YMT Seminar Exhibits Final

YMT HMC- Seminar- 18/04/2024 – Dr. Ananya O.
Chitale
Topic- Understanding neurodevelopmental disorders and its holistic mananagement
EXHIBITS For the Seminar on 18/04/2024
Note: There are total 4 exhibits.

Exhibit 1- Case background.
Exhibit 2- Case data from History form and case taking.
Exhibit 3- Psychometric assessment.
Exhibit 4- Occupational therapist assessment report.
There are directives given. To get the maximum learning of the session, You all
are requested to do the case working as per the directives, and preferably submit to
me by 17/4/2024 10am on my email ID- drananyachitale@gmail.com.
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YMT HMC- Seminar- 18/04/2024 – Dr. Ananya O. Chitale
EXHIBIT 1
Directives:
• Go through the background of the case and try to note down what you understand about
Parent’s state of mind.
• Explain what you think the child is going through. (think about both, possibles diagnoses and
his mental state)
Case Back Ground:
This is the case of Mst. AB, 5.5 yr old when 1st referred, by school counsellor, in Feb 2022.
He was in Sr. Kg CBSE school. The school had started alternate days online and offline schooling from
month of December 2021. TH class teacher had noticed following concerns:
1. Child had struggled with meaningful communication.
2. Would soil pants at least 2-3 times.
3. Would grab food from other children’s tiffin.
4. Pushing, hitting them if children did not listen to him.
5. Would not follow instructions.
6. Would keep roaming in the class.
7. Was not able to copy from the board.
8. Had difficulty in age-appropriate reading, writing.
9. Overall disruptive behaviour in class, would suddenly start rolling, shouting, would also use
abusive words like to anyone including teacher such as – gadhi, stupid, potty, paagal etc.
10. He would scare other kids by, making angry faces and punching them randomly. Parents of
other children had complained to take an action against him.
From December 2021 to February 2022, School counsellor and class teacher tried to work with him
with various counselling techniques and gave him benefit of doubt that he may have adjustment
issues with post covid schooling. But his condition was only getting worse.
Th parents were referred in first week of Feb 2022, but they came to me in March first week of 2022.
The parents felt that school is unnecessarily making an issue and there are no problems as such with
him, but they came as school counsellor forced them saying that he will not be allowed to give exams
if they don’t consult speciality and get an opinion.
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EXHIBIT 2 (case data taken in March 2022)

Directives:
Go through the History form (part A) and Case taking data (Part b) Based on the added data, now
Answer these questions:
• What is the possible diagnosis now you think?

