Autism

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Autism

• Tammy Marie Baker RN
• The Pediatric Educational Series
• March 1st 2012

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What is autism Autism Spectrum Disorders

• A Complex group of Neuro developmental disorders
  characterized by
• Social impairments
• communication difficulties
• repetitive behaviors
• patterned behaviors

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The spectrum

• Autism ( more sever form )
• Aspergers ( higher functioning)
• Child disintegrative disorders
• Pervasive Developmental Disorders

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Causes and theories

• Environmental's
• genetics variances
• variants of Serotonin and neurotransmitters in
  the brain itself ?
• disruption of normal brain development in early
  fetal stages?
• Speculative theories include diet Digestive
  tract change Mercury poisoning The body's
  inability to properly use vitamins and minerals (
  these are not proven)

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Statistical ratio of autism

• 6 out of every 1000 children will be affected
• Boys are 4 times more likely to be affected than
  girls.

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most common signs of autism

• lack of social engagement
• fixation on objects
• patterned behaviors
• avoid eye contact
• unresponsive to name
• disengaged or intently focused on something
• cant interpret social cues from others
• parallel play verses interactive

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early signs of autism

• no babbling or pointing by age 1
• no single words by 16 months or two-word phrases
  by age 2
• no response to name
• loss of language or social skills
• poor eye contact
• excessive lining up of toys or objects
• no smiling or social responsiveness.

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characteristic findings

• repetitive movement such as rocking or twirling
• self abusive behaviors biting, head banging
• communication delays
• sing/song verbalizations

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Latent signs of autism

• impaired ability to establish friends with peers
• impaired ability to initiate or sustain a
  conversation with others
• absence or impairment of imaginative and social
  play
• stereotyped, repetitive, or unusual use of
  language
• restricted patterns of interest that are abnormal
  in intensity or focus
• preoccupation with certain objects or subjects
• inflexible adherence to specific routines or
  rituals.

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common related concuring syndromes

• fragile X syndrome
• tubularsclerosis
• Turets syndrome
• seizure disorders new or latent onset
• learning disabilities
• ADD

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testing should be multidisciplinary in format and
include

• psychologist
• psychiatrist evaluation
• Neurologist
• speech and language evaluation
• hearing screening
• cognitive testing
• Physical therapist evaluation

Child Study Team Evaluation
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treatment

• Behavioral Assessment
• Behavioral Intervention Plan/Tool
• Social skills classes
• Speech and Language intervention
• Structured Environment
• one one therapy with psychologist/ psychiatrist
• IEP Individualized Educational Plan ( school )
• Medications for coexisting diagnosis

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nursing care of the autistic child

• Follow Behavioral plan
• Approach child slowly
• Allow child time to get to know you and establish
  a rapport with child
• Encourage eye contact ( eyes on me, cup child's
  chin and encourage eye contact)
• Praise child for positive social interactions
• Awareness of speech processing delays and
  communication variables
• Maintain routines and structure ( autistic
  children do not respond well to changes)
• Be aware of Autistic sensory issues, avoid loud
  noises, tactile defensiveness smell and taste
  aversions. introduce new things slowly to the
  child.

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Communcation 101just because its not spoken
doesnt mean its not there.......it is essential
that we recognize the non verbal and us
alternative methods to foster the unspoken
voice

• non verbal cues to include eye gaze , lips facial
  expression, head nodding, and body language
• Alphabet boards
• Picture board
• computer Enhanced technological communication
  devices ( switches, pc programs)

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communication 102

• a non verbal child is not dumbintelligence is
  not measured of words
• Autistic children can be highly intelligent with
  high IQ function
• Standardized testing isnt standard with a child
  in the Autistic Spectrum and not always a true
  measure of his/ her ability verses disabilities.
• Autism is out of the box
• Verbal expression of the care giver/ skilled
  nurse should always respect the child's and
  families feelings.
• Children although non verbal may possess a higher
  level of understanding and interpretation of our
  verbal expression. The child maybe staring or
  appear non engaged and at the same time be
  internalizing his environment quietly within his
  world .

The Autistic Child Spins inside himself self as
our world rotates around him... Our galaxy may
only be a small universe in histmb
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Sensory integration Dysfunction

• The Care giver/ nurse must be aware that Children
  with Autism present with Sensory issues
• Their neurological system functions differently
  in interpreting the world around them.
• Hypersensitivity and Hyposensitivity to external
  stimuli can cause great discomfort and behavioral
  issues
• Loud noises, large environments, thermoregulation
  hot/cold intolerances,tastes, smells ect.
  Environmental input can be overwhelming to them.
• Communication impairment can impede their ability
  to tell us what is wrong or bothering them. A non
  verbal child may pull away from stimuli, cover
  their ears or retreat into them selfs when over
  stimulated.
• Retrospect-fully the child may crave neurological
  input and stim off the environment as well.
• Occupational therapist can work with the child to
  increase tolerance to environmental Factor as
  well as offer deep pressure activities to sooth
  the child. A technique involved may include
  brushing, deep pressure, texture tolerance
  exercises ect.
• some sensory issues can be outgrown or the child
  may mature to a point of higher tolerance to the
  environmental stimuli that irritate or stimulate
  him.

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Sensory Integration
Learning to tolerate the environment can be over
whelming
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Autism Awarenessmaking a differenceEducation
opens doors , changes perceptions and cans change
lives......

• Awareness
• Understanding
• Tolerance
• Intervention
• Support
• Make a Difference

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Educational terms

• Acronyms and terms used in association with
  autism treatment

Acronym What It Stands For ABA Applied Behavioral
Analysis AS Asperger Syndrome ASD Autism Spectrum
Disorder BIP Behavior Intervention
Plan BMP Behavior Management Plan ESY Extended
School Year FAPE Free and Appropriate Public
Education FERPA Family Educational Rights and
Privacy Act IDEA Individuals with Disabilities
Education Act IEP Individualized Education
Program IFSP Individualized Family Service
Plan IPP Individual Program Plan ISP Individual
Service Plan LRE Least Restrictive
Environment NT Neurotypical