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Timely recognition of autism in children is integral to improve developmental outcomes. This study used mixed-methods (84 case-registers and 20 in-depth interviews with caregivers of children with a diagnosis of autism) to explore the extent to which the nature of parental concerns and prior knowledge of developmental disorders impact the time between symptom recognition and autism diagnosis, and the contextual family, societal and health-system related factors that impede the autism help-seeking pathway. Lack of awareness of age-appropriate child developmental milestones, apparent amongst the community and health professionals, contributed to a 1.5-year delay between parental concerns and autism diagnosis. Recommendations to shorten this help-seeking pathway include harnessing the potential of non-specialist workers to increase awareness and enable developmental monitoring of young children through scalable tools.

Timely recognition of autism in children is integral to improve developmental outcomes. This study used mixed-methods (84 case-registers and 20 in-depth interviews with caregivers of children with a diagnosis of autism) to explore the extent to which the nature of parental concerns and prior knowledge of developmental disorders impact the time between symptom recognition and autism diagnosis, and the contextual family, societal and health-system related factors that impede the autism help-seeking pathway. Lack of awareness of age-appropriate child developmental milestones, apparent amongst the community and health professionals, contributed to a 1.5-year delay between parental concerns and autism diagnosis. Recommendations to shorten this help-seeking pathway include harnessing the potential of non-specialist workers to increase awareness and enable developmental monitoring of young children through scalable tools., Author(s): Supriya Bhavnani [sup.1] [sup.2] , Georgia Lockwood Estrin [sup.3] , Rashi Arora [sup.1] , Divya Kumar [sup.1] , Minal Kakra [sup.1] , Vivek Vajaratkar [sup.4] , Monica Juneja [sup.5] [...]

Background: According to the National Crime Records Bureau (2014), traumatic brain injury (TBI) is increasingly being recognized as a public health problem of immense proportions with the substantial burden of disability and death occurring in low- and middle-income countries. Many people with TBI experience various degrees of motor function impairment which can have a significant impact on participation in all the areas of occupation. There is a dearth of evidence-based occupational therapy (OT)-specific motor intervention. Moreover, it is necessary to be aware of the current literature available on OT interventions to support recovery of patients with TBI. Objective: To describe the recent trends in OT-specific motor interventions for adults with TBI. Study Design: A scoping review was employed for this study. Methods: Arksey and O'Malley's six-stage framework for scoping reviews guided our study. A search was conducted in various databases, including PubMed, Cochrane Database of Systematic Reviews, National Institute for Health and Care Excellence, and the Cumulative Index to Nursing and Allied Health Literature–CINAHL for papers published between 2016 and 2021. The search strategy was developed based on the concepts and keywords used in the Population, Intervention, Comparison, Outcomes, and Study design framework. Numerical and thematic analyses were employed. Results: Of the 35 articles identified in the review process, 13 papers were included in the scoping review. On performing analyses, 6 major themes were identified which were as follows: (1) The centrality of occupation (top-down approach), (2) Should bottom-up approach be used? When? (3) Contemporary approaches to intervention, (4) Traditional approaches to intervention, (5) Outcome measures for motor intervention, and (6) Futuristic intervention concepts and opportunities. Conclusion: Several recent trends in OT-specific to motor intervention have emerged in the yesteryears which may be considered for integration into practice with TBI survivors. Whilst there have been some advancements in TBI literature including "occupation" in the limelight, multidisciplinary or interdisciplinary collaboration and several contemporary approaches with unique and new concepts, there are still undeniable challenges to the practicing occupational therapists with regard to understanding its implementation, limited evidence, and equivocacy of its effectiveness. [ABSTRACT FROM AUTHOR]

Background Neurodevelopmental disorders (NDDs) compromise the development and attainment of full social and economic potential at individual, family, community, and country levels. Paucity of data on NDDs slows down policy and programmatic action in most developing countries despite perceived high burden. Methods and findings We assessed 3,964 children (with almost equal number of boys and girls distributed in 2- Conclusions The study identifies NDDs in children aged 2-9 years as a significant public health burden for India. HI was higher than and ASD prevalence comparable to the published global literature. Most risk factors of NDDs were modifiable and amenable to public health interventions., Author(s): Narendra K. Arora 1,*, M. K. C. Nair 2, Sheffali Gulati 3, Vaishali Deshmukh 1, Archisman Mohapatra 1, Devendra Mishra 4, Vikram Patel 5,6, Ravindra M. Pandey 7, Bhagabati [...]

The treatment gap for autism globally is high. Our previous PASS intervention, delivered by community based lay health workers, showed effectiveness. This article reports the development and evaluation of a new "PASS 'Plus'" intervention in a rural population in India. Using formative research methods, we supplemented the PASS intervention with additional (Plus) modules to address autism comorbidities. This is the first time that a rigorous methodology has been used to evaluate autism symptom outcomes in a low and middle-income country setting. 40 parent-child dyads were recruited in a pilot randomized controlled trial against usual care (mean age 65 months (34 boys); n = 19 PASS Plus, n = 21 UC). 89% of intervention families partially or entirely completed the 12-session intervention. Intention to treat analysis showed a reduction in mean scores of autism symptom severity, though the confidence interval contains zero, (adjusted mean difference AMD -2.42 95% CI -7.75, 2.92; ES 0.22); large treatment effects on proximal outcomes of proportion of parent synchronous responses (AMD 0.35; 95% CI 0.18, 0.52; effect size ES 3.97) and proportion of child communication initiations with parent (AMD 0·17; 95% CI 0.03, 0.32; ES 1.02). Confidence intervals for effects on mutual shared attention (AMD 0.10; 95% CI -0.07, 0.27; ES 0.5) and co-morbid symptoms (AMD -9.0; 95% CI -24.26, 6.26; ES 0.32) contained zero. There were significant effects to improve parental mental health. PASS Plus shows good feasibility and adds to the evidence of the effectiveness of task sharing complex autism interventions to lay health workers in India. Autism Res 2019, 12: 328-339 © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This article describes the development of a comprehensive, community-delivered, intervention for young children with autism, which combines a previously developed parent-mediated communication intervention with support for co-morbid problems like challenging behaviors and sensory sensitivities. The unique aspect of this intervention is that it can be delivered by community health workers, addressing the lack of specialists in low resource settings. Our study reports the encouraging findings of a pilot trial evaluating its feasibility and effectiveness., (© 2018 International Society for Autism Research, Wiley Periodicals, Inc.)