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Oxford Specialist Handbooks
in Paediatrics
Neurodisability
and Community
Child Health
SECOND EDITION
edited by
Srinivas Gada
Consultant Paediatrician in Neurodevelopment and
Neurodisability, Nuffield Health Oxford and HCA
Healthcare London
Honorary Senior Clinical Lecturer, University of Oxford
Honorary Consultant, Oxford University Hospitals NHS
Foundation Trust, Oxford, UK
1
1
Great Clarendon Street, Oxford, OX2 6DP,
United Kingdom
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It furthers the University’s objective of excellence in research, scholarship,
and education by publishing worldwide. Oxford is a registered trade mark of
Oxford University Press in the UK and in certain other countries
© Oxford University Press 2022
The moral rights of the author have been asserted
First Edition published in 2012
Second Edition published in 2022
Impression: 1
All rights reserved. No part of this publication may be reproduced, stored in
a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by licence or under terms agreed with the appropriate reprographics
rights organization. Enquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above
You must not circulate this work in any other form
and you must impose this same condition on any acquirer
Published in the United States of America by Oxford University Press
198 Madison Avenue, New York, NY 10016, United States of America
British Library Cataloguing in Publication Data
Data available
Library of Congress Control Number: 2021945282
ISBN 978–0–19–885191–2
DOI: 10.1093/med/9780198851912.001.0001
Printed in Great Britain by
Ashford Colour Press Ltd, Gosport, Hampshire
Oxford University Press makes no representation, express or implied, that the
drug dosages in this book are correct. Readers must therefore always check
the product information and clinical procedures with the most up-to-date
published product information and data sheets provided by the manufacturers
and the most recent codes of conduct and safety regulations. The authors and
the publishers do not accept responsibility or legal liability for any errors in the
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adult who is not breast-feeding
Links to third party websites are provided by Oxford in good faith and
for information only. Oxford disclaims any responsibility for the materials
contained in any third party website referenced in this work.
v
Dedication
I dedicate this book to my parents, Sulochana and Shankerappa,
for their countless sacrifices for my education, and without whom
I would not be here.
vii
Foreword
It is a privilege to offer a foreword to this new Handbook for the ever-
expanding field of neurodisability—what I like to call the field of ‘Applied
Child Development’.
As Dr. Gada rightly notes in his Preface, child-onset neurodisability and
community child health has seen remarkable change and development in
the past decade. Fundamental shifts—more accurately characterized as ex-
pansions in our thinking—have made the field almost unrecognizably richer
than was ever imagined possible by those of us trained in twentieth-century
thinking! Among the contributing forces in these developments one can cite,
in no implied order of priority, the WHO’s 2001 International Classification
of Functioning, Health, and Disability (ICF) framework for health; the rec-
ognition that parents must be equal partners with professionals, and the
importance of our engagement with them at every step of the journey;
seeking and heeding the voices of children; seeing ‘childhood’ issues in a
life-course perspective; and promoting the functioning and participation of
young people with impairments who were traditionally assumed to be sen-
tenced to lives of limited possibility.
This Handbook provides readers with accessible notes and guides to a
myriad of topics, with detailed cross-linking of each section to many others.
In this respect, the Handbook is a refreshing complement to the traditional
textbook, with discursive writing on background, placing ideas in context
with the history of the topic, detailed explanations, justifications, interpret-
ations of the arguments, and so on. (Full disclosure, I have experience with
such textbooks and believe they also have a place!)
What makes this current volume so useful is the immediacy of access to
whatever the user seeks to know right now. As a Handbook, the focus is
on the practical application of the available knowledge and ideas it offers.
As noted, there are always links to other parts of the text where the reader
can recognize the ways that concepts discussed in relation to a particular
impairment or diagnosis almost always have wide-ranging ‘non-categorical’
relevance across the field.
Finally, I believe it is essential to celebrate, with this Handbook, the ac-
cumulation of what Dr. Gada notes as the ‘insights, experience, and know-
ledge’—indeed, it is fair to call this ‘clinical wisdom’—of colleagues across a
wide range of disciplines and from many countries. Their rich contributions
blend together the modern scientific developments of our ever-expanding
field with the humanism and art of caring for children with complicated lives
and their families. This is a much-appreciated achievement.
