Consensus Statement of the Indian Academy of Pediatrics on Newborn Hearing Screening.

JUSTIFICATION: Hearing impairment is one of the most critical sensory impairments with significant social and psychological consequences. Evidence-based, standardized national guidelines are needed for professionals to screen for hearing impairment during the neonatal period. PROCESS: The meeting on formulation of national consensus guidelines on developmental disorders was organized by Indian Academy of Pediatrics in Mumbai, on 18th and 19th December, 2015. The invited experts included Pediatricians, Developmental Pediatricians, Pediatric Neurologists and Clinical Psychologists. The participants framed guidelines after extensive discussions. OBJECTIVE: To provide guidelines on newborn hearing screening in India. RECOMMENDATIONS: The first screening should be conducted before the neonate's discharge from the hospital - if it 'fails', then it should be repeated after four weeks, or at first immunization visit. If it 'fails' again, then Auditory Brainstem Response (ABR) audiometry should be conducted. All babies admitted to intensive care unit should be screened via ABR. All babies with abnormal ABR should undergo detailed evaluation, hearing aid fitting and auditory rehabilitation, before six months of age. The goal is to screen newborn babies before one month of age, diagnose hearing loss before three months of age and start intervention before six months of age.

Consensus Statement of the Indian Academy of Pediatrics on Evaluation and Management of Attention Deficit Hyperactivity Disorder.

JUSTIFICATION: Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent in children worldwide. Management of ADHD requires a systematic, multidisciplinary approach and therefore evidence-based, standardized national guidelines are essential. PROCESS: A meeting for formulation of national consensus guidelines on neurodevelopmental disorders was organized by Indian Academy of Pediatrics in Mumbai, on 18th and 19th December, 2015. The invited experts included Pediatricians, Developmental Pediatricians, Pediatric Neurologists, Psychiatrists, Remedial Educators and Clinical Psychologists. The participants framed guidelines after extensive discussions. OBJECTIVE: To provide consensus guidelines on evaluation and management of ADHD in children in India. RECOMMENDATIONS: ADHD is a chronic condition and thus education of patients, families, and teachers regarding the diagnosis is an integral part of management. Involvement of patient the and the family in the management program is extremely vital. Management of ADHD centers on the achievement of target outcomes, which are chosen in collaboration with the child, parents, and school personnel. Coexisting conditions must be treated concurrently with ADHD. Modalities of management of ADHD include behavioral interventions, medications, and educational interventions. These modalities can be implemented individually or in combination.

Consensus Statement of the Indian Academy of Pediatrics on Evaluation and Management of Learning Disability.

JUSTIFICATION: Learning Disability (LD) in children is a well-recognized developmental disorder, which has profound academic and psychosocial consequences. Due to the complex nature of LD and multiple disadvantages posed to the child due to LD, a multidisciplinary approach towards intervention is warranted. Given the paucity of evidence-based standardized treatment approaches, consensus guidelines for management of LD are needed. PROCESS: The meeting on formulation of national consensus guidelines on neurodevelopmental disorders was organized by Indian Academy of Pediatrics in Mumbai on 18th and 19th December, 2015. The invited experts included Pediatricians, Developmental Pediatricians, Pediatric Neurologists, Psychiatrists, Remedial Educators and Clinical Psychologists. The participants framed guidelines after extensive discussions. Thereafter, a committee was established to review and finalize the points discussed in the meeting. OBJECTIVE: To provide guidelines on evaluation and management of LD in children in India. RECOMMENDATIONS: A basic intervention approach should focus on: (i) interpretation of evaluation reports; (ii) description of specific skills that may be delayed (e.g., phoneme awareness and phonics; reading comprehension; spelling; number sense and organizational skills) and (iii) identification of co-morbidities. The intervention should be inter-disciplinary and individualized to each child. Required services include: developmental pediatrics evaluation; neurological evaluation; ophthalmology and audiology evaluation; clinical psychology assessment; occupational therapy, remedial education, counseling for family, and career-counselling.

Consensus Statement of the Indian Academy of Pediatrics on Evaluation and Management of Autism Spectrum Disorder.

JUSTIFICATION: Autism Spectrum Disorder (ASD) is a clinically heterogenous condition with a wide range of etiological factors and causing significant public health burden. ASD poses a serious developmental disadvantage to the child in the form of poor schooling, social function and adult productivity. Thus, framing evidence-based national guidelines is a pressing need. PROCESS: The meeting on formulation of national consensus guidelines on neurodevelopmental disorders was organized by Indian Academy of Paediatrics in Mumbai on 18th and 19th December 2015. The invited experts included Pediatricians, Developmental Pediatricians, Psychiatrists, Remedial Educators, Pediatric Neurologists and Clinical Psychologists. The participants framed guidelines after extensive discussions. Thereafter, a committee was established to review the points discussed in the meeting. OBJECTIVE: To provide consensus guidelines on evaluation and management of ASD in children in India. RECOMMENDATIONS: Intervention should begin as early as possible. A definitive diagnosis is not necessary for commencing intervention. Intervention should target core features of autism i.e. deficits in social communication and interaction, and restricted repetitive patterns of behavior, activities and/ or interests. Intervention should be specific, evidence-based, structured and appropriate to the developmental needs of the child. Management of children should be provided through interdisciplinary teams, coordinated by the Pediatrician. Management of co-morbidities is critical to effectiveness of treatment. Pharmacotherapy may be offered to children when there is a specific target symptom or co-morbid condition.