BRIEF REPORT Use of a Developmental Milestone Chart (DMC) in Rural Bangladesh to Educate Health Workers and Stimulate Referral for Early Diagnosis and Intervention Tasneem Karim, MBBS, MPH, 1,2,3 Alfred Scherzer, MD, EdD, FAAP, 4 Mohammad Muhit, MBBS, MSc, MSc (Ophth), PhD, 2,3 Nadia Badawi, MBBCh, DCH, MSc, PhD, FRCPI, FRACP, 1,5 and Gulam Khandaker, MBBS, DCH, MPH, PhD, FAFPHM, 1,2,3 1 Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney 2145, Australia 2 Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka 1213, Bangladesh 3 CSF Global, Dhaka 1213, Bangladesh 4 Weill Cornell Medical College, New York 10065, USA 5 Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney 2050, Australia Correspondence: Dr Gulam Khandaker, The Children’s Hospital at Westmead (Clinical School), Cnr Hawkesbury Rd and Hainsworth St, 15 Locked Bag 4001, Westmead, NSW 2145, Australia. Tel: þ61 0423 229 073, Fax: þ612-9845 1418. E-mail <gulam.khandaker@health.nsw.gov.au>. ABSTRACT We aimed to determine the feasibility of using a simplified Developmental Milestone Chart (DMC) for assessment of neurodevelopmental status of children of age 1 month and 8 years. Participants were assessed by medical practitioners using DMC as part of regular health checkups in three sub-districts in Bangladesh between January and May 2017. Total 256 children were recruited (41.0% girls, mean age 1.3 6 1.6 years). Total 107 children (41.8%) failed at least one and 3 (1.2%) failed all four developmental milestones. Majority missed motor milestones (75.6%, n ¼ 81). Four medical practitioners trained on the use of DMC deemed it to be an appropriate tool for develop- mental screening as part of regular health checkups/care in terms of acceptability, practicality and implementation. In countries with limited facilities, a simplified instrument such as the DMC can be administered by medical practitioners in rural settings. However, further studies are required to es- tablish the validity of DMC before it could be adopted into routine clinical practices. KEYWORDS : developmental screening; early diagnosis; Bangladesh; low- and middle-income country (LMIC); developmental milestones V C The Author(s) [2018]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com  505 Journal of Tropical Pediatrics, 2019, 65, 505–509 doi: 10.1093/tropej/fmy073 Advance Access Publication Date, 19 December 2018 Brief Report Downloaded from https://academic.oup.com/tropej/article/65/5/505/5253843 by guest on 08 September 2022