The child development milestone chart ‐‐ An approach to low cost programming in Indonesia

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Abstract
As nutrition, growth monitoring and immunization programs have dramatically increased the rates of child survival throughout the developing world there has been a ground swell of interest in going beyond survival to increase children's chances for optimal development. Past experience has shown that when developmental monitoring and stimulation programs are added to health and nutrition programs the rates of both physical and mental development may be improved. As a step toward a low cost developmental monitoring and early intervention program, a simple chart was developed in Indonesia. Based on the familiar growth monitoring chart and composed of items which are most predictive of long term developmental outcomes, the chart is designed to be used with existing nutrition or mother‐child welfare programs. For each developmental milestone in the first thirty‐six months of life the chart suggests simple stimulation activities which strengthen that milestone or encourage the child to achieve the next skill. The chart also teaches infant feeding and weaning practices supportive of child growth. A reliability and validity study conducted with a sample of 108 Indonesian children from birth to thirty‐six months of age established a tester‐observer reliability of .87 and a correlation with the Bayley Scales of Infant Development of .91. The use of charts of this type to educate parents, community workers and program planners about the need for child development interventions is discussed.

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