Spandan Holistic Institute of Applied Institute of Homoeopathy
Holistic Child Care Centre & Special Schools
Advance school for Autism
Special school for slow learner
HIV care centre
Rheumatology clinic
Diabetes clinic
Comprehensive  mobile clinic
Medical centre
Indian Journal of Homoeopathic medicine
Recent Events
 



 1. LEARNING DISABILITY (LD) 


           1.   What is disability?

           2.   How does LD manifest?

           3.   What causes LD

           4.   What is not LD

           5.   What are the indications of LD

           6.   How do we identify a child with LD at an early age?

           7.   What is typical dyslexic reading?

           8.   What are typical mistakes in writing?

           9.   What is visual dyslexia?

           10. What is auditory dyslexia?

           11. What are secondary psychological problems that people with LD face?

           12. What steps are needed to take to manage children with LD?

           13. What does our institute offer for management of LD?

           14. How can we help a child with LD in classroom?

           15. Can LD be cured?

           16. What is Homoeopathy?

           17. On what concepts does Homoeopathic science operate?

           18. What does Homoeopathic science offer in the management of LD?

           19. What improvement can I expect in my child with homoeopathic treatment?

           20. Is Homoeopathy compatible with other therapies?

           21. What is remedial teaching? How does it benefit children with LD?


 2. Autism

           1. What is pervasive developmental disorder (PDD)?

           2. Which clinical conditions come under the heading of PDD?

           3. How to diagnose autism?

           4. What causes autism?

           5. Do children with autism come from any particular family background?

           6. What is the level of intelligence in children with Autism?

           7. In short, what characterizes the autistic behavioural pattern?

           8. How to differentiate autism from a similar looking condition?

           9. Can children with autism be educated? And how is this done?

         10. What modes of therapeutic interventions are available for children with Autism?

         11. What is Homoeopathy?

         12. What improvement can I expect in my child after receiving Homoeopathic

               treatment?

         13. What factors determine the rate of improvement?

         14. Can the child be given Homoeopathic medication if he is already under
               Allopathic medication?

         15. Can other therapies be given to child receiving homoeopathic treatment? 


3.
Cerebral Palsy


           1.   What is Cerebral Palsy?

           2.   How is cerebral palsy caused?

           3.   What are the different types of CP?

           4.   Spastic Cerebral Palsy

           5.   Ataxic Cerebral Palsy

           6.   Athetoid Cerebral Palsy

           7.   Mixed Cerebral Palsy

           8.   What are the problems associated with CP?

           9.   What are the various types of therapy for CP?

         10.   What management strategies one should adopt after diagnosing a child as CP?

         11.   What is Homoeopathy?

         12.   Why choose Homoeopathy?

         13.   What improvement can I expect in my child with Homoeopathic treatment?

         14.   What facilities does foundation provide for the management of children with CP?

 4. Attention Deficit Hyperactivity Disorder


           1.   What is Attention Deficit Hyperactivity Disorder (ADHD)?

           2.   What are the causes of ADHD?

           3.   How is ADHD diagnosed?

           4.   How is ADHD treated?


 5. Mental Retardation

           1.   What is mental retardation (M. R.)?

           2.   What is non-specific M.R.?

           3.   What is pseudo-M.R.?

           4.   What do we define the degree of M.R.?

           5.   What are the causes of M.R.?

           6.   Can a baby who is born normal become mentally retarded after birth?

           7.   What are the various options available for educating M.R. individuals?

           8.   How does special education and rehabilitation help the mentally retarded?

           9.   What are the various types of therapy for CP?

 6. Down Syndrome

           1.   What is Down syndrome?

           2.   What is the historical background of Down syndrome?

           3.   What is the incidence of Down Syndrome?

           4.   What are the factors affecting the incidence of Down syndrome?

           5.   What are the clinical features in Down syndrome?

           6.   What steps need to be taken if the diagnosis of Down syndrome is suspected?

           7.   What is the long-term prognosis for patients with Down syndrome?

          
 8.   What is general management of cases with Down syndrome?

           9.   What is the role of HOMOEOPATHY in Down syndrome?

        
10.   Why is Speech Therapy essential with Down Syndrome children?


 7. HIV/AIDS 

           1.   What is AIDS?

           2.   How is the HIV virus transmited? How do you avoid the HIV infection?

           3.   What do HIV test results mean?

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  LEARNING DISABILITY (LD)

1. What is disability?
Learning disability is a condition where in individual's performance in reading, Mathematics or written expression is substantially below the expected age, schooling and level of intelligence.

The term 'Specific learning disability' means a condition in one or more of the basic psychological processes involved in the process of learning. These processes are

(a) attention

(b) perception

(c) Memory

(d) language.

It can also be a combination of the above. The term Learning disability does not include children who have learning problems, which are primarily the result of visual, hearing or motor handicaps, mental retardation, emotional disturbance, or of environmental, cultural or economic disadvantages.

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2. How does LD manifest?

The deficits in any of the above mentioned processes are manifested as difficulty in learning to develop.

(a) Reading Skills – DYSLEXIA

(b) Writing Skills – DYSGRAPHIA

(c) Arithmetic – DYSCALCULIA

These may manifest individually or in combination. LD is manifested despite conventional instruction, adequate intelligence and socio- cultural opportunity.

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3. What causes LD

The fact that Dyslexia tends to cluster in certain families has been known for many years. Familial transmission for Dyslexia has been well documented. Transmission of Dyslexia in these families followed an autosomal dominant mode of inheritance i.e. inheritance of a single copy of a specific allele (a kind of gene) is sufficient to cause Dyslexia. The prevalence of unexpected reading failure in males than in females proposes that the condition may be caused by a recessive allele carried in the x chromosome. Non-genetic factors like focal cortical dysgenesis and disarrays in the layered pattern of the brain's surface are also known to cause Dyslexia.

Although genetic predispositions, Perinatal injury and various neurological conditions may be associated with the development of LD the presence of such conditions does not invariably lead to genesis of LD and there are many individuals with LD who have no such history. Learning Disabilities are however, frequently found in association with a variety of general medical conditions (eg. lead poisoning, foetal alcohol syndrome or fragile X syndrome)

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4. What is not LD

   A sign of poor intelligence.

   Laziness or lack of caring.

   A vision problem.

   A disease.

   Something you grow out of.

