CHECKLIST DISTURBANCES OF

FOR PERCEPTION, ADHD/ADD

Date: Patient name:

To enable us to find a suitable homeopathic

remedy, we need you to precisely record here all
changes in how you feel which have arisen during
SYMPTOMS the current illness. To do this:
1) Below, write the main symptoms you have noticed with your illness:

MAIN SYMPTOMS (e.g. restlessness, impulsiveness, poor

concentration, speech difficulties)
restlessness, impulsiveness, poor concentration, speech difficulties(he can pronounce few words clearly but he does not do that unless
his willingness,some time he pronounce himself ,does not complete the sentence like dad,mom,no,give etc

2) Underline below whatever applies to you during your illness.

For example: if it gets worse when you perspire, mark: during / after perspiration
better / worse

SYMPTOMS PERCEPTION
Light (bright): worse Visual
Looking at something close-up (strained vision): worse (e.g. nervousness after watching TV,
Hearing: sensitive Auditory
using PC or mobile phone)
Talking: worse (speech disturbance)
Reading: worse (dislikes reading, tires quickly) Olfactory
Sense of smell: oversensitive / diminished

Gustatory
Sense of taste: reduced (adds sauce or spice to everything)
Vestibular
Travelling in car: worse (e.g. nausea)
Tactile
Touch: worse (dislikes touch)
Sensitivity to
Warmth: worse (finds warmth unpleasant) temperature
Warm room: worse (e.g. warm room makes the restlessness worse)
Uncovering: better
Movement: better Movement
Cold: worse (feels cold easily, unpleasant)
Dislikes movement, inactive
Uncovering:
worse
Writing: worse (writes in cramped way, tires quickly) Time when
complaints get worse
Muscles: flabby / tense
After waking up: worse
Understanding difficult / easy Understanding
Before falling asleep: worse
Memory weak / vivid (distinguish weakness of memory from absent-mindedness) Memory

All contents 2014 Heiner Frei

 CHECKLIST DISTURBANCES OF
FOR PERCEPTION, ADHD/ADD
Sad, depressed, weepy Change in mood
Irritable, aggressive, fits of rage

All contents 2014 Heiner Frei

 CHECKLIST DISTURBANCES OF
FOR PERCEPTION, ADHD/ADD

3) The following symptoms are very common in disturbances of perception

and ADHD/ADD but have proved less reliable when choosing a homeopathic
remedy. Therefore, only underline symptoms below if you have noticed that
they are very pronounced in your child.

MIND Annoyed: worse WEATHER / PHASES OF MOON

Mood swings Angry: worse Cold wet weather: worse
Sulky Lack of sleep: worse Autumn: worse
Serious Motor phenomena Winter: worse
Fearful dependent on mind Windy weather: worse
Compulsive ideas Stammering (Kent, Change of weather: worse
Proud, arrogant Mouth, p. 356)* Full moon: worse
Nasty Grinding teeth (Kent, Teeth, New moon: worse
Jealous p. 368)*
Greedy, stingy
Brash, cheeky, rude
EATING / DRINKING
PERFORMANCE Disgust
Dictatorial (Kent,
Mistakes in arithmetic Desires sweet things
Mind, p. 28)*
(Kent, Mind, p. 52)* Desires salty things
Dislike washing
Slowness (Kent, Mind, Desires milk
themselves
p. 65)* Midday: worse
Modalities of mind
Hunger: worse
Mental exertion:
Sweet things: worse
worse FRESH AIR / MOVEMENT Milk: worse
Being alone: worse Fresh air: desire for /
After eating: better
Being with people: aversion to After drinking: better
worse Fresh air: worse
Darkness: worse Walking in fresh air: better
Being in a room full Physical exertion: better
of people: worse Involuntary movements
Strangers: worse (tics)
Being consoled:
worse
Afraid: worse TOUCH
Upset: worse Pressure of clothes: worse
Combing hair: worse
Touch: better
Rubbing / massaging: better

4) Write here any symptoms not listed so far that you have noticed in your child:

All contents 2014 Heiner Frei

 CHECKLIST DISTURBANCES OF
FOR PERCEPTION, ADHD/ADD
INSTRUCTIONS FOR THE HOMEOPATH
1. Repertorise only with the polar symptoms on page 1 to generate a list of likely remedies.
2. Use the symptoms on page 2 only for the subsequent materia medica comparison of
likely remedies. It can be misleading to include the symptoms on page 2 in the
repertorisation. The exceptions to this rule are the following symptoms from page 2, which
if present can be included in the repertorisation: Stammering, Grinding teeth, Mistakes in
arithmetic, Slowness.

All contents 2014 Heiner Frei