Effects of psychosocial stimulation on growth and development of severely malnourished children in a nutrition unit in Bangladesh.
OBJECTIVE
Young children with severe malnutrition usually have poor mental development. Psychosocial stimulation may reduce their cognitive deficit, but it is not usually provided. The aim of the study was to incorporate stimulation into the routine treatment of severely malnourished children in a nutrition unit and evaluate the impact on their growth and development.


METHODS
Time-lagged controlled study.


METHODS
Nutritional Rehabilitation Unit (NRU) in ICDDR,B Dhaka Hospital.


METHODS
Severely malnourished children, aged 6-24 months, admitted to the NRU were enrolled. All received standard nutritional care. A control group of 43 children was studied initially, followed by an intervention group of 54 children. The intervened mothers and children participated in daily group meetings and individual play sessions for 2 weeks in hospital and were visited at home for 6 months. Children's growth was measured and development assessed using the Bayley Scales of Infant Development.


RESULTS
Twenty-seven children were lost to the study. In the remaining children, both groups had similar developmental scores and anthropometry initially. After 6 months, the intervention group had improved more than the controls did by a mean of 6.9 (P<0.001; 95% CI: 3.9, 10.0) mental and 3.1 (P=0.024; 95% CI: 0.4, 5.7) motor raw scores and a mean of 0.4 (P=0.029; 95% CI: 0.1, 0.8) weight-for-age z scores, controlling for background variables.


CONCLUSIONS
Psychosocial stimulation integrated into treatment of severely malnourished children in hospital, followed by home visits for 6 months, was effective in improving children's growth and development and should be an integral part of their treatment.
Nahar
B
B
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
Hamadani
J D
JD
Ahmed
T
T
Tofail
F
F
Rahman
A
A
Huda
S N
SN
Grantham-McGregor
S M
SM
D001459:Bangladesh; D001835:Body Weight; D002657:Child Development; D005260:Female; D006128:Growth; D006757:Hospital Units; D006801:Humans; D007223:Infant; D008297:Male; D010988:Play and Playthings / Q000523:psychology*; D011502:Protein-Energy Malnutrition / Q000523:psychology / Q000628:therapy*; D011610:Psychosocial Deprivation