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5. What are the indications of LD

   A marked discrepancy between ability and the standard of work being produced.

   A persistent or severe problem with spelling, even with easy or common words.

   Difficulty with comprehension as a result of slow reading speed.

   Poor short-term memory, especially where information is language based, which results
        in insufficient processing into long term memory.

   Difficulty with organization and classification of data.

Note taking may present problems due to spelling difficulties, poor short term memory and poor listening skills.

Handwriting may be poor and unformed, especially when writing under pressure.Students often show a lack of fluency in expressing ideas and with vocabulary.

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6. How do we identify a child with LD at an early age?

   A child with LD :

   Shows clumsiness.

   Becomes rigid and inflexible.

   Is poor at copying from the black board.

   Is restless or a daydreamer.

   Is quiet in class but does not learn.

   Cannot remember the sequence of letters in the alphabet, day, year and /or the season.

   Does not remember what he sees. Can add and multiply but has difficulty subtracting.

   Skips or adds words when reading.

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7. What is typical dyslexic reading?

   Reads slowly but hesitantly

   Gives stress on wrong syllables.

   Reads words backward ‘god’ for ‘dog’

   If text is in past tense, reads in present tense.

   Mispronounces the words.

   Makes own stories from illustration rather than read.

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8. What are typical mistakes in writing?

   Shortens word – ‘rember’ for ‘remember’

   Omits prefixes ‘happy’ for ‘unhappy’

   Omits suffixes like ‘s’, ‘ed’.

   Puts syllables in wrong order ‘ emeny’ for ‘enemy’

   Puts letters in wrong orders ‘felt’ for ‘left’

   Substitutes another word of similar meaning ‘little’ for ‘small’.

9. What is visual dyslexia?

Visual Dyslexia is the failure to notice internal detail, the result being that there is confusion between words such as beg and bog or ship and snip. The rate of perception is slow. There are reversal tendencies both in reading and writing. For example, dig and big. There is also a tendency to transpose the letters in a word.

10. What is auditory dyslexia?

These include problems with auditory discrimination and phonetic analysis. Auditory dyslexics cannot hear similarities in initial and final sounds of words or double consonant sounds, which they tend to write as one consonant. They find it difficult to discriminate between short vowel sounds or recognize rhymes. They cannot break words up into syllables or their constituent sounds. Auditory dyslexics cannot remember the sound of a letter, cannot say a word even if they know its meaning and cannot remember rhythmic pattern. They are inferior in tasks that involve auditory memory sequence and discrimination.

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11. What are secondary psychological problems that people with LD face?

   Demoralization, low self esteem and deficits in social skills may be associated with LD.

   School drop out rate for children or adolescents with LD is reported at nearly 40%

   Adults with LD may have significant difficulties in employment or social adjustment.

12. What steps are needed to take to manage children with LD?

The emotional, intellectual, social and physical growth of the child is dependent on various factors. Inputs that a child receives during the early formative years are crucial. Integration of sensory process is crucial for the healthy development of the process of learning. Faulty integration gives rise to number of anomalies contributing to the development of the process of learning disorders. Thus it is essential to restore correct sensation to deal with these disorders. Management demands HOLISTIC APPROACH taking child ----- environmental as a unit.

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13. What does our institute offer for management of LD ?

M.B.Barvalia foundation’s Spandan holistic institute has set up Holistic child care centre where we skillfully utilize remedial education, occupational therapy, Homoeopathy, Counselling and yoga for this purpose. This approach has resulted in great acceleration in the process of learning.

14. How can we help a child with LD in classroom?

Explain to the pupil what his problems are.
Attempt to restore the pupil's confidence in himself.
Be aware of the possibility that the student may be using avoidance techniques.Be constructively critical.

15. Can LD be cured?

Learning disability should not be viewed as a disease but a condition. All therapeutic efforts are directed towards ameliorating the difficulties. It may be noted that several famous people with this invisible handicap ‘include Albert Einstein, Thomas Edison, Leonardo de Vinci, Abraham Lincoln, Tom Cruise and Steven Spielberg. They have moved on to lead brilliant careers.

16. What is Homoeopathy?

Homoeopathy is a holistic, individualistic science which was discovered by Samuel Hahnemann in the year 1790 in Germany.

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17. On what concepts does Homoeopathic science operate?

Homoeopathy is a HOLISTIC SCIENCE, which considers the person as a whole. It treats the ‘entire person’ and not merely the external symptoms.

Homoeopathic medicines do not act merely on any one particular organ of an individual but it has much more deeper and central action on psycho neuro endocrinological and psycho immunological axis. It promotes the growth gradient and hence facilitates the process of development.

A homoeopathic physician spends a lot of time with each patient and takes a detailed history. He makes attempt to understand all dimensions of the personality. He not only studies the data pertaining to the main difficulties of the patient but also other significant aspects of body and mind like emotions, temperament sleep patterns, eating habits, dreams etc. this study enables him to find a correct homoeopathic medicine which acts on the entire person and brings about correction in the disturbance within the person.

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18. What does Homoeopathic science offer in the management of LD?

These children often present with difficulties at various levels: Perceptual problems, sensorymotor coordination, emotional disturbances.

We witness various patterns of presentation at all these level – like awkwardness, clumsiness, confusion in directions, hyperactivity, sadness, withdrawal, low self-esteem etc.

Homoeopathic science lays a lot of emphasis on these ‘individualistic patterns’ and not merely the diagnosis.

Homoeopathic literature provides a rich material describing graphically various characteristic features, which we relate to learning disorder.
e.g.

    Omits final letter when writing (Lac. Can – Herring page 515)

    Uses wrong syllables, mixes up letters and syllables or omits parts of words
      (Herring page 91)

    While writing transposing letters: China, Lyco, (Kent Rep. Page 67)

    Mistakes reading (Kent Rep. Page 66)

    Mistakes writing (Kent Rep. Page 67) A systematic study of such characteristic individualistic patterns of LD allows us to select an appropriate homoeopathic remedy. Problems of LD cannot be cured but rational homoeopathic therapeutics can definitely bring about amelioration in perceptual errors, behavioural problems and emotional disturbances.

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19. What improvement can I expect in my child with homoeopathic treatment?

· Homeopathic medicines help in correcting the faulty motor patterns and help in improving
  the coordination thus reducing difficulties of perception.

   This helps in reduction of difficulty in reading & writing.

