongly associated with reaching a given developmental milestone (p.01). Yet other research showed W/A to be more influential in motor development than L/A. It was not significantly linked to crawling for Gumine children, however. These results suggested that chronic or long term malnutrition as evidenced by L/A differentiates the age at which children develop certain motor skills. Overall children in Gumine tended to have slightly higher L/A levels and reached developmental milestones earlier than children in Karimui. Karimui children received an adult type diet (sweet potato and green vegetables) earlier than Gumine children. Gumine children ate more fruit and other soft foods than Karimui children. In both districts, mothers introduced solid foods early (3.9 months in Karimui and 4.8 months in Gumine). Further introduction of solid foods took place before any motor development delay which did not support other studies that found an association between tooth eruption and development delay. In conclusion, this study demonstrated that growth retardation is strongly linked with delayed achievement of important motor skills.
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