How evidence-based neurodevelopmental follow-up models are transforming developmental care for millions of Indian children
Imagine a young mother in rural West India, her baby born months premature, who now regularly attends a specialized follow-up clinic. There, using simple but scientifically-validated tools, healthcare workers carefully track her infant's progress—catching subtle developmental delays that might have gone unnoticed for years.
Indian children under 12 affected by neurodevelopmental disorders 3
High-risk infants showing developmental delays at 12 months 7
Through early stimulation exercises and parental guidance, they help steer this vulnerable infant toward a healthier developmental trajectory. This scenario represents a quiet revolution in how India addresses neurodevelopmental disorders in children—a revolution grounded in evidence-based models specifically tailored to the country's unique needs and resources 1 6 .
Groundbreaking research from Kottayam, Kerala revealed an overall NDD prevalence of 0.80% (approximately 1 in 125 people), with a significantly higher prevalence of 1.38% (1 in 72) among children under 12 years old 3 .
A recent prospective observational study from Western India followed 88 high-risk infants and found that 31.6% showed developmental delays at 12 months of corrected age 7 .
Indian researchers have developed innovative color-coded risk stratification systems that categorize infants based on specific risk factors, allowing for tailored follow-up intensity 4 .
The model employs culturally-adapted tools like DASII alongside internationally-validated instruments including GMA and HINE for comprehensive developmental assessment 7 .
Non-intrusive observational method that assesses infant spontaneous movements
Standardized neurological examination for infants 2-24 months
Culturally-adapted tool measuring mental and motor development quotients
785 infants screened using GMA (12-17 weeks) and HINE (3-18 months)
Definitive neurological examination at 18 months, blinded to initial screening
| Tool Category | Specific Examples | Primary Function |
|---|---|---|
| Developmental Assessments | DASII, GMA, HINE | Measure developmental quotients and identify delays |
| Neuroimaging | 3T MRI, fNIRS | Map brain structure and function |
| Biospecimen Collection | Blood, buccal swabs, hair, nails | Genetic, toxicological, and metabolic analyses |
| Environmental Monitoring | Satellite-derived indicators, pollution sensors | Measure urbanisation and toxic exposures |
| Cognitive Testing | Computerized batteries, traditional tests | Assess specific neurocognitive functions |
The PARAM project aims to enroll approximately 9,000 participants from the antenatal period to 30 years of age, creating one of the most comprehensive developmental datasets from a low or middle-income country 2 .
Research shows designing services around family preferences could increase uptake by approximately 24% 5 .
Large-scale projects like PARAM are charting neurodevelopmental trajectories across prenatal, childhood, adolescence, and early adulthood while examining the impact of early-life exposures 2 .
The advances in India's neurodevelopmental follow-up models represent more than just academic achievements—they signify a fundamental shift in how we understand and support childhood development.
By building evidence-based systems tailored to local needs and resources, researchers and clinicians across India are creating sustainable solutions that promise to improve countless young lives.