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Penn Neurologist Inspires India to Screen 230 Million Children for Neurodevelopmental Disorders

Image002Donald Silberberg, MD, professor emeritus and former chair of Neurology in the Perelman School of Medicine at the University of Pennsylvania, is continuing his efforts to improve neurological assessment and care across the globe. He's been praised for his work in Ecuador and Iraq, and now the Government of India is bringing one of his pilot projects to life - screening every child in India for neurodevelopmental disorders. 

A few years ago Silberberg initiated an epidemiological study to determine the prevalence and causes of neurodevelopment disorders in various regions throughout India. The study was done in collaboration with the International Clinical Epidemiological Network (INCLEN), an organization that started at Penn 30 years ago, and supported by NIH funding. As it moved forward, Autism Speaks, the Government of India, and INCLEN itself provided additional support for the study.

While the final study results are pending, an initial analysis of 4,000 households showed that, on average, 15 percent of children in India had one or more neurodevelopmental disorders. Disorders included attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, intellectual disability, epilepsy, learning disability, neuromuscular disorders including cerebral palsy, speech and language disorders, and hearing and vision impairment. Among lower economic strata, these conditions have been largely unrecognized, for lack of attention to the problems, shortage of health workers in many areas, and among all classes, the stigma that is often attached to these disorders.

Based on this initial pilot, the Government of India has initiated a nation-wide study using the same methodology, with the purpose of identifying children with neurodevelopmental disorders and securing treatment and rehabilitation for them. 630 centers are being established across the country, where they estimate that 230 million children will be screened. The Government of India has allocated over $400 million U.S. dollars to the program, which will be rolled out over seven years. Dr. Silberberg had the opportunity to visit the first center to be established, among villages 50 miles south of New Delhi, in October 2013. 

Silberberg India
Dr. Donald Silberberg, far right, visits a village 50 miles south of New Delhi, one of the sites included in the INCLEN study, in October 2013 along with Jere Behrman (right), the William R. Kenan Jr. Professor of Economics and Sociology, Population Studies Center, who is advising the researchers regarding future studies of the economic consequences of neurodevelopment disorders.

Dr. Silberberg comes to the office three or four times a week when he’s not traveling and lecturing. After serving as chair of the department, he served as Senior Associate Dean for International Medical Programs, from 1994-2004. He has noted that the NIH program which provided the initial R-21 grant, the Fogarty Center's “Brain Disorders Across the Lifetime” program, was developed in response the 2001 Institute of Medicine report that he initiated, Neurological, Psychiatric and Developmental Disorders – Meeting the Challenge in the Developing World.

"Needless to say, I am overwhelmed by the impact of our study," said Dr. Silberberg. "It will be important to many other countries that will develop their own programs, once India's program becomes widely known."

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