IAP Handbook of Developmental and Behavioral Pediatrics
IAP Handbook of Developmental and Behavioral Pediatrics
Editor-in-Chief
Samir H Dalwai
Developmental Behavioral Pediatrician New Horizons Child Development Centre and Research Foundation National Coordinator, IAP Fellowship in Developmental and Behavioral Pediatrics Nanavati Max Superspecialty Hospital, Mumbai, Maharashtra, India
Chief Academic Editors
Jeeson C Unni
Senior Associate Consultant Aster Medcity Kochi, Kerala, India Editor-in-Chief, IAP Drug Formulary
Shabina Ahmed
Founder Director Assam Autism Foundation Guwahati, Assam, India
Academic Editors
Kawaljit Singh Multani
Consultant Pediatrician 11 Air Force Hospital Ghaziabad, Uttar Pradesh, India
Leena Deshpande
Developmental and Behavioral Pediatrician iCAN Child Development Centre MGM Hospital, Apollo Hospital Navi Mumbai, Maharashtra, India
Leena Srivastava
Head, Division of Developmental and Behavioral Pediatrics Department of Pediatrics Bharati Vidyapeeth Medical College and Hospital Visiting Consultant, Developmental Pediatrics, CloudNine Hospital and LMCCH Pune, Maharashtra, India
Forewords
MKC Nair
Piyush Gupta
Remesh Kumar R
Bakul Jayant Parekh
Upendra Kinjawadekar
Vineet Saxena
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© 2022, Indian Academy of Pediatrics
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IAP Handbook of Developmental and Behavioral Pediatrics
First Edition: 2022
9789389776485
Printed at
This book is dedicated to our parents and teachers who by their wisdom and patience continue to help us develop far beyond our childhood years and to our little patients who are the reason for the spring in our step every morning!
- A Somasundaram
- Founder and Developmental Pediatrician
- D'Soul Child Development Centre
- Chennai, Tamil Nadu, India
- Abhishek R jain
- Consultant Pediatric Neurologist
- Rainbow Children's Hospital
- Hyderabad, Telangana, India
- Abraham K Paul
- Consultant Pediatrician and Convener
- Newborn Hearing Screening Programme—IAP
- Cochin Hospital
- Kochi, Kerala, India
- Alka A Subramanyam
- Associate Professor
- Department of Psychiatry
- TNMC and BYL Nair Charitable Hospital
- Mumbai, Maharashtra, India
- Ami Shah
- Consultant Clinical Geneticist
- Genetic Clinic
- Department of Pediatrics
- Nanavati Superspecialty Hospital
- Mumbai, Maharashtra, India
- Anaita Udwadia-Hegde
- Consultant Pediatric Neurologist
- Jaslok Hospital and Research Center
- SRCC Narayana Health Children's Hospital
- Breach Candy Hospital Trust
- Wadia Children's Hospital
- Mumbai, Maharashtra, India
- Anjan Bhattacharya
- Senior Consultant Developmental Pediatrician and Head
- Child Development Centre
- Apollo Multispecialty Hospital, Kolkata
- Director
- Nabajatak Child Development Center
- Kolkata, West Bengal, India
- Ann M Neumeyer
- Child Neurologist
- Assistant Professor
- Harvard Medical School
- Medical Director, Lurie Center for Autism/MassGeneral Hospital for Children
- Boston, Massachusetts, USA
- Aradhana Rohil
- Fellowship in Developmental and Behavioral Pediatrics
- New Horizons Child Development Centre and Research Foundation
- Mumbai, Maharashtra, India
- B Yambao-Dela Cruz
- UC Davis MIND Institute
- UC Davis Health
- California, San Francisco, USA
- Barkha Chawla
- Developmental Pediatrician
- New Horizons Child Development Centre and Research Foundation
- Mumbai, Maharashtra, India
- Dilip R Patel
- Professor
- Pediatrics and Adolescent Medicine
- Department of Pediatric and Adolescent Medicine
- Western Michigan University Homer Stryker MD School of Medicine
- Kalamazoo, Michigan, USA
- Hilla Sukhadwala
- Fellowship in Developmental and Behavioral Pediatrics