   Spelling mistakes reduce

   Correction in the altered state of sensitivity. Children appear calmer. It helps in reducing
     emotional disturbances.

   Improvement in behavioural problems like hyperactivity, fidgetiness, impulsiveness etc.

   Attention span improves. A child who was earlier very inattentive starts to focus on the
     task given.

    Homoeopathic medicines act as immuno-modulators. They help to build up the general
      resistance power of the patients. This significantly improves their tendency to
      develop recurrent infections.

    At physical level – child starts showing improved sleep pattern, improves digestion.

    They do not have any adverse or depressing neurophysiological side effects.

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20. Is Homoeopathy compatible with other therapies?

Homeopathic medicines are not substitute for all other essential therapies or teaching techniques like Remedial education, occupational therapy, counselling, speech therapy etc. Homoeopathy works in perfect synergy with above techniques and therefore we promote holistic integrated care.

In fact, positive influence of correct homoeopathic remedy makes the child more receptive to other therapeutic inputs like Remediation, occupational therapy etc. This entire process speeds up the process of management.

21. What is remedial teaching? How does it benefit children with LD?

Remedial education is a specialized teaching concept and method for the benefit of children with learning disabilities. Remedial programmes are designed to meet the individual learning styles and educational needs of these children.

 
   
  AUTISM

1. What is pervasive developmental disorder (PDD)?
It is a disorder characterized by severe and pervasive impairment in several areas of development such as social interaction skills, communication skills, or the presence of stereotyped behaviour, interests and activities.
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2. Which clinical conditions come under the heading of PDD?
   Autistic disorder.

   Rett's disorder.

   Childhood disintegrative disorder.

   Asperger's disorder.

   PDD not otherwise specified.
 
3. How to diagnose autism?

   There are various criteria used in diagnosing autism.

   Difficulty with social relationships.

   Difficulty with verbal and non-verbal communication.

   Difficulty in the development of play and imagination.

   Resistance to change in routine.

   All these symptoms must have been present by 36 months of age
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4. What causes autism?
In autism, there are one or several abnormalities in the brain, which are caused by one or several biological factors such as Genetic factors, Maternal rubella, Lack of oxygen at birth, Excess of oxygen at birth, Encephalitis, Untreated phenylketonuria, Tuberose sclerosis.
This is known as "the biological theory of autism"

Serotonin has been found to be contributory in either genesis or maintainance of Autism. However, detailed studies have to be carried out to confirm this possibility.
 
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5. Do children with autism come from any particular family background?
NO. Autism has been found equally in all social classes and in all cultures. However a predominance of boys to girls is seen in the ratio of 4:1.
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6. What is the level of intelligence in children with Autism?
When autistic children are given IQ tests, roughly 2/3rd of them score in the below average range. The remaining 1/3rd have an IQ in the normal range. So, autism can occur at any point on the intelligence spectrum.
7. In short, what characterizes the autistic behavioural pattern?
Social behaviour - unresponsiveness to people, lack of attention to people, reacting parts of people as detached objects, lack of eye contact, treating people as if they were inanimate objects, lack of behaviour appropriate to cultural norms, attention to the non social aspects of people, lack of awareness of the feelings of others, lack of social perceptiveness, Failure to develop a concept of mind - MIND BLINDEDNESS.

Language - Abnormalities in speech i.e. they cannot produce sounds that are recognizable as words is called as FUNCTIONALLY MUTE CHILDREN. In those children with autism who do develop speech, a variety of unusual features are sometime (but not always) seen. These include Echolalia (words/phrases, which are echoed either immediately after they are heard or sometime later and persist even after the age of 3yrs),

Neologism (coining new words to give meaning to things) or saying 'you' when they mean 'I' or calling themselves by their first name.

Repetitive, obsessive behaviour - Lack of flexible imagination coupled with obsessive behaviour e.g. counting lampposts, collecting bottle tops etc. their play is very uncreative.

Islets of ability - Children with autism often perform unusually well in drawing, music and calendar calculations. Sometimes they are the only skills a child has and sometimes they are even superior to normal
8. How to differentiate autism from a similar looking condition?
 
Conditions which are similar to autism include:
Elective mutism (child refuses to talk in certain situation)
Attachment disorder (child fails to develop stable emotional bonds with his/her parents
possibly following abuse, deprivation or family problems)
Mental handicap (all skills are delayed)
Rett's syndrome (hand writing and other odd movements)Developmental receptive
language disorder
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19. Can children with autism be educated? And how is this done?
Yes. Many institues now make provision for the special education of children with autism. One such institution is being run at Ghatkopar (East), Mumbai by the name of M.B.BARVALIA FOUNDATION'S HOLISTIC CHILD CARE CENTRE. It's a unique centre for children where all work under one roof with a holistic approach.

Autistic children can be educated using behaviour therapy and parental guidance and counseling, speech therapy, sensory integration therapy, homoeopathy, special educational facilities etc.

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20. What modes of therapeutic interventions are available for children with Autism?
Autism can be understood as a NEUROPSYCHIATRIC REGRESSION. As discussed earlier these children present with a myriad of problems. This demands HOLISTIC INTEGRATED CARE.

At foundation we provide following modes in an integrated way.
Homoeopathy
Occupational therapy – sensory integration, Auditory integration, water therapy etc.
Counselling – behaviour modification
Special education
21. What is Homoeopathy?
Homoeopathy is 200 years old system of medicine discovered by Dr. Samuel Hahnemann a German Physician and is based on Natural Holistic Form of medicine based on laws nature. Homeopathy takes consideration the person as a whole and the prescription is based on INDIVIDUAL FEATURES. So each child though having same diagnosis of Autism will need INDIVIDUAL Homeopathic Medicine. And that is how it helps in holistic way – improvement is seen at both the levels physical as well as mental level.
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22. What improvement can I expect in my child after receiving Homoeopathic treatment?
   
Homoeopathic medicines based on rational principles have a deep impact on the system.

When a child starts responding to homoeopathic medications, improvement is first seen at a general level. Child starts getting calmer, improvement is seen in sleep, appetite & bowel habits.

Next is the improvement in behaviour
Reduction is seen in hyperactivity, restlessness, tantrums, violence etc.

Improvement in eye contact and ability to respond

Further we see change in communication skills. He starts indicating and subsequently starts developing ability to speak words. echolalia improves too.

