Children's Neuroscience Services | (CNS)


    Attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) is a common childhood behavioral disorder that can continue its progression into adulthood. Symptoms in children include difficulty staying focused, over-activity and impulsivity. Children with ADHD often find it hard to complete tasks and perform up to their peers and often have problems at school.

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    There are three subtypes of ADHD which include:

    • Combined ADHD: involves symptoms of both lack of attentiveness and over-activity/impulsivity
    • Inattentive ADHD: previously known as ADD, involves symptoms of lack of attentiveness and concentration
    • Hyperactive-impulsive ADHD: involves symptoms of over-activity paired with impulsivity, without problems with attentiveness

    Development Delay

    Development is the process by which a child learns new skills to interact with those around them and survive in their environment. It happens at a rapid rate during early childhood. Basic skills developed are combined to learn more complex skills such as walking, playing, speaking and thinking. Although children grow at different rates, certain milestones of development such as sitting, walking, talking etc. are associated with particular age groups. Some children may catch up with their peers after displaying an initial delay in development (transient developmental delay) while others show significant developmental delay that need further evaluation (persistent developmental delay).

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    Children may show persistent developmental delay in one or more areas including:

    • Speech and language: understanding, speaking and using language
    • Motor skills: Basic movement and fine motor skills such as manipulating objects
    • Intellectual or cognitive ability: Understanding, thinking and learning
    • Social and emotional skills: Ability to associate with people and develop independence

    Sleep Disorders

    Sleep is essential for physical health and emotional wellbeing. Everyone experiences occasional sleeping problems, but if your child repeatedly experiences problems sleeping, it could indicate an underlying health problem. Sleep disorders are problems associated with sleeping, including difficulty falling or staying asleep through the night, feeling sleepy during the day, snoring, breathing pauses while sleeping, sleepwalking, nightmares or waking up feeling exhausted. Because of lack of sleep, your child may find it difficult to concentrate and perform activities of daily living. This lack of sleep can lead to problems in mood, learning and behavior, or other health problems.

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    Some of the common types of sleep disorders include:

    • Insomnia: Insomnia is a type of sleep disorder characterized by disruptive sleep cycles – difficulty falling asleep or staying a sleep.
    • Obstructive sleep apnea: Obstructive sleep apnea is a common sleep disorder in which breathing occasionally stops or gets very shallow during sleep.
    • Restless legs syndrome (RLS): Restless legs syndrome is a disorder characterized by a tingling or prickly sensation in the legs and an urge or need to move the legs.
    • Parasomnias: This refers to abnormal behaviors that occur during sleep. Parasomnias include nightmares, night terrors, sleep walking, and sleep talking, head banging, wetting the bed and grinding teeth.


    Autism or autism spectrum disorder (ASD) is a group of neuro developmental disorders characterized by impaired social skills, communication and behavior, which are usually recognized in the first three years of life. A range of symptoms may occur in different combinations of varying severity.

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    Social skills:

    • Withdrawal from social situations, avoiding eye contact or smiling, difficulty responding to their name and sometimes lack of empathy
    • As they grow older, autistic children have difficulty making friends due to their inability to sustain conversations or pick up on social cues, such as facial expressions or changes in voice tone, which normally help a person understand what others are thinking or feeling.


    • Delay in speech development
    • Speech is characterized by a sing-song voice
    • Lack of speech in severe forms


    • Focus on one object for a long time
    • Engage in repetitive acts such as twirling or rocking, or self-abusive behavior such as banging their head or biting
    • Develop certain rituals or routines


    Epilepsy is a condition caused by abnormal electrical activity in the brain, which produce episodes of involuntary shaking (seizures)that may be followed by periods of unconsciousness. Seizures may be generalized, involving the whole brain, or partial, where a part of the brain is involved. Generalized seizures may present as staring spells, unconsciousness, sporadic jerking movements, muscle rigidity, or loss of muscle tone, causing your child to fall down. Partial seizures may produce changes in sensation (hearing, vision, smell, taste or touch), involuntary chewing, lip smacking and other repetitive movements, and emotional disturbances. Other symptoms of epilepsy include confusion and staring spells. Epilepsy usually begins in childhood.

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    Your child’s doctor will first rule out other possible causes of seizures before confirming a diagnosis of epilepsy. A thorough history and physical examination is performed. Your child’s doctor may order blood tests, an electroencephalogram (EEG) to study the electrical activity of the brain and an MRI to look for brain abnormalities.

    Speech Delay

    Phonology is referred to as the study of the sounds of language. Pronunciation errors are common in children when they are learning to talk. During the child’s development stages, phonological disorders can affect a child’s ability to learn, read or spell. Speech problems are usually temporary and can often be overcome.

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    Types of problems with speech may include:

    • Mispronunciation: Your child often substitutes ‘f‘ or ‘d’ for ‘th’, or mixes up words. For example your child may say “I am taking abaf” instead of “I am taking a bath.”
    • Lisping: Your child may pronounce “s” as “th”. For instance, “sister” will become “thithter” and“seven” may be pronounced as “theven”. During this condition, your child pushes the tongue out while pronouncing these letters whereas normally the tongue touches the upper teeth while speaking or pronouncing these letters.
    • Stuttering: This is the repetition of certain words, sounds or phrases. In children, it is common to stutter until the age of 7 years, but sometimes it may become a permanent speech disorder. One of the causes for stuttering is genetic predisposition.
    • Flow: This condition is where your child is learning new speech skills and struggles to speak in sentences.
    • Hoarseness: This refers to a change in voice or sound because of laryngitis or upper respiratory tract infection.
    • Slurred speech and difficulty in speaking: This can develop from nerve and muscle disorders.

