A dissertation submitted to the University of Madras in the partial fulfillment of the requirement for the M.A Degree in Social Work
The Investigator express her sincere thanks to P.K. VISVESWARAN Principal of Madras School of Social Work for all his guidance rendered to the research thus enabling her study to take its present shape.
The researcher would also like to thank the R.M.O and A.R.M.O. Mr.Muthu Veerappan, of Royapettah Hospital and Dr.Miss.V.Priya Register No.50371 formly doctor of Royapettah Hospitals and presently Doctor of Railway Hospital. The researcher would also like to thank Project Officer of Integrated Child Development Scheme Programme.
The researcher would also like to thank all respondents for their wonderful cooperation last but not the least my researchers sincere thanks to Mr.Albert and Latha Srinivasan, Psychologist of Schizophernic Research Foundation India.
| CONTENTS PAGE NO. |
| List of Tables i |
| List of Illustrations ii |
| List of Photographic vi |
| CHAPTERS |
| I. Introduction 12 Review of Literature Research Methodology |
| II. Section A 22 Childrens Physical Health and Related Aspect's Objective & Clinical Aspects Section B Childrens Health Related Aspects Parents Perception & Views |
| III. Childrens Intellectual Development & Status 48 |
| IV. Summary & Conclusion Finding & Recommendation 58 |
| APPENDIX |
| Clinical Schedule – A 61 Interview Schedule – B 66 Mental Ability Test's - C 70 |
| I. Verbal Ability Test's |
| II. Word Fluency Test's |
| BIBLOGRAPHY – D 79 |
| LIST OF TABLES |
| TITLE PAGE NO |
| THE AGE OF THE CHILDREN'S TAKEN TO STUDY IN MONTHS |
| THE SEX DISTRIBUTION OF THE CHILDRENS INCLUDED IN THE STUDY |
| THE HEIGHT OF THE CHILDREN |
| THE WEIGHT OF THE STUDY CHILDREN |
| THE RELATIONSHIP BETWEEN HEIGHT AND WEIGHT IN THE STUDY DATA |
| CHILDREN'S HEIGHT BY SEX |
| GENERAL NUTRITIONAL CONDITION OF THE CHILDRENS INCLUDED IN THE STUDY |
| INDICATION OF MALNUTRITION SEEN IN THE CHILDREN'S |
| GENERAL RATING OF CHILDREN'S WELL-BEING (By Doctor) |
| CHILDREN'S EYE CONDITION |
| PIGMENTATION EYE CONDITION OF THE CHILDREN'S |
| XEROSIS CORNEA CONDITION OF THE CHILDREN'S |
| NIGHT BLINDNESS AMOUNG THE CHILDREN |
| CHILDRENS ORAL HYTGEINE AND CONDITIONS |
| THE TEETH OF THE CHILDREN'S |
| DENTAL CONDITION OF THE CHILDREN'S |
| GENERAL SKIN APPEARANCE OF THE CHILDREN'S |
| ELASTICITY CONDITION PF THE CHILDREN'S SKIN |
| HAIR CONDITION OF THE CHILDREN'S |
| ALIMENTARY SYSTEM CONDITION OF THE CHILDREN'S |
| AGE OF THE MOTHERS OF THE CHILDREN |
| EDUCATIONAL STATUS OF THE RESPONDENTS |
| THE RESPONDENTS BY MARITAL STATUS |
| RESPONSE TO THE QUESTION; 'TO WHAT TYPE OF FAMILY DO YOU BELONG?' |
| EMPLOYMENT STATUS OF MOTHERS |
| EMPLOYMENT STATUS OF FATHERS |
| INCOME CATEGORY | NATURE OF RESIDENTIAL LOCALITY
| RESPONSE TO QUESTION; 'HABITS DOES YOUR CHILD PRACTICE HYGIENE HABIT?' |
| RESPONSE TO QUESTION; 'POSITION OF CHILD IN THE FAMILY?' |
| RESPONSE TO THE QUESTION; 'HOW DO YOU TAKE SPECIAL CARE OF YOUR CHILD BY RESPONDENTS?' |
| RESPONSE TO THE QUESTION; 'DOES YOUR CHILD HAVE GOOD APPETITE?' |
| RESPONSE TO THE QUESTION; 'DOESYOUR CHILD SUFFER FROM ANY COMMUNICABLE DIESEASE?' |
| RESPONSE TO THE QUESTION; 'CHILD SUFFER FROM DIFICIENCY DIESEASE?' |
| RESPONSE TO THE QUESTION; 'DOES YOUR CHILD ANY BEHAVIOUR DISORDER?' |
| RESPONSE TO THE QUESTION; 'DOES YOUR CHILD HAVE ALL SENSORY ABILITIES?' |
