A Retrospective Study Report of 20 years of Clinical Experience in the Treatment of Children with Autism
- Background:One of the main areas of concern for parents of children diagnosed with Autism Spectrum Disorders (ASD) is in dealing with the educational needs of the child. Children with autism have a number of issues that make it difficult for them to do well in a regular school set up. Although neuropsychological therapies help deal with these issues, it is a long-term process. Many mainstream schools do not have the appropriate resources or staff to help provide therapies or support for children with autism while in a busy school setup especially in India.Homeopathic treatment at this stage may not only help speed up the process of integration but also help children who are already integrated to continue being part of the mainstream. This paper is an attempt to retrospectively look at how homeopathic treatment has helped children with autism get integrated into mainstream schools and also how homeopathy could contribute to help deal with issues faced by these children while at school.
- Methods:An informal before and after quasi experimental study design was used. This involved both quantitative analysis and qualitative observation.A non-probability purposive/convenience sampling method was applied. This is a retrospective study of homeopathic clinical case studies of forty children with ASD seen by this author in private practice (both direct and online consultation) over the past 20 years, who were on homeopathic treatment and were integrated into mainstream schools.
- Results:The quantitative analysis found that there was a statistically significant reduction in the mean Autism Treatment Evaluation Checklist (ATEC) scores of children after the homeopathic treatment (33.17) when compared with the scores before starting the homeopathic treatment protocol (78.15). The retrospective qualitative analysis of the children who were integrated into mainstream schools found that there was an improvement in areas that could help them be part of a regular school setup such as better communication skills, reduction in hyperactivity, better concentration and focus, better peer group interaction, better group learning abilities, team work, compliance and ability to follow instructions.
- Conclusion: Homeopathic treatment is a promising approach in helping children with autism spectrum disorders reach an optimal level of functioning and in helping them integrate into the mainstream.
Keywords: Autism Spectrum Disorder; Autism; Inclusive Integration; Homeopathy for Autism
Integration of children with Autism Spectrum Disorder (ASD) or autism (the two terms have been used interchangeably throughout to mean the same syndromic presentation), into the regular mainstream of education has been found to be a challenge in most parts of the world. This is especially true in the case of a vast and diverse country like India with different cultures and value systems.Inclusive integration into regular schools is difficult to achieve due to a number of different factors. Many of the schools do not have the resources or manpower to accommodate children with special needs into the mainstream setup. In many cases children who are attending a regular school program may not be able to continue due to a number of different reasons including attention deficit, communication skill deficits and sensory issues. Although this is true of most countries, this is more so the case in a country like India.
The three major barriers to an effective integration of children with ASD are communication difficulties, hyperactivity and social skill deficits including poor group interaction, difficulties with group activities and problems with carrying about instructions as part of a group rather than on a one to one basis. In the course of a clinical practice over the last 20 years this author had the opportunity to see children with autism across the spectrum ranging from mild, moderate to severe. The children seen also had different levels of communication skills, social abilities and sensory issues. Some of them were high functioning, some low functioning, some of them were verbal, some non-verbal. In most of the cases the major concern for parents was that the child should reach an optimum level of functioning that could facilitate their integration into society as independent individuals who could manage on their own. All the children with autism referred to the clinic were already undergoing various neuropsychological therapies or attending a special school. Despite this there were persistent issues such as sensory issues, communication difficulties, behavioural issues and even physical complaints that could not be resolved and had prompted the parents to seek other alternative therapies including homeopathic treatment.
Generally, the term inclusive integration of children with autism or other types of developmental difficulties is used in the context of integration into a regular school setup. In the context of this paper the term inclusive integration is used not just to mean integration into a regular school but also societal and familial integration. The children with autism included in this study are not just children who were able to be integrated in terms of educational integration but also children with autism who were already in an integrated educational program but had social skill deficits or other issues such as behavioural or sensory issues due to which the parents could not continue with their normal social activities or were contemplating changing or removing the child from the school. The qualitative reports explain these issues and how homeopathic treatment in conjunction with other therapies helped these children.
This is a retrospective study based on clinical practice of this author. The information was collated from case reports already available. There is no identifiable information used in this study. Homeopathic treatment was given to children after informed consent of the parents who had voluntarily consulted this author.
