Caregiving can be taxing when your child suffers from a neuro-developmental disorder. But, don’t lose hope. Dr. Ennapadam S Krishnamoorthy
Children with neuro-developmental disorders (NDD) suffer from these core symptoms: learning disability, childhood epilepsy, cerebral palsy, mental retardation, attention deficit and hyperactivity disorder, autistic spectrum disorder …
What is neuro-developmental disorder?
Conditions that follow abnormal brain development and impact on motor (strength, dexterity, coordination); cognitive (intelligence, learning, aptitude); or emotional and behavioural (mood swings, temper tantrums, socialisation issues etc.) function.
While some have NDD imprinted in their biological code (through genetic, hormonal, and other neurobiological factors), for many the causes lie in critical stages of development — during pregnancy, trauma, drugs, alcohol, smoking, infections, malnutrition etc. Factors affecting the child include birth trauma, infection and neonatal compromise (asphyxia, jaundice, accidents or abuse, infections, malnutrition).
Who is at risk?
The majority of NDD may be deemed to be multi-factorial, i.e. more than one genetic/ biological abnormality being responsible, with strong contributions from environmental events. In general, having a parent with a neuro-psychiatric or developmental condition may double the risk. Parental consanguinity also increases the risk.
When to suspect NDD?
Moderate to severe problems manifest early. Typically they are slow-learners in school, who find academic progress challenging.
Why should we take action early?
Children who do not receive support are likely to feel stigmatised and lose their confidence. The paediatrician should be the first port of call. The class teacher may also have valuable inputs. When either the paediatrician or the class teacher (or both) suspect a problem, more specialised inputs become necessary. Consultations include:
Learning and intelligence: clinical psychologist
Motor weakness/other brain disorders (like epilepsy): neurologist assisted by the occupational therapist
Behaviour: psychiatrist assisted by a counsellor
Language development: ENT doctor supported by speech and language therapists.
In many instances, comprehensive assessment requires a team approach. Depending on the problem, a range of laboratory tests may be required, from brain scans, EEG/ electrophysiological tests to blood and urine tests, including hormonal assays.
How should I progress once diagnosed?
The paediatrician should be your primary support. The child’s school needs to be kept in the loop. Identify a team of professionals; be consistent in your interactions and regular in follow up. Make sustainable plans and set realistic goals. Don’t focus only on the disability; your child may also have special interests and abilities. Focus on them too. Don’t be preoccupied with academic results; focus on overall development.
Care-giving is challenging and tiring; share the challenge as a family. Develop your own support networks with other parents and keep your spirit up. It’s a long road, but rest assured, there is light at the end of the tunnel.
Originally Published in The Hindu on 1 December 2013