I don’t like to write- A case of Dysgraphia

Dr.Uttara Agale¹
Dr.D.G.Bagal²

Abstract:- Dysgraphia is learning disability that affects handwriting and writing skills of a person. It is generally associated when a child gets difficulty in converting the sounds of language into written form. . Such children speak properly and easily but have difficulty in writing.Such children are misunderstood for poor concentration and dull or poor memory and many scolds them as they are unable to perform in schools. Homoeopathy with its holistic approach treats such children and eases their complaints thoroughly. This article throws light on the signs of dysgraphia with a case which can be treated effectively with homoeopathy.

Keywords:- Dysgraphia, Homoeopathy

Introduction:-Dysgraphia is learning disability that affects handwriting and writing skills of a person. It is generally associated when a child gets difficulty in converting the sounds of language into written form. A child with dysgraphia is not able to form sentences with correct grammar and punctuation, along with spelling mistakes and many times omits words in sentences. Such children speak properly and easily but have difficulty in writing.^(1,2)

Signs and Symptoms^(1,2):-

 It is difficult to get such cases and diagnosed as they are generally misunderstood in schools and by parents. They are often seen with following signs:-

1. Illegible handwriting
2. Inconsistencies in writing i.e., shape and sizes of letter and cursive letter.
3. Unfinished words, letters or omitted words.
4. Large spaces between words and letters
5. Such children hold pencil in an unusual and awkward manner with difficulty in griping.   ( Holding thumb over two fingers and writs with wrist as a base)
6. Talks to self while writing.
7. Slow writing
8. Easily gets tired to write.

Case Report- ( Date- 11/ 03/2019)
A boy of 7 yrs old was brought by his mother with the complaint of restlessness and poor concentration. On asking in detail the mother narrated that the child is not getting good marks in school also and he is poor in writing and remembering the things told to him. It makes a lots of efforts to her to make him sit along with him and get the home work done as he doesn’t sits at one place and it becomes difficult for her to make him write.

The mother complained that child is good as such in obeying her things as to get ready to school easily on his own, tells everything sharply whatever happened at school and good in reciting but  many times she beats him as he don’t do homework and don’t write for the same she feels bad.

She said many times she gives him chocolates cakes or other things like to bribe him to get it write and complete school work but still sometimes its of no use.

On asking the details about her 

Obstetric history –FTND, but the mother told that it was LSCS and the labour pains was too protracted so LSCS was done.

Mind of Mother during Pregnancy:- 

She said as such there was no stress as she uses to stay as a nuclear family with her husband when she was pregnant and in laws and parents use to visit on and off so there was no complaint regarding any trouble and she is working lady working in a firm but now she is doing her own small scale business.

When asked in detail about the child whether there is any h/o of fall it was not having any history of major head injury except small falls during playing.

On observation of child:- He was having typical bashful behavior, dressed up properly and when being looked at he smiles and shy away. 

On Interrogation of child :- On asking questions he is giving answers properly with low tone voice.

His hobbies are playing and eating cakes and chocolates, he has aversion to green leafy vegetables. He said he has 6-8 friends in school and able to remember school things and he recited a poem in front of us. He is thermally chilly patient.

His mother said that her child is scoring less than previous class and insisted only to do something to improve his studies. She told they are giving him coaching also but all seems effortless and they are feeling that child is having low IQ so unable to get marks and are stressed.

On telling the child to write on paper he scribbled in a very bad handwriting for I simply said to write A to Z but handwriting was totally unable to recognize at first and then when asked to write numbers it was observed that his grip to pencil was not also good and he recites the alphabets and numbers to himself as he wrote but as I was stranger he wrote, obeyed me and then went away so as to avoid any other questions.

On asking whether there were any illness in past , it was concluded that there was no major illness in past.

Other physical generalities are common except sweating of palms and soles and also of face, the sleep and urine and stool habits of child were not having any complaints. 

As such the child was not too naughty and troublesome but only complaint was unable to write properly which the mother explained as poor concentration and poor memory and restlessness.