MATERIALS AND METHODS
This study is a retrospective look at the author’s database of homeopathic clinical case studies of children with Autism Spectrum Disorder (ASD). Parents usually approach this author after a complete evaluation of their child has been done either by a developmental paediatrician, a child psychiatrist or a clinical psychologist that confirmed the diagnosis of autism.
Over the past 20 years of clinical practice from 1998 to 2018, the major portion of which involved seeing children with developmental disabilities, this author had occasion to see more than 300 children with ASD.Most of these 300 children showed significant progress with homeopathic treatment when seen through qualitative observations by the author, reports from the teachers and by the parents themselves. The children who were on therapies or going to a special school were regularly evaluated by their speech therapists, occupational therapists or child psychologists where progressive changes could be seen in the children based on the evaluation reports. There have been many instances of children being integrated into the mainstream. One of the difficulties of keeping track of the child, to know if integration has happened, is that parents stop coming for follow-ups once the child reaches a level of functioning according to their expectations or when they get admitted into a regular school setup. Once this happens, follow up evaluation is also not possible as parents usually stop taking their children for therapy sessions or evaluations. In such instances reports that certify the child as neurotypical or reduction of scores such as the Childhood Autism Rating Scale(CARS) to the non-autistic range are not available.
In this study 40 children who were regularly followed-up and where the parents were in touch with this author even after they were attending a regular school program were selected. There have been instances especially in children with autism who are on the severe end of the spectrum where inclusive integration is not possible in spite of the improvements seen in communication skills, sensory integration, social skills and reduction of behavioural issues due to a number of other factors. There are also some instances where children remain at the same level in spite of being on therapies and homeopathic treatment for a long period of time.
In this paper there is first a brief overview of the symptom pictures of the children with autism from the homeopathic perspective. This is followed by the main remedies used and the changes seen in these children. The pre-treatment and post treatment scores of the children are reported in the next section followed by the statistical analysis of the same. This is followed by sample qualitative case reports and a summary of the results.
HOMEOPATHIC CLINICAL CASE STUDY AND SYMPTOM PICTURE TABLE
Homeopathy is based on the principle of “Similia SimilibusCurantur” or like cures like. This postulates that substances that can cause symptoms in a healthy individual are used to cure the same symptoms in a diseased individual. To find the matching remedy requires a detailed history-taking and clinical case study by the homeopath. The homeopath looks at what is known in homeopathic parlance as the “Peculiar, Queer, Rare or Strange Symptoms” (PQRS), in each particular case, in order to find the matching remedy or the simillimum. An explanation of the principles of homeopathy including the case taking process can be found in another research paper by this author “Healing Autism with Homeopathy in Synergy with Other Therapies (Rajalakshmi, 2015).
Homeopaths look at the individual variations in each particular patient even in the common symptoms that help distinguish one individual from the other and also to help find the appropriate remedy. For example, if a child has a trait of getting upset easily, the homeopath will try to find if the child is better with consolation or feels better when left alone. This qualifies the symptom and also makes it easier to select the remedy as there are different remedies for better with consolation and worse with consolation. This is just a small example of the detailed case history that needs to be taken to find the suitable remedy for each child.
The following table is a brief overview of the psychological and physical symptoms of the children with ASD as elicited from a homeopathic perspective of PQRS.
