LEARNING DISABILITY (LD)
2. How does LD
What causes LD
is not LD
What are the indications
How do we identify a child with
LD at an early age?
7. What is
typical dyslexic reading?
are typical mistakes in writing?
is visual dyslexia?
10. What is auditory dyslexia?
are secondary psychological problems that people with LD face?
steps are needed to take to manage children with LD?
does our institute offer for management of LD?
can we help a child with LD in classroom?
LD be cured?
16. What is Homoeopathy?
what concepts does Homoeopathic science operate?
does Homoeopathic science offer in the management of LD?
improvement can I expect in my child with homoeopathic treatment?
Homoeopathy compatible with other therapies?
is remedial teaching? How does it benefit children with LD?
is pervasive developmental disorder (PDD)?
clinical conditions come under the heading of PDD?
to diagnose autism?
children with autism come from any particular family background?
is the level of intelligence in children with Autism?
short, what characterizes the autistic behavioural pattern?
to differentiate autism from a similar looking condition?
children with autism be educated? And how is this done?
modes of therapeutic interventions are available for children
improvement can I expect in my child after receiving Homoeopathic
factors determine the rate of improvement?
the child be given Homoeopathic medication if he is already
other therapies be given to child receiving homoeopathic treatment?
3. Cerebral Palsy
is Cerebral Palsy?
is cerebral palsy caused?
are the different types of CP?
are the problems associated with CP?
are the various types of therapy for CP?
management strategies one should adopt after diagnosing a
child as CP?
improvement can I expect in my child with Homoeopathic treatment?
facilities does foundation provide for the management of children
4. Attention Deficit Hyperactivity
is Attention Deficit Hyperactivity Disorder (ADHD)?
are the causes of ADHD?
is ADHD diagnosed?
is ADHD treated?
5. Mental Retardation
is mental retardation (M. R.)?
is non-specific M.R.?
do we define the degree of M.R.?
are the causes of M.R.?
a baby who is born normal become mentally retarded after birth?
are the various options available for educating M.R. individuals?
does special education and rehabilitation help the mentally
are the various types of therapy for CP?
6. Down Syndrome
is Down syndrome?
What is the historical background
of Down syndrome?
is the incidence of Down Syndrome?
are the factors affecting the incidence of Down syndrome?
are the clinical features in Down syndrome?
steps need to be taken if the diagnosis of Down syndrome is
is the long-term prognosis for patients with Down syndrome?
What is general management of
cases with Down syndrome?
What is the role of HOMOEOPATHY
in Down syndrome?
Why is Speech Therapy essential
with Down Syndrome children?
is the HIV virus transmited? How do you avoid the HIV infection?
What do HIV test results mean?
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
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.
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.
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)
4. What is not LD
sign of poor intelligence.
or lack of caring.
you grow out of.
5. What are the indications
marked discrepancy between ability and the standard of work
persistent or severe problem with spelling, even with easy or
with comprehension as a result of slow reading speed.
short-term memory, especially where information is language
based, which results
processing into long term memory.
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.
6. How do we identify
a child with LD at an early age?
child with LD :
rigid and inflexible.
poor at copying from the black board.
restless or a daydreamer.
quiet in class but does not learn.
remember the sequence of letters in the alphabet, day, year
and /or the season.
not remember what he sees. Can add and multiply but has difficulty
or adds words when reading.
7. What is typical
slowly but hesitantly
stress on wrong syllables.
words backward ‘god’ for ‘dog’
text is in past tense, reads in present tense.
own stories from illustration rather than read.
What are typical mistakes in writing?
word – ‘rember’ for ‘remember’
prefixes ‘happy’ for ‘unhappy’
suffixes like ‘s’, ‘ed’.
syllables in wrong order ‘ emeny’ for ‘enemy’
letters in wrong orders ‘felt’ for ‘left’
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.
are secondary psychological problems that people with LD face?
low self esteem and deficits in social skills may be associated
drop out rate for children or adolescents with LD is reported
at nearly 40%
with LD may have significant difficulties in employment or social
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.
13. What does our institute offer for management of
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.
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.
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.
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.
18. What does Homoeopathic science offer in the management
These children often present with difficulties at various
levels: Perceptual problems, sensorymotor coordination, emotional
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.
19. What improvement can I expect in my child with
Omits final letter when writing (Lac. Can – Herring
Uses wrong syllables, mixes up letters and syllables or omits
parts of words
(Herring page 91)
While writing transposing letters: China, Lyco, (Kent Rep.
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.
· Homeopathic medicines help in correcting the faulty
motor patterns and help in improving
the coordination thus reducing difficulties of
helps in reduction of difficulty in reading & writing.
in the altered state of sensitivity. Children appear calmer.
It helps in reducing
in behavioural problems like hyperactivity, fidgetiness, impulsiveness
span improves. A child who was earlier very inattentive starts
to focus on the
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
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.
