My supervisor and I visited Thatta, a city in Sindh, in order to learn how to use Bailey’s test for cognitive and motor development since we will be using this same model to test our children in our Complementary Feeding study (please see previous journal entry). Bailey’s test is used to assess motor and mental development of children after their first year of life through tasks that involve play and motor function. Once the test is performed and raw scores established, the children are classified into: 1) Exceeds normal development, 2) Normal development, 3) Mild developmental delay, and 4) Severe developmental delay. If a child falls into the last two categories, then they are closely monitored and interventions are set in place. These interventions include educational messages and recommendations as to what the mother and the family can do to help the child develop in a supportive environment.

One of the children we tested was classified as being “mildly delayed.” This particular child was actually premature. I think you can appreciate the connection between premature and low birth weight babies with developmental delays. However, developmental delays do not JUST occur due to these poor birthing outcomes. Factors such as malnutrition, lack of a supportive environment, inappropriate stimulus or lack thereof, inadequate psychosocial support, etc… Interestingly, research shows that these same factors lead to poor pregnancy outcomes.

Majority of mothers here are unable to tend to their children because they have to work long hours in villages in order to contribute to the household income. Here is the sad part; many mothers give their babies a cough syrup early in the morning, which puts the child to sleep for the entire day. The mothers then return in the evening and by then the child is awake. Throughout the day, while the child is asleep, he or she has received not a single drop of breast milk nor has he or she engaged in any sort of play, which has been proven time and time again to improve growth and development of children. This same child has not been exposed to any form of stimuli. Some children are not given cough syrups but are instead left with their other siblings. These siblings are not any older themselves. So basically, these children are left to fend for themselves. They pick up anything from the ground to eat as food and play with stray animals. Go figure that these children suffer from developmental delays! These deficits remain in the later years of life, unless intervened immediately. It is such a sad environment for innocent children to grow up in but no one dares to solve the grassroots of these problems. Mothers that have to leave their children are given no options and no support. And so this vicious cycle continues...