Katy, age 3, was brought in eight months ago by her mother, who was
worried about her stuttering. She was a delicate-looking, but active little
girl with straight blonde hair. She was sweet and a bit shy. We noticed that
she covered her eyes periodically when her mother talked about her. Her
stuttering began when she first started to talk at 13 months. Her
com-munication skills were always below average. She could get out the first
part of a word, but not the rest, and would repeat the first part over and over
again. There were certain words she couldn't pronounce at all. For example, she
would want to ask "why?", but would ask "how" instead, because "why" was too
hard to say. When she couldn't get her words out fast enough, she became tense
and frustrated. She would scrunch and contort her face, ball up her fists and
put them in her mouth, appearing extremely anguished. The day after she and her
mother moved to a new house, she wouldn't speak for three days because it was
so hard to get the words out. Katy was receiving regular speech therapy.
Despite her communication difficulties, Katy was very talkative. (As her
mother told Katy's story, Katy sang happily to the teddy bears on the office
Katy weighed six and a half pounds at birth, but was chubby by six months
of age. Her mother, a single mom, had nursed her for the first three months,
during which time the mother's diet was not very good due to lack of money. The
mother was going to school and working fifty hours a week . She stopped nursing
because Katy wanted to nurse every fifteen minutes. She was slow to teethe (she
cut her first tooth at about ten months). She suffered from otitis media
beginning at a year and a half. She would have a brown, gooey discharge. It
more often affected her left ear. She rarely cried with the otitis. She had
received numerous courses of antibiotics for the otitis. She received all of
her childhood immunizations. At age two, Katy was apparently given some
hallucinogen, unbeknowsnt to her mother. She was hospitalized overnight to pump
She had some eczema on her back at age two from chocolate, and
occasionally across the bridge of her nose. Katy's mother told us that her hair
grew slowly and her nails were weak.
Katy had a vaginal yeast infection two weks before her mother first brought her
in, with itching, redness, and a milky white discharge. She was treated with
Katy was warm, and liked to run around the house naked. She sweated on her
head while sleeping. She slept soundly, usually on her left side. Katy loved
ripe fruit, ice cubes, popsicles, ice cream, milk, and cheese. Salty foods and
sweets were close behind. She also liked scrambled eggs. Katy was very thirsty
for cold drinks.
Katy's mother described her as imaginative. She would cry after her
mother read her a story because she wanted the character in the story to come
play with her. She would pretend that she were Cinderella and only answer to
thst nsme. She talked often to her stuffed animals. She was stubborn,
strong-willed, independent, active, and social. She feared the dark and
monsters. She laughed when reprimanded. She became defiant and "fell apart"
when she got tired.
There was no significant family history and nothing remarkable was found
on physical examination.
Now, take some time to study this case and decide what remedy
you are going to give to Katy. Then, turn to page _____ to finish the