By Devishobha Chandramouli
Parenting is challenging under any circumstances, and raising a child with special needs requires rethinking many everyday approaches. Alarmingly, misdiagnosis of developmental and special needs is on the rise. Causes include preconceived ideas held by parents, incomplete or inaccurate information, reliance on unverified online sources, and well-meaning but uninformed advice from acquaintances.
Misdiagnosis of developmental delays and neurodevelopmental conditions is more common than most people realize, and its consequences can be significant. To clarify the correct path for assessment and intervention, I spoke with Dr. Samir Dalwai, a developmental pediatrician, founder of The New Horizons Child Development Centre, and former chairperson of the Indian Academy of Pediatrics’ Chapter of Neuro-developmental Pediatrics.
Devishobha: Hello, Dr. Dalwai. Thank you for speaking with us.
Dr. Samir Dalwai: Thank you. Parents understandably grow anxious when their child seems to miss typical developmental milestones. In that anxiety, many seek quick fixes or turn to anyone who promises improvement—online sources, unqualified therapists, or well-intentioned neighbors. Often, families arrive at my clinic without a documented diagnosis or written recommendations from previous practitioners. I frequently see children labeled as “ADHD” who, after proper evaluation, range from typically developing to emotionally disturbed, or may have an autism spectrum disorder or another neurodevelopmental issue.
Such mislabeling is harmful. For example, a child who struggles with speech might actually have a broader neurodevelopmental condition or an unrelated medical issue. Prescribing repetitive activities—like hearing nursery rhymes on loop or using language apps—without understanding the underlying cause can train rote repetition without comprehension. A wrong diagnosis leads to inappropriate therapy, wasted time, and missed opportunities for effective intervention.
Devishobha: If a misdiagnosis leads to a few months of therapy, how harmful can that be?
Dr. Dalwai: It can be quite damaging. Time is crucial in early development: the wrong therapy delays appropriate intervention. Additionally, therapies that focus on irrelevant skills may reinforce behaviors that do not translate to real-life functioning. A child might demonstrate improved performance within a clinic setting—sitting tolerance, for example—but not generalize that skill at home or in school. Worse, parents may replicate clinic exercises at home, unintentionally creating an artificial environment that masks the child’s real challenges. Therefore, not all therapy is harmless; therapy must be tailored to the child’s specific needs at the right time.
Devishobha: Who should parents consult when they suspect developmental delays?
Dr. Dalwai: A developmental pediatrician is trained to assess overall child development across multiple domains. The first step should be a comprehensive consultation with such a specialist to ensure no aspect is overlooked and to receive documented, written recommendations. It is essential to obtain a written report from any professional working with your child. Documentation—assessment notes, diagnoses, and therapy plans—is both an ethical and legal right. Unfortunately, this accountability is often missing in the special needs arena, which compounds the risk of misdiagnosis and inappropriate treatment.
Devishobha: Once therapy begins, how soon should parents expect to see results?
Dr. Dalwai: With an accurate diagnosis and a well-designed therapy plan, you should receive clear, time-bound goals and expectations. Each condition has its own timeline for improvement, and professionals should explain what progress is reasonable and when. If you receive vague responses such as “nobody can really say,” and nothing is provided in writing, consider that a red flag.
Devishobha: How has the pandemic affected access to developmental assessment and therapy?
Dr. Dalwai: The pandemic has expanded access to developmental pediatric care via telehealth. Families who previously lacked geographic access can now consult specialists remotely. In our program, a developmental pediatrician evaluates the child monthly, maps specific milestones to achievable goals, and prescribes home-based activities. Crucially, we coach parents to implement these activities in the child’s natural environment and then reassess progress the following month to set new goals.
Devishobha: How effective is online parent coaching?
Dr. Dalwai: Parent coaching via live video has proven highly effective. We can demonstrate activities in real time, observe the parent and child interaction, and provide immediate feedback. This approach allows repetition in the child’s natural setting, avoids travel, and helps families integrate therapeutic activities into daily life—an essential factor for generalization and lasting progress.
Devishobha: What steps can parents take to reduce the risk of misdiagnosis?
Dr. Dalwai: Comprehensive, detailed assessment is key. In our practice we evaluate children across a wide range of milestones—hundreds across multiple developmental domains—so we can identify which sub-skills are affected. For instance, progressing from rolling over to sitting requires not only muscle strength but also body awareness, motor coordination, sensory feedback, and motivation to change perspective. A developmental pediatrician breaks down skills into smaller components, charts the child’s current level for each sub-skill, and designs targeted interventions to advance each one. Repeated, focused work on these sub-skills, paired with coaching for caregivers, enables meaningful progress rather than mere labeling.
This model of parent empowerment and individualized planning is the foundation of our E-nable Parent Coaching Program®—a structured, milestone-driven approach that equips families to participate actively in their child’s development.
About Devishobha Chandramouli
Devishobha is the founder of Kidskintha, a global parenting and education collective that hosts virtual conferences in collaboration with organizations such as UNESCO. Her writing has appeared in numerous international publications, and she organizes global events that bring together experts in early childhood development.
Follow Devishobha Chandramouli on Twitter: @kidskintha