- New Horizons Child Development Centre and Research Foundation
- Mumbai, Maharashtra, India
- Jeeson C Unni
- Senior Associate Consultant
- Aster Medcity
- Kochi, Kerala, India
- Editor-in-Chief, IAP Drug Formulary
- Jyoti Bhatia
- Senior Consultant (Developmental and Behavioral Pediatrics)
- Department of Pediatrics
- Max Superspecialty Hospital, Patparganj
- New Delhi, India
- Kawaljit Singh Multani
- Consultant Pediatrician
- 11 Air Force Hospital
- Ghaziabad, Uttar Pradesh, India
- Kaye M Napalinga
- Consultant Pediatrician
- MedMom Institute for Human Development
- Pasig City, Philippines
- Kersi Chavda
- Consultant Psychiatrist
- Department of Psychiatry
- Hinduja Hospital and Sir HN Hospital
- Mumbai, Maharashtra, India
- Lata Bhat
- Developmental and Behavioral Pediatrician
- Indraprastha Apollo Hospital
- New Delhi, India
- Lavanya Iyer
- Counseling Psychologist and Remedial Educator
- iCAN Child Development Centre
- Navi Mumbai, Maharashtra, India
- Leena Deshpande
- Developmental and
- Behavioral Pediatrician
- iCAN Child Development Centre
- MGM Hospital, Apollo Hospital
- Navi Mumbai, Maharashtra, India
- Leena Srivastava
- Head, Division of Developmental and Behavioral Pediatrics
- Department of Pediatrics
- Bharati Vidyapeeth Medical College and
- Hospital
- Visiting Consultant, Developmental
- Pediatrics, CloudNine Hospital and LMCCH
- Pune, Maharashtra, India
- Lokesh Lingappa
- Senior Consultant Pediatric Neurologist
- Rainbow Children's Hospital
- Hyderabad, Telangana, India
- MA Florita
- UC Davis MIND Institute
- UC Davis Health
- California, San Francisco, USA
- Manju George Elenjickal
- Associate Professor and In-Charge
- Child Development Centre
- Department of Pediatrics
- Pushpagiri Medical College Hospital
- Thiruvalla, Kerala, India
- Manoj Bhatawdekar
- Consulting Psychiatrist
- Bhatawdekars’ Clinic
- Mumbai, Maharashtra, India
- Naveen Jain
- Coordinator and Senior Consultant
- Department of Neonatology
- Kerala Institute of Medical Sciences
- Thiruvananthapuram, Kerala, India
- Neelkamal Soares
- Professor of Pediatric and Adolescent Medicine
- Western Michigan University Homer Stryker MD School of Medicine
- Kalamazoo, Michigan, USA
- Neepa Thacker Dave
- Pediatric Ophthalmologist and Strabismologist
- Kids Eye Clinic
- Mumbai, Maharashtra, India
- Neethu Mary Mathew
- Audiologist and Speech Language Pathologist
- Pratheeksha Child Development Centre
- Department of Pediatrics
- Pushpagiri Medical College Hospital
- Thiruvalla, Kerala, India
- Omkar Pradip Hajirnis
- Consultant Pediatric Neurologist
- Synapses Child Neurology and Development Centre
- Jupiter Hospital, Bhaktivedanta Hospital and Research Centre
- Thane, Maharashtra, India
- Patricia Osbourn
- Deputy Director
- University of New Mexico
- Pediatrics Center for Development and Disability
- Albuquerque, New Mexico
- Prameela Joji
- Consultant Pediatric ICU and ER
- Kerala Institute of Medical Sciences
- Thiruvananthapuram, Kerala, India
- Randi J Hagerman
- UC Davis MIND Institute
- UC Davis Health
- California, San Francisco, USA
- Rashid Merchant
- Senior Consultant Pediatrician
- Nanavati Superspecialty Hospital
- Mumbai, Maharashtra, India
- Rhishikesh Thakre
- Director and Chief Neonatologist
- Neo Clinic and Hospital
- Aurangabad, Maharashtra, India
- Samir H Dalwai
- Developmental Behavioral Pediatrician
- New Horizons Child Development Centre and Research Foundation
- National Coordinator, IAP Fellowship in Developmental and Behavioral Pediatrics
- Nanavati Max Superspecialty Hospital Mumbai, Maharashtra, India
- Santhosh Rajagopal
- Developmental Pediatrician
- Rio Hospital for Women and Children