Obsessive behaviour takes a long time to improve.

Child starts showing improved general resistance. This is because homoeopathic medicines act as immunomodulators.

23. What factors determine the rate of improvement?
In most cases, order of improvement seen is as discussed earlier.

Best result are seen when we start the treatment at the earliest i.e. as soon as possible when the symptoms or signs are observed.

Improvement also depends upon the degree of Autism i.e. mild/moderate/ severe.
Other associated conditions like epilepsy, genetic disorders etc also influence the outcome.
24. Can the child be given Homoeopathic medication if he is already under Allopathic medication?
If a child has achieved stability certain drugs for a long time like Antiepileptic drugs then they can be continued along with homeopathic medications. But if there are serious side effects or child is on some other allopathic drugs then it is desirable that they are gradually tapered off.
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25. Can other therapies be given to child receiving homoeopathic treatment?
Homoeopathy works in perfect synergy with other essential therapies like sensory integration therapy, special education, auditory integration therapy etc.

Rational and judicious coordination of homeopathic treatment along with sensory integration therapy makes tremendous difference to the management of children with Autism. Senior therapists and educators have often remarked that they have found that Children receiving Homoeopathic medicines are much calmer and easier to handle. They were much more receptive to therapy & educational inputs.
  CEREBRAL PALSY ^^Top^^

1. What is Cerebral Palsy?
Cerebral Palsy (CP) is a medical condition that affects control of the muscles. If someone has cerebral palsy it means that because of an injury to their brain, they are unable to use some of the muscles in their body in the normal way. Children who have cerebral palsy may not be able to walk, talk, eat or play like other kids. CP is not a disease or illness. It isn't contagious and it doesn't get worse, but it is not something you "grow out of." Children who have CP will have it all their lives.
2. How is cerebral palsy caused?
Cerebral palsy is caused by an injury to the brain before, during, or shortly after birth. Sometimes injuries to a baby's brain happen while the baby is still in the mother's womb. The injury might be caused by an infection or by an accident in which the mother is hurt. If the mother has a medical problem such as high blood pressure or diabetes, this can also cause problems in the baby. There may be problems during birth such as the baby not getting enough oxygen, or a difficult delivery in which the baby's brain is injured. Problems after birth may happen when a baby is born too soon (premature delivery) and his body is not ready to live outside his mother's womb. The most important thing to remember is that you do not "catch" CP from another person, and you do not develop CP later in life. It is caused by an injury to the brain near the time of birth.
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3. What are the different types of CP?
Children with CP have damage to the area of their brain that controls muscle tone. Depending on where their brain injury is and how big it is, their muscle tone may be too tight, too loose, or a combination. Muscle tone is what lets us keep our bodies in a certain position, like sitting with our heads up to look at the teacher in class. Changes in muscle tone let us move. Children with CP are not able to change their muscle tone in a smooth and even way, so their movements may be jerky or wobbly. The different types of CP are:
4. Spastic Cerebral Palsy
If muscle tone is too high or too tight, the term spastic is used to describe the type of cerebral palsy. Children with spastic CP have stiff and jerky movements because their muscles are too tight. They often have a hard time moving from one position to another or letting go of something in their hand. This is the most common type of CP. About half of all people with CP have spastic CP.
5. Ataxic Cerebral Palsy
Low muscle tone and poor coordination of movements is described as ataxic CP. Kids with ataxic CP look very unsteady and shaky. They have a lot of shakiness, like a tremor you might have seen in a very old person, especially when they are trying to do something like write or turn a page or cut with scissors. They also often have very poor balance and may be very unsteady when they walk. Because of the shaky movements and problems coordinating their muscles, kids with ataxic CP may take longer to finish writing or art projects.

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6. Athetoid Cerebral Palsy
The term athetoid is used to describe the type of cerebral palsy when muscle tone is mixed - sometimes too high and sometimes too low. Children with athetoid CP have trouble holding themselves in an upright, steady position for sitting or walking, and often show lots of movements of their face, arms and upper body that they don't mean to make (random, involuntary movements). These movements are usually big. For some kids with athetoid CP, it takes a lot of work and concentration to get their hand to a certain spot (like to scratch their nose or reach for a cup). Because of their mixed tone and trouble keeping a position, they may not be able to hold onto things (like a toothbrush or fork or pencil). About one-fourth of all people with CP have athetoid CP.
7. Mixed Cerebral Palsy
When muscle tone is too low in some muscles and too high in other muscles, the type of cerebral palsy is called mixed. About one-fourth of all people with CP have mixed CP.
8. What are the problems associated with CP?
In addition to problems controlling their muscle movement, children with CP may have some other problems too. Most of these are caused by the same brain injury that caused CP.
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Talking and Eating
Just as CP can affect the way a person moves their arms and legs, it can also affect the way they move their mouth, face and head. This can make it hard for the person to talk clearly and to bite, chew and swallow food. Their speech is hard to understand, they are unable to make their lips, jaw and tongue move quickly.
Learning Problems
About one-fourth to one-half of children with CP also have some type of learning problem. It may be a learning disability or a more severe learning problem like mental retardation in which they learn everything at a slower rate. People with mild mental retardation may learn to read and write but people with more severe mental retardation probably will not. This does not mean that children with severe mental retardation cannot learn, just that they learn at a slower pace than most other kids and will need some extra help in school.

