Autism Spectrum Disorder

1
Autism Spectrum Disorder

• Ricci, pp. 1900-1901

2
Incidence and Types

• Usually manifests in infancy or early childhood
  as developmental delays or regression
• No relation to socioeconomic level or parenting
  style
• Ranges from mild to severe types autism,
  Aspergers, pervasive development disorder, Rett
  syndrome, disintegrative

3
Etiology

• Genetic disorder of brain development most likely
• Viruses or toxic chemicals have been speculated
• Autosomal recessive pattern
• No evidence of link to thimerosal-containing
  vaccines

4
Manifestations

• Abnormal EEG
• Seizures
• Delayed development of hand dominance
• Persistence of primitive reflexes
• Limited language acquisition
• Losing language and social skills
• Elevated serum serotonin levels
• Brain hypoplasia
• Large head, large ears

5
Manifestations

• Indifference to touch and affection
• Shows unusual attachments to objects
• Overly sensitive to light, touch, sound, hearing,
  smell, taste
• Performs repeated body movements
• Language delays or regression
• Nonsense rhyming or word repetition
• Communicates with gestures
• Cannot start or maintain conversation

6
Manifestations

• Behavioral outbursts, preoccupation
• Head banging, hand biting
• Limited pretend play
• GI/nutritional issuesconstipation, willful
  starvation, gagging, mouthing objects, eating
  non-edibles, smelling and throwing food
• Screening for manifestations are main way of
  diagnosing (see Box 42-8, p. 1200)

7
Nursing Management

• Highly structured behavior modification with
  routines, consistency, and positive reinforcement
• Increase social awareness of others
• Teach verbal communication skills
• Decrease unacceptable behaviors

8
Pharmacologic Therapy

• Meds to decrease irritability, aggression,
  anxiety, mood swings, hyperactivity
• Risperidol
• SSRIs
• Divalproex
• Ritalin

9
Hospitalized Autistic Child

• Parents present
• Encourage parents to bring in favorite
  possessions
• Limit physical contact when possible
• Private room with low stimulation

10
Parental Support

• Feel guilt and shameneed counseling and support
• Encourage parents to care for child in home with
  family support, if possible. If not, then
  institutional care
• Early intervention/IEP for public school
• Refer to mental health facilities and facilities
  for developmental disabilities
• Refer to Autism Society of America
  www.autism-society.org

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Owen SuskindAutism Story on ttbook.org