Prevalence and correlates of neurodevelopmental disorders among children in India: a narrative review




Neurodevelopmental disorders, Prevalence, Comorbidities, Risk factors, Correlates, India, Review


Neurodevelopmental disorders (NDD) are seen disproportionately affecting the low-income communities. Paucity of consistent and large-scale studies in India and variations in assessment and diagnostic tools reduce the scope for generalization of prevalence estimates to national level. This review tried to consolidate the existing community-based evidence of the prevalence of NDDs, risk factors and comorbidities among children in India. We searched studies related to the review objectives on search engines PubMed and Google Scholar. The community or school-based studies in India, published in English language were included. The prevalence of each of these NDDs differed in different locations and age groups. The prevalence appeared to be increasing with increase in age. Non-institutional delivery, perinatal asphyxia or delayed crying, low birth weight or prematurity, neonatal illness or neurological infections were significantly associated with the NDDs. Most of the significant risk factors are modifiable with the help of effective programs to improve maternal and child healthcare and nutrition. Further large-scale, good-quality epidemiological studies in community settings are needed to develop and prioritize the delivery of the prevention and rehabilitation interventions.

Author Biography

Leena Gaikwad, Indian Institute of Public Health, Hyderabad, Telangana

Research Coordinator, Addiction Research Group


Boivin MJ, Kakooza AM, Warf BC, Davidson LL, Grigorenko EL. Reducing neurodevelopmental disor- ders and disability through research and interventions. Nature. 2015;527:S155-60.

Durkin MS, Schneider H, Pathania VS, Nelson KB, Solarsh GC, Bellows N, et al. Learning and develop- mental disabilities.In: Jamison DT, Breman JG, Measham AR, editorsDisease control priorities in low- and middle-income countries. 2nd, Ed. New York: Oxford University Press and World Bank; 2006:933-52.

UN World Health Organization (WHO). 58th World Health Assembly: Resolutions and Decisions, Annex. Geneva: World Health Organization, 2005. Document WHA58/2005/REC/1. Available at: Accessed on 10 June 2020.

Sustainable Development Goals (SDGs) and Disability. Division for Social Policy and Development Dis- ability, 2012. Available at: development-goals-sdgs-and-disability.html. Accessed on 20 June 2020.

Bhatnagar P, Gupta S, Kumar R, Haldar P, Sethi R, Bahl S. Estimation of child vaccination coverage at state and national levels in India. Bull World Health Organ. 2016;94:728-34.

Zaka N, Alexander EC, Manikam L, Norman ICF, Akhbari M, Moxon S, et al. Quality improvement initia- tives for hospitalized small and sick newborns in low- and middle-income countries: a systematic review. Implement Sci. 2018;13:20.

Arora NK, Nair MKC, Gulati S, Deshmukh V, Mohapatra A, Mishra D, et al. Neurodevelopmental disorders in children aged 2–9 years: Population-based burden estimates across five regions in India. PLoS Med. 2018;15(7):e1002615.

Kuppili PP, Manohar H, Pattanayak RD, Sagar R, Bharadwaj B, Kandasamy P. ADHD research in India: A narrative review. Asian J Psychiatr. 2017;30:11–25.

Chattopadhyay N, Mitra K. Neurodevelopmental outcome of high risk newborns discharged from special care baby units in a rural district in india. J Public health Res. 2015;4(1):7-12.

Oommen SP, Santhanam S, John H, Roshan R, Swathi TO, Padankatti C, et al. Neurodevelopmental Outcomes of Very Low Birth Weight Infants at 18-24 Months, Corrected Gestational Age in a Tertiary Health Centre: A Prospective Cohort Study. J Trop Pediatr. 2019;65(6):552-60.

Pawar SJ, Oleti T, Bharathi S, Tipparaju S, Mustafa E. Growth and Neurodevelopmental Outcome in Preterm LBW Infants with Sepsis in India: A Prospective Cohort. Int J Pediatr. 2018;2018:1-9.

