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,
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
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).