ORGANIZER: M.B. BARVALIA FOUNDATION’S SPANDAN HOLISTIC INSTITUTE OF APPLIED HOMEOPATHY-MUMBAI, INDIA As per the latest epidemiological Survey, carried out in March 2017, the prevalence of Autism is 1 in 68 children in the US according to Centers for Disease Control (CDC). The incidence in India has also gone up substantially. Autism knocks every physician’s door. Every physician must be equipped for early detection and early intervention of all Developmental Disabilities. This is how AUTISM WORKSHOP took shape, to empower the physicians with the requisite knowledge. As soon as the workshop was announced, doctors from all over the country got interested and enrolled for the workshop wherein Dr. Praful Barvalia shared his immense knowledge and experience gained by him in the massive field of AUTISM SPECTRUM DISORDER. The contribution of the entire Spandan team to the workshop, academic, and otherwise was commendable. The project coordinator was Dr. Piyush Oza. Participants came from Gujarat, Maharashtra, Kerala, Tamil Nadu, Andhra Pradesh and Telangana for this AutismWorkshop. The highly successful AUTISM NATIONAL WORKSHOP was conducted at M.B. BARVALIA FOUNDATION’S, SPANDAN HOLISTIC MOTHER AND CHILD CARE HOSPITAL located in Deonar, Govandi, Mumbai on 23rd, 24th and 25th November 2018. Autism is a neurodevelopmental disorder. It is a deep-seated chronic disease. It presents as a spectrum exhibiting a wide range of symptoms. IMPORTANT HIGHLIGHTS OF THE WORKSHOP WERE: Neurons and Synapses: Understanding Enigma of Autistic Brain Arriving at the diagnosis of Autism Grading severity of Autism Understanding Autism as multi factorial phenomenon grasping various etiological & contributory factors Understanding evolution of Autism and developmental pattern and its implications in Homeopathic anamnesis Differentiating childhood Autism, Asperger’s syndrome and ADHD. Understanding their therapeutic implications Understanding prognosis of Autism in terms of cure, control, recovery, reversibility, complications etc. What can be achieved through Homeopathy with above mentioned knowledges Understanding implications of knowledge of Autism to appreciate miasmatic state and susceptibility of Autistic child Studying frequently coming group of medicines in the management of Autism Application of repertory in the management of Autism An understanding dynamic portrait of Remedy Understanding remedy response in Autism for an effective second prescription –learning concepts of follow up Management Role of ancillary measures and ancillary modes in the management – Occupational therapy, Speech therapy, role diet in autism, yoga etc. Dr Prachi Barvalia, a young neurologist, pursuing D.M. in neurology from J.J. hospital (team Spandan) conducted the opening session of the SPANDAN NATIONAL AUTISM WORKSHOP. She took the participants through the gamut of neurons and synapses explaining synaptic transmission function and dysfunction aspects in detail. She talked about neuroanatomy of Autism and various tests and investigations that can be carried out to understand the Autistic brain. She stressed that the clinician must be alert and aware of the genetic syndromes accompanying. Dr Prachi Barvalia introduced the participants to a novel concept of ‘Neuroplasticity’.
Neuroplasticity is the brain’s ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment. It is the change in neural pathways and synapses that occurs due to certain factors, like behaviour, environment, or neural processes. During such changes, the brain engages in synaptic pruning, deleting the neural connections that are no longer necessary or useful, and strengthening the necessary ones. This also explains how our Homoeopathic remedies sync and work at a dynamic level correcting and developing new neuronal pathways and synapses taking the Autistic child on the road to recovery so much so as to reversing the child’s autistic features. Dr Praful Barvalia, Founder Chairman, Spandan, pioneering research-based work in Autism; over three days took all the participants on a journey of the spectrum of autism. He explained how to approach any case of developmental disorder right from the time, the child enters our clinic. CLINICAL and HOMOEOPATHIC dimensions must be well defined. Diagnosis as per DSM-V and ICD-10 taking the help of clinical psychologist as and when required is essential. Here important concept of multiaxial classification of Autism was discussed. Its implications in understanding of susceptibility, miasmatic dimensions as well as overall prognosis was highlighted. How a case of high functioning Autism can have a different outcome compared to child with severe autism with severe retardation and comorbidities like epilepsy. Also its reflection on posology was presented. There were cases with high functioning Autism which responded with very infrequent repetition, while cases with severe Autism with severe retardation and regressive features needed frequent repetitions. INDIVIDUALISATION is vital in the management of these cases. Importance of early identification and scientific intervention was discussed through illustrative cases. The child must be studied in its environment considering the pre-disposing factors, the possible aetiological or triggering factors; the genetic load, emotional trauma of the child and mother, the allopathic medication taken by the child or mother, vaccination, preceding infective illness and even physical trauma in children. Age of onset of illness is a very important parameter for diagnosis. The milestones, any developmental lag or regression, behavioural pattern, cognitive functioning, sensory issues and all the complaints must be systematically observed, investigated and recorded in a proper format. Proper history taking- clinical, peri-natal, developmental followed by a thorough interview of parent and child and laboratory investigation coupled with various psychometric tests will give a complete understanding of the case. Laboratory investigations required are thyroid hormones, biochemical, urine analysis, radiological, X-ray, CT scan, MRI, chromosomal analysis and psychometric tests. Prognosis of the case must also be defined. Problem formulation of each case must be done in the areas of behaviour, cognition, immunity, perceptual, motor, communication, metabolic, genetic, emotional, psychosocial and parenting. This is vital in arriving and utilizing the concept of CAUSATION from angle of homoeopathic philosophy. This was methodically touched upon with the help of various case examples. The cases also demonstrated evolving