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Seizures
About half of all children with CP have seizures. This is due to some abnormal activity in their brains that interrupts what they are doing. Often, the abnormal brain activity happens in the same place as the brain injury which caused the CP. The brain is constantly sending messages out to the body - to breathe, to move, to keep your heart pumping. A seizure is a series of abnormal messages being sent out very close together. This may cause someone to stop moving during a seizure or to loose control of his or her body and fall down. Some people show shaking movements all over when they are having a seizure. Seizures usually last a few seconds to a few minutes, and in most case are not dangerous. Medications are required for the management of seizures.
9. What are the various types of therapy for CP?
Children with CP often go through different kinds of therapy to help them improve their motor skills for things like walking, talking and using their hands. Some kids get therapy at school and some kids go to a special clinic to see their therapists. Therapists are special teachers who are trained to work with people on learning better or easier ways to do things. Therapists coach people to help them learn and practice new skills.
Physical Therapy
Physical therapists help children learn better ways to move and balance. They may help children with CP learn to walk, use their wheelchair, stand by themselves, or go up and down stairs safely. Kids may also work on fun skills like running, kicking and throwing a ball, or learning to ride a bike.
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Speech and Language Therapy
Speech therapists work with children on communication skills like talking, using sign language, or using a communication aid. Children who are able to talk may work with a speech therapist on making their speech clearer or on building their language skills by learning new words, learning to speak in sentences, or improving their listening skills. Children who are not able to talk because of their difficulty controlling the muscles needed for speech may learn sign language or use some kind of communication aid like a book, a poster or an alphabet board. Computers that talk can also be used as communication aids!
Occupational Therapy
Occupational therapists usually work with children on better ways to use their arms, hands, and upper body. They may teach children better or easier ways to write, draw, brush their teeth, dress and feed themselves, or control their wheelchair. Occupational therapists also help children find the right special equipment to make some everyday tasks easier.
Recreational Therapy
Recreational therapists help kids with CP have fun. They work with children on sports skills or other leisure activities. In recreational therapy kids may work on dance, swimming or horseback riding. They may also work on art or horticulture or almost any other hobby they are interested in.what we do to manage with CP

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10. What management strategies one should adopt after diagnosing a child as CP?
 
A child with CP requires a multidisciplinary approach since the problems are at various levels. Following therapeutic modes are recommended.

   Medical intervention

   Homoeopathy

   Physiotherapy

   Occupational therapy

   Counselling

   Special education

   Speech therapy

   Yoga

   Surgical intervention where ever necessary

 

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11. What is Homoeopathy?

Homoeopathy is 200 years old system of medicine discovered by Dr. Samuel Hahnemann a German Physician and is based on Natural Holistic Form of medicine based on laws nature. Homeopathy takes consideration the person as a whole and the prescription is based on INDIVIDUAL FEATURES. So each child though having same diagnosis of CP will need INDIVIDUAL Homeopathic Medicine. And that is how it helps in holistic way – improvement is seen at both the levels physical as well as mental level.

12. Why choose Homoeopathy?

   
Homoeopathy is a holistic science.

   Homoeopathic medicines are safe without any adverse side effects and are soothing to
     the child.

   Homoeopathy works in perfect synergy with other essential therapies like physiotherapy,
     occupational therapy, speech therapy, yoga

   At our centre although we work in a team with allopathic colleagues like orthopaedic      surgeon, neurologist etc. homoeopathy is the central therapeutic modality.

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13. What improvement can I expect in my child with Homoeopathic treatment?

   
Homoeopathic medicine correct the defective ‘ motor patterns’ and so there is improved      seen in coordination as well as perception.

   Child shows improvement in involuntary jerky movements.

   Improvement is also seen in balancing and equilibrium

   Correction in altered state of sensitivity. Various fears like height, loud noise etc
     are remarkably reduced.

   Homoeopathic medicines are essentially immunomodulators. Thus child who is prone to
     recurrent infection shows improvement in that ‘ tendency’. It will be noted that the
     frequency, intensity, duration of his infections like respiratory infections, gastric infections
     etc will start reducing and child shows build up in the general resistance power.

   Correct homoeopathic medicines also promote growth processes thereby speeding up
     the developmental milestones.

   Management of underlying neurological and metabolic disturbance like seizures.

   Child starts appearing ‘calmer’ and ‘at ease’. He / she starts showing improvement in
     behavioural disturbances like restlessness, impulsiveness, tantrums etc.
     these developments help the child to be ‘ more receptive’ to the therapies.

   As highlighted earlier, homoeopathic science is not a substitute for other therapies but
     it is complementary. That is the prime reason why at our centre we work as a team.

   Homoeopathic medicines are very soothing for the child and they ‘prepare’ the child
     receives other therapeutic inputs. Our therapists have time and again commented that they
     have to spend less time controlling the children who are benefited from homoeopathic
     treatment.
14. What facilities does foundation provide for the management of children with CP?
 
Foundation skillfully utilizes a holistic approach combining Homoeopathy with other therapies as well as intervention of Paediatric Orthopaedic surgeon.
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Comprehensive Neuromuscular rehabilitation Unit
  ATTENTION DEFICIT HYPERRACTIVITY DISORDER

1. What is Attention Deficit Hyperactivity Disorder (ADHD)?

Individuals with ADHD may know what to do but do not do not consistently do what they know because of their inability to efficiently stop and think prior to responding, regardless of the setting or task.

Characteristics of ADHD have been demonstrated to arise in early childhood for most individuals. This disorder is marked by chronic behaviours lasting at least six months with an onset often before seven years of age. At this time, four subtypes of ADHD have been defined. These include the following:

1. ADHD – Inattentive type is defined by an individual experiencing at least six of the following characteristics: Fails to give close attention to details or makes careless mistakes. Difficulty sustaining attention. Does not appear to listen. Struggles to follow through on instructions. Difficulty with organization. Avoids or dislikes requiring sustained mental effort. Often loses things necessary for tasks. Easily distracted. Forgetful in daily activities.

2. ADHD – Hyperactive/Impulsive type is defined by an individual experiencing six of the following characteristics: Fidgets with hands or feet or squirms in seat. Difficulty remaining seated. Runs about or climbs excessively (in adults may be limited to subjective feelings of restlessness). Difficulty engaging in activities quietly. Acts as if driven by a motor. Talks excessively. Blurts out answers before questions have been completed. Difficulty waiting in turn taking situations. Interrupts or intrudes upon others

3. ADHD – Combined type is defined by an individual meeting both sets of attention and hyperactive/impulsive criteria.

4. ADHD – Not otherwise specified is defined by an individual who demonstrates some characteristics but an insufficient number of symptoms to reach a full diagnosis. These symptoms, however, disrupt everyday life. Children and adults who have ADHD exhibit degrees of inattention or hyperactivity/impulsivity that are abnormal for their ages. This can result in serious social problems, or impairment, of family relationships, success at school or work or in other life endeavors.

Children and adults can exhibit other psychiatric disorders, along with their ADHD symptoms. Most commonly, these include oppositional defiant or conduct disorder, along with or separate from internalizing disorders, such as anxiety and depression.

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2. What are the causes of ADHD?