|Sl. no.||INITIALS,GENDER,AGE, DIAGNOSIS|| |
|AG- Male (M) -4 years 5 months – ASD||Expressive Speech absent, Better interaction with adults, crying refused things when, better consolation Loves playing in water, likes riding in cars, trains or buses, Prenatal stress in the mother during pregnancy, is ok with noisy and crowded places, knocking things with knuckles||Frequent tendency to catch cold, Tendency to recurrent boils and rashes, chewing on indigestible things like paper, cloth etc. desires chips and chocolates, perspiration-head, hands and feet|
|2||AN- Female (F) -4years 10months-ASD||Sound sensitive extreme, anger with hitting and beating when spoken to in a loud voice, speech wanting, using 2 words at a time, laughing spells of with cheerfulness alternating with spells of irritability with temper tantrums||Headache, worse from change of tone, shrill sounds, reprimands from, constipation, desires spicy and salty food, ice creams, cold things|
|3||AS-M-2 years 9months- ASD||Sensitive offended easily, crying, pulling hair, throwing things when angry, better consolation, speech wanting, receptive and expressive uses 5-6 words, anger contradiction from, otherwise mild and cheerful, sound sensitive to mixer, toilet flushing, vacuum cleaner, closes ears, hair cutting and nail cutting difficult||Blowing and spitting cannot do, desires milk, chocolates, juicy fruits, does not like to touch sticky foodstuff, cannot tolerate sitting in swings or slides|
|4||AM-M-3years 9months-ASD||Speech regression probably from emotional trauma, transition difficult, sensitive to change of tone, rudeness, weeps easily, consolation aggravates confidence wanting, fear of insects, likes playing with sand, drawing, painting, gardening||picky eater, reduced food intake, aversion to head bath due to sensory issues, dry skin, tendency to dermatitis, decreased thirst, past h/o severe constipation, perspiration more on head and hands|
|5||AT-M-2years 8months-ASD||Sensitive, weeping easily, Sensory issues- will cry if blindfolded for games in school, fixated on spoons and Cars, Hyperactive, Poor Sitting Tolerance and Attention Span, Poor eye , No expressive language skills,Does not use gestures or pointing||Constipation, Dislikes Sticky food especially Bananas, Pica-Craving for Raw Rice|
|6||AH-M-2years 9months- ASD||Humming, makes sounds but no words, fear of injury, tapping, beating refused things when, likes to play with water, sand, rolling objects with fingers, likes music-soft melodies, cannot spit, sensitive to haircut, nail cutting and brushing||Bowel movements immediately after food, has to rush to the toilet, desires spicy and salty food, chips, vegetables, lentil soup, aversion to sweets, biscuits, milk and curd, head sweating, increased thirst, allergic to eggs|
|7||DK- M – 5 years -ASD||Eye poor, biting self when angry or when forced for activities, weeping reprimands from, like to play with light switches, curiosity makes him excited and hyperactive||Will not pass motion when outside, nocturnal enuresis, thirst for small quantities at small intervals|
|8||CD-5years 4 months- ASD||Timid, fearful, cannot see cruelty, clenching of fists and tightening of facial muscles, stiffening when afraid, sensitive to noise especially when people screaming and fight, squishes insects, pushing other children, fear of dark||Desires sweets, ice creams, chips, cold drinks, frequent tendency to catch cold, poor appetite, head sweating at night|
|9||PR- M – 4years 11months – ASD||Speech regression, poor attention span, focus good for activities of interest, restless runs about and jumps, likes travelling, sudden screaming or shouting while doing activities, crying refused things when, consolation aggravates, stimming fingers with, prefers playing with older children||Picking of lips, desires rice, sweets, ice-cream, wants to eat all the time, aversion to milk, sleep delayed, teeth grinding|
|10||DY-M-2 years 6 months -ASD||Speech regression of, hyperactive, poor eye , crying refused things when, better consolation, fear of loud sounds occasional, likes playing with, water and sand, listening to music, likes cars, poor response to commands, thumb sucking, moody, poor sitting tolerance||Perspiration more on face, occasional constipation, not toilet trained, likes crunchy food|
|11.||PN- M – 5 years 4 months -ASD||Echolalia, speech only on prompting, hyperactive, restless, throwing things against the wall, uses single words, lost in own world, likes hugging and cuddling, jumping, spinning, likes to put light switches on and off, mouthing, biting, responds when called for preferred activities, capricious, fear of dark and thunderstorms||Frequent tendency to catch cold, dry cough, desires sweets, chocolates, spicy food, sour curds, aversion to milk and vegetables, dermatitis in the legs, diarrhea occasional, head sweating|