the portrait of the disease vis-à-vis portrait of the child -the remedy in the autistic children complete with psycho-dynamic, miasmatic and understanding of susceptibility. Dr Praful Barvalia highlighted the importance of proper regular follow ups following definite criteria and most essentially supported by tests to evaluate the treatment with checklists. It is very important to document all the cases systematically and the scores of psychometric tests recorded. Most important highlight was systematic classification of remedies suited for entire spectrum of autism. Sir presented synthesis of rich experience of managing hundreds of children with autism. Identification of PATTERN and corresponding homoeopathic material medica and repertorial study allows us classify the spectrum as Kinetic, Monomanic, Regressive etc. The commonly coming up medicines in the case studies of children with Autism Spectrum Disorder were: The patients with regressive features required medicines like- Baryta carb, Bufo, Hyoscyamus and Zincum met. Patients with kinetic features -medicines like Aurum, Belladonna, Cina, Stramonium and Tarentula hispania came up. The patients having sensory issues required China, Nux vomica, Phosphorus. The patients with childhood depression – medicine used were Hura, Natrum mur, Staphysagria. Dr Piyush Oza (Senior Homoeopath. Faculty, Spandan research team) demonstrated through his case presentation how the physician’s job does not end with the diagnosis and prescription. Rather that is just the beginning. The physician continues to be with the patient in his journey of learning, adapting, decision making and see the child transform into a confident grown up with a fair level of independence -case specific. His case example depicted how an Autistic child with no speech had grown up into a confident, bright, smart child who joined a mainstream school and developed fluent speech with no traces of Autism remaining. His case demonstrated, physician’s role as a friend, philosopher and guide. The remedy used was Stramonium—Carcinosin— Silica. He also presented a case of self-injurious behavior in a child with autism. Both cases highlighted identification of patterns – rigid, mechanical, concrete pattern in first case, while self-destructive pattern in second case. The concept of sequence of medicines was also discussed. Dr Shankar Chawla’s; (Senior Homoeopath) case of an IUGR child who had developmental lags along with sensory issues and behavioural problems was beautifully managed as a long distance patient. Patient resided in Europe and the doctor had to take all decisions and prescribe sitting in his clinic at Mumbai communicating with the help of technology. The remedy prescribed being Stramonium here. Dr Rahul Suryawanshi’s case of MR with ADHD and sensory processing and speech regression was meticulously followed up with definite criteria and sensory profiling done every three months. The child had remarkable improvement, the drug of choice being Hyoscyamus here. Dr Nrupen Bhutkar (Ph.D Scholar), gave a complete work up on Sensory Processing Disorders giving a clear understanding of various evaluation tools used to understand the sensory profile of the patient. He is doing his Ph D under Dr Praful Barvalia sir’s guidance. Dr Kolli Raju, a senior scientist from Homoeopathy Research Institute for Disabilities (HRID), Chennai under CCRH gave a presentation of work done by their institute followed by three cases of Autism Spectrum Disorder. CCRH has collaborated with NIEPMD, NATIONAL INSTITUTE FOR EMPOWERMENT OF PERSONS WITH MULTIPLE DISABILITIES (DIVYANJAN). This is the first ever Government national institute that has come up in Chennai to serve as a national resource centre for empowerment of persons with multiple disabilities. They provide integrated care with Homoeopathy. Dr Sivakumar Goli from HRID joined Dr Kolli Raju. In their experience, commonly coming up medicines for autism are Baryta carb, Belladonna, Calcarea carb, Chamomilla, Natrum mur, Nux vomica, Opium, Silica, Stramonium and Tarentula. Dr Purnima Thakkar, Ph.D, Senior Clinical Psychologist exhaustively dealt with various commonly used Psychometric tests for diagnosing Autism as well as evaluating the treatment. She discussed tests like M-CHAT, CARS, GARS, ISAA, ATEC, AHS, KAMAT BINET, WISC, SEGUIN FORM BOARD TEST, SPM, CPM, VSMS, SQ etc. Her presentation highlighted the importance of standardized tools in the management of special children. All cases presented were well documented in this regard in diagnostic confirmation as well as periodic follow up evaluation. The participants included Dr Ram Subramanium, Paediatrician who contributed beautifully with the help of diagrams how our conscious mind is just 20% while the sub-conscious mind is 80%. The child’s sub-conscious is raw and virgin. It will take in whatever the child gets/ sees in the environment. Therefore, we must be very careful as this will be shaping up the child’s future. Negative inputs go in automatically. It is the positive inputs that we must put in. Dr Priya Vaidya, Ph.D philosopher, attached to the Department of Philosophy, Mumbai University, Kalina, gave the concluding talk of the day. She gave a very insightful thought on ‘KNOWING’. The ‘what’ of it, ‘why’, ‘when’, ‘how’ etc. The process of ‘knowing’ continues. As a clinician also, if we know ourselves, it helps us in knowing the patient better. Shri Sudheendraji Kulkarni, one of the trustees of Barvalia foundation and a noted columnist, Past joint secretary in PMO, close aid to Late Atal Bihari vajpeyaji gave the valedictory address in a most humble manner. He was full praise of Dr Praful Barvalia and his contribution to the medical world especially in the treatment of developmentally delayed and mentally challenged children. He acknowledged the work done by Spandan team and gave his blessings to the Spandan team. He is great supporter of Homoeopathy and said India should take global leadership in this aspect. Both the above talks from our distinguished speakers brought into focus the concept of CARE. This concluded the Spandan National Autism Workshop on a happy note. All the participants were awarded certificate of participation. Each participating doctor went home with a take-home learning and happy faces looking forward to more such learning sessions. The success of the workshop also goes to Dr Mrs Alka Barvalia who silently managed overseeing all the aspects of the entire workshop. REPORT PREPARED BY DR. LEENA CHOPRA AND DR. PIYUSH OZA
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