Dr. Sohail Ambi Consultant Pediatrician HCG Suchirayu Hospital, Hubli

Every caregiver carries an instinct – that quiet voice that senses when something just doesn’t
feel right. It might be the way a child avoids eye contact, a word that takes longer to
emerge, or a behaviour that seems unusually repetitive or withdrawn. These little moments,
often brushed aside with comforting labels like “just a phase” or “a late bloomer,” can
sometimes whisper the earliest signs of a neurodevelopmental disorder (NDD).
For the citizens, especially in Tier 2 cities where access to specialized care can be limited,
recognising these signs early can make all the difference. The window of early childhood is a
powerful one – it’s when the brain’s wiring is most adaptable, ready to reshape and grow.
Acting during this time isn’t just about identifying a condition like Autism Spectrum Disorder
(ASD) or Attention Deficit Hyperactivity Disorder (ADHD); it’s about using the brain’s natural
ability to evolve and adapt to build a stronger, brighter future for the child.
The Invisible Burden: Why Early screening matters in India
Neurodevelopmental disorders are not rare occurrences. They represent a significant, yet
often unseen, public health concern across the country. In fact, a large-scale, multi-site
Indian study involving children aged 2 to 9 years indicated that approximately one in every
eight to ten children might be affected by at least one form of developmental challenge.
This suggests millions of young lives need targeted support.
In our diverse social landscape, misconceptions and social stigma often shroud these
conditions, leading to significant delays. Many families wait years for a confirmed diagnosis,
frequently due to a lack of awareness among caregivers and non-specialist medical
practitioners. This delay is critical because a child’s brain exhibits peak plasticity, its ability
to form new connections, during the first few years of life. Missing this period means
missing the optimal time when interventions, such as speech or occupational therapy, can
profoundly improve cognitive and social outcomes.
Understanding the Tapestry of Causes
Neurodevelopmental disorders are complex, generally resulting from a combination of
genetic predispositions and environmental factors. They are not caused by simple external
negligence, but rather by disruptions in early brain development.
Indian research has highlighted several specific risk factors that influence developmental
outcomes. Complications during birth, such as low birth weight or difficult deliveries
without institutional support, play a notable role. Furthermore, a mother’s health and
nutrition during pregnancy and the child’s early years are vital. While the link between

modern lifestyle factors and NDDs is still being investigated globally, the general
deterioration of healthy habits, such as inadequate sleep, poor maternal nutrition, and
excessive screen time displacing active, social play, is known to impede overall cognitive and
physical development in children. Simple factors, such as maternal literacy, have also been
observed to correlate positively with better developmental achievements in children,
underscoring the importance of parental awareness and education.
Finding the Right Path: A Caregiver’s Guide to Action
For caregivers, the journey begins with observation and simple, consistent monitoring of
developmental milestones. Instead of waiting for a specialist, parents and pediatricians can
proactively watch for certain ‘red flags’ starting in infancy.
These signs are not diagnoses in themselves, but simply cues to seek professional
evaluation:
 Social & Communication Cues: By 9 months, a child should be sharing joyful
expressions or smiles. By 12 months, there should be clear attempts at gestures like
pointing or waving. A consistent lack of eye contact or failure to respond to one’s
name by the age of one is a crucial sign. A significant delay in speech development,
or a sudden regression in previously acquired language skills, warrants immediate
attention.
 Behavioural Cues: Look for repetitive behaviours like constant hand-flapping,
spinning, or an intense, singular focus on objects or parts of objects. Notice an
unusual rigidity or extreme resistance to minor changes in routine.
The most powerful action a family can take is to bring these observations to a trusted
paediatrician or a developmental specialist. They can use standardized Indian screening
tools, which have been adapted and validated for our cultural context, to monitor a child’s
progress systematically. Early detection leads to early intervention, which is not a cure, but
a highly effective foundation that uses the child’s brain plasticity to build essential skills,
paving the way for a more independent and fulfilling life.
A Future Built on Hope and Early Action
Addressing neurodevelopmental disorders requires a shift in perspective, from viewing
them as family secrets to embracing them as common health challenges that can be
effectively managed. The road ahead, while demanding, is brightened considerably by the
possibilities unlocked through timely intervention.
Every child deserves the opportunity to reach their full potential. By replacing stigma with
knowledge and hesitation with immediate action, we empower families to leverage the
golden window of early childhood. Your actionable takeaway is clear: Trust your instinct,
track your child’s milestones actively, and insist on early screening. This commitment is the
greatest investment you can make in your child’s future well-being and success.