Nearly one in eight Indian children ages 2 through 9 might have a neurodevelopmental disorder, a new report by the INCLEN Trust International estimates.
The Delhi-based medical research organization highlighted the number as a significant health burden.
Experts say the study is the first to provide insight into the prevalence of neurodevelopmental disorders, including hearing impairment, epilepsy and learning disorders, across India.
It was conducted in the northern states of Himachal Pradesh and Haryana, Andhra Pradesh and Goa in the South, and eastern Odisha. The five states are varied not only in terms of geography but in percentage of urban and rural populations.
Of about 4,000 children studied, nearly 480 were found to have at least one neurodevelopmental disorder. The report was published in the medical journal PLOS Medicine.
A past estimate in the 2011 Census counted a lower number of people with neurodevelopmental disorders, according to Dr. N.K. Arora, executive director of INCLEN and one of the authors of the report. But Arora said it had only a few questions and focused on visible disabilities.
“The Census wasn’t geared to calculate these problems, and that is the reason why NDDs are underestimated,” he said.
Nearly 24% of India’s population is below the age of 10, a total of 239 million children, the Census found.
“Out of the total number of children between the ages of 2 and 9, around 23.7 million children face neurodevelopmental disorders,” said Dr. Sheffali Gulati, a child neurology expert and one of the contributors to the study.
The prevalence of these disorders “has been identified only for the age group of 2 through 9. One can only imagine how many people of the entire population have these problems.”
Experts say the main reason for India’s high rate of neurodevelopmental disorders in children is a lack of facilities and care at birth.
In many cases, “these disorders could have been prevented if birth asphyxia had been prevented and if there was a sufficient supply of oxygen,” Arora said. “Prenatal and neonatal care are crucial in curbing the rise of neurodevelopmental complications in children.”
Birth asphyxia occurs when a child is not able to receive the required amount of oxygen at birth, potentially leading to complications such as developmental disabilities and behavioral and learning disorders.
The primary treatment of these disorders lies first in diagnosing them and then providing therapy, helping bring them into mainstream society, according to doctors from the All India Institute of Medical Sciences.
In 2013, as a part of its National Children’s Health Program, the Indian government included neurodevelopmental disorders as one of the public health issues to be addressed, naming it as a national health concern for the first time.
As a part of the program, the government has opened District Early Intervention Centers in all districts of the nation in an effort to diagnose and treat these children.
Arora said it could be decades before improvement is seen because there will be a reduction in the prevalence of these disorders only once there are measures to improve child health care at birth.
“Most of these (neurodevelopmental disorders) occur because of a lack of care given during and after birth,” said Dr. Rakesh Kumar Jain, a pediatric neurologist at Fortis Memorial Research Institute in Gurgaon, who was not involved in the research. “I’m not saying that all the deliveries should happen in hospitals, we don’t have enough infrastructure in place for that. But our target should be that delivery should be attended by medical professionals.”
Jain said the data is “alarming, but I would say it is also conservative.” There is no reporting system to track neurodevelopmental disabilities, he said, so he “wouldn’t be surprised if the number was twice the amount.”
“This study is a good motivation for people to do further work on this subject,” he said.