AutismTammy Marie Baker RN Pediatric Series March 1st 2012
What is autism Autism Spectrum DisordersA Complex group of Neuro developmentaldisorders characterized by:Social impairmentscommunication difﬁcultiesrepetitive behaviorspatterned behaviors
The spectrumAutism ( more sever form )Aspergers ( higher functioning)Child disintegrative disordersPervasive Developmental Disorders
Causes and theoriesEnvironmentalsgenetics variancesvariants 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; Thebodys inability to properly use vitamins and minerals ( these are not proven)
Statistical ratio’ of autism 6 out of every 1000 children will be affected Boys are 4 times more likely to be affected than girls.
most common signs of autismlack of social engagementﬁxation on objectspatterned behaviorsavoid eye contactunresponsive to namedisengaged or intently focused on somethingcant interpret social cues from othersparallel play verses interactive
early signs of autismno babbling or pointing by age 1•no single words by 16 months or two-wordphrases by age 2•no response to name•loss of language or social skills•poor eye contact•excessive lining up of toys or objects
characteristic ﬁndings:repetitive movement such as rocking ortwirlingself abusive behaviors biting, head bangingcommunication delayssing/song verbalizations
Latent signs of autismimpaired ability to establish friends with peers•impaired ability to initiate or sustain a conversation withothers•absence or impairment of imaginative and social play•stereotyped, repetitive, or unusual use of language•restricted patterns of interest that are abnormal in intensityor focus•preoccupation with certain objects or subjects
common related concuring syndromesfragile X syndrometubularsclerosisTurets syndromeseizure disorders new or latent onsetlearning disabilitiesADD
testing should be multidisciplinary in format and include: psychologist psychiatrist evaluation Neurologist speech and language evaluation hearing screening cognitive testing Child Study Team Physical therapist evaluation Evaluation
treatmentBehavioral AssessmentBehavioral Intervention Plan/ToolSocial skills classesSpeech and Language interventionStructured Environmentone one therapy with psychologist/ psychiatristIEP Individualized Educational Plan ( school )Medications for coexisting diagnosis
nursing care of the autistic childFollow Behavioral planApproach child slowlyAllow child time to get to know you and establish a rapport with childEncourage eye contact ( eyes on me, cup childs chin and encourage eye contact)Praise child for positive social interactionsAwareness of speech processing delays and communication variablesMaintain routines and structure ( autistic children do not respond well to changes)Be aware of Autistic sensory issues, avoid loud noises, tactile defensiveness; smelland taste aversions. introduce new things slowly to the child.
Communcation 101 just because its not spoken doesn’t 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)
communication 102 a non verbal child is not “dumb”intelligence is not measured of words Autistic children can be highly intelligent with high IQ function Standardized testing isn’t 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 childs 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 “The Autistic Child Spins inside himself self as our world .world rotates around him... Our galaxy may only be a small universe in his” tmb
Sensory integration DysfunctionThe Care giver/ nurse must be aware that Children with Autism present with Sensory issuesTheir neurological system functions differently in interpreting the world around them.Hypersensitivity and Hyposensitivity to external stimuli can cause great discomfort and behavioral issuesLoud noises, large environments, thermoregulation hot/cold intolerances,tastes, smells ect. Environmentalinput can be overwhelming to them.Communication impairment can impede their ability to tell us what is wrong or bothering them. A non verbalchild 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 offerdeep 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 theenvironmental stimuli that irritate or stimulate him.
Sensory IntegrationLearning to tolerate the environment can be over whelming
Autism Awarenessmaking a difference Education opens doors , changes perceptions and cans change lives...... Awareness Understanding Tolerance Intervention Support Make a Difference
Educational terms Acronym What It Stands For ABA Applied Behavioral Analysis AS Asperger Syndrome ASD Autism Spectrum Disorder BIP Behavior Intervention Plan BMP Behavior Management Plan ESYAcronyms and terms used in association with Extended School Year FAPE Free and Appropriate Public Education FERPAautism treatment 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