Health researchers on Wednesday demonstrated a World Health Organisation-developed digital tool to assess early childhood brain development, which has been adapted into local languages (Urdu and Sindhi) and integrated into provincial systems, amid concerns over the cost and inaccessibility of existing assessment methods.
The tool, known as the Global Scales for Early Development (GSED), was originally designed by WHO to measure cognitive, socio-emotional, language and motor skills in children from birth to 36 months of age.
The GSED measures were extensively field-tested and validated in three countries (Bangladesh, Pakistan, and Tanzania) before the first full version of the tool was launched.
At an event held at Karachi’s Aga Khan University, attended by researchers, policymakers, and other stakeholders, experts highlighted that the lack of reliable and comparable data has made it difficult for governments to prioritise early childhood development and to track progress on Sustainable Development Goal indicator 4.2.1, which measures whether children are developmentally on track.
“What we do not measure, we struggle to prioritise and often fail to act on,” said Dr Imran Nisar, associate professor in paediatrics and child health, while outlining the rationale behind the tool and its validation in Pakistan.
According to WHO estimates shared during the seminar, more than 250 million children globally are at risk of not reaching their developmental potential.
In Pakistan, the figure stands at 54 per cent, or about 33 million children, WHO representative Ellen Thom said, adding that early childhood development is a global priority, “essential not only for child survival, but also for lifelong health, learning and well-being”.
Dr Salim Virani, vice provost for global research at AKU, said early childhood should be viewed as a foundation rather than a “warm-up” for later life, arguing that interventions in the first few years have long-term social and economic returns.
He also urged policymakers to integrate development measurement into existing public health surveys, including nutrition assessments.
“If we invest in early childhood, the dividends are magnified,” Dr Virani said. “I’m a cardiologist. We know that addressing a risk factor early, rather than at 30, 40, or 50, doesn’t just give additive benefits; it’s multiplicative. You follow a completely different curve when you start early. It’s the same for human development,” he explained.
According to WHO’s Dr Vanessa Cavallera, one reason early childhood development has remained under-measured is the absence of tools that are feasible, affordable and culturally adaptable for low- and middle-income countries.
The GSED, she said, was developed using data from more than 70,000 children across 31 countries and is designed for programmatic-level and population-level evaluations. Dr Cavallera also linked brain development in the first 1,000 days of life to later health, learning and productivity outcomes.
Speaking via a recorded message, Sindh Parliamentary Secretary for Health Nida Khuhro said reliable and standardised data was essential for policy planning and investment. “When adapted into local languages and integrated into provincial systems, no child is left invisible,” she said.
Dr Seema Lasi, assistant professor at AKU’s human development programme, explained that childhood development in Pakistan is often discussed only in terms of nutrition, which can be measured through a child’s weight and height, while brain development remains harder to assess.
“Brain development is not always visible or obvious,” she told Dawn, explaining that it requires structured interaction with children or their caregivers, often through specific questions, to understand whether development is on track.
She said the first five years of a child’s life are critical for both mental and physical growth, noting that around 80pc of brain development is completed by the age of three.
The new assessment tool allows health professionals to identify developmental delays and respond early. “If development is happening as it should, that is a good sign. If not, then it shows us where intervention is needed,” she said.
Dr Lasi clarified that the tool is currently intended for population-level surveys rather than individual diagnosis. “For now, it will be used in national and population-based surveys. In the future, it may also be used for screening or diagnosing individual children,” she said.