Dwivedi D, Singh S, Singh J, Bajaj N, Singh HP. Neurodevelopmental Status of Children aged 6-30 months with Severe Acute Malnutrition. Ind Pediatr. 2018;55(2):131-3.

Solomon RS, Sasi T, Sudhakar A, Kumar RK, Vaidyanathan B. Early Neurodevelopmental Outcomes After Corrective Cardiac Surgery In Infants. Ind Pediatr. 2018;55(5):400-4.

Raina SK, Chander V, Bhardwaj AK, Kumar D, Sharma S, Kashyap V, et al. Prevalence of autism spectrum disorder among rural, urban, and tribal children (1-10 Years of Age). J Neurosci Rural Pract. 2017;8(3):368-74.

Poovathinal SA, Anitha A, Thomas R, Kaniamattam M, Melempatt N, Anilkumar A, et al. Prevalence of autism spectrum disorders in a semiurban community in south India. Ann Epidemiol. 2016;26(9):663-5.

Sharda V, Subbalakshmi NK, Narayana S, Samal RK. Prevalence of Autism Autistic Features and Associated Risk Factors in Subjects Attending Special Schools in Our Community. J Heal Allied Sci NU. 2012;02(02):24-9.

Manohar H, Kuppili PP, Kandasamy P, Chandrasekaran V, Rajkumar RP. Implications of comorbid ADHD in ASD interventions and outcome: Results from a naturalistic follow up study from south India. Asian J Psychiatr. 2018;33:68-73.

Sehgal R, Gulati S, Sapra S, Tripathi M, Kabra M, Pandey RM. Neurodevelopmental and epilepsy outcome in children aged one to five years with infantile spasms-A North Indian cohort. Epilepsy Res. 2014;108(3):526-34.

Geetha B, Sukumar C, Dhivyadeepa E, Reddy JK, Balachandar V. Autism in India: a case–control study to understand the association between socio-economic and environmental risk factors. Acta Neurol Belg. 2019;119(3):393-401.

Chauhan A, Singh M, Jaiswal N, Agarwal A, Sahu JK, Singh M. Prevalence of Cerebral Palsy in Indian Children: A Systematic Review and Meta-Analysis. Ind J Pediatr. 2019;86(12):1124-30.

Nair MKC, Harikumaran Nair GS, Beena M, Princly P, Abhiram Chandran S, George B, et al. CDC Kerala 16: Early Detection of Developmental Delay/Disability Among Children Below 6- A District Model. Ind J Pediatr. 2014;81(2):151-5.

Najar B, Kachroo A, Gattoo I, Hussain S. Cerebral palsy: risk factors, comorbidities and associated MRI findings, a hospital based observational study. Int J Contemp Pediatr. 2015;2(2):90.

Bhati P, Sharma S, Jain R, Rath B, Beri S, Gupta VK, et al. Cerebral palsy in North Indian children: Clinico-etiological profile and co-morbidities. J Pediatr Neurosci. 2019;14:30-5.

Minocha P, Sitaraman S, Sachdeva P. Clinical spectrum, comorbidities, and risk factor profile of cerebral palsy children: A prospective study. J Pediatr Neurosci. 2017;12(1):15-8.

Sharma P, Gupta RK, Banal R, Majeed M, Kumari R, Langer B, et al. Prevalence and correlates of Attention Deficit Hyperactive Disorder (ADHD) risk factors among school children in a rural area of North India. J Fam Med Prim Care. 2020;9:115-8.

Jacob P, Srinath S, Girimaji S, Seshadri S, Sagar J V. Co-morbidity in attention-deficit hyperactivity disorder: A Clinical study from India. East Asian Arch Psychiatry. 2016;26(4):148-53.

Jaisoorya TS, Beena K V, Beena M, Ellangovan K, George S, Thennarasu K, et al. Prevalence and Correlates of Self-Reported ADHD Symptoms in Children Attending School in India. J Atten Disord. 2020;24(12):1711-5.

