An Engaging Child with Asperger’s Syndrome

1675771Original patient complaint: Asperger Syndrome

We first saw Gregory, eight years old, in January of 1996. He was originally diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and Pervasive Developmental Disorder (PDD). The diagnosis was later changed to Asperger’s Syndrome, a mild form of autism (although a distinct diagnostic entity) and diffuse encephalopathy. Principal areas of difficulty generally include communications and social skills. By the time he was three years old, Gregory had been kicked out of several daycare centers. A very unusual child, Gregory had an astounding vocabulary and an excellent memory for music. His parents remarked that he sounded like a little professor. He often invented language. He instructed his dad, “Stop that teasement.” Gregory could read all day and tested at a sixth grade reading level. His developmental kindergarten teacher was amazed at his precocity. Tirelessly engaged, Gregory always had to be doing something. He fiddled with things incessantly. We observed Gregory in the office to be constantly busy, compelled to touch everything, very restless, moving furniture, and talking all the time. We agreed with his parents’ description of him as “frenetic”. Gregory was medicated with Amitriptyline 75 mg at night. Without it he was unable to sleep. Gregory had been on Imipraimine previously, but developed such severe constipation that he was taken to the hospital.

Making friends was a challenge for Gregory in part because he tended to interrupt and talk out of turn. He was quite a talker but was unable to sustain reciprocal conversation. Self-focused, he had difficulty picking up on nonverbal communication or the feelings of others. In addition to talking excessively, Gregory sang songs from beginning to end, regardless of what else was going on. He had always been a jumper. He could suddenly trip over himself. Tantrums were a significant problem. He was unable to calm himself down, called his parents names, and was extremely non compliant.

Gregory had learned to walk at ten months. As soon as he could manage, he was moving constantly “like King Kong had burst out of a cage… In stores he’d be wild, ran around, and screamed if he didn’t get what he wanted. He just couldn’t restrain himself.” From the time he was an infant, he experienced episodic colic. At two he had surgery for an undescended left testicle. At two and a half Gregory was hospitalized with severe asthma after being in a home daycare with four cats and a dog. When he was two, Gregory’s parents had to remove all of their plants from the house. At five he flipped over a large couch when he became angry at a babysitter. He screamed at strangers and cried inconsolably until after they left, yet he also enjoyed showing off with new people.Gregory told me that every time he thought of something sad, he would get a weird feeling in his stomach as if a creature were inside gnawing on the walls.

When it came to food, Gregory loved waffles or pancakes with syrup, ice cream, and ice. His mother told us that he would only eat fruits or vegetables “at gunpoint”. He hated pickles, limes, and anything carbonated. Always hot, Gregory perspired a bit more than average. He feared scary movies  and the dark.

We asked more about what was unique about Gregory. If he knew a fact, he’d recite it. He was typically very insistent that he was right  and called his parents names if they didn’t agree with him. Charming and bright, Gregory had an incredible memory. At two and a half, he was capable of putting together puzzles that many five-year-olds couldn’t figure out. He had a great sense of humor, but often laughed too loudly.

What we knew to be true of Gregory was his precocity, loquacity, intellectual nature, excessive restlessness and busyness, self-focus, tantrums, frenetic quality, impulse to touch everything, and his desire for ice and ice cream. These symptoms led us initially to prescribe Veratrum album (White hellebore) 1M and 12C twice weekly. We have found this to be a very useful remedy for precocious, overly busy children. The reason that we prescribed 12C in addition to the 1M was because of possible interference by his allopathic medication, although we sometimes give only the 1M when children are medicated.

At his follow-up visit in mid-February, his parent reported that Gregory was much calmer for one week but back to his name-calling and frenetic pace the next. However he was now mellower with fewer flareups. His tended to get less wound up. His impulsivity was possibly improved. We increased the 12C dosage to once daily.

Six weeks later Gregory’s parents were happy to say that he was continuing to progress. He was considerably more cooperative and often “a pleasure to have around.” His ability to make friends was improving. We continued the remedy on a daily basis.

Four months after the original dose of the Veratrum album 1M, Gregory experienced a partial relapse. He had been placed in a regular classroom. Although Gregory was calmer more often, his frustration was now coming out in physical aggression. He also complained of ear pain and crackling and bronchitis at the time of the visit. We repeated the Veratrum 1M and instructed the parents to continue the 12C as prescribed. We also gave Gregory garlic, mullein, calendula eardrops and an Echinacea and Hydrastis supplement.