• Any investigations you would like to order?
• Would you take up the case, or refer?
• Do you think Homoeopathy has scope in this case? If yes, to what extents, what symptoms you
feel can bet completely managed? And in what time frame you can give significant results?
• If you think there is no scope, then give your reasons.
• If you think there is partial scope for homoeopathy, give reasons why you think so.
• Would you want any assessments to be done? If yes which professionals you will refer?
• Which Homoeopathic remedy are you thinking as his similimum? Give your totality.
PART A- History form given to parent
Mast AB
6/6/2016
Male
Hindu/Punjabi
Veg/Egg ( No meat consumption)
Eating Habits: Milk/Biscuits/Chocolates/Sweets/Home-cooked-food/marginal-on-fruits/
Family Description :
———————————————
Father is working as Computer Engineer
Mother is working with Bank
(Both parents are married not within family )
Nuclear family of 3 including the only child , residing in Pune. Both parents hail from Kanpur city
(Home Town)
GrandFather lives back in home town
GrandMother died due to Ovarian carcinoma complications in 18/4/2016 . (Illness continued for 3
years)
Daily routine :
——————————
Child gets up in the morning ~7 AM and prepare for school. Usually takes milk with 2-3 biscuits. ( He
3
has not picked up the routine of nature call in the morning so he always skips) . There is enormous
laziness while getting up in the morning for school and sometime screams to not going to school.
Once back from school, he will have Lunch with good appetite. Next 2 hours are his leisure time with
no concrete ajenda and by the evening he goes to play out with friends. Late evening he is back and
by 8:30 he take his dinner. Around this time he seldom studies ( which he always resist ) and if not
then takes dinner watching mobile phone ( ALWAYS)
Chief Complaint:
————————————
Ever since born he has been healthy and little more on extra weight as compared to other children till
now. Current weight : 39Kg
No Potty training was facilitated till the age of 4.5 years. Parents wash his business with wipes and
child did not learn to go to toilet or complaint about the feeling of stool pressure. By this time there
was huge fear in him to sit on the potty seat. He has significant problem of constipation since
childhood, wouldn’t pass stools for 3-4 days, many times when passed would be hard.
Personal Data
——————————
1. Little overweight and healthy
2. Poor speaking ability & Fear ( in early years) , significant changes After OT :-> Loud , frustrative,
refusal behaviour on all account, stubborn, torment having screen time, destructive and do not
cooperate. Does not follow the rule of games and get involves in quarrel.
3. Average school performance tends to disturb teacher/mates. He does skates in school. He has
taken prior training of quads skates in academy where he struggled badly to learn the tacts (heavy
weight is one reason)
4. Difficulty in developing relationship with friends but he is more incline towards friendship with kids
younger to him.
5. Imitate the action of other children. Ask questions repetitively multiple times which sometime
sense awkward.
6. Reaction to surrounding has been developed after OT sessions. Body awareness is improved since
then.
7. No story telling. Does not want to describe school activities.
8. Seldom speak few words while dreaming.
9. Delivery type : cesarean, No health issues after birth
10. Teething: 1 year/ sitting : 9mnths / walking :17 months
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PART B : CASE TAKING ( both Parents were called separately for the interview)
Generals:
Craving sweets++ Chocolates +++
Very sensitive, cries when someone gets even a little angry.
Fear of Dark +++
Fear of being alone++
Fair, very curly hair, very bushy, obesity ++ overall delayed milestones, sweating scalp +++
Thermals- Chilly Constipation++++ Fat and fair complexion.
Parenting:
His mother mentioned that since there marriage, both husband and wife had been having arguments
and fights on any trivial matter. She doesn’t trust him that if she quits her job her husband will take
care of her adequately. So after birth of Mst. AB, withing three months she got back to job, which is
from 8am to 6pm. Her husband too has a fulltime job. So thay had kept a maid throughout the day
from his age of 3 months. They have installed cctv cameras, and they could see that AB would be
lying or playing all by himself with TV constantly running behind. The Maid would take him down for
a round only in evening for 1 hour. When asked about potty training both parents started blaming
each other for not doing it. As per mother when there is a fight between them, they both tend to use
abusive words in front of the child. His mother wouldn’t really get time to play with him or spend
qualitative time with the child. Father said he tried to at his best. When they fight, AB puts hands on
his ears and starts crying asking them to stop. During Lockdown, his screen time apart from schooling
was7- 8 hours a day. His father reported that when AB would get obstinate for anything, his mother
would lock him in the bathroom. And mother reported that his father hits him when he is obstinate.
He becomes very stubborn if there are any sudden plan changes, or he must wear different clothes.
He is very picky when it comes to eating and gets very stubborn. He always prefers soft foods. He
gets very irritable or too excited in crowded places, especially birthday parties. He often has tantrums
where he goes on the floor and starts rolling at any place. That’s where his father loses temper and
hits him and shouts at him. But that only increases his disruptive behavior.
Since few months because of these issues and also due to his soiling of pants, other children in
society have started mocking at him and avoiding him. Neighbors don’t include him in their house for
playing with kids or invite him to birthday parties any more. Parents tried to send him for tuition
classes, activity classes, but from everywhere he was sent back home. He still needs mobile
constantly.
They had taken him to child psychiatrist and the psychiatrist had given him Tab. Axepta for 1 month,
but parents found no change only worsening of symptoms.
O/E- NAD
5
Observations during 1st interaction with child: He was not able to sit at one place for more than 3
minutes, he gave irrelevant answers, he showed obstinacy and aggressive body language when he
wasn’t given the toy he asked for. He was not understanding roleplay and wasn’t able to understand
turn taking and follow simple instruction in games like peek a boo, simon says etc. He would
suddenly start crying and suddenly disproportionately laugh without able to tell the reason. He had
difficulty to tell anecdotes from his daily life. He was not able to sit and focus on listening to story be
read or narrated.
----------------------------------------------------
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EXHIBIT 3
• Go Though the Assessment reports. Basic Investigations done – all were normal
• Now formulate final plan of how you would want to manage the case in details.
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EXHIBIT -4 – OT Report (done after 2 months of Homoeopathic medication and Play therapy
was started).
Directives :
Note down the changes that have occurred in 3 months. What is the reason of change?
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YMT HMC- Seminar- 18/04/2024 – Dr. Ananya O.

EXHIBITS For the Seminar on 18/04/2024

Note: There are total 4 exhibits.

EXHIBIT 2 (case data taken in March 2022)

Answer these questions:

• What is the possible diagnosis now you think?

PART A- History form given to parent

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