    Some of the common speech disorders are:

    • Apraxia: It is caused due to disorders of the nervous system, which affects the child’s ability to pronounce words and produce sounds. In this condition, the brain does not send signals properly to the body parts involved in speech. For example, your child may pronounce ‘sut’ for ‘sat’.
    • Dysarthria: This is a dysfunction or impairment of the neuromotor or neuromuscular systems causing unclear speech articulation.

    Learning Disability (Memory or Learning Difficulties)

    Memory is the ability to retain and retrieve information. Memory retained indefinitely such as your name, where you work or how to ride a bike is termed long-term memory. Working memory is the ability to hold on to information for a short while as you process and integrate it with new information being received. This includes remembering the beginning of a sentence when you reach its end or remembering numbers while performing simple math. Difficulties with learning are usually associated with difficulties in working memory.

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    Difficulties with working memory may be present by itself or as a feature in a wide variety of specific learning difficulties which may include:

    • Dyslexia: Affects reading and language processing to various degrees
    • Dyscalculia: Problems with numbers, mathematical calculations and telling time
    • Attention deficit disorder (ADHD): Difficulties with paying attention and focusing
    • Dysgraphia: Problems with the formation of alphabets
    • Aphasia: Difficulty with the use of language to understand other’s speech, comprehend while reading and express themselves with the right words

    Movement disorder service

    Movements are produced by an interaction between the brain, spinal cord, nerves and muscles. Damage to any of these structures can lead to disruption or loss of movement. Movement disorders are a group of neurological disorders characterized by abnormal involuntary or voluntary movements. Deficit in movements may involve weakness, paralysis or exaggerated reflexes of voluntary muscles, decreased movement of involuntary muscles, and loss of coordination.

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    Some movement disorders in children may include

    • Tics: sudden, non-rhythmic and repetitive movements that ofteninvolvethe head and upper body
    • Chorea: Brief, chaotic, repetitive movements
    • Dystonia: Sustained repetitive movements with abnormal postures
    • Tremors: Rhythmic oscillation around a central position of one or more parts of the body
    • Sterotypy: Episodic, repetitive, rhythmic movements that have a pattern

    Neurometabolic & Neurogenetic conditions

    These conditions are rare but collectively they have a substantial impact on the local healthcare system. These conditions require a systematic and evidence-based diagnostic approach with continuous discussion with parents. Many a times a definitive diagnosis is not reached in spite of all the investigative processes and in those cases symptomatic management is initiated. We have collaborated with accredited and reputed laboratories across the country for the judicious use of investigative procedures. Once the diagnosis is made appropriate referral to the clinical geneticist and metabolic physician is made.

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    Behavioral/Conduct disorders

    Behavioral problems are common in children as they grow up and learn to relate to people and situations. They may show defiance and have difficulty getting along with others, causing them to talk back and get into fights. If these problems are persistent and cannot be corrected with time, advice or redirection, it may be a sign of a behavioral disorder.

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    Behavioral disorders may be recognized through symptoms such as anger, defiance, involvement in law-breaking activities, lack of empathy, being aggressive and impulsive, poor performance at school, premature sexual activity, and inability to handle frustrations. Substance abuse and suicidal tendencies are common in those with behavioral disorders;hence, it is necessary to seek assistance early. While the dynamics of the family and upbringing play a vital role, behavioral disorders may also be associated with other mental health problems, such as depression and attention deficit hyperactivity disorder (ADHD).

    Headaches & Migraines

    Pain in any region of the head is called a headache. It may involve one or both sides of the head and may radiate to the neck and shoulders. Your child may experience dull pressure, a throbbing sensation or sharp pain that may last anywhere between an hour to days.In some cases it may indicate a serious underlying disease.

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    Headaches are broadly classified into 2 types:

    • Primary headaches are caused by stress, anxiety or certain triggers. They occur due to an overactive pain-sensitive region in the head and are not associated with any other condition.Common primary headaches can include tension headaches (result from tight muscles in the neck, scalp and shoulders), migraine (throbbing pain on one side of the head) and cluster headache (occurs in patterns or clusters).
    • Secondary headaches may be described as a symptom of another condition such as anear infection, sinusitis, dehydration, panic attack,meningitis (inflammation of the membranes covering the brain and spinal cord) and concussion (brain injury), which may trigger the pain-sensitive region in the head.

    Neuromuscular disorders

    A neuromuscular disease is a disorder that affects the muscles and the nerves that control them. Neuromuscular disorders are conditions caused by impaired neuronal activity of the nerves that control the voluntary muscle activities. Children with neuromuscular disorders often experience muscle pain or weakness, muscle twitching, cramping, numbness and tingling, and muscle stiffness that causes joint deformities and sometimes difficulty in swallowing and breathing. Neuromuscular disorders in children may be present at the time of birth or may develop at later stages of life.

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