At his visit nine weeks later, Gregory’s tantrums had become more violent. Now that he was in a mainstream classroom, he received less individual attention.The teacher had kept him in from recess because he got into fights with the other children. He tore up lists of spelling words because they were too easy. He couldn’t stand being told he was wrong and would respond by walking away. He had begun to hurt other children by squeezing, hitting, and biting them. He ran around his school library and knocked down books. During the last week of school, the administration asked that he not return. He had also been expelled from summer camp and another children’s daytime activity program.

At his worst, Gregory was unreasonable, frenzied, threw dirt, shook his fist, grabbed, and was completely out of control. He had become very destructive.

We spoke with Gregory to see if anything else had changed in order to see whether his remedy picture had shifted. He told us, “I don’t like hearing ghost stories or anything spooky or scary. They can give me a nightmare. When I go to bed, I can’t get my mind off those things.” His mother reported that Gregory needed her to go to bed with him recently. Gregory continued, “Sometimes it’s like being in a dark crystal. Like with the Emperor. The Blue Wolf part of Sky Island and Zog the Sea Monster.” When we asked Gregory more about his fears, he shared that he wouldn’t like to be in the woods alone because he might get kidnapped. He was very careful to never leave the car door open unless his mom or dad was there because he was afraid that someone might grab him out of the window. Gregory locked himself in the trunk area of their hatchback if his parents went out of the car for even a few minutes. He wanted his dad with him if it was dark and felt a lot more comfortable with the light on at night. Gregory loved maple bars  and desserts.

The combination of Gregory’s fear of the dark, being kidnapped, his nightmares, hitting, biting, and kicking, the sensation described previously as “something alive in his stomach” (the remedy chosen appears under abdomen in the repertory), and his desire for sweets led us to change the prescription to Stramonium (Thorn apple) 1M and 12C twice a week. Once we find a remedy that works well, it is unusual that we switch to another remedy unless the picture clearly changes. Gregory had experienced some definite improvement from the Veratrum but his symptoms did shift in the direction of more violence and fear. He was also needing the remedy on a daily basis which is generally not the case with the correct remedy, especially as improvement continues.

Two weeks after beginning the Stramonium , his parents reported a significant improvement in the violence. At the visit seven weeks later, he was doing much, much better. Gregory’s frustration had diminished, he was much less violent. he had less fear of the dark, was no longer ruminating about scary things at night, and was more able to respond appropriately. His parents happily told us, “We see the true kid… very loving, easy to please, a wonderful temperament.” We discussed consulting with Gregory’s neurologist to discontinue the Amitriptyline, but his mother was reluctant given how well he was doing.

Over the past ten months Gregory has continued to improve. He has been under homeopathic care for over eighteen months. He is doing very well in his classroom and the teacher is gradually adding more challenging subjects. His parents still describe him as a high-maintenance child.When tired, he can still become violent, but nowhere to the extent and frequency he experienced prior to homeopathic treatment. His parents report that he is much more receptive to negotiation and to talking out problems. His social skills are improving and he now has a friend. Gregory’s nightmares have diminished.

We last saw Gregory in mid-June. He is reading and writing at a tenth grade level. The teacher is very impressed with his creative writing talents. He will no longer be in a special classroom, to the pleasant surprise of his teachers. Gregory’s neurologist is also pleased with the improvement and willing to begin tapering off the Amitriptyline. His temper flareups are infrequent, usually if he stays up too late. His father pointed out that one year ago he was in major distress and removed from school. This year his teacher said she hated to see him leave her classroom. He even enjoys swimming, which he couldn’t previously because of a reaction to chlorine, and is no longer affected by food colorings. We instructed Gregory to take the Stramonium 12C only once a week. The neurologist will decrease the Amitriptyline and we will see Gregory in three months.

It is extremely gratifying to see the transformation in children like Gregory. This bright, engaging child was extremely limited by his excessive behaviors and social inappropriateness. Although he still has some problems with behavior, temper, and social interactions, Gregory is much more able to interact appropriately with his peers and family.

Overall he is much easier to manage and much less a source of concern to his parents.

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