Early intervention guidelines for infants at risk of neurodevelopmental delay using traditional childcare practices from India.

BACKGROUND: India is witnessing a growing concern around neurodevelopmental disorders, with nearly one in eight children potentially affected. The early years of life, especially the first 1000 days offer a crucial window to support brain development and positive long-term outcomes. Global early intervention (EI) strategies focus on caregiver involvement, enriched environments and learning through meaningful repetition. However, applying these approaches in everyday community settings remains challenging due to the need for specialised training which is inaccessible for grassroots-level workers. Interestingly, many traditional Indian caregiving practices echo these global principles, though they remain undocumented in scientific literature. OBJECTIVE: This study aimed to explore traditional Indian child-rearing practices aligned with evidence-based EI and developing culturally rooted, easy-to-follow video resources to train grassroots-level workers (Accredited Social Health Activists (ASHA)). METHODS: We conducted 11 focus group discussions with 121 mothers and grandmothers from varied regions and cultural backgrounds across India. Using open-ended prompts, we gathered insights into daily caregiving routines for infants under 1 year of age. Conversations were recorded, transcribed and thematically analysed by age group (0-3, 3-6, 6-9 and 9-12 months). Based on recurring patterns, a series of EI videos was created and validated through community and expert feedback. RESULTS: Findings revealed that many common Indian practices-such as massage, floor play, lullabies and face-to-face interaction-align closely with global EI principles. The videos developed from these practices were well-received by caregivers and experts for their clarity, cultural relevance and practical usefulness. CONCLUSIONS: Indian families already practise many nurturing routines that support early development. By capturing these practices in simple, accessible videos, we can bridge traditional wisdom with modern science-empowering parents and ASHA workers to support children's development meaningfully in the home environment.