Experts have investigated genetic and environmental causes for ADHD. Some children may inherit a biochemical condition, which influences the expression of ADHD symptoms. Other children may acquire the condition due to abnormal fetal development, which has subtle effects on brain regions that control attention and movement. Recently, scientists have uncovered research based on brain imaging to localize the brain areas involved in ADHD and have found that areas in the frontal lobe and basal ganglia are reduced by about 10 percent in size and activity in ADHD children. Recent research based on genetic mechanisms has focused on dopamine as the primary neurotransmitter involved in ADHD. Dopamine pathways in the brain, which link the basal ganglia and frontal cortex, appear to play a major role in ADHD.

3. How is ADHD diagnosed?

While there is no biological or psychological test that makes a definitive diagnosis of ADHD, a diagnosis can be made based on one's clinical history of abnormality and impairment. An evaluation for ADHD will often include assessment of intellectual, academic, social and emotional functioning. Medical examination is also important to rule out low occurring but possible causes of ADHD like symptoms (e.g., adverse reaction to medications, thyroid problems, etc.). The diagnostic process must also include gathering data from teachers as well as other adults who may interact on a routine basis with the individual being evaluated. It is even more important in the ADHD adult diagnostic process to obtain a careful history of childhood, academic, behavioral and vocational problems. With the increased recognition that ADHD is a disorder presenting throughout the life span, questionnaires and related diagnostic tools for the assessment of adult ADHD have been standardized and are increasingly available. ADHD diagnoses are based on a person having three different symptoms. The full syndrome is diagnosed when at least six symptoms from both sets of subtypes (above) are present. Partial syndromes, which are predominantly inattentive or hyperactivity/impulsivity subtypes, are diagnosed when six or more symptoms are present from just one set.

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4. How is ADHD treated?
There are two modalities of treatment that specifically target symptoms of ADHD. One uses medication and the other is a non-medical treatment with psychosocial interventions. The combination of these treatments is called multimodality treatment. Treating ADHD in children requires a coordinated effort between medical, mental health and educational professionals in conjunction with parents. This combined set of treatments offered by a variety of individuals is referred to as multi-modal intervention. A multi-modal treatment program should include: . Parent training concerning the nature of ADHD as well as effective behavior management strategies . An appropriate educational program . Individual and family counseling, when needed, to minimize the escalation of family problems .

What services does foundation provide for management of ADHD?Foundation provides integrated care. Our multidisciplinary team of homoeopath, psychologist, occupational therapist, and counsellor work in coordination for the management.

Homoeopathy is a holistic science and plays a vital role in the management of ADHD

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Well-selected homoeopathic remedies
   Help in calming down the behaviour, reduces the restlessness

   Help in reducing impulsivity, tantrums

   Act as immunodulators

   Bring about moderation in sensitivity disturbances

   Help to manage underlying neurological disturbances

   Do not have any adverse or depressing neurophysiological side effects

   What other therapies / techniques are helpful for children with ADHD?

   Along with Homoeopathy, children greatly benefit from

   Behaviour modification therapy

   Play therapy

   Family counselling

   Children with perceptual difficulties may need remedial education

Behavior modification techniques have been used to treat the behavioral symptoms of ADHD for more than a quarter of a century. A summary of the literature on trials that have validated the efficacy of this approach shows that, in many cases, behavior modification alone has not been sufficient to address severe symptoms of ADHD. Classroom success for children with ADHD often requires a range of interventions. Most children with ADHD can be taught in the regular classroom with either minor adjustments in the classroom setting, the addition of support personnel, and/or special education programs provided outside of the classroom. The most severely affected children with ADHD often experience a number of occurring problems and require specialized classrooms.
  MENTAL RETARDATIO

1. What is mental retardation (M. R.)?
The American Association on mental deficiency states that mental retardation is a "significantly sub-average general intellectual function existing concurrently with deficit in adaptive behaviour, and manifested during the development period". From a biological point of view, M.R. is a state of incomplete mental development of a kind and degree such that the individual is incapable of adapting himself to the normal environment as to maintain existence independently of supervision, control or external support.
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2. What is non-specific M.R.?
It is not always possible to precisely pinpoint the cause of M.R. even in the presence of laboratory diagnostic facilities with DNA and molecular studies. Some cases may show dysmorphic features, which only help in identifying the inherent condition or syndrome. It is not uncommon that a child with subnormal intelligence shows normal findings on medical, neurological and laboratory examinations and such cases of M.R. are referred to as non-specific or unknown M.R.
3. What is pseudo-M.R.?

Some children with mild to borderline retardation give no evidence of brain damage on any of the above - mentioned medical, family or laboratory parameters. Most of them belong to the lower socio-economic status, thus assuming that their poor adaptive function is likely due to adverse socio-cultural influences like lack of a stimulating environment, rather than any of the organic or genetic factors. Such pseudo-retardation should be clearly distinguished from true mental retardation.

4. What do we define the degree of M.R.?
Depending on the I.Q., the degree of mental retardation, according to the DSM IV is as below:

Degree of M.R.          I.Q.
Mild M.R.               50 – 55 to 70
Severe M.R.         20 – 25 to 35 – 40
Profound M. R.       Below 20 to 25
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5. What are the causes of M.R.?

Mental retardation is not a disease; it's an expression of many symptoms. The underlying problem in M.R. is an aberration of brain function. The causes of brain dysfunction could be environmental and/or genetic factors.

6. Can a baby who is born normal become mentally retarded after birth?
All the characteristics of M.R. can appear long after birth due to injury to the brain anytime during the development period upto 18 years of age. Injury to the brain can be caused by the following factors: Severe malnutrition in the child especially upto 2 years of age. Infection to the child such as meningitis or encephalitis. Repeated episodes of epileptic fits. Injury to the brain from accidents or falls. Strangulation, smoke inhalation or near drowning. Accidental poisoning. Genetic disorders etc

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7. What are the various options available for educating M.R. individuals?
There are 3 ways to educate the mentally retarded: Special schools meant exclusively for M.R. individuals. Integrated schools wherein M.R. children are trained along non-handicapped students Home based training programmes wherein parents are taught how to train their M.R. children.