- Madurai, Tamil Nadu, India
- Sarbani Raha
- Child Neurologist
- Child Neurology and Epilepsy Clinic
- Vadodara, Gujarat, India
- Shabina Ahmed
- Founder Director
- Assam Autism Foundation
- Guwahati, Assam, India
- Shambhavi Seth
- Developmental Pediatrician
- Director, Bright Beginnings Child Development Centre, New Delhi
- Senior Consultant, Max Hospital Saket and Gurugram
- BLK Superspecialty Hospital
- New Delhi, India
- Shekhar Patil
- Consultant
- Department of Pediatric Neurology
- Apollo Hospital
- Navi Mumbai, Maharashtra, India
- Shibani Kanungo
- Associate Professor of Pediatric and Adolescent Medicine
- Western Michigan University Homer Stryker MD School of Medicine
- Kalamazoo, Michigan, USA
- Snehal Mallakmir
- Consultant Clinical Geneticist
- Genetic Clinic
- Department of Pediatrics
- Nanavati Superspecialty Hospital
- Mumbai, Maharashtra, India
- SS Kamath
- Consultant Pediatrician
- Indira Gandhi Co-Operative Hospital
- Kochi, Kerala, India
- Swati Y Bhave
- Adjunct Professor
- Department of Adolescent Medicine
- Dr DY Patil Medical College and Dr DY Patil Vidyapeeth, Pune
- Senior Consultant in Adolescent Pediatrics
- Head and In-Charge of Adolescent Wellness Clinic, Jehangir Hospital
- Pune, Maharashtra, India
- Executive Director AACCI, Mumbai (Association of Adolescent and Child Care in India)
- Vasudha N Rao
- Consultant Pediatric Oncology
- Rainbow Children's Hospital
- Bengaluru, Karnataka, India
- Vrajesh Udani
- Child Neurologist and Epileptologist
- PD Hinduja Hospital
- Mumbai, Maharashtra, India
- Waheeda Pagarkar
- Consultant in Audiovestibular Medicine
- Great Ormond Street Hospital for Children, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
- New Horizons Audiology and Hearing AIDS Centre for Adults and Children
- Mumbai, Maharashtra, India
- Yamini Jagannath Howe
- Developmental and Behavioral Pediatrician
- Instructor, Harvard Medical School
- Lurie Center for Autism/MassGeneral Hospital for Children
- Boston, Massachusetts, USA
- YK Amdekar
- Former Medical Director
- BJ Wadia Children's Hospital
- Mumbai, Maharashtra, India
- Z Bassi
- Consultant in Pediatric
- Neurodevelopment and Neurodisability
- Department of Development Pediatrics
- Alder Hey Children's Hospital
- Liverpool, UK
- Zafar Mahmood Meenai
- Director, Ummeid Group of Child Development Centers
- Bhopal and Nagpur
- Advisor and International Advocacy Group Member of American Academy of
- Cerebral Palsy and Developmental Medicine (AACPDM) and Past Chair of International Affairs Committee
I am happy to know that the IAP Chapter of Neurodevelopmental Pediatrics is publishing a Handbook of Developmental and Behavioral Pediatrics with contributions from eminent developmental pediatricians across the country and abroad. This comprehensive handbook covers all essential topics in the subject in 60 chapters. This handbook has come at a critical time, when we are looking for a simple user-friendly handbook for the personnel of District Early Intervention Centres under Rshtriya Bal Swasthya Karyakram (RBSK).
I do hope that this handbook would serve to initiate students of pediatrics into the field of developmental and behavioral pediatrics. It would also serve as a handy reference not only for practicing pediatricians but also for the developmental behavioral pediatricians—Developmental Therapist team at all levels. The DEIC therapy team of physiotherapists, occupational therapist, speech therapist, child psychologists, and special educators may find it handy. It could also be a textbook on Developmental Behavioral Pediatrics for the large number of community health personnel both in government and in private sector.