Catherine TG, Robert NG, Mala KK, Kanniammal C, Arullapan J. Assessment of prevalence of attention deficit hyperactivity disorder among schoolchildren in selected schools. Ind J Psychiat. 2019;61:232-7

Manjunath R, Kishor M, Kulkarni P, Shrinivasa B, Sathyamurthy S. Magnitude of Attention Deficit Hyper Kinetic Disorder among School Children of Mysore City. Int Neuropsychiatr Dis J. 2016;6(1):1-7.

Srinivasaraghavan R, Mahadevan S, Kattimani S. Impact of comorbidity on three-month follow-up outcome of children with ADHD in a child guidance clinic: Preliminary report. Indian J Psychol Med. 2013;35(4):346-51.

Manohar H, Pravallika M, Kandasamy P, Chandrasekaran V, Rajkumar RP. Role of exclusive breastfeeding in conferring protection in children at-risk for autism spectrum disorder: Results from a sibling case-control study. J Neurosci Rural Pract. 2018;9(1):132-6.

Girimaji SC, Srinath S. Perspectives of intellectual disability in India: Epidemiology, policy, services for children and adults. Curr Opin Psychiatry. 2010;23(5):441-6.

Chordia SL, Thandapani K, Arunagirinathan A. Children ‘At Risk’ of Developing Specific Learning Disability in Primary Schools. Ind J Pediatr. 2020;87(2):94-8.

Sridevi G, George A., Sriveni D, Rangaswami K. Learning disability and behavior problems among school going children. J Disabil Stud. 2015;1(1):4-9.

Gajre MP, Meshram H, Shah H, Lele B, Setia M. Anxiety Disorders in Learning Disabled School Children. Int J Medic Appl Sci. 2015;4(4):76-80.

Singh S, Sawani V, Deokate M, Panchal S, Subramanyam AA, Shah HR, et al. Specific learning disability: a 5 year study from India. Int J Contemp Pediatr. 2017;4(3):863.

Elsabbagh M, Divan G, Koh YJ, Kim YS, Kauchali S, Marcin C, et al. Global Prevalence of Autism and Other Pervasive Developmental Disorders. Autism Res. 2012;5:160-79.

Boyle CA, Boulet S, Schieve LA, Cohen RA, Blumberg SJ, Yeargin-Allsopp M, et al. Trends in the prev- alence of developmental disabilities in US Children, 1997–2008. Pediatrics. 2011;127:1034-42.

Christensen DL, Baio J, Braun KV, Bilder D, Charles J, Constantino JN, et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years—Autism and Developmental Dis- abilities Monitoring Network, 11 Sites, United States, 2012. MMWR Surveill Summ. 2016;65:1-23.

Boyle CA, Doernberg NS, Schendel DE. Prevalence of selected developmental disabilities in children 3–10 years of age: the metropolitan Atlanta developmental disabilities surveillance program, 1991. Sur- veillance Summaries, MMWR, CDC. 1996,45:1-14.

United Nations. UN Millennium Project. The Millennium Development Goals Report 2015. Cited on 2018 May 09. Available at: Accessed on 20 June 2020.

World report on disability. Washington, DC: World Bank, 2011. Available from: disabilities/world_report/2011/report.pdf. Accessed on 20 June 2020.

Mung’ala-Odera V, Newton CRJC. Identifying children with neurological impairment and disability in resource-poor countries. Child: care, health Dev. 2007;33:249-56.

Maulik PK, Darmstadt GL. Childhood disability in low- and middle-income countries: overview of screen- ing, prevention, services, legislation, and epidemiology. Pediatrics. 2007;120:S1-55.

Rashtriya Bal Swasthya Karyakram (RBSK). National Health Mission, Government of India. Available at: karyakram-rbsk/background.html. Accessed on 20 June 2020.

Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, et al. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007;369:145-57.






Review Articles