What facilities does foundation provide for MR children?Under the auspices of Holistic Child Care Centre foundation focuses on prevention, early diagnosis and early intervention for theses conditions.We run a registered special school for mental retardation.We also provide therapy, special education, Counselling as well as Homoeopathic medications

Homoeopathy mainly helps to

   Bring about moderation in sensitivity disturbances

   Control the behavioural problems

   Control the emotional disturbances

   Manage underlying neurological, genetic, metabolic disorders

   Promote the growth process and general resistance of the system

   Do not have nay adverse or depressing neurophysiological side effects.
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8. How does special education and rehabilitation help the mentally retarded?
The field of mental retardation is a meeting point for all biological and behavioural sciences. Physical and mental development forms its basis. Since mental retardation can be prevented but not cured in the customary sense of the word, the special training to the mentally retarded gives them the opportunity to develop and to improve if detected early. A major objective of training or education is to attain some degree of vocational competence and economic productivity. Vocational education refers to the preparation of the process of the persons for all aspects of life. The effectiveness of vocational training or specific education is largely controlled by certain environmental factors besides the degree of disability inherent in the child. The ultimate goal should be to make the mentally retarded person socio-economically independent.
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  DOWN SYNDROME

1. What is Down syndrome?
Down syndrome is a genetic disorder, which is caused due to trisomy 21 ie. by the presence of a third, extra copy of chromosome 21,which is characterized by mongoloid facies, developmental abnormalities and mental retardation & hypotonia. It is the most common & the best known chromosomal syndrome in humans.
2. What is the historical background of Down syndrome?

There are hints in the historical records that an awareness of the condition of Down syndrome existed perhaps even thousand years ago. Images in old paintings & ancient stone carvings suggest that this might be so. Throughout history it has always been plain that people need to explain minorities, those who were in some way or another different or deviated from the norm. People with mental retardation were dealt with based on socio-cultural belief structures & were isolated, punished & tortured. In 1866 J. Langdon Down provided the first formal description of Down syndrome.Down in attempting to classify the various forms of 'feeble mindedness' that he had observed, concluded that individuals with mental disabilities belonged to various ethic classification, including the "Ethiopian & Mallay varieties". Down's syndrome he felt belonged to the "Mongolian family". Therefore it is also called Mongolism.As recently as 1970, the encyclopedia Britannica listed the conditions of Down syndrome under the heading 'MONSTER'. (1974 edition shows it under the appropriate heading of Down syndrome)'Idiot' was still being used as a medical description of severely mentally handicapped people well into the 1960's.
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3. What is the incidence of Down Syndrome?
Incidence in general population is 1 in 600 to 800 live births but the incidence among all conspectuses is more than double this frequency because more than half are spontaneously aborted during early pregnancy.

The outlook towards the mentally challenged has undergone tremendous modifications from time to time.

1866 – J. Langdon Down provides the first formal description of Down syndrome.

1896 – Smith attempts to treat Down syndrome with drug (Thyroid hormone extract) for the first time.

1920 – The "Eugenics Scare" leads to a massive residential institution construction programme. Many of those institutionalized were persons with Down syndrome.1940s –

1950s – world war II heigtens awareness that the human rights of vulnerable people must be establised & protected.1959 - Lejeune and his associates discover that Down syndrome is a chromosomal disorder.

1960s – 1970s - Deinstitualization begins on a national scale, prompted by litigation. Head start helps to spawn early education efforts for children with Down syndrome.

1973 - The Down’s syndrome congress (now the National Down syndrome congress) is formed.

1970s – 1980s – Passage of major social, educational and vocational registration.

1982 - The case of baby Doe leads to a new application in rehabilation Act of 1973, establising the right of new born children with Down syndrome to customary medical care.
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4. What are the factors affecting the incidence of Down syndrome?
These may be divided into factors that are basically endogenous and factors that are basically environmental or exogenous.

ENDOGENOUS
Maternal age
- Relationship between advanced maternal age and increased risk of Down syndrome was suggested a century ago. With increasing age, eggs present in the ovaries are more likely to undergo the process of non-disjunction where by an extra chromosome 21 is retained at the initial all division of the developing embryo. This results in Down’s syndrome.

EXOGENOUS
Prenatal diagnosis
- prenatal diagnostic procedure like Amniocentesis and chorionic villus sampling have been used for chromosomal study.

X- irradiation, an extensively studied potential hazard, must be viewed at this time as a serious candidate for producing trisomy only when small doses accumulating over a time period are coupled with a long lag period to conception (Alberman, 1972). Start ford at al (1988) note that their review does not justify any thing other than the continued careful use of x-rays.

Use of oral contraceptives around the day of conception, as opposed to other times or duration of ingestion has been proposed but again there is no clear picture.

Vaginal spermicides, smoking, alcohol and seasonal variations all remain unproven culprits.
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5. What are the clinical features in Down syndrome?
General - Mental retardation, hypotonia.

Craniofacies - Flat occiput, oblique palpabral fissures, epicanthic folds, brush field, Spots (speckled irides) protruding tongue, prominent, malformed, low Set ears, flat nasal bridge.

Thorax - Congenital hearts disease mainly septal defects.

Abdomen & pelvis - Decreased acctabular and iliac angles, small penis, cryptorchidism.

Hand and feet - Simian crease, short, broad hands, hypoplasia of middle phalanx of 5th finger, gap between 1st and 2nd toes.

Other features observed with significant frequency: High arched palate, strabismus, observed with significant broad, short neck, small teeth, furrowed tongue, intestinal atresia, imperforate anus.

Children with Down’s syndrome have an increased tendency to infection. There are many conditions of an abnormal immune response in Down syndrome e.g.: - an increased incidence of antommune disease. Elevated serum level of antithyroid autoantibodies and increased risk of hypothyroidism are most well known. Coeliac disease has to be suspected if there are signs of malabsorption and growth retardation in a child with Down syndrome.