MKC Nair
DSc PhD MD MMedSc (NewCastle) MBA MA (Philosophy) MA (MC&J) FNNF FIAP FIACAM FAMS
Fomer Vice Chancellor and Professor Emeritus-Research Kerala University of Health Sciences
Founder Director and Professor Emeritus in Developmental Behavioral and Adolescent Pediatrics, CDC Kerala
Director, NIMS-Spectrum-Child Development Research Centre
Editor, IAP Textbook of Pediatrics and High-risk Newborn
Editor, Illingworth's The Development of the Infant and the Young Child (11th Edn)
E-mail: cdcmkc@gmail.com
Foreword
I am very much privileged to present the foreword for the Handbook of Developmental and Behavioral Pediatrics, which is being published by IAP to better equip practicing pediatricians to understand and assess developmental and behavioral problems in children. This book is a step forward in IAP's mission to continuously enlarge its scope to cover the entire spectrum of child health and child care. It is a comprehensive compilation of valuable information for the early detection of developmental and behavioral disorders in children, along with providing remedial measures.
Research into adult health issues and behavioral disorders clearly indicate that many such problems originate in childhood. It logically follows that these could have been better resolved with early intervention. As the saying goes, “Prevention is better than cure.” Hence, developmental and behavioral pediatrics has a special role to play in heralding a healthy society. This stream focuses on scientifically evaluating the child's physical, emotional and cognitive development to identify problem areas and prescribe corrective measures, which are designed to enable a transition to healthy adulthood. Judging by the important role this plays in child health, there can be no doubt that this domain of pediatrics will eventually take center stage in our profession.
Conventional wisdom holds that “Happy childhood leads to happy life”. However, with the advent of developmental pediatrics, we can confidently rephrase this as “Healthy childhood leads to healthy life”. However, as this his domain deals with the intangible “gray areas” of life, practitioners of this craft will need special qualities like sensitivity, observation, empathy and a helping nature to derive the best results. This handbook introduces the clinician to the fundamentals of developmental and behavioral issues and acquaints oneself to the new doors that are being opened in the field of pediatrics.
I congratulate the editorial team comprising Dr Samir H Dalwai as the Editor-in-Chief, Dr Jeeson Unni and Dr Shabina Ahmed as Chief Academic Editors, Dr Kawaljit Singh Multani, Dr Leena Srivastav and Dr Leena Deshpande as Academic Editors. They have taken pains to access the best brains in the field from across the country and abroad to produce an authoritative high quality publication which is worthy of the reader's attention. I wish them success in this venture and hope that the reader response will motivate them to continue updating this book with further inputs in the years to come.
Remesh Kumar R
National President 2022
Indian Academy of Pediatrics
Foreword
I am extremely happy to know that IAP has taken a very important initiative and is publishing a Handbook of Developmental and Behavioral Pediatrics. Neurodevelopmental disorders have a diverse influence on function, development, learning, behavior, mental health, and the child's capacity to meet the range of age-based expectations across a variety of settings.
What happens to children in the earliest years of their lives has a great impact on their immediate well-being and their future. Similarly, what does not happen for a child in their early years can be an impediment to their well-being and entire future. Any significant deviation in the behavior or the development of the child needs to be detected and addressed in the most comprehensive way. I am sure that this handbook will provide a collegiate and supportive structure for pediatricians and other medically trained professionals who work with children and families affected by eurodevelopmental and behavioral disorders, and share similar professional and related personal challenges.
In the last two years of the pandemic, while the entire medical fraternity irrespective of the field of their expertise was busy concentrating on prevention, control and cure of COVID-19, sadly, too many children around the world were denied the right to reach their full potential. And every year, some of them are held back, deprived, in one way or another, of the love, care, nurturing, health, nutrition and protection that they need to survive, grow and develop resulting in some behavioral and neurodevelopmental challenges.
The editorial team under the leadership of very talented Dr Samir H Dalwai and comprising of great academicians with huge experience in the field across the country like Dr Jeeson Unni, Dr Shabina Ahmed, Dr KS Multani, Dr Leena Shrivastava, Dr Leena Deshpande are aware about the advances in the field as well as the ground reality in regard to the current understanding of general pediatricians of behavioral and developmental pediatrics.
