Clinical Cases

A Case of Pervasive Developmental Delay (PDD)

A case of Pervasive Developmental Delay analyzed with great clarity.

While the range of intelligence in children with Pervasive Developmental Delay can vary widely, PDD presents a wide range of communication problems including:

        Conversational deficits, speaking and understanding;

        Lack of eye contact, inadequate pointing behavior, and under-expressive facial response;

        Unusual play with toys and other objects;

        Difficulty with situational transitions;

        Stimming (repetitive or peculiar body movements) such as hand flapping, hair twirling, foot tapping, or more intricate movements;

        Aversion to consolation or cuddling.

12/29/2009:

A male child, age 2 from Northeastern Africa. Diagnosed ASD in May of 2009. Subsequent diagnoses include hypotonia.

The boy has a sister, two years older. Fine, sensitive features, large forehead. In the office keeps saying, Mommy, mommy. Sits on the floor wiith feet behind him very loose jointedly.

The mother reports that he does a lot of hand wringing and humming. He seems not to follow other children in play, maybe because he is tired. Prior to being put on a gluten-free diet was non-verbal, did not understand any directions and constantly running about, liking to wave a stick. His fine motor skills were very poor. Could not do a jigsaw puzzle…..would spin the piece…. has trouble putting the piece in place. Used to have offensive and mushy bowel movements. This is now only occasional. Used to hide under a table when a little over a year old, when a cousin would scream. When reprimanded he would laugh. That too has improved. Only now, gross motor skills delayed. Cannot jump.

Beginning to repeat what others say (echolalia) but also imitate and show interest in others, such as his sister. Has a good memory for details and appears to be mechanically oriented like his father. Still prefers to play alone. Can get spaced out and stare into space. Has to be called several times before one gets a response. Generally sweet-natured, but also lethargic. Easily angered if told “No” or transitioned from a preferred activity. Will begin sucking on two fingers. Poor self-help skills as in pulling up his pants.

A major family issue is his sensitivity to food textures: chicken has to be ground up. He prefers a texture not hard to chew. Smells food before tasting it, also touching it to determine its texture.

BIRTH: Born normal with good APGARs though also jaundiced. Began breast feeding immediately, even before cord was cut.

ENVIRONMENTAL FACTORS: Mother was positive for Strep and so was given antibiotics one hour before birth.

Child was very active but began sleeping a lot after the Hep B vaccine.

At age one: became terribly picky eater following MMR vaccination.

Huge bacterial and yeast overgrowth as per urine test for which he is currently taking Diflucan.

Found to have zinc deficiency, but when zinc supplementation was prescribed the child became aggressive.

PARENTS: Well-educated professionals who had read Amy Lansky’s book Impossible Cure prior to contacting me.

Father: mechanically oriented, as a child much affected by a beloved nanny’s leaving the family.

Mother: When pregnant 6 months while traveling to London with the little girl, the girl grew ill and then the mother was very upset and panicky. Also reports that mitochondrial problems run in her side of the family.

ASSESSMENT:

Especially given the child’s being born jaundiced, his treatment with Diflucan, a powerful anti-fungal drug carrying risk to the liver is worrisome. In fact, were he no longer taking this drug and were I to see this child for the first time today my first choice might be to perform a Diflucan “clear.” At the time I informally requested the family to explore ceasing the Diflucan. I also prescribed Zincum. This was in consideration of the remedy’s connecting the dots for me between the child’s:

Echolalia

Defective vitality

Hypersensitivity

Purposeless activity (hand wringing)

Aggravation from zinc supplementation

RX: ZINCUM 200

1/25/10

First follow-up. He remains lethargic, but the mother reports he is trying to be more active. Is asking more questions..

Diflucan has been stopped. He is taking only grapefruit seed extract.

Less humming and hand wringing these past few days. Low muscle tone remains evident. Very rarely now the echolalia, although occasionally a kind of nonsense speech. Parents have placed his fingers in a plastic restraint so as to control his fiddling.

Has acquired a strong interest in the tongues of any animal he sees or learns about. His eye for minute detail is increasingly in evidence, noticing small things that his mother does not. Becoming more decisive with regard to choosing among foods to eat or toys to play with. Increasing evidence of having a powerfully strong memory. Drawn to books about polar bears.

Still a very picky eater, but not sensitive to the temperature of food.

Not as alert as other children; still emotionally under-expressive. Cries easily and remains intolerant of refusal.