BEHAVIOUR & PSYCHIATRIC DISORDERS:-Behavioral problems like hyperactivity, Autistic behaviour are not uncommon in Down syndrome. Depressive disorder, might be more common in adolescents and young adults with Down syndrome. Depression is due to loneliness and might be helped by increasing the person’s social contracts. Adults with Down’s syndrome have been formed to have an accelerated aging process. Down syndrome Dementia is uncommon with any clinical symptoms before the age of 40 years (<5percent). Signs of Dementia is formed in 20 to 25 percent of persons with Down syndrome in their fifties (wisneiwski, et.al.1985). Others have reported that at the age of 54 years about 50 percent of the individuals with Down syndrome have developed signs of dementia (Johnson et.al.1991). Epilepsy is less common during childhood (4 percent), but infantile spasm occur more in children with Down syndrome. Seizure disorders are, however, more common in the third decade mostly as myoclonic epilepsy.
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6. What steps need to be taken if the diagnosis of Down syndrome is suspected?
When, after delivery, a newborn infant is suspected to have Down syndrome, a thorough physical and neurological examination should be carried out in order to establish the clinical diagnosis. A chromosomal analysis should be performed which will establish the karyotype and can be used for genetic counseling purposes. If the child with Down syndrome has regular trisomy 21, the recurrence risk is about 1 percent. If the child has a Rebertsonian translocation, the parents will have to undergo a chromosomal analysis since one of them might be balanced carrier, with a much higher recurrence risk. It is very essential that the child should undergo periodic checkup with a physician so that various conditions mention before are diagnosed earlier & treated.
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7. What is the long-term prognosis for patients with Down syndrome?
Persons with Down syndrome run an increased risk of developing disorders in various organs and of multiple congenital malformations. However, better medical care and changing attitudes during the last 20 to 30 years have had a profound effect on the health of individual with Down syndrome in many countries. Previously, most persons with Down syndrome died during childhood but with better medical care, the median life expectancy for persons with Down syndrome has increased to more than 55 years (Baind and Sadovniek, 1989).With proper medical care and parental support, people with Down syndrome are able to lead a quality life.
8. What is general management of cases with Down syndrome?
Based on the clinical problems & the prognosis described above, the management is mainly symptomatic. Special problems for intellectual and motor difficulties and special medical care to prevent treatable disorders from remaining undiagnosed both benefit persons with Down syndrome. Cases with Down syndrome need to be treated with a multidisciplinary approach to deal with the spectrum of development, neurological and mental health problems. Remedial education, occupational therapy, speech therapy, play therapy etc. are very essential & should be started at the earliest.

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9. What is the role of HOMOEOPATHY in Down syndrome?
Homoeopathy is a holistic system of medicine. It treats the person as a whole. A detailed Homoeopathic case history helps to understand the problem in adequate depth. Homoeopathic medicines are basically immunomodulators. They promote native immunity and have a capacity to improve the resistance power of the individual which helps to deal with recurrent infections. A detailed Homoeopathic case history gives an insight into the individualizing aspect of the patient. A properly selected Homoeopathic medicine stimulates the overall growth and development of the individual at various levels viz. physical, emotional, intellectual. It helps to tap and utilize a person’s capacities to the fullest & entrenches the person’s performance.

Behavioural problems present with Down syndrome respond very well to Homoeopathic treatment.

The M.B.Barvalia Foundation promotes Holistic Care. So in addition to Homoeopathy other therapeutic options such as speech therapy, occupational therapy, remedial education and psychological assessment are used. Cases are handled with the help of a multidisciplinary team with various specialists working under one roof. The entire therapeutic programme is well co-ordinated and periodic panel meetings are held to ensure HOLISTIC INTEGRATED CARE.

Occupational Therapy Intervention
Occupational Therapy Intervention uses play therapy and active participation of the child within a therapeutic environment to provide stimulation for motor, mental and sensory problems associated with Down’s syndrome.

These include:
Tackling Balance, Posture, gait problems through exercise therapy.

Co-ordination & Hand function Training.

Sensory Integrative Therapy.

Social skills Training & Group therapy.

Education & Training for performing daily skill activities.
 
Why is Speech Therapy essential with Down Syndrome children?
Down syndrome children exhibit multiple deficits of Inadequate attention and concentration. Communication problems including dysfluencies. Hearing deficit.A speech language pathologist Assesses and describes articulation and phonological disorders. Assesses and describe long urge disorder. Assess other communication problems including dysfluencies. Recommendation for hearing screening or Audiological Assessment.Prognosis is generally good as compared to M. R. children due to fairly adequate comprehension skills and good intellectual capacity.
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  HIV/AIDS

1. What is AIDS?
AIDS, which stands for Acquired Immunodefficiency Syndrome, is a serious illness for which there is presently no cure. AIDS is caused by a virus known as HIV (Human Immunodeficiency Virus). HIV leaves the body defenseless against illnesses that are usually rare or mild in people who are not infected with the virus. These illnesses may kill people with HIV.

Many people feel that only certain "high risk groups" are infected with HIV. This is untrue. It is not who you are that puts you at risk for HIV disease, it's what you do. People have died of AIDS regardless of gender, age, race, economic status, or sexual orientation.

2. How is the HIV virus transmited? How do you avoid the HIV infection?
 
HIV is not spread through casual contact, which is non-sexual, everyday activities such as shaking hands, sharing equipment, eating together, coughing or sneezing, using restrooms, or working together. Another misconception is that a person may contact HIV from an insect bite. This is not true. HIV is not spread to humans by animals or insects, including mosquitoes.

HIV can be transmitted in three ways: 1) blood to blood contact, 2) sexual contact, and 3) prenatal contact. Infectious body fluids include blood, semen, vaginal/cervical secretions, and breast milk. The HIV virus must be in sufficient concentration in an infectious body fluid for transmission to occur. The infectious body fluid must then get into the body and into the bloodstream for an individual to become infected. People may become infected with HIV if they

Have sexual intercourse with someone infected with HIV (oral, anal, &/or vaginal)
Use a needle or syringe that has previously been used by someone infected with HIV (Such as unsafe tattooing or body piercing)
Are born to a woman who is infected with HIV

Many people are concerned about saliva as an infectious body fluid. Saliva is not considered to be infectious because it is not sufficiently concentrated for transmission. In addition, there are enzymes in saliva that can break down the virus, and the ph of the mouth is detrimental to the survival of the virus.

HIV does not survive well outside the human body. It can be easily killed (deactivated) by using heat, hand soap, hydrogen peroxide or anything with 25% alcohol, bleach, Lysol, and other disinfectants.

3. What do HIV test results mean?
A negative test result means that you are not infected with HIV or you have recently been infected with HIV and can infect others, but the test did not yet detect enough HIV antibodies to provide accurate test results. Consider getting a retest six months from your last exposure. A positive test result means you are infected with HIV, you will always have HIV, and you can infect others. If you have engaged in risky behavior or had sexual intercourse with someone who has, speak frankly to a health care provider who understands HIV disease.
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The above list of FAQs have been prepared by

Dr. Praful Barvalia
Dr. Piyush Oza


with the help of the entire team of Holistic Child Care Centre.