In acknowledgment of the complexity and uncertainty inherent to this area of developmental and behavioral pediatrics, the editors value the sharing of knowledge and experience towards the development of good clinical judgment. They have addressed dual goals of alleviating current distress, and working towards optimal outcomes, considering the fact that there is no magic bullet to treat or cure many of these disorders. This handbook has kept a highly practical focus, emphasizing evaluation, counseling, medical treatment, and follow-up with a single aim to promote and support the development of excellence in the practice of Neurodevelopmental and Behavioral Pediatrics.
I am sure this handbook will be a permanent companion of every medical practitioner working in the field of child health.
Best Wishes
Upendra Kinjawadekar
National President Elect 2022
Indian Academy of Pediatrics
Foreword
I am very happy to know that the Indian Academy of Pediatrics is coming out with the first Handbook of Developmental and Behavioral Pediatrics!
Developmental and Behavioral Pediatrics has traditionally been a subject, which has not received its due importance in the medical curriculum. Infectious diseases, intensive care, even growth and nutrition have been accorded much higher significance. However, as times have changed and pediatricians are faced with a larger proportion of concerns in the field of development and behavior in their practice, it is imperative for the practicing pediatrician to be well versed with basic clinical manifestations as well as primary intervention on these topics.
Indeed, the Indian Academy of Pediatrics has launched one of its most significant programs on Nurturing Care for Early Childhood Development; development and behavior is a very important component of the same. I am glad that this handbook is being released during these times, as this will add to the overall knowledge and practice of early child development.
I congratulate the Editor-in-Chief, Dr Samir Dalwai, the Chief Academic Editors, Dr Shabina Ahmed and Dr Jeeson Unni as well as the Academic Editors, Dr Leena Deshpande, Dr Leena Srivastava and Dr Kawaljit Singh Multani as well as all the esteemed authors who have contributed to this handbook.
I am sure this handbook will serve as an import source of knowledge to clinicians and academicians alike as well as residents and students and will stimulate a holistic interest in the subject.
Piyush Gupta MD FIAP FNNF FAMS
President, Indian Academy of Pediatrics, 2021
Foreword
Dear friends,
Greetings from the Indian Academy of Pediatrics!
In today's era, where the competition among children is rising at a fierce pace – a time when children are scoring more than 90 percent, the most common complaint heard from the parents are a few rather simple questions – Why is my child not able to study well? What is wrong with my child? Why is my child not attentive in class? Why is the teacher always complaining about my child? Why does my child get low marks in a certain subject, but excel in others? This has become more common today because of the COVID-19 pandemic scenario, wherein the schools were completely shut for more than a year. Unfortunately, the answer to these questions is not that simple, but the best person who can answer is from a comparatively new and upcoming field—Developmental and Behavioral Pediatrician.
Developmental and Behavioral Pediatrics is a specialized branch of pediatrics that deals with evaluation, counseling as well as providing treatment for children, adolescents, and their families with a wide range of developmental and behavioral difficulties including learning disorders, writing difficulties, math disorders, attention deficit/hyperactivity disorder, habit disorders, etc. to name a few. Unfortunately, the very mention of a behavioral and developmental pediatrician requirement often makes the parent rather defensive. They cannot accept that anything could be wrong with their child. However, we—the general pediatricians—can help the situation easily. By having a basic knowledge about the different issues, we can be the first point of contact and help in the correct diagnosis.
Since it is a specialized science, not all of us are trained in proper detection of the various scenarios that may lead to an actual visit to the specialist. This is where this book proves its usefulness. By having several problems faced by parents explained in a simple and lucid language, I am sure that it will help us in early and easy detection and provide the correct way forward. This book fills a void, which was felt regarding this specialized area of expertise, and I am certain that it will be very well received by all our colleagues.
With the schools on the verge of reopening once again and the concerns of parents regarding their child's scholastic performance, this handbook which was actually conceived pre-pandemic in 2020 and has dealt extensively with these topics as well, will aid the common pediatrician to guide the parents carefully in such situations. The book is very aptly named Handbook of Developmental and Behavioral Pediatrics. This handbook covers the most essential questions that have been asked by several parents during our practice and has been written by stalwarts in the field of Developmental and Behavioral Pediatrics. Since it is written by pediatricians, you can be assured that the contents are hundred percent proper and applicable in your day-to-day lives.
