Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulties with social interaction and communication, and by restrictive and repetitive behavior. It is caused by differences in the brain and is diagnosed through assessments of social skills and development. While there is no cure, early diagnosis and treatment including behavioral therapies and social skills training can help children with ASD develop skills and improve functioning.

2. INTRODUCTION
Autism, or autism spectrum
disorder, refers to a range of
conditions characterized by
challenges with social skills,
repetitive behaviors, speech and
nonverbal communication, as well
as by unique strengths and
differences.

3. Definition
Autism is a complex neurobehavioral condition that
includes impairments in social interaction and
developmental language and communication skills
combined with rigid, repetitive behaviors. Because of
the range of symptoms, this condition is now
called autism spectrum disorder (ASD).
Autism the condition is the result of a neurological
disorder that has an effect on normal brain function,
affecting development of the person's communication
and social interaction skills.

4. EPIDEMIOLOGYIN WORLD
 Every 20 minutes, a child is diagnosed
 Autism affects four times as many boys as girls
 An estimated 50,000 children and 150,000 adults in Canada
have autism
 The diagnosis rate in North America is currently 1 in 88
children.
IN INDIA
 Over 18 million people with autism
 1 in 68 have autism spectrum disease.
 The third most common developmental disorder
Autism Resource Centre in Tamil Nadu reports ~ 1 in 150
children affected

5. Cause
 inherited genetically
 result of environmental toxins (heavy metals,
chemicals, pesticides, viruses)
 Neurological Implications
MRI studies have suggested - rapid overgrowth in the
first year and minimal growth after age 2 until approx.
age 4 and lack of overgrowth
Frontal Cortex - rapid overgrowth until age 4
(cognitive language functions, social-emotional
processing)
Visual cortex - relatively intact.

6. Cause
There are several theories. Researchers are
exploring various explanations but, to
date, no definitive answers or specific
causes have been found. Current research
studies say it may be inherited genetically.
May also be a result of environmental
toxins (heavy metals, chemicals,
pesticides, viruses)

7. Possible signs of autism in babies and
toddlers:
 By 6 months, no social smiles or other warm, joyful
expressions directed at people
 By 6 months, limited or no eye contact
 By 9 months, no sharing of vocal sounds, smiles or other
nonverbal communication
 By 12 months, no babbling
 By 12 months, no use of gestures to communicate (e.g.
pointing, reaching, waving etc.)
 By 12 months, no response to name when called
 By 16 months, no words
 By 24 months, no meaningful, two-word phrases
 Any loss of any previously acquired speech, babbling or
social skills

8. Possible signs of autism at any age:
 Avoids eye contact and prefers to be alone
 Struggles with understanding other people’s feelings
 Remains nonverbal or has delayed language development
 Repeats words or phrases over and over (echolalia)
 Gets upset by minor changes in routine or surroundings
 Has highly restricted interests
 Performs repetitive behaviors such as flapping, rocking or
spinning
 Has unusual and often intense reactions to sounds, smells,
tastes, textures, lights and/or colors

9. well-baby or well-child visit, your child’s doctor should perform a
“developmental screening,” asking specific questions about your
baby’s progress. The National Institute of Child Health and Human
Development(NICHD) lists five behaviors that warrant further
evaluation:
Does not babble or coo by 12 months
Does not gesture (point, wave, grasp) by 12 months
Does not say single words by 16 months
Does not say two-word phrases on his or her own by 24 months
Has any loss of any language or social skill at any age
Any of these five “red flags” does not mean your child has autism.
But because the disorder’s symptoms vary so widely, a child
showing these behaviors should be evaluated by a
multidisciplinary team. This team might include a neurologist,
psychologist, developmental pediatrician, speech/language therapist,
learning consultant or other professionals who are knowledgeable
about autism.

11. Diagnosing an ASD takes two steps:
1. Developmental Screening
2. Comprehensive Diagnostic Evaluation
Developmental Screening:
i)All children should be screened for developmental delays
and disabilities during regular well-child doctor visits at:
 9 months
 18 months
 24 or 30 months
 Additional screening might be needed if a child is at high
risk for developmental problems due to preterm birth, low
birth weight or other reason

12. Contd.,..
ii)In addition, all children should be screened
specifically for ASD during regular well-child doctor
visits at:
 18 months
 24 months
 Additional screening might be needed if a child is at
high risk for ASD (e.g., having a sister, brother or other
family member with an ASD) or if behaviors
sometimes associated with ASD are present

13. 2.Comprehensive Diagnostic
Evaluation
 Developmental Pediatricians (doctors who have
special training in child development and children
with special needs)
 Child Neurologists (doctors who work on the brain,
spine, and nerves)
 Child Psychologists or Psychiatrists (doctors who
know about the human mind)

14. Risk factors Your child's sex.
 Family history.
 Other disorders. (fragile X syndrome, an
inherited disorder that causes intellectual
problems; tuberous sclerosis, a condition in
which benign tumors develop in the brain; and
Rett syndrome, a genetic condition occurring
almost exclusively in girls, which causes slowing
of head growth, intellectual disability)
 Extremely preterm babies. Babies born before 26
weeks of gestation may have a greater risk of
autism spectrum disorder.
 Parents' ages. There may be a connection between
children born to older parents and autism
spectrum disorder.

