Analysis of Development in Stunted Children Based on Measurements within a Structured Play Therapy Context

Abstract

Stunting remains an important child health concern because developmental abilities may vary among affected children and cannot be fully represented by anthropometric status alone. This study aimed to analyze the development of stunted children based on developmental measurements within a structured play therapy context. An analytical observational study with a cross-sectional design was conducted among 358 stunted children aged 24 to 60 months in Makassar, Indonesia. Participants were selected using purposive sampling, with proportional sample allocation according to study area and KPSP age group. Development was assessed using the age-specific Kuesioner Pra Skrining Perkembangan (KPSP), while structured play therapy was used as a context for observing developmental responses. Overall KPSP results showed that 191 children (53.4%) had appropriate development, 124 (34.6%) had questionable development, and 43 (12.0%) had possible developmental deviation. Domain-specific assessment showed that 12.3% required further stimulation in the motor domain, 29.2% in the language domain, and 27.1% in the social-emotional domain. Cognitive data were available for 128 children, of whom 7.8% required further stimulation. Among 356 children with valid structured play observations, 84.6% demonstrated good or very good play quality. These findings demonstrate heterogeneous developmental profiles among stunted children, with relatively greater needs for further stimulation in language and social-emotional domains. Multidomain developmental assessment may complement growth monitoring, while structured play therapy may provide a child-appropriate context for observing developmental abilities without implying a causal therapeutic effect.