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

Objectives: This is the first 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 fit between data and theory. The model also identifies 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 nutritionally-at-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.