I would like to take this opportunity to thank all the editors and contributors in general and Dr Samir Dalwai in particular who have burnt the midnight oil and made the dream of mine and all pediatricians come true. It is without doubt an amazing handbook worth recommendation to be there in every parent and pediatrician's bookshelf. I am certain that the timing for the book and its contents could not have been better in any manner. Keep up the great work. Kudos to the entire team who has worked diligently on this project throughout the pandemic while fulfilling their duties at the same time.
Happy Reading!
Bakul Jayant Parekh
President, Indian Academy of Pediatrics, 2020
Foreword
Dear Friends,
It gives me immense pleasure to introduce the ‘Handbook of Developmental and Behavioral Pediatrics’ by IAP. As we all know that Growth, Development and Behavioral Pediatrics is the most intriguing, interesting and unique aspect of our specialty. It is the real Pediatrics, which sets it apart from Medicine. It starts right from the time when the fetus is formed and especially how a newborn baby grows into a mature human being, passing through various milestones one after the other.
Even at the first glance, an astute pediatrician knows whether the baby is growing normally or if there is something amiss. Despite this skill which every pediatrician possesses by virtue of his/her training, it always needs to be honed and sharpened and approached in a systematic manner. I am sure that this handy book by IAP will stand out among all the available books on the subject of Development and Behavioral Pediatrics.
Each one of us needs to go through this book again and again so that the benefit of this fantastic book reaches to its final target—the little babies. Their growth and developmental assessment is our primary responsibility after all. Given the expertise of the Editorial Team and contributors, it will serve to be an indispensible tool for practicing pediatricians and postgraduates.
No words of appreciation are enough for Dr Jeeson Unni and Dr Shabina Ahmed who have worked so hard as Chief Academic Editors, and Dr Kawaljit Singh Multani, Dr Leena Srivastava and Dr Leena Deshpande, who have taken the responsibility of Academic Co-Editors and Dr Samir H Dalwai the Editor-in-Chief who has taken the mantle upon himself to bring out this gem for IAP. IAP is thankful to their yeoman service for the children as well as pediatricians.
Vineet Saxena
Honorary Secretary General
Indian Academy of Pediatrics 2022-23
Preface
Over the past decade, interest in Developmental and Behavioral Pediatrics has shown a remarkable surge. A steady decline in infectious disorders, increased survival of high-risk neonates, smaller families, rising incomes and an overall increase in aspiration about the quality of life for the family has contributed to increasing awareness and increased care seeking for children and adolescents with neurodevelopmental and behavioral problems. The pediatrician who was content with a cursory look at motor milestones and weight gain is now being asked probing questions about the child's development and behavior. “Wait and watch”, worse—“Nothing can be done”—the earlier answers for most cases, is now neither acceptable assurance nor scientifically correct advice. A spiraling increase in autism and other neurobehavioral problems, coupled with insistence from schools, and indeed society, for perfection to fit the curriculum and expected norms are leading to increased consultancy for these issues.
The Indian Academy of Pediatrics has been at the forefront of training and coaching more than 30,000 pediatrician members to equip them with clinical skills. The demand for training on developmental and behavioral problems in children and adolescents has led to many of us having overbooked calendars. Often, the way this subject is practiced in the western world is far removed from the limitations and advantages of our family-oriented culture; teachers and authors that adapt with this important aspect are oft sought after. The IAP Fellowship in Developmental and Behavioral Pediatrics is now into its sixth successful year with an increased demand from Fellows for content of Indian origin. The thirst for such knowledge, albeit in a palatable dosage, has led to the birth of the first such Handbook of Developmental and Behavioral Pediatrics.