|12||SK- M – 4years 6months-ASD||Speech regression of, speaks 3-4 word or small sentences but on prompting, wants parents to be with him but will not interact, crying when forced to do things, throwing things, banging the door, beating others when upset, separation anxiety, better rapport with older children, shyness, fears firecracker sounds, balloons and fire, rigid routines||Low immunity with frequent attacks of viral fever, likes sweets, fried food, curd and milk|
|SB- M – 8years 8months-ASD||Poor fine motor abilities, speech regression of, uses 2-3 words occasionally, no sense of danger, aversion to haircut, loud sounds like crackers, blowing of the conch, disinclination to mingle with unknown people, sensitive offended easily with weeping, lethargic, fear of being in the dark, likes looking at picture books||Cannot tolerate extremes of heat and cold, likes spicy and salty foods, cold drinks, will eat salt directly, aversion to meat, fish and eggs, sweating more on the head, palms and feet, Increased appetite|
|14||VJ- M – 3years-ASD||Poor expressive language ability, speaks 2-3 words, poor response to parents, attention span good only for preferred activities, good self-help skills, throwing things, biting pillows when upset, wants to be hugged and consoled when upset, like to watch lights go off and on||Constipation episodes of, lack of focus during these episodes, frequent episodes of conjunctivitis, pica, peels wall plaster and eats it, desires spicy, hot food and sweets, likes sour food, likes to suck raw lemons|
|15||SD- M – 2 years 5 months – ASD||Speech delayed, uses single words, delayed development, microcephaly, poor response to commands and name, sensitive to haircut and nail cutting, likes to play in the swing and slide, pacing up and down, cannot suck, spit or blow||Sleep disturbed, frequent tendency to catch cold with watery coryza, hard stools, desires spicy food, wheat products, vegetables and milk, aversion to fruits curd and buttermilk|
|16||SN-F-4years 10months-ASD||Speech regression of, uses single words or gestures to communicate, obsession with spinning things, round objects red colors, curious, constantly climbing up and sown staircases, like to go upside down in the swing, poor attention span and focusing ability, plays with saliva, likes to apply cream and powder to the face||aversion to food with certain textures spicy food, past history of bronchitis, teeth grinding while asleep, cannot bear the sight of blood, fear of darkness, constipation, bowel movements on alternate days, desires chocolates, chips, biscuits|
|17||TS-F-7years-ASD||Verbal but no meaningful communication, self-talk when idle, uses 2 words, need-based communication, mood swings, adamant, self-willed, good memory, watches other children play but will not join them, fear of coconuts, cautious, fear of injury||Appetite poor, very limited choice of foods, will eat only crunchy foods and curd, constipation, flatulence with, aversion to milk, rice, vegetables, thirst increased, sleep disturbed|
|18||TV-F-3years-ASD||Speech-regression after major LRT infection, loves to dress up, fear of dogs, travelling desires, wants to go out, likes to play in the swing and slide, good memory and grasping capacity, poor focus and attention span, no stranger anxiety, Mouthing objects||Delayed dentition, poor appetite, desires chocolates, biscuits, food needs to be mashed, aversion to food in general, frequent tendency to catch cold, head sweating, ability for sustained physical activity|
|19||KV-M-4years- ASD||Speech wanting, uses gestures to communicate, intelligent, good at task completion, hyperactive good with numbers, stubborn, cheerful, cannot tolerate contradiction, consolation aggravates, aversion to black color, fear of the dark, curious, tears paper when unoccupied||Previous history of poor sleep patterns, desires curds, milk, salt, sugar, hearing acute sense of, tendency to catch cold with coryza and mild LRT infections|
|20||BV-M – 3years-ASD||Poor expressive and receptive language ability, tries to use single words when prompted, likes to look at picture books, play with water and on the swing, ride on tricycle, sensitive to loud sounds and change of tone, shouts, screams and clenches fists when angry, sometimes lost in his own world, tendency to lie on the back and move backwards, jump, Indifferent if parents leave||Feels better in winter, occasional nocturnal enuresis, head sweating, desire sweet, sour and spicy food, aversion to fried rice, fruits and curd, cough with wheeze and nasal obstruction|
