Case management: Real life example

Real case example (treatment ongoing)  Male age 5


Presenting Symptoms

Language & Communication:

• Echolalia

• Can state minor needs

• Doesn’t call parents “mum” or “daddy”

• Understands some routine phrases

• Major tantrums if not understood

Behaviour & Emotion:

• Happy and reasonably adaptable in routine

• Severe tantrums (kicking, flopping) if frustrated

• Doesn’t respond well to consoling if upset

• Attachment to tablet (primary play tool at home)

• Attempts to engage peers at the park but doesn’t know how

• Mood is changeable, not aggressive

Sensory & Social:

• Doesn’t play with toys at home, only at school

• Tablet dominant at home, no structure

• Strong attachment to nanny; sleeps with nanny

• Fear of dogs (especially close proximity)

• Wants clean hands

Sleep & Environment:

• Sleeps through the night, no sweating

• Eats limited diet (cereal, peanuts, camel milk, banana, onion crisps)

• Mostly protein from peanuts and camel milk

• No fruits/vegetables apart from banana

• Picky eater, food has to be soft

• No digestive concerns reported

Overview of timeline

Post-vaccine regression with significant developmental disruption (classic MMR regression around 14m)

Sensory-seeking and screen-dominated home environment

Attachment-based behaviours: sleeps with nanny, attached to tablet, poor frustration tolerance

Social-emotional immaturity: struggles with peer play, doesn’t use parent names, echolalia rather than expressive speech

Control struggle: “He’s in charge of us,” lacks clear boundaries or routine

Fear-based pattern: fear of dogs, tantrums when confused, strict preference for routine



1st Prescription 

Tub. bov 1M collective single dose to start:

Lac maternum 1M 1 x week

Crcn 30c 2 x week 

MMR 30/200 4 weeks each, twice a week 

Varicella 30/200 4 weeks each twice a week 

**Had been spitting at people so we used Lachesis briefly and this behaviour stopped completely

Follow up:

Less repeating of the questions 

Started to answer appropriately

Hits his head when frustrated 

He can focus ok

He has lots of tantrums about not going to the playground 

When school started he started wetting the bed but past few weeks hes having less accidents…

Staying longer in school 8am-4pm…

Limited diet

Hes careful with the swing but when it comes to animals wont know whats safe and whats not 

Doesnt know if a car is going to hit him …if hes not familiar with something …..


Continued treatment:

MMR 1M/10M

Varicella 1M/10M

Swapped to Lac hum 30c for feeding issues

Added:

Thuja 30c to support vaccine detox 

Poly bowel 30c to support gut health 



Follow up:

Recent Improvements seen:

Speech: Saying his name, short sentences, using manners (“thank you,” “you’re welcome”), fewer echolalic loops

Social Awareness: Greets parents, mimics older children, wants to play with peers, initiates connection

Emotional Recognition: Recognises mum coming home, shows joy, starting to understand basic emotions

Behaviour: Tantrums decreasing. Still some occassional scratching, head banging when frustrated

Sleep: Much improved, sleeps well

School: Attending longer days (8am–4pm), improved transitions, fewer bedwetting incidents

Diet: Limited but it is expanding (e.g. bananas, grapes, eggs, camel milk, mackerel)



Case ongoing: New prescription to be decided!

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