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| Hpathy Ezine - May, 2004 | |||||
A Case of Learning Disability, Dyslexia- Dr. Praful M Barvalia |
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| PRELIMINARY INFORMATION: NAME: Master S.V.
CHIEF COMPLAINT Intellect: A known case of Dyslexia. He writes the opposite – mirror image like. e.g.: F for 7, b for d. Difficulty in reading and writing. Speaks one thing and writes another. He has been receiving remedial training at M.S.S. EDUCATIONAL ASSESSMENT REPORT SUMMARY:-Master S.V. shows deficits in area of position in space. He has difficulties in sustenance of attention for a required amount of time, as well as attending to finer details. He lacks efficient strategies for learning. His auditory analysis and synthesis are weak and phonetic associations are poor. His cognitive abilities are not age appropriate. All these lead to his academic performance being below average. Diagnosis: DYSLEXIA ASSOCIATED COMPLAINTS: Since birth: Coryza 2, thick blakish crusts + from
the nose. < COW 2 PAST HISTORY
- 3 attacks of Hepatitis ’94, ’95 , Jan., 2000 Family History: Paternal Gr. Father – Died 3 years back – Cancer BIRTH HISTORY: FTND (Full Term Normal Delivery) MILESTONES: Head holding -? PATIENT AS A PERSON: Appearance: plump child, chubby. Dreams: Examination: Rhinorrhea + LIFE SPACE: Master S is an 8 year old child from a middle class Kutchi Jain family. He was accompanied by his mother. Since the last 3 months they were living as a nuclear family - mother, father and 2 sons. Earlier they were staying in a joint family with paternal grand father, paternal grand mother, 1 paternal uncle, his wife and daughter. The paternal uncle is the father's younger brother. There were a lot of conflicts in the family after paternal uncle’s marriage. Till then things were fine. These conflicts between family members were about financial issues and household chores. His father runs a 'Kirana' store (grocery shop). Paternal uncle is in service. The mother assists at the shop as it is at close to their house. Mother said that the quarrels in house affected her children very much. She explained that S always had a typical frown on his face, which has reduced now since they have separated. She said that the children would always be very concerned about her. “What if they do something to my mother?” He carried a fear that paternal uncle’s family would harm her mother especially in the father’s absence. He didn’t take her with him when going out and left them alone. S never liked to spend time with his paternal uncle or paternal aunt. Recently a cousin sister was born. His mother said that the patient went to his teacher and told her that he doesn’t have any cousin sister and he will never go close to her. His mother explained that she never encourages such ideas and this was his own thinking. The dreams that he described also showed a lot of resentment towards parental uncle and his family. He was attached to paternal grandfather. He always used to spend time with him when his mother went to the shop. After paternal garnd father's death, the patient used to remember him all the time. He remained in a depressed mood and always said that he wanted to go to him.
Mother also said that the elder brother takes care of the patient. Last year when the mother was sick, they managed all the work. The patient is also quite independent. He does all his work on his own. He enjoys staying at maternal garnd father’s place. Since there are a lot of people around, he mixes with other children there and is playful. He is extremely impulsive. Recently he chopped off his eyebrows with a scissor. He goes into the tank to hide there. He plays a lot of pranks with other children in school. HE is quite a restless, impulsive child. Has no fears, and when questioned about this he said that parents beat him if he doesn’t study. Mother reported that patient gets along extremely well with his father.
In the interview when mother was talking about the family conflicts, the patient started crying and had to be sent out to play. Later he was observed to be playing on the slide. The supervisor reported that child went to his cabin was standing there for some time and then lay down on the examination table. He described the child as `BINDAS’ (ready to take risks). We see here a lot of discrepancy in the picture that mother gave and the observation made by others. But she was probably better able to appreciate to the problems and psychological pressure of this child. She said that the elder brother doesn’t allow the patient to play with him and so he generally plays with children younger than his age. HOMOEOPATHIC UNDERSTANDING: - Here we have explained the dynamic interaction between the child and his environment The child is extremely sensitive to the conflicts in the family, which have affected him very badly. There has been an insecure feeling. He has a lot of resentment for the uncle and his family, which he harbors all the time : ‘He has a frown on his face’. He settles down somewhat after the separation into a nuclear family set up. Also there was the state of grief after the loss of paternal garnd father, whom he was very attached to. His resentment towards his uncle is reflected in his dreams and the way he discusses his cousin sister. His behavior during the interview in terms of weeping further reflects tendency to harbor emotions. Though mother has shown sensitivity towards the child’s educational problem, there was a slightly mistaken perception regarding the emotional impact that he had from certain key events and other social inputs e.g., his relationship with peers, brothers perception of his problems and their interactions etc. Corrections of these, would go a long way in the further progress of the child. Currently, it was all being compounded by behavioral problems. He is an extremely restless and impulsive child. It is out of control. The way he hides in the water tank, clips off his eye brows etc. demonstrates this. From the above understanding the following totality emerged: R.S - <Grief - Brooding - Hatred - Weepy - Restless - Impulsive - Insecurity - Perspiration- profuse - Perspiration- offensive PDF Speech delayed <
Summer, hot weather The prominent remedies which came up were Causticum and Natrum Mur. Causticum covers the sadness part with weepiness and impulsiveness. But it does not cover the features of deep hatred and resentment. Based on this understanding Natrum Mur was selected as the remedy. With an analysis pointing to moderate susceptibility, we started with Natrum Mur 200 1 PHS The dominant miasm was understood in the Tubercular zone based on his restless, impulsive behaviour and suppurative tendencies. However some of his dispositional traits like attachments, brooding tendency and physical appearance, delayed speech show Sycotic traits.
Remedy: NATRUM MUR DISCUSSION: MULTIDISCIPLINARY PLANNING AND PROGRAMMING:- Master S. has been studying in a school which has a provision for remedial education. He had already been assessed and had received remedial education at another institute which co-ordinated with his school. His behaviour has not shown any improvement. The psychologist then referred him to our institute for the purpose of Homoeopathic management and schooling. S was taken up by our miltidisciplinary panel and it was decided that he would need a proper structured programme with coordinated care as he had not responded in a normal school with remedial back up. So he would need to be admitted in a special school for children with learning disabilities. Since the problems are at multiple levels, a holistic approach was required with the help of a multidisciplinary team of -
The input of this multi-disciplinary approach are as follows:
TPD: - (1) Learning disability - Dyslexia (2) Behavioural problems – Impulsiveness - Restlessness TPR: - (1) Homoeopathic Rx medicines (2) Structured remedial programme (3) Individualized Educational Programme (4) Behaviour Modification (5) Sensory Integration therapy (6) Speech therapy (7) Yoga. FOLOW UP NOTES: ·
Initially Homoeopathic medication was started Dr. Praful M Barvalia Email: praful@bom3.vsnl.net.in |
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