What are the challenges in managing neurodevelopmental disorders (NDDs)?

What is meant by neurodevelopmental disorders (NDDs)?

A neurodevelopmental disorder is identified when, from a very young age, the functioning of one of the brain networks involved in motor skills, vision, hearing, language, or social interactions is altered. This alteration leads to the onset of disorders such as language or learning difficulties, challenges in communication, or difficulties interacting with others¹CeAND. Neurodevelopmental Disorders (NDD) | CeAND | Montpellier University Hospital (n.d.). CeAND. https://www.ceand.org/le-ceand/diagnostics-concernes/. According to the DSM-5*, NDDs begin during a child’s developmental period and generally manifest before the start of primary school.

Among NDDs, we notably find dys disorders (dysphasia, dyslexia, dyspraxia, dysorthographia…), attention deficit disorders with or without hyperactivity (ADHD), intellectual developmental disorders (IDD), autism spectrum disorders, etc. Two-thirds of people with NDDs experience at least two of these different disorders, which can lead to complex situations requiring specialized care and support.

Just a few years ago, individuals with neurodevelopmental disorders and their families often faced diagnostic uncertainty and sometimes inadequate management. However, in recent years, there has been a paradigm shift with a national commitment to better support these patients.

* Version 5 of the DSM, Diagnostic and Statistical Manual of Mental Disorders, published in the United States in 2013.

Early identification and management of neurodevelopmental disorders

At the end of 2023, a national strategy for neurodevelopmental disorders was launched, continuing from the one implemented between 2018 and 2022²French Government. New National Strategy for Neurodevelopmental Disorders: Autism, Dys, ADHD, Specific Learning Disorders (n.d.). handicap.gouv.fr. https://handicap.gouv.fr/nouvelle-strategie-nationale-pour-les-troubles-du-neurodeveloppement-autisme-dys-tdah-tdi. Running until 2027, it highlights six commitments, with a particular focus on two objectives: “ensuring a support solution for every individual” and “bringing forward the age of screening and diagnosis and intensifying early interventions.”³French Government. National Strategy for Neurodevelopmental Disorders (NDD): Autism, Dys, ADHD, Specific Learning Disorders 2023–2027 (2023–2027). https://handicap.gouv.fr/sites/handicap/files/2025-04/Liste-des-mesures-strategie-nationale-TND-2023-2027.pdf

Because the brains of young children have high plasticity, they are capable of adapting and reorganizing during the first three years of life. For the French National Health Insurance (Assurance Maladie), the key challenge is therefore to support children as early as possible, “as soon as an unusual developmental difference is confirmed, and even before a diagnosis is made.” In this context, a new version of the health record was introduced in January 2025. It now includes benchmarks for screening NDDs, a developmental milestone checklist for unusual signs, information on risk factors, guidance for healthcare professionals, and a QR code redirecting to coordination and orientation platforms (PCOs).

Coordination and orientation platforms (PCOs) are central actors in this national strategy. From the first suspicions of a neurodevelopmental disorder, it is recommended to contact them in order to begin a pathway toward early diagnosis and interventions. The 76 PCOs⁴French Government. Commitment 2 (2021, February 4). handicap.gouv.fr. https://handicap.gouv.fr/engagement-2 coordinate stakeholders and specialized centers within a given territory: medico-psychological centers (CMP), medico-psycho-pedagogical centers (CMPP), healthcare professionals, etc. They provide initial care (speech therapy, occupational therapy, psychomotricity…), establish a diagnosis, and then refer patients to appropriate structures.

It is important to remember that a person with a neurodevelopmental disorder is considered to have a disability and can therefore apply for recognition from a MDPH (Departmental Disability Center) to access available support.

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Challenges to be addressed for optimal NDD management

Despite the measures introduced in recent years, several challenges remain to ensure optimal management of neurodevelopmental disorders (NDDs).

Although PCOs are essential to the care pathway of a person with NDD, they come with several issues: caregivers are often understaffed and face significant administrative burdens. In addition, there is a broader shortage of professionals such as speech therapists, occupational therapists, neuropediatricians, psychologists, which complicates overall support and lengthens care timelines, particularly in community settings. Furthermore, care provided through these platforms is covered for a duration of 12 to 18 months, but “experience shows that nine out of ten children still require care once this early package is no longer available”⁵Hoppenot, I. (2022, July 11). Neurodevelopmental Disorders: The Critical Issue of Early Detection. VIDAL. https://www.vidal.fr/actualites/28515-troubles-du-neurodeveloppement-l-enjeu-majeur-du-reperage.html and have not yet been referred to an appropriate network in the community.

There is also a real challenge in training frontline healthcare professionals, particularly pediatricians and general practitioners, to identify neurodevelopmental disorders (NDDs).

Finally, it is urgent to improve coordination between healthcare professionals, the school system, and medico-social structures. This lack of alignment hinders the implementation of truly appropriate support systems and does not facilitate smooth and continuous management for children.

At Alcimed, we closely monitor developments in the field of neurodevelopmental disorders and support stakeholders in their management (hospitals, associations, platforms…). We would be delighted to discuss this with you, please do not hesitate to contact our team!

About the author, 

Marie, Consultant in Alcimed’s Innovation and Public Policy team in France