ASSESSMENT:

When a remedy is effective my preferred method is to attend closely to “follows well” and complementary remedies. Here, where enhanced consolidation of energy was evident and the Diflucan could be stopped with no ill effect, Zincum’s complement, Calc Phos appeared a solid follow-up choice in regard to:

Continued malnourishment profile;

Looseness of joints;

Adverse effects of bad news (crying from refusal)

RX: CALC PHOS 200

3/1/10

More energy! Does not get tired! Now prefers to move around. Suddenly is highly impatient: When in the car at a green light, will urge, Go! Go! If asked to wait, will scream….. “I want to go in and play!” Eating more. Seems we have to give him food all the time! Will eat two lunches in the same day! Has become greedy. Will insist it HIS turn to eat instead of his sister’s! Much more alert with other children!

Concern the family now relates:

He is not gaining weight or height;

He is back to fiddling with his fingers and stimming in various ways;

Sleeps in a fetal position;

Runs in a funny manner with feet outward, and one hand up and the other down, all the while looking upwards, or downward;

Still some food sensitivities;

Has become self-conscious about his pooping, wants his privacy.

ASSESSMENT:

A huge shift in response to the Calc Phos: the child’s malnourishment pattern is no longer in evidence. Instead, as per the heightened impatience, anxiety, raging appetite with no weight gain, a remedy following well after Calc Phos suggests itself:

RX: IODIUM 200

4/6/10

In advance of this follow-up I received from the mother, the following letter:

“I would like to let you know how Horace (not his name) is doing after the last remedy.

On the good side, he’s interacting more with kids and adults, says “Hi” spontaneously and most of all he attended his cousin’s birthday party and wanted to hit piñata. These things never happened before. He also continues to be more energetic.

The drawback is that he is still very impatient and is screaming more than before whenever he wants food, or other things he wants to get. He is still constantly requesting food.

He also wants to spend his time with me; he wants me to hold and hug him.

We did some tests a while back to check his bacterial and yeast levels. I checked with his DAN doctor’s office and they told me his bacterial levels are higher and they prescribed an antibiotic called Gentamicin and honestly, I don’t want to give him medication. Is there any way that we can work on it using homeopathic remedies? Please let me know also if it will affect his homeopathic treatment.”

NOTES from during the follow-up: He is doing great. Tremendous energy, running all the time. And now gaining weight. Very impatient. Still screaming a lot. Cannot wait to eat. Craving avocadoes, bananas. Especially hungry in the morning.

A lot of head shaking, some licking behavior. Seems to be practicing visual self-stimulation, as with frequent winking of his eye.

Has become very friendly!

Repeating everything his older sister says.

Engaging in huge power battles with his mother.

No longer frightened of going on playground swings, yet cautious generally.

ASSESSMENT:

Another huge gain and evident shift into the important developmental remedy, Lycopodium

RX; LYCOPODIUM IM

5/10/10

Child is doing great. Very good weight gain. Full of energy. Less impatient. Wanting to play more with his sister as opposed to formerly being more of a loner.

Still looks at objects, scrutinizing each one. Speaking more properly, developing his language. Wants to do what other kids are doing.

Face has become rounder. He continues to eat new things.

Gets a bit possessive about his toys, though not with his sister.

Still some slight problem with understanding. Can still confuse How old are you with How are you?

Can be stubborn and willfully passive as if he is holding something back. Resistant to demands and continues to notice very small details.

Appears not bothered by loud noise. Mostly obedient, but if reprimanded may scream or vanish under the table. Punishing him does not work as he seems to not understand it.   Time outs do not affect him.

Has become more independent. Likes to line things up nicely, neatly.

DAN doctor has recommended further work with homeopathy.

ASSESSMENT:

The strong attention to details, general holding back and stubbornness point to a shift to Silica.

RX: SILICA 200

6/22/10

The child’s awkwardness and timidity are less in evidence.  It is reported that the therapist who had made the ASD diagnosis now says, it is one in a million children who change like this, and can no longer justify this child’s diagnostic placement within the autism spectrum.

Subsequently, this child required treatment from me as a normal child with garden variety ailments of childhood only. As of this date he continues to enjoy a perfectly normal childhood.

About the author

Jerry Kantor

Jerry Kantor

Jerry Kantor, Lic. Ac., CCH practices and teaches at Vital Force Health Care in Needham, MA. He is the author of an integrative medicine text: Interpreting Chronic Illness, the Convergence of Traditional Chinese Medicine, Homeopathy and Biomedicine; and a homeopathy book, The Toxic Relationship Cure, Clearing Traumatic Damage from a Boss, Parent, Lover or Friend with Natural Drug-Free Remedies. His new book on the treatment of Autism will be brought out by Emryss in 2015. www.vitalforcehealthcare.com / www.rightwhale press.com

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