Prepared by: Kshirabdhi Tanaya Tutor, SUM Nursing College S‘O’A Deemed to be University

5. INTRODUCTION
 Autism spectrum disorder(ASD) is previously
known as pervasive developmental disorder
that affects communication(social)and
behaviour (restrictive)
 Autism is known as a “spectrum” disorder
because there is wide variation in the type and
severity of symptoms people experience.
 ASD occurs in all ethnic,racial and economic
groups..
 ASD can be a life long disorder ; treatments and
services can improve person’s symptoms and
ability to function.

11. AUTISM
Definition :-
It is defined by the presence of abnormal & or
impaired development that is manifest before
the age of 3 years, characterized by
abnormalities of social development,
communication and a restriction of behaviour &
interest.

12. PREVALENCE:-
Prevalence is 2-6 /1000 individuals (1/2 to
1 and half million affected)
4 times more prevalent in boys than girls.
No known racial, ethnic or social
boundaries.

13. ETILOGY:-
1-Genetic factors-
More in monozygotic twins than dizygotic
twins
Siblings of autistic children shows a
prevalence of autistic disorder of 2%.

14. 2-Medical factors:-
Post natal neurological infections(meningitis,encephalitis),congenital
rubella,cytomegalovirus, phenylketonuria(birth defect due to decrease
metabolism of aminoacid phenylalanine).
Untreated phenylketonuria can lead to brain damage, intellectual
disabilities, behavioural symptoms or seizures.
3-Perinatal factors:-
Maternal bleeding after 1st trimester & meconium in amniotic fluid.
4-Parenting influence & social environmental factors:-
Parental rejection.
Family break up
Family stress
Faulty communication patterns

15. 5-Biochemical factors:-
1/3rd of patients with autistic disorder have
elevated plasma serotonin.
6-Neuroanatomical studies:-
Enlargement of lateral ventricles and cerebellar
degeneration.
7-Theory of mind:-
Children with autistic disorder are sometimes said
to be ‘mind blind’.In that they lack the ability to
put themselves in the place of another person.

16. CLINICAL FEATURES:-
1-social interaction:-
•Inability to make warm relationship with
people.
•Children do not respond to their parents
affectionate behaviour.(Autistic aloofness)
•Smile and look at others less often,& respond
less to their own name.
•They tend to their own things regardless of
who is around or what is happening in the
environment.

17. • Poor use of social signals & weak integration of
social,emotional & communicative behaviour.
• failure to make eye to eye contact with people.
•Dislikes being touched or kissed.
•No separation anxiety on being left in an
unfamiliar environment with stranger.
•Anger or fear without apparent reason
&absence of fear in the presence of danger.

18. 2-Impairmentincommunication:-
•Failureto developnormal speech,failure to communicateby
gestures,bodymovements or facialexpressions.
•Lackofsocialusageofwhateverlanguageskillsarepresent.
•Delayedonsetofbabbling,unusualgestures.
•Diminishedresponsiveness&vocalpatternsthatarenot
synchronizedwiththecaregivers.
•Lesslikelytomakerequestsorshareexperiences.
•Impairmentinsocialimitativeplay.

19. 3-Activities:-
•Restricted repetitive & stereotyped pattern of
behaviour.(ex-hand flipping or twisting,head
banging)
•Fixated interests or obsessive attachment to
unusual objects (rubber bands, keys, light
switches)
•Gets very upset by minor changes in routine.
•Difficulty in generalizing newly learned skills to
new situations.

22. Other features:-
More than half of autistic children have moderate to
profound mental retardation.
Over –responsive or under-responsive to sensory
stimuli.
Other behavioural problems like temper tantrum , self
injurious behavior ,head banging ,biting , hair pulling are
common.
IDIOT SAVANT SYNDROME-inspite of
pervasive(abnormalities in social &communication
interaction)or abnormal development of functions
,certain functions may remain normal.eg-calculating
ability, musical abilities etc

23. Diagnostic tests:-
Routine developmental exams
Language milestones
Hearing evaluation
Blood test
Screening test for autism (checklist for
autism in toddlers i.e. CHAT)
Genetic testing
Complete physical examination
Neurological examination

25. COURSE AND PROGNOSIS:-
•About 10-20% autistic children begin to
improve between 4 -6 years of age &
eventually attend on ordinary school &obtain
work.
•10-20% can live at home ,but need to attend
a special school or training center.
•60% improve little & are unable to lead an
independent life.

26. Treatment:-
1-BEHAVIOUR THERAPY-
•Development of regular routine
•Structured class room training.
•Positive reinforcement to teach self care skills.
•Speech therapy or sign language teaching.
•Relationship development intervention
•Story boarding
2-counseling & supportive therapy:-
The family of an autistic child needs
considerable help to cope with the child’s
behaviour.

29. Other therapies:-
•Speech therapy
•Occupational/physical therapy
•Auditory integration therapy(AIT)
•Vocational therapy

32. Nursing diagnosis:-
Risk for self mutilation related to neurological alteration ;history of self
mutilative behaviours;hysterical reactions to changes in the environment
as evidenced by head banging,hand flicking.
Goal:-client will not harm to self.
Nursing interventions:-
•Work with the child on a one to one basis.
•Try to determine if the self mutilative behaviour occurs in response to
increasing anxiety.
•Try to intervene with diversion or replacement activities.
•Protect the child when self mutilative behaviours occur.

33. Nursing diagnosis:-
Impaired social interaction related to inability to trust;neurological
alterations as evidenced by lack of responsiveness or interest in people.
Goal:-client will demonstrate trust in one caregiver within specified time.
Nursing intervention:-
Nursing interventions:-
•Assign a limited number of caregivers to the child .Ensure that warmth
,acceptance ,and availability are conveyed.
•Provide child with familiar objects such as familiar toys
•Give positive reinforcement for eye contact with something acceptable to
the child (food, familiar object).Gradually replace with social
reinforcement.

34. Nursing diagnosis:-
Impaired verbal communication related to withdrawal into the self
;neurological alterations as evidenced by inability or unwillingness to
speak; lack of nonverbal expression.
Goal:-client will establish a means of communicating needs and desires
to others.
Nursing interventions:-
•Maintain consistency in assignment of caregivers.
•Anticipate and fulfill the child’s needs until communication can be
established.
•Seek clarification and validation.
•Give positive reinforcement when eye contact is used to convey
nonverbal expressions.

35. Nursing diagnosis:-
Disturbed personal identity related to neurological alterations; delayed
developmental stage as evidenced by difficulty separating own
physiological and emotional needs and personal boundaries from those
of others.
Goal:-client will name own body parts as separate and individual from
those of others.
Nursing interventions:-
•Assist child to recognize separateness during self care activities such
as dressing and feeding.
•Assist the child in learning to name own body parts. This can be
facilitated by the use of mirrors, drawings and pictures of the child.
•Encourage appropriate touching of and being touched by others.

36. THANK YOU