Dr Rohit Kiran Cherukuri

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Neurodevelopmental Disorders

These are the disabilities associated primarily with the functioning of the neurological system and brain.

These include a wide range of disorders that can present with varying symptoms. A pediatric neurologist will help you identify and treat them to bring out the best in your child.

What are the common Neurodevelopmental disorders?

Some disorders can be categorized under these disorders include:

➡️ Autism Spectrum Disorder
➡️ Attention-deficit/ Hyperactivity disorder
➡️ Specific learning disorders
➡️ Communication disorders
➡️ Motor disorders
➡️ Other Neurodevelopmental disorders

Autism

What is Autism?

Autism which is also called the autism spectrum disorder is one of the most common neurodevelopmental disorders of childhood. Autism is associated with problems in behaviour and communication.

What should a parent know about Autism?

It is the third most common developmental disorder, which is shown to have affected over 18 million children in India in recent studies. Autism presents itself before the age of three years in most children. While it occurs at birth in maximum cases, at times it may not present itself till the child turns two and half years of age.

It is diagnosed by pediatricians and specialist pediatric neurologists, by assessing the child’s developmental milestones. The best time to detect autism is around 12-18 months of age, and the best way to detect it is by regular visits to your pediatrician.

Symptoms of Autism?

Autism can present itself with various symptoms, such as lack of eye contact, high sensitivity to sound or smell, repetitive robotic speech, etc.  Not all children with Autism show all the symptoms. While some may be fluent in their speech, others may show little or no communication. Thus, it becomes important to discuss this with a specialist, who if suspects Autism on screening, carries out a more complete detailed evaluation before this diagnosis is made. Another interesting aspect is the uneven development of skills in these children. For example, a four-year-old may communicate like a two-year-old, but might be able to draw like a six-year-old. By such scattered developmental patterns, they can turn out to be exceptionally good in some rare skills.

A child with an Autism spectrum may show some early symptoms as listed below by the time they are 8-10 months old. These are particularly important for the early identification of the disease:

➡️ They don’t respond to their name by their first birthday
➡️ They don’t like playing with others and prefer being alone
➡️ They avoid or reject physical contact, including hugging
➡️ They avoid eye contact
➡️ When they’re upset, they don’t like to be comforted
➡️ They may not stretch out their arms to be picked up or guided with walking

What causes Autism in a child?

Various genetic and environmental causes can be associated with the development of autism. In most cases, multiple factors play a role together for this condition to develop. Thus, it is important to understand that pointing out a single cause is not possible in such cases. Instead of blaming any reason, what is more important is that once the condition is detected all the measures should be taken by the parents for better development of the child. Pediatric neurologists, behavioral pediatricians, child psychologists, language and occupational therapists can work together to bring out the best in Autistic children.

The specialist team not only detects Autism at the right age but also, helps improve the specific problems which the child is facing. With this, improvement in communication, daily skills, and a better understanding of the environment develops gradually. Since the needs of the children may be different with growing ages, Ankura hospital is equipped to take care of them as per their developing requirements. Autistic children have normal intelligence levels and do not require any special school. However, the teaching staff and the other students should both be aware of the behavior changes of the autistic child so that together they can help the child adapt to newer ways. Just like none of us is the same, children with Autism too are differently enabled, making them their kind of normal.

If you suspect Autism in your child then visit a pediatric neurologist near you at the earliest!

Cerebral Palsy

What is Cerebral Palsy?

Cerebral palsy is neuromotor impairment. It is the most common motor disability in childhood. It affects muscle tone, movement, and coordination. Cerebral palsy occurs when the brain can’t send messages to the muscles about how to move in smooth or well-coordinated ways. It can also affect other body functions like breathing, bladder and bowel control, eating, and talking.

There are different types of CP. These can exist solely or at times a child may present with more than one variant at the same time:

Spastic cerebral palsy: causes stiffness and trouble moving
Dyskinetic cerebral palsy:  This type causes uncontrolled movements in the child
Ataxic cerebral Palsy: it causes a problem with balance and depth of perception (for example- the inability to know the distance between two objects)
Hypotonic cerebral Palsy: it causes unusually relaxed muscles.

