Letter to the Editor: Developmental milestones: Even the Physicians don’t know enough and what we need to do?

Madam, we have read Developmental milestones: Do the parents know enough?1 by Mushtaq and Rehman with interest. They have highlighted an important aspect of child health and development which is often neglected in Pakistan. We support their proposals of increasing awareness among the parents regarding developmental milestones. But we also need to target the physicians as well. We, as Rehabilitation medicine physicians with training and expertise in diagnosis, management and rehabilitation of paediatric disabilities have served in different provinces of Pakistan (Punjab, Sindh and Khyber Pakhtonkhawa). We have observed that, apart from the parents (majority of whom are not health care professionals or educated), even many of the Pakistani physicians are not well aware of the important motor and mental developmental milestones in their paediatric patients. More than often they fail to detect the delayed developmental milestone or simply ignore it. The referral for rehabilitation are either delayed or never made. The referral forms rarely have any details of ante-natal, natal and family history of developmental delays. Similarly essential elements of a basic physical examination (tone, abnormal posture, reflexes etc) are not documented.