| RESPONSE TO THE QUESTION; 'DOES YOUR CHILD GET TIRED EASILY AFTER WORK OR PLAY?' |
| ACTIVENESS OF THE CHILD |
| RESPONSE TO THE QUESTION; 'DOES YOUR CHILD FALL ILL OFTEN?' |
| RESPONSE TO THE QUESTION; 'DO YOU CARE TO GO THROUGH REPORTS GIVEN TO YOU BY THE NOON MEAL CENTRE?' i.e (Medical and Class Report) |
| THE RATING OF THE CHILD'S HEALTH BY THE PARENT'S |
| PARENT'S VISIT TO SCHOOL TO MEET THE TEACHERS TO KNOW THE PROGRESS OF THE CHILD |
| CHILDRENS DIFFICULTIES IN STUDIES AS REPORTED BY THE MOTHERS |
| RESPONSE TO THE QUESTION; 'DOES YOUR CHILD HAVE GOOD VOCABULARY?' |
| SPEED OF LEARNING BY THE CHILD |
| VERBAL ABILITY TEST |
| AGE AND VERBAL ABILITY |
| AGE ND WORD FLUENCY |
| RELATIONSHIP BETWEEN WORD FLUENCY AND VERBAL ABILITY |
| THE EMOTIONAL STATUS OF THE CHILD |
| DOCTORS ASSESSMENT OF RELATIONSHIP BETWEEN EMOTIONAL STATUS AND VERBAL ABILITY |
| NUTRITIONAL STATUS OF THE CHILD AS RELATED TO VERBAL ABILITY PERFORMANCE DOCTOR'S ASSESSMENT OF NUTRITIONAL STATUS OF THE CHILD AND CHILD'S VERBAL ABILITY PERFORMANCE |
| LIST OF FIGURES |
| NIGHT BLINDNESS AMOUNG THE CHILDREN |
| EDUCATIONAL STATUS OF THE PARENTS |
| INCOME OF THE RESPONDENTS |
| THE DIFFERENT METHODS USED BY THE TAKING CARE OF THE CHILD BY THE PARENTS |
| THE RATING OF THE CHILD'S HEALTH BY THE PARENTS |
| BEHAVIOUR DISORDER OF THE STUDY CHILDRENS |
| ACTIVENESS OF THE CHILDREN |
| EMOTIONAL STATUS OF THE CHILDREN |
| LIST OF PHOTOGRAPHIC ILLUSTRATION |
| CHILDREN'S MEDICAL CHECK-UP DONE BY THE DOCTOR (Done specially for the present study) |
| MEDICAL CHECK-UP – CLOSER VIEW |
| VERBAL ABILITY TEST CHART (Naming the objects) |
| VERBAL ABILITY TESTS DONE BY THE RESEARCHER |
| WORD FLUENCY CHART (Forming sentences) |
| CHAPTER 1 |
| INTRODUCTION | REVIEW OF LITERATURE
| METHODOLOGY |
| CHAPTER I |
| INTRODUCTION |
| A community of healthy children is like a garden with beautiful flowers and plants. |
| Today's world depends on their mental and physical development for peace and harmony in the future. |
Positive relation between the level of health and socio-Economic status has been documented. Recent studies have investigated the mechanism by which low Socio-Economic status adversely affects physical and behavioral and mental health of the children in the age group between 1-5 years. In South India condition. It has become necessary to find the association between nutritional status and mental status of the preschool children, in terms of specific socio economic factors. Such that indices are urgently required not only for operation research in the field of health but also to help in development of children's health.
If nutrition is part of health, malnutrition is part of disease which is a tragic accompaniment of the poverty of people living below the poverty line. It is estimated that 130 million men women and children go to bed hungry every night.
Malnutrition acts as obstacle to the social and economic development and it is that has brought it to the fine front national and international concern malnutrition is one of the most important health problems today's world faces.
In India poverty and hunger have led to malnutrition. Hunger and malnutrition are the enemies of mankind. In India the diet of the preschool children of the lower socio economic level is inadequate in calories and essential nutrients This has led to 40% of the group to be malnourished.