15. Complications
Problems with social interactions,
communication and behavior can lead
to:
Problems in school and with successful
learning
Employment problems
Inability to live independently
Social isolation
Stress within the family
Victimization and being bullied

18. PSYCHO PHARMACO-THERAPY
Hyperactive behaviour
Ritalin and Concerta
Anxiety and obsessional behaviour
Selective serotonin re-uptake inhibitors (SSRIs) can
help reduce anxiety
Tics antipsychotics and noradrenergic agents like
clonidine
Trouble sleeping Melatonin maintains your
circadian rhythm, which is your internal 24-hour clock
Seizures :- effectively with anti-epilepsy medication.

20. Behavioral Therapies
 APPLIED BEHAVIOR ANALYSIS (ABA):- teaches play,
communication, self-care, academic and social living skills,
and reduces problematic behavior
 VERBAL BEHAVIOR THERAPY (VBT) :- VBT seeks to
move children beyond labeling, a first step of learning
language, and gesturing to vocalizing their requests – “I
want a cookie.”
 COGNITIVE BEHAVIORAL THERAPY (CBT) :-
focus more on developing skills a child already has and
working on their deficiencies
 DEVELOPMENTAL AND INDIVIDUAL DIFFERENCES
RELATIONSHIP (DIR) therapy (also called Floortime)
motivation to engage and interact with others. The
therapist follows a child’s lead in working on new skills.

21. Contd.,..
 RELATIONSHIP DEVELOPMENT INTERVENTION
(RDI):- RDI breaks its various objectives down into
step-by-step paths adults use to prompt development,
such as building eye contact or back-and-forth
communication.
 TREATMENT AND EDUCATION OF AUTISTIC AND
RELATED COMMUNICATION HANDICAPPED
CHILDREN:- is a classroom-based program that
customizes academic instruction and social development
to a child’s strengths.
 SOCIAL SKILLS GROUPS:- help children engage in
pragmatic language and manage real-world difficulties
with peers

22. Various other therapies
Music Therapy
Auditory Therapy
Vitamin/Mineral Therapy
Holding Therapy
Daily Life Therapy
Picture Exchange Communication System (PECS)
Speech –Language Therapy
Occupational Therapy
Swimming Therapy
Animal Therapy

23. Autism is still not recognized as a
separate form of disability in the
Persons with Disabilities (Equal
Opportunities, Protection of Rights
and Full Participation) Act, 1995, the
primary piece of legislation that
provides for the rights of and
benefits for persons with disabilities
in India.

24. Prevention
 No way to prevent autism spectrum
disorder, but there are treatment
options. Early diagnosis and
intervention is most helpful and can
improve behavior, skills and language
development. However, intervention is
helpful at any age. Though children
usually don't outgrow autism spectrum
disorder symptoms, they may learn to
function well.

25. savant syndrome
 Children who display savant syndrome have
traditionally been referred to as idiot,
retarded, or autistic savants. The negative
connotations of the term "idiot" have led to
the disuse of idiot savant. Because the
syndrome is often associated with autism, the
term autistic savant is more frequently heard.
The first known description of a person
displaying savant syndrome occurred in
a German psychology journal in 1751. The term
savant was first used in 1887 by J. Langdon
Down

26. Definition
Savant syndrome is exceedingly rare, but
a remarkable condition in which persons with
autism, or other serious mental handicaps, or
major mental illness, have astonishing islands
of ability or brilliance that stand out in
stark contrast to their overall disability.
Savant syndrome occurs when a person with
below normal intelligence displays a special
talent or ability in a specific area.

27. symptoms
have an exceptional talent or skill in a
particular area, such as the ability to
process mathematic calcalculations at a
phenomenal speed
music, visual art common skill
demonstrated by savants is extraordinary
memory.
Children with savant syndrome may be able
to memorize extensive amounts of data in
such areas as sports statistics, population
figures, and historical or biographical data.

28. Diagnosis
Savant syndrome is diagnosed when a
child's ability in one area is exceptionally
higher than would be expected given his or
her IQ or general level of functioning.
Treatment
making use of the special talent of the
child with savant syndrome may help treat
the child's underlying developmental
disorders.

29. Nursing interventions
Engage the child in therapeutic alliance begining with
non-verbal play
Provide individualized care
Meet the basic needs –the child unable to express
Teach the child self- care activities
Motivate the child to express it needs
Encourage to vocalize with sound ,games and songs.
Identify desired behaviour and reward it.
Motivate the child express or communicate his needs.

30. Contd.,..
Facilitate super ego development by role modeling
Provide language training
Demonstrate communication &social skills
Foster ego development by reinforcing self
identity ego boundaries through drawing, stories
and play activities.
Teach the patient about disease and prognosis
Teach the parent how to facilitate speech
development in order to continue behavior
modification.