Neuro-Developmental Disorders in India - From Epidemiology to Public Policy (I10-1.006)

Abstract

Objective: The main objectives of our research were: 1) To estimate the prevalence of Neuro-Developmental Disorders (NDDs) among children aged 2-9 years, among urban, rural, hilly areas, and tribal communities in India; 2) To gather data on risk factors for NDD’s; and 3) To develop and disseminate screening and diagnostic methodology for India, and other countries in which individuals with NDD’s have been under-recognized. Background: The domains studied were: Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorders, Intellectual Disability, Epilepsy, Learning Disability, Neuromuscular Disorders including cerebral palsy, Speech and Language Disorders, and Hearing and Vision Impairment. Design/Methods: Analysis of the data derived from the original 39-question Neurodevelopmental Screening Tool (NDST) utilized in gathering data from 4,000 families from 6 regions of India revealed that optimal sensitivity and specificity was achieved by utilizing only 11 questions. Results: Countrywide results (excluding Tribal data) revealed that from 10 % (Hilly areas), 13% (Urban areas), to 18 % (Rural areas) of children ages 2-9 yrs were found to have one or more NDD. The tribal prevalence was 4.96%, perhaps reflecting lower infant and child survival. Conclusions: On the basis of the methodology and results, The Government of India has undertaken two initiatives: 1. Questions regarding Disability have been included in the 2011 Census of India, the first time that this has taken place; 2. A national program for screening, diagnosis and treatment of NDD’s has been included in the recently launched Rashtriya Bal Swasthya Karyakram (RBSK; National Child Health Program). Study Supported by: Supported by: NIH (USA) Grant R21 HD53057, MKC Nair (PI), J. Pinto-Martin and D. Silberberg (Co-PI's), S Gulati, Network Coordinator); Autism Speaks (USA); The National Trust (Government of India) and INCLEN.