Diagnosis :- Dysgraphia 

(Diagnosis is based on the chief complaint which is inability to write properly along with other associated symptoms and case history)

Case Processing:-

Analysis of symptoms:-

Mental Generals:-

1. The child is shy
2. The child obeys
3. The child is not able to write properly and makes mistakes in writing and easy fatigability during writing.
4. Improper grip of pencil with paper

Physical generals:-

1. Desires cakes and chocolates
2. Aversion to green leafy vegetables
3. Perspiration of palms and soles and also on face

Particulars:—Nil

Evaluation of symptoms:-

Sr.no	Symptoms	Grades	Evaluation
1.	The child is shy	Ist grade	Characteristic mental general
2.	The child obeys		Characteristic mental general
3.	The child is not able to write properly and makes mistakes in writing and easy fatigability during writing		Characteristic mental general
4.	Desires cakes and chocolates	IInd grade	Characteristic Physical general
5.	Aversion to green leafy vegetables		Characteristic Physical general
6.	Perspiration of palms and soles and also on face		Characteristic Physical general

Totality of symptoms:- 

1. The child is shy
2. The child obeys
3. The child is not able to write properly and makes mistakes in writing and easy fatigability during writing.
4. Improper grip of pencil with paper
5. Desires cakes and chocolates
6. Aversion to green leafy vegetables
7. Perspiration of palms and soles and also on face.

Repertory selected:- Complete repertory

Justification of selection:- It has  many diagnostic and clinical and behavioral rubrics related with complaints of children.

Repertorisation:-

Probable remedies

• Nat-Mur-6/3
• Phos- 6/3
• Sac-all- 5/4
• Thuja- 5/2
• Lyc- 4/2

The remedy selected is Nat Mur

Justification for selection of remedy-

1. The child is shy
2. The child obeys
3. The child is not able to write properly and makes mistakes in writing and easy fatigability during writing.
4. Improper grip of pencil with paper

(In the article of Use of Homoeopathic remedies in the management of learning disabilities by Dr.Dhawale, published in IJRH on Jun 2014 it was explained in results that among the 30 cases analysed 6.25% children were benefitted with natrum salts.)²

Prescription:- Nat- Mur 200 1 dose stat

SL 200 -2 glb TDS

Auxiliary Treatment:-

1) Counseling of Parents and child to deal with the case along with assurance.

2) Worksheets are provided to write

3) To provide writing aids- Pencil grips, bold-lined paper, or other tools which can help child with dysgraphia manage the physical process of writing.

4) Making learning a fun process

5) Not to scold child but to appreciate him in his efforts.

Follow-Up-

1. Writing examples of first time before treatment:- (11/3/2019)

Unable to read the writing with less space in between letters.

2. After one month:- (17/ 4/2019)

Nat Mur 200  1 dose stat , Sl 200 -2glb TDS

Child able to write few symbols also and able to make good space in handwriting. Before it was not able for him to write small and capital alphabets together now he is able to do it.

3. After two months from :- (15/5/2019)

Since improvement is seen so patient is continued on SL

The grip of pencil while writing also became good and now he able to draw fine things and symbols.

4. After four months:- (18/7/2019)

Since improvement is seen so patient is continued on SL

Still child is not able to write sentences and words told to him and handwriting is readable. He still talks to himself while writing but still him complaints became lessen and his parents are happy with his progress.

Bibliography:- 

1. Dr. James Roland,  What is Dysgraphia, December 2018, www.healthline.com
2. Dr.K.M.Dhawale, Dr.Madhavi Tamboli, Dr. M.Katawala, Dr.Namita Tambitkar, Dr.Prashant Tamboli, Useof Homoeopathic remedies in the management of learning disabilities, June 2014, Indian Journal of Research in Homoeopathy, Vol-8, issue-2.

Dr.Uttara Agale¹                                  Dr.D.G.Bagal²
Associate Professor Professor,     Vice-Principal
Dept. of Repertory
Y.M.T.H.M.C Navi Mumbai