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relationship which can develop along with an increase in self worth in the mother (Cox, 1993).
Short-term hospital programmes of psychosocial stimulation of malnourished children produced only transient benefits in Mexico (Cravioto and Arrieta, 1979), and in Lebanon (McLaren et al, 1973). North American experiences in preschool programmes and programmes in Jamaica (Grantham McGreger et aI, 1987) with malnourished children showed that long term intervention programmes involving mothers and children in their own homes were more successful.

In another study (Grantham McGreger et al, 1991), four groups of children were studied -control, only diet supplemented, only psychosocially stimulated, and the last group with both supplementation and psychosocial stimulation. The home visits were carried out by community mental health aides and the stimulation group was visited for an hour per week to carry out the programme of psychosocial stimulation. The DQ was assessed by Griffith's mental development scales. It has four subscales -locomotor, hand and eye coordination, hearing and speech and performance (shape recognition, block construction, block patterns).

In the first year follow-up, the early effect was that stimulation benefitted all subscales of DQ, except speech and hearing. The later effect was that, supplementation benefitted locomotor scale.

In the second year follow-up stimulation benefitted performance, hand and eye subscales and supplementation benefitted the performance subscale. Total DQ score was benefitted in every group. However, the group which received both supplementation and stimulation benefitted more than the other intervention groups and the control group.

In the earlier Jamaican study (Grantham McGreger et at; 1987) the intervention was incorporated into primary health care sessions and home visits made by community health aides every week. After 2 years of intervention, the children showed remarkable improvement in developmental levels. The effects lasted for the third year of intervention and lasted for 3 subsequent years after the stoppage of intervention, though there was an early decline in scores when visits were reduced (which subsequently levelled off). The locomotor subscale, ip the stimulated group did not catch up with the adequately nourished group (i.e., supplementation favours motor development, while stimulation favours language development).


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