|21||AV-5years 3months-ASD||Speech poor, few words on prompting, sensitive offended easily, weeping with worse when consoled, does like others to sing unfamiliar songs, like cycling, playing in water, aversion to haircut and nail cutting, spinning, looks at the fan more when nervous, cannot tolerate pressure cooker and conch shell sounds||frequent tendency to catch cold, allergic rhinitis, desire for salty food, oily food and chocolates, picky eater, aversion to sweets, heat of palms and foot|
|22||SM- M – 4years- ASD||Head banging mild-reprimands from, uses single words, fear of drum sounds, certain songs, learns at his own pace, loves open spaces, prefers playing with adults, want people around but will not interact||Appetite average, desires sweets, oily fried food, curd, wheat and milk products, aversion to spicy food and vegetables, midnight hunger pangs|
|23||SK- M – 2 years 7 months -ASD||Lack of eye , poor grasping capacity, poor expressive and receptive language, plays with other children, poor sitting tolerance and attention span, likes playing in water, likes building blocks, watching songs on TV, screaming, throwing things when angry, sympathetic, cries when he sees other children crying, sensitive to shrill sounds, tactile sensitivity to fur clothes||Want to eat independently, likes sugar, sweets and milk, bowel movements on alternate days|
|24||AY-M-2 years 7 months – ASD||Speech wanting, use gestures, poor response to commands, poor receptive language ability due to lack of attention span, social with known people, playful, throwing things as a game, capricious, head banging and spitting when angry or when refused things, does not want to be carried when upset||Past history of febrile convulsions at 18 months, heat of head and feet, desires salty, spicy food, sweets, milk. Fried snacks, allergic to milk causes rashes, frequent tendency to respiratory infections, Increased thirst|
|25||JN- M – 2years 6months- ASD||Speech wanting, regression, developmental delay, occasional use of gestures and pointing, head banging occasional, crying when refused the things he wants, better consolation, likes playing with spoons and cups, shyness, hides when he sees strangers, good memory and grasping capacity||Frequent tendency to lower respiratory infections, nose block, emaciated, lack of appetite, perspiration more on head, skin dry and rough with itching-more on hands, feet and abdomen, fanning desires, does not want blankets while sleeping|
|26||RH-F-5years-ASD||Speech difficult, poor expressive language, sensitive impatient sympathetic, does not like to be spoken to in a loud tone, sensitive to criticism, restless, has to walk around, retorts back when reprimanded, crying when upset, has to be left alone, like doing puzzles, climbing, screams suddenly in the middle of classroom activities||Thirst decreased, desires salty food, cold food, head sweating|
|27||RN-M-4years 8months-ASD||Need-based communication, uses 2-3 words only on prompting, hyperactive when idle, screaming, impatient, friendly demeanor but no social interaction, crying refused things when, consolation aggravates, likes playing in the swing, playing with water, solving jigsaw puzzles, spinning, irritability in crowds, separation anxiety when father is away||Sleeps light, wakes up from slight sounds, desires sweets, tea, chips, groundnuts, dry fruits, tendency to mouth ulcers, aversion to fruits, juices and milk, frequent tendency to catch cold with nasal obstruction and thick coryza|
|28||SR-M-9years-ASD||Poor expressive language ability, screaming contradiction from, wants to be appreciated, curious, laughing spells of, anxious, fear of loud sounds, startled easily, lost in his own world, likes drawing and coloring, emotionally sensitive weeping with||Constipation occasional, sleeps late, heat intolerance of, desires salt, chocolate, chips, pizza, aversion to vegetables, tendency to cough with high fever, past history of diarrhea alternating with constipation|
|29||TJ- M – 4years-ASD||Poor expressive language ability, has started using single words and gestures to communicate recently, like to explore, do puzzles, cycle, writing numbers and counting, likes to play in the park and be around people but no social interaction, shows attachment to family members, attention seeking, screams when upset||Frequent tendency to catch cold with cough and nasal obstruction, fever with head hot and cold hands and feet, desires sweets, head-sweating, face becomes red when heated, constipation|
|30||JB- M – 5years9months-ASD||Speech-Regression of, uses few words on prompting, Restless, Better Consolation, Stacking, Escape Desire to, Poor attention span, Sound sensitive-loud sounds to, spinning, likes playing with sand||Constipation, hard stools, passes on alternate days, dry skin, likes spicy food, chocolates, fried food, better in cool climates, poor fine motor abilities|
