Ayurvedic approaches to neurodevelopmental disorders: Evidence, challenges and future directions

Neurodevelopmental disorders (NDDs) are the leading cause of long-term disability in children worldwide. They include autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), cerebral palsy (CP), intellectual disability (ID), and specific learning disorders. Despite improvements in conventional management, many children still experience persistent cognitive, behavioral, motor and psychosocial impairments, highlighting the need for complementary therapeutic strategies. Ayurveda, especially the branch of Kaumarabhritya, offers a holistic approach in the management of pediatric neurological disorders by use of herbal medicines, dietary and lifestyle modifications and specialized therapeutic procedures. This narrative review assesses the current evidence, challenges, and future directions of Ayurvedic approaches for NDDs. A narrative review of the literature was done using PubMed, Google Scholar, and other available electronic databases along with classical Ayurvedic texts. Research indicates that Medhya Rasayana herbs (e.g., Bacopa monnieri, Centella asiatica, Withania somnifera, and Tinospora cordifolia) are antioxidants, anti-inflammatory, neuroprotective, adaptogenic, and neuroplasticity-enhancing, and cognitive and behavioral functions can be improved. Clinical studies have reported that Ayurvedic interventions, such as Abhyanga, Nasya, Shirodhara and selected Panchakarma procedures, have positive effects on attention, communication, motor function, adaptive behavior, sleep quality and overall quality of life when used in conjunction with conventional rehabilitation. However, evidence to date is limited by methodological challenges including small sample sizes, heterogeneity of intervention protocols, poor standardization, heterogeneous outcome measures and limited long-term follow-up. Future research should include multicentre randomized controlled trials, standardized formulations, validated outcome measures, biomarker-based investigations and mechanistic studies. Ayurveda seems to be a promising complementary aspect of multidisciplinary care in neurodevelopmental disorders, but strong clinical evidence is needed to support its evidence-based incorporation into pediatric practice.