Preface
A lack of a concise, easy-to-use, and updated resource on child neurodisability
and community child health motivated me to write this book. This book is
a sequel to the Oxford Specialist Handbook of Community Paediatrics, pub-
lished in 2012, but this edition focuses more on neurodevelopmental dis-
orders. Thus, this book contains hundreds of topics on neuroplasticity, child
development, neurobehavioural disorders, sensory impairments, neuro-
orthopaedics, neuro-genetics, neurorehabilitation, mental health and allied
therapies.
This book is a culmination of my twenty plus years of clinical experience
in child neurodisability and community child health at Oxford University
Hospitals NHS Foundation Trust, Oxford and previously at Royal Free
Hospital and Royal London Hospital in London. During the past two dec-
ades, I have had the privilege to work with my colleagues in Oxford and
learn in my various professional capacities, such as consultant community
paediatrician, child development team lead, course director, hon senior
clinical lecturer, educational supervisor, clinical governance lead, editor, re-
viewer and a team member. This book contains all my clinical experience
enriched with informative, up-to-date and concise summaries on hundreds
of topics written by experts across the globe. I have been honored to work
with this team of specialists from the USA, Canada, Australia, India, and the
UK who have decades of medical experience and abundant clinical wisdom.
Therefore, this book will serve as an essential companion and first point of
reference to both established practitioners and trainees in neurodisability,
community child health, paediatrics, general practice and professionals from
multidisciplinary and multiagency teams.
Changes in the field of neurodisability and community child health can
seem slow, feel imperceptible and even go unnoticed. Yet, so much has
changed since this book’s predecessor in 2012. There has been the launch
of the DSM-5, ICD-11 and numerous new guidelines from authoritative
sources such as NICE, AAP, RCPCH, and EACD. This book has been com-
pletely revamped to reflect this updated guidance. In addition, this book has
been presented in an intuitive, easily readable format, with extensive use
of bullet points, tables, boxes, flow charts, sample reports, clinical tips, and
signposting to valuable resources.
This book is a portable guide focusing on practical advice that is clinically
effective, helping you know what to do and how to do it. Furthermore,
this book contains the insights, experience, and knowledge of experts from
various disciplines such as neurodevelopmental paediatricians, neurology,
psychiatry, orthopaedics, genetics, rehabilitation specialists, child protec-
tion, safeguarding, adoption and fostering, special educational needs, and
x Preface
Acknowledgements
After serving at Oxford University Hospitals NHS Foundation Trust from
2005, I stopped working at this prestigious institute in 2019 to focus on
completing this handbook and be more available to my ageing parents.
I want to offer my special thanks of gratitude to my parents, both of whom
passed away during the writing of this book and couldn’t be around to
see this book in print. Like many around the globe, the COVID-19 pan-
demic was brutal, and it affected the production of this book in many ways.
Nevertheless, reminding myself of the patience and perseverance of my
parents helped me to conclude this book.
This book would not have come into being without the expertise and as-
sistance of the editorial team at OUP, namely Nicola Wilson, Nic Williams
(freelance copyeditor), Clement Raj (Newgen Knowledge Works), and es-
pecially Sylvia Warren. Sylvia’s patience and support were crucial for this
project.
As a practising neurodevelopmental paediatrician, much of the informa-
tion in this handbook was drawn from my two decades in clinical practice.
Therefore, my utmost thanks go to all the children and their families who
shared their challenges with me.
I would like to extend my sincere gratitude to all the contributors for
their hard work and for offering their valuable time and expertise, despite
challenging work conditions at their institutes due to the pandemic. Their
commitment was crucial for the conclusion of this project.
My special thanks go to Professor Georg Hollander, Dr Ivor Byren, Dr
Martin Smith, and Nicki Sullivan for offering me professional support. My
thanks also go to all my ex-colleagues at Oxford University Hospitals NHS
Foundation Trust.
I am indebted to my wife, Vaishali, and my daughters, Ritu and Pooja, for
their numerous sacrifices, encouragement, and practical help while I spent
countless evenings and weekends working on this book.
Dr Srinivas Gada
Oxford
October 2021
xiii
Contents
Contributors xv
Symbols and abbreviations xvii
Index 685
xv
Contributors
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