This handbook is organized into chapters that deal with basics of developmental and behavioral pediatrics and chapters that offer some in-depth knowledge about individual conditions. There are chapters on therapeutics as well various social aspects like digital exposure and medicolegal aspects, as well as a peek into the history of this subject. Each chapter has a brief introduction about the topic followed by simple to grasp clinical features often with key questions and a succinctly presented management of the condition. As such, the handbook can be read across at one go (for an examination, perhaps!) or can be used as a ready reference in the busy clinic. The authors have been invited nationally as well as overseas to present a swathe of clinical and academic aspects of the above. We are sure this will spur the uninitiated—the students and residents—into the subject, as well as the practicing pediatricians to spend a little more time with their patients with neurodevelopmental and behavioral disorders. Serious students of this subject will have to wait a little longer for a detailed textbook to follow this handbook soon. Meanwhile, if even a few families seen by each pediatrician receive a longer interaction about their child's concerns, we will be both delighted and relieved to have pulled off a difficult job well.
We will be happy to receive constructive criticism and suggestions about this handbook as we are sure it will help us “develop” the next edition better (Developmental Behavioral Pediatricians are an optimistic lot!). As blessed practitioners of this enchanting field, we are gratified by the fact that pursuit of no other subject or practice helps the practitioner to develop the self as much as this subject does. To this, we owe our emancipation! Long live the practice of Developmental Behavioral Pediatrics!
The despondency of earlier years where neurodevelopmental disorders were relegated to optional short notes in theory examinations and to asylums in real life gave way to Tennyson's “Tis better to have loved and lost than never to have loved at all” approach, when our earlier generation attempted forays into offering a more humane life to those affected. We hope coming generations of pediatricians will rather see most of these “disorders” for what they are in Ghalib's words, “Meherbaan ho ke bula lo mujhe chaho jis waqt, Main gaya waqt nahin hoon ke phir aa bhi na sakun!” (Your benevolent intervention is all that I seek for my resurrection; I am not time that I may never return once it passes.)
It is never too late. It is only needed that we try!
Samir H Dalwai
Jeeson C Unni
Shabina Ahmed
Leena Deshpande
Leena Srivastava
Kawaljit Singh Multani
Acknowledgments
We wish to thank the Indian Academy of Pediatrics for the opportunity to contribute this handbook, which will serve to increase the knowledge of developmental and behavioral pediatrics.
We wish to thank the authors who have contributed their knowledge in a simple and lucid manner and complied with the (various) timelines.
We wish to thank our families who supported us through hours of being locked away in front of a screen interspersed with late night frantic phone discussions.
We wish to thank our individual staff and teams who accommodated our absence from our regular clinics.
We wish to thank Dr Bakul Parekh, who encouraged us when the idea for such a text was floated way back in 2020, Dr Piyush Gupta who helped us keep the momentum going through the COVID year, Dr Remesh Kumar R for always supporting us with this academic venture as well as our teachers, Dr YK Amdekar, Dr MKC Nair, Dr Rashid H Merchant and Dr Swati Bhave for their presence in this handbook.
We wish to thank Dr Waheeda Pagarkar, Dr Dilip R Patel, Dr Randi J Hagerman, Dr Ann M Neumeyer, Dr Patricia Osbourn, Dr Yamini Jagannath Howe, Dr MA Florita, Dr B Yambao-Dela Cruz, Dr Kaye M Napalinga, Dr Zahabiyah Bassi, Dr Shibani Kanungo and Dr Neelkamal Soares for their distinguished contribution in this field as well as adding an international flavor to this handbook.
We are forever grateful to our mentors Dr Sachidanand S Kamath and Dr Abraham K Paul for their guidance.
We are thankful to Shri Jitendar P Vij (Group Chairman), Mr. Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy) and Dr Rajul Jain (Development Editor) of Jaypee Brothers Medical Publishers (P) Ltd, New Delhi for their constant help in publishing the book.
Finally, we wish to formally thank each other—the editors! One remembers the concluding lines from the legendary Robbins and Kumar's Textbook of Pathology—“It is not that we always thought alike, but we were always happy to acknowledge each other's thoughts.”
We thank each other and all the authors for standing by us through all the unforeseen difficulties. This book is a conception of the COVID years as much a child of our years of study and work in this field.
Finally, we wish to thank the innumerable children and adolescents and their families who across the decades have taught us not just what little we know about this subject, but what it means to be human. We are but a product of their chisel.