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!