|31||VK- M – 3years 4months-ASD||Poor expressive language, uses 2-3 words but out of context, likes playing in water, wants to be hugged, attention and focus only for preferred activities, spinning cars, sometimes sings first 2 words of a song, screaming and crying, better consolation, sensitive to loud sounds such as firecrackers, sensitive – offended easily, poor response to commands||Likes cookies, nuts, biscuits, wafers, aversion to vegetables, fruits, does not like wet and slimy stuff, sleeps late after 1 am, poor appetite|
|32||HR- M – 5years 6months-ASD||Poor expressive language ability, apparent deafness, poor response to commands and name calling, lost in his own world, weeping and throwing things, worse consolation, wants to be left alone when upset, prefers to play in open spaces, likes music, hyperactive, jumping, fear of firecracker sounds, does not want to be alone but poor social interaction||Lack of appetite, does not ask for food,desiressweets, chocolates,chips, apples, pancakes, aversion to rice and fruits, cannot tolerate heat, worse in summer|
|33||SY- M – 5 years 8 months – ASD||Speech wanting, regression with, no stranger anxiety, poor task completion, likes writing, likes playing in the slide, swings, cycling, doing jigsaw puzzles, fascinated by words, likes writing words, pinching and scratching when upset, hyperactive, inquisitive||Adenoids, frequent tendency to catch colds with nasal obstruction and allergic rhinitis, snoring,thirst increased, desires rice, lentil soup, milk, curd, chocolates, aversion to vegetables, certain type of sweets|
|34||HV- M – 4years-ASD||Speech wanting, continuous weeping, no response when called, irritated in crowded places, biting and scratching when irritated, lack of sense of danger, possessive about his things, fastidious about placement of his things, likes to play in water, laughing spells of, sensitive to haircut and brushing teeth, fear of balloons||Increased appetite, Desires sweets and cold food or drinks, thirst decreased, frequent tendency to catch cold, tendency to dry skin with decreased perspiration, skin rashes|
|35||AL- M – 3years-ASD||Poor expressive language ability, humming, curious, screaming excited when, problems with fine motor abilities, humming, tendency to bite and head banging when angry, fear of sitting in the swing, loves to travel especially by bus or three wheelers, pulls or hugs children||Past history of hard stools, teeth grinding while asleep, tactile sensitivity, does not like the sensation of sand on the feet, desires sweets, chips, jaggery, milk and curd|
|36||DS- M – 4years 7months-ASD||Poor expressive language ability, delayed echolalia, sensitive to haircut, poor sense of danger, tactile sensitivity, cannot bear to be touched, does not like getting wet in general but likes to play with water while bathing, likes riding in cars, cycling, enjoys watching children play but will not join them, spells of causeless weeping||Fungal infection of the skin, desires bananas, vegetables, eggs, aversion to apples, bowel movements regular, sleep sound but takes time to go to sleep|
|37||PV- M – 3years 6months-ASD||Poor expressive language ability, speech regression of uses small sentences on prompting recently, will not share his things, stubborn, manipulative, self-willed, possessive, good memory and grasping capacity, fear of darkness, sensitive to loud noises||Constipation-bowel movements on alternate days, frequent episodes of respiratory infections with coryza, cough and high temperature with febrile convulsions, thirst absent, perspiration decreased, tendency to body heat, desires chocolates, sweets and juices, tendency to agglutination of eyelids|
|38||SC- M – 2years 3months-ASD||Speech wanting, Poor eye , No response to name calling, Shouting and laughing for no reason, poor focus, obsessed with gadgets, prefers to be alone, causeless weeping, likes to listen to music and watch rhymes on T.V.||Toe-walking, sleep disturbance, constipation, fussy eater, limited choices in food,|
|39||AR- M – 2years3months- ASD||Lack of expressive language, tightening facial muscles when excited, obsessed with cars, sensitivereprimands to temporary regression with, prefers visual cues rather than auditory, watches T.V but fear of certain ads or pictures closing eyes with,||Frequent tendency to catch cold with coryza and cough, desire s cakes, crispy food, juice, sweets, milk, thirst decreased, perspiration more on head, sweating while asleep|
|40||AA- M – 7years-ASD||Jumping and screaming excited or happy when, Lack of Expressive Speech, uses 2-3 words,Likes playing in water, jigsaw puzzles, music, restless, pacing about, fear of dark, sensitive to loud sounds, anger refused things when, pinching, pulling hair, consolation aggravates||Thirst increased, desires milk-based sweets, toilet trained, sleep sound, perspiration normal|
MAIN HOMEOPATHIC REMEDIES USED AND CHANGES SEEN