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.
||2. Which clinical
conditions come under the heading of PDD?
not otherwise specified.
||3. How to diagnose
are various criteria used in diagnosing autism.
with social relationships.
with verbal and non-verbal communication.
in the development of play and imagination.
to change in routine.
these symptoms must have been present by 36 months of age
||4. What causes
||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
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.
||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.
||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
In short, what characterizes the autistic behavioural pattern?
- 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
Neologism (coining new words
to give meaning to things) or saying 'you' when they mean 'I'
or calling themselves by their first name.
obsessive behaviour - Lack of flexible imagination
coupled with obsessive behaviour e.g. counting lampposts, collecting
bottle tops etc. their play is very uncreative.
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
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.
What modes of therapeutic interventions are available for children
||Autism can be understood
as a NEUROPSYCHIATRIC REGRESSION. As discussed earlier these
children present with a myriad of problems. This demands HOLISTIC
At foundation we provide following modes in an integrated way.
Occupational therapy – sensory integration, Auditory integration,
water therapy etc.
Counselling – behaviour modification
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.
What improvement can I expect in my child after receiving Homoeopathic
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,
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/
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
||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
Can other therapies be given to child receiving homoeopathic
||Homoeopathy works in
perfect synergy with other essential therapies like sensory
integration therapy, special education, auditory integration
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 &
1. What is Cerebral
||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
||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.
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:
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
||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.
||6. Athetoid Cerebral
||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
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.
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.
||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.
||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.
||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.
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 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.
||Speech and Language
||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
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
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
||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.
intervention where ever necessary
||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
is a holistic science.
medicines are safe without any adverse side effects and are
works in perfect synergy with other essential therapies like
therapy, speech therapy, yoga
our centre although we work in a team with allopathic colleagues
like orthopaedic surgeon, neurologist
etc. homoeopathy is the central therapeutic modality.
||13. What improvement
can I expect in my child with Homoeopathic treatment?
medicine correct the defective ‘ motor patterns’
and so there is improved seen
in coordination as well as perception.
shows improvement in involuntary jerky movements.
is also seen in balancing and equilibrium
in altered state of sensitivity. Various fears like height,
loud noise etc
are remarkably reduced.
medicines are essentially immunomodulators. Thus child who is
recurrent infection shows improvement in that ‘
tendency’. It will be noted that the
duration of his infections like respiratory infections, gastric
etc will start reducing and child shows build up
in the general resistance power.
homoeopathic medicines also promote growth processes thereby
the developmental milestones.
of underlying neurological and metabolic disturbance like seizures.
starts appearing ‘calmer’ and ‘at ease’.
He / she starts showing improvement in
like restlessness, impulsiveness, tantrums etc.
help the child to be ‘ more receptive’ to the therapies.
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.
medicines are very soothing for the child and they ‘prepare’
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
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.
Neuromuscular rehabilitation Unit
DEFICIT HYPERRACTIVITY DISORDER
1. What is Attention
Deficit Hyperactivity Disorder (ADHD)?
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
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
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.
||2. What are the
causes of ADHD?
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
||3. How is ADHD
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.
||4. How is ADHD
||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
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
in calming down the behaviour, reduces the restlessness
in reducing impulsivity, tantrums
about moderation in sensitivity disturbances
to manage underlying neurological disturbances
not have any adverse or depressing neurophysiological side effects
other therapies / techniques are helpful for children with ADHD?
with Homoeopathy, children greatly benefit from
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.
1. What is mental retardation
||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.
||2. What is non-specific
||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.?
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
Degree of M.R.
55 to 70
20 – 25 to 35 – 40
Profound M. R.
Below 20 to 25
||5. What are the
causes of M.R.?
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
||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
||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
about moderation in sensitivity disturbances
the behavioural problems
the emotional disturbances
underlying neurological, genetic, metabolic disorders
the growth process and general resistance of the system
not have nay adverse or depressing neurophysiological side effects.
||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.
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.
||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.
||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.
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.
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.
||5. What are the
clinical features in Down syndrome?
- Mental retardation, hypotonia.
- Flat occiput, oblique palpabral fissures, epicanthic folds,
brush field, Spots (speckled irides) protruding tongue, prominent,
malformed, low Set ears, flat nasal bridge.
- Congenital hearts disease mainly septal defects.
Abdomen & pelvis - Decreased acctabular
and iliac angles, small penis, cryptorchidism.
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,
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
||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.
What is the long-term prognosis for patients with Down syndrome?
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.
What is general management of cases with Down syndrome?
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.
What is the role of HOMOEOPATHY in Down syndrome?
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.
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.
is Speech Therapy essential with Down Syndrome children?
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
What is 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.
How is the HIV virus transmited? How do you avoid the HIV infection?
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
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
What do HIV test results mean?
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.
above list of FAQs have been prepared by
Dr. Piyush Oza
with the help of the entire team of Holistic Child Care Centre.