What causes cerebral palsy in a child?

Any abnormal development of the brain or injury to the developing brain can cause cerebral palsy in a child. Thus, it develops either before birth or in early infancy while the brain is still developing in children. Some causes include:

➡️ Head injury as a result of a car accident, fall, or child abuse
➡️ Intracranial haemorrhage – bleeding into the brain
➡️ Brain infections, such as encephalitis or meningitis which are not attended at the right time
➡️ Infections acquired in the womb can also lead to cerebral palsy
➡️ Lack of oxygen to the brain during labour and delivery process
➡️ Genetic abnormality which leads to atypical development of the brain
➡️ Severe jaundice in a child which goes unattended

What are the symptoms of cerebral palsy?

The symptoms of cerebral palsy vary from person to person and depend on the type of cerebral palsy. Most children with this disease are born with it, but may not show symptoms till a few months or later. Symptoms range from mild to severe and need to be identified at the earliest. Some of the more common symptoms include:

➡️ Delays in reaching motor skill milestones, such as rolling over, sitting up alone, or crawling
➡️ The child shows difficulty in walking
➡️ Child may show abnormal muscles tone- Very stiff or very loose
➡️ Presence of poor muscle coordination
➡️ Presence of involuntary movements or tremors
➡️ Delay in other developmental aspects such as speech
➡️ Problem in swallowing food
➡️ Other neurological issues, such as seizures

Any symptom of Cerebral Palsy needs to be identified at the earliest. Visit a pediatric neurologist near you at the earliest in case you have any doubt regarding cerebral palsy in your child.

Though this disease cannot be cured completely, your pediatric neurologist can help your child grow and develop at the best of their potential with the aid of:

➡️ Treatment that may involve medicine or surgery
➡️ Therapy for speech, etc
➡️ Special equipment to help your child with motor movements and the ability to communicate with others

Dr. Rohit Kiran works in close association with a team of other behavioural pediatricians to give children with cerebral palsy the best cure.

Attention deficit and hyperactivity disorder (ADHD)

ADHD is one of the most common neurodevelopmental disorders in childhood. Diagnosed in childhood, this can last into adulthood. Children who have this disorder usually have trouble paying attention, controlling their impulsive behavior, or can be overly active.

Symptoms of ADHD

Unlike adults, children are spontaneous in their behavior and it is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not grow out of these behaviors. The symptoms in such children can be severe enough to cause difficulty at school, at home, or with friends.

The following symptoms can be seen in a child with ADHD:

➡️ The child daydreams a lot
➡️ Forgets things or loses them
➡️ Make unnecessary movements
➡️ They talk too much
➡️ Make careless mistakes
➡️ Have a hard time resisting temptation
➡️ Have difficulty getting along with others

Types of ADHD

ADHD can present differently. The following are the types:

➡️ Predominantly Inattentive Presentation: In such a type it is hard for the child to organize or finish a task. The child is unable to pay attention to details, or to follow instructions or conversations. Some children also get distracted easily or forget their routine activities.

➡️ Predominantly Hyperactive-Impulsive Presentation: A child with this type moves and talks a lot, they find it difficult to sit in one place for example for homework or any attentive task. Smaller children may run, jump or climb constantly and they may have a constant restlessness and impulsive nature. They may also interrupt others a lot and speak at an inappropriate time.  Such impulsiveness may make them more prone to accidents and injuries.

➡️ Combined Presentation: In this type, symptoms of the above two types are equally present in the child.

Children with any type of disorder may show a change in symptoms from time to time.

What can cause ADHD?

Genetics plays a very important role in the development of ADHD. Besides genetics some important causes for this disorder can be:

➡️ Brain injury
➡️ Exposure to environmental risks during pregnancy or at a young age
➡️ Alcohol and tobacco use during pregnancy
➡️ Premature delivery
➡️ Low birth weight

A combination of behavioral therapy and medication is best used to treat ADHD. In case you suspect ADHD in your child then visit a pediatric neurologist near you to bring out the best in them!