Proximal Feeding Processes and Refinement of Bipedal Walking in institutionalised children aged 12 to 30 months in Cameroon: A longitudinal bioecological study of developmental trajectories

Abstract The acquisition of bipedal locomotion is a major milestone in early motor development. Although neurological and environmental determinants of motor development have been widely studied, few longitudinal investigations have examined the specific role of feeding processes in African institutional settings. This study investigates the influence of feeding processes on the longitudinal refinement of bipedal locomotion among institutionalized children aged 12–30 months in Cameroon. Grounded in Bioecological Theory of Human Development, the study employs the PPCT model (Process–Person–Context–Time) to explore developmental trajectories. A prospective longitudinal multicenter design was conducted with two institutionalized children followed from 12 to 30 months of age. Data were collected across six measurement waves using the Brunet-Lézine Revised (2001) and adapted Scale, the Healthy Eating Index, the Dietary Diversity Score, a Feeding Assessment Scale, direct observations, and semi-structured interviews. Findings indicate that nutritional quality, dietary diversity, hydration, and caregivers’ feeding competencies significantly influence motor developmental trajectories. Improvements in nutritional indicators were associated with accelerated locomotor achievements, whereas nutritional deterioration corresponded with developmental stagnation. The study introduces the concept of Structured Proximal Feeding Processes (SPFP) as a theoretical extension of the PPCT model (Process, Person, Context, Time) of the bioecological theory of human development. Keywords Proximal Feeding ProcessesRefinement of bipedal walkingSubstitute family institutionDevelopmental trajectory