The Malnutrition survey carried out in some parts of Tamilnadu in 1954-1971 showed that nutritional deficiencies most observed were those of calories protein vitamin A and Vitamin B complex Although the above nutritional studies and are mainly concentrated in Tamil Nadu malnutrition is a widespread problem. Hence besides the governments international organizations such as UNICEF attempt aid the developing countries in an attempt to combat malnutrition.
The dictionary meaning of malnutrition is imperfect or faulty nutrition. It can be simply defined as a precipitated (or even latent) stage of disproportion between demands of the body for a certain nutrient and its intake. Logically therefore there could be two types of malnutrition; one in which the demand is not fully met, and the other when the nutrient is consumed in excess. The first condition is under nutrition and the second over nutrition. The margin of safety for various nutrients is very variable and is usually wide enough take care of small disproportions. In India under nutrition is more prevalent and is only in rare situations that over nutrition exists. In general usage, therefore, the terms malnutrition and under nutrition have come to be taken as almost synonymous.
Balanced diet is that diet which supplies the body essential nutrients which gives the body necessary growth and energy. Balanced diet must contain carbohydrates, proteins, fats, vitamins and minerals. When balanced diet is not taken inadequate diseases and deficiency are caused.
Phenoderma is popular eruption on the skin is the result of fat. Lowered energy level is the result of carbohydrates deficiency. Night blindness, day blindness xeropthalmia, Bitot's spot and Keratomalacia are the result of vitamin A deficiency. Clarity of vision is affected by back of vitamin A deficiency.
Rickets is caused due to deficiency in vitamin D. Fatigue, lethargy. Lack of appetite and beri beri results from lack of Vit.B. Visual fatigue blurred vision photo phobia are a result of Vit B12 and Vitamin A deficiency.
Diarrhoea dermatitis and dementia is due to Niacin deficiency. Malnutrition is a pathological state resulting from a relative or absolute deficiency or excess of one or more nutrients is cordely prevalent in many facts of world in fact the no is rapidly increasing especially in the developing countries. It is one of the gceatent international problem of today.
The problem of nutrition is a result of several factors interacting, physical, ecological and cultural. The physical factors include the quantity and quality of food produced in the community. Its distribution and delivery, the physical, and mental work involved for the individual. The cultural elements refer to the educational background, dietary habits, values and tradition of the individual and the family. The ecological factors include the flora and fauna, the air, water surroundings of the individual.
The level of living condition of the person in the community and country also counts.National sample survey for 1950, 1960 and 1964 show that the subnormal food intake has had identical consequence on the poor families in all the three years. Malnutrition is one of the distressing nutritional decorde of early childhood chronic malnutrition damages the moral and economic fibre of a nation. Nearly 300 million children every year in the world are malnourished. This represents the first and foremost health problem.
The malnutrition also reduces the mental efficiency affecting the child national development is through the damaged brain and impaired intellectual, psychological and neuromuscular capacity as discussed earlier. According to present state of knowledge it appears that in children who had about a severe protein calorie malnutrition there is incomplete restoration of functional capacities of the brain insprit of the intensive therapy resulting in apparent clinical cure. According to a study although there might not appear any serious mental retardation the damage may be sufficient to limit the individual's ability to reach the inherent potential. Reduced endurance, inability to face stress and lowered threshold to electroshock have been shown experimentally in presence of malnutrition. Some studies have found that 70% of pre-school children in developing countries and malnourished, and even if a small number of our children suffering from severe protein calorie malnutrition fail to develop into useful adults.
In India poverty and hunger has lead to malnutrition. Hunger and malnutrition are the dead least enemies of man kind. If the availability of food is not enough for adequate or if the nutrients are not balanced and consumed children are led to various developmental disorders the dietary requirement for balanced diet according to age group is given in the following table.
| Food item | Age Group 1 to 3 yrs | Age Group 4 to 5 yrs |
|---|---|---|
| Cereals | 175 gms | 270 gms |
| Pulses | 35 gms | 35 gms |
| Leafy Vegetable | 40 gms | 50 gms |
| Other Vegetable | 20 gms | 30 gms |
| Roots & Tubes | 10 gms | 20 gms |
| Milk | 300 gms | 250 gms |
| Oils & fat | 15 gms | 25 gms |
| Sugar and Jaggery | 30 gms | 40 gms |
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