Clinical Cases

A Case of ADHD with Dull-Normal Intelligence and Defiant Behavior

A Case of ADHD with Dull-Normal Intelligence and Defiant Behavior

Dr. Vijaya Patil presents a case of ADHD with defiant behavior

f-adhd.jpgM.G. is an 8.7 yr old Gujarati boy studying in 3rd STD and stays with his parents, uncle and aunt.  His mother was complaining about his inattentiveness, restlessness, and obstinate behavior. According to his parents he has good intelligence and ability to understand, but his academic performance is decreasing.

He is born out of a full term normal delivery to non-consanguineous parents. According to his mother the pregnancy was uneventful. He cried immediately after birth and his birth weight was slightly below average. His motor, speech and social milestones were normal, and only double syllable speech was delayed. He had tuberculosis at the age of 8-10 months and had undergone treatment for the same. He has dust allergies and tendency to recurrent upper respiratory tract infection. His appetite is very poor and his growth is affected in terms of weight gain.

His mother says that day by day he is becoming very mischievous. He troubles others at school, pinches and teases children without any reason. He is very inattentive, extremely restless and likes to run a lot, rather than walking. Teachers usually complain about his restlessness, decreased concentration, destructive nature and carelessness. He hardly sits for few minutes at one place. Also he doesn’t listen in school or at home and has no fear of teachers (but mild fear of tuition teacher).  He is very obstinate by nature and will do whatever he wants.  His first answer is always “No” for any work. He always has conditions for doing any work. He would refuse to complete any household work given to him.

He will eat only if he likes, but otherwise will remain hungry for a full day. He does not get along with children, wants to dominate, quarrels with and beat them. If things do not happen according to his wishes, he is angry and will throw and destroy things.  He destroyed all his toys.

If someone says anything against him, he destroys things nearby. He was very much attached to his grandma and grandpa. After their death he used to frequently ask about them and cry a lot for them. He is very much attached to his uncle and listens to him.

According to his mother, in 1st std he would concentrate, but since PGM’s death in 2nd  std he has decreased concentration, restlessness and finally in 3rd he scored lower marks in his academics. This concerned his parents. He needs assistance for each and every activity of daily living. He is not able to tie shoe laces and is messy while eating.  In school he makes spelling mistakes, has difficulty in copying from the board, does incomplete work and is easily distracted. At the time of interview he was very fidgety.

Physical – Lean with wheatish (light brown) complexion.

Craving-for sweets

Thermals-throws off covering, always needs fan.

 

PSYCHOLOGICAL ASSESSMENT REPORT: 22-1-2011

1) KBI—IQ Report-the scores is suggestive of DULL NORMAL RANGE of intellectual functioning.

2) ADHD Report-ADHD quotient found to be 104.Thus ADHD quotient was AVERAGE indicating that the child has Attention Deficit Hyperactivity Disorder combined type

3) DSM-4 for ADHD–Child meets the criteria for ADHD combined type disorder.

4) Informal assessment (spelling test, math test, comprehension test); his spelling age was around 8.4yrs. He was observed to be careless. He misses words while reading. He was not able to grasp the central idea of a passage. He started fidgeting while answering questions, as his confidence level is very low. He was not able to solve the basic problems, mostly due to poor attention and concentration.

 

According to psychological reports he has an I.Q range between 84-89 that means dull- normal range. As per the psychologist, his understanding is good, but due to his inattentiveness, easily distractible behavior and restlessness, he is lagging behind in his studies. His logical thinking is also poor. He was not able to differentiate between stone and potato.

Analysis of the case and Totality:

Clinical diagnosis—ADHD combined type with dull-normal intelligence

Totality: From the above description it is evident that he is obstinate and disobedient. He is restless and desires to run. He gets very angry and throws things and is destructive. The following rubrics were taken:

Headstrong obstinate children

Destructive

Anger -throws things

Restlessness-Run desire to

Disobedience in children, Defiant

Mischievous

Talk slow learning to

Hot, lean

Craving-sweets

H/o-tuberculosis

 

O7/1/2011- Treatment started with Tuberculinum 1M. Infrequent doses given in water. (See Tuberculinum from materia medica of Allen -Nosodes by Allen H.C.)

Follow up analysis: During follow up child was assessed for appetite/hyperactivity/defiant behavior/ lack of concentration /mischievous / obstinate-anger/ destructive/recurrent URTI/wt

 

26/03/11 – He is becoming compliant, listens to mother, anger decreased along with destructiveness; tolerance for sitting is increasing. URTI infection much better. Appetite is improving.

12/7/2011– can sit for 2 hrs;  now obeys commands. Passed and promoted to 4th grade. Now he is interested in drawing, sits for study, respiratory infections are just  occasional.

 

PSYCHOLOGY REPORT –23/8/2011—ADHD QUOTIENT-87

This suggests that the scores are better. (From 104 to 87)

Treatment was continued till Jan 2012. Then they used to report infrequently.

There are no complaints from school and he is doing well in school.

Recently they contacted me for his cousin’s brother, as he is also very hyperactive. At that time I requested his mother to write down her observations about M.G. Here is the written testimonial by his mother.

Testimonial by mother in Gujarati –translated to English (thanks to Dr. Amit Daftary for the translation)

Mast M was born on 15/6/2002. His development was normal except his speech. He was very obstinate and never listened to anybody. He could not sit at one place and was extremely mischievous. At Dr.Vijaya’s centre (SPARSH) he was diagnosed as a hyperactive child.

We noticed changes after starting with homoeopathic treatment. He started attending school regularly. The number of complaints from teachers reduced drastically. His attention span improved and he started scoring better marks. Now he can sit at one place for long. He started taking part in school activities and sports. His appetite is improved and he has gained weight around 2 kg. People within his family and society noticed a drastic difference in him. He behaves more maturely now. He keeps his possessions properly and doesn’t throw or break them. His tests were repeated again and have shown improvement. We are very much thankful to Dr. Vijaya for the help and care.

About the author

Vijaya Patil

Vijaya Patil

Dr. Vijaya Patil is a senior homoeopath from Mumbai practicing homoeopathy for 23 yrs. She graduated from C.M.P. Homoeopathic Medical College Mumbai (1989) and completed her M.D. from V.H. Dave Homoeopathic College from Anand Gujarat. She is founder and director of SPARSH Homoeopathy and Child Care Centre at Navi Mumbai. SPARSH has a special unit for children with developmental and mental health problems. She participated as a senior research assistant in the project “Homoeopathy in Childhood Autism Disorder” a project under AYUSH, ministry of health and family welfare, Govt of India, conducted at M.B. Barvalia foundation’s SPANDAN Holistic Institute at Mumbai. Cases presented here are from her SPARSH child care centre. For more details refer to the website www.sparshhomeopathymumbai.in/ www.drvijayap.in

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