Autism is a complex developmental disability that impacts communication and social skills. It is defined by challenges with social interaction, communication, and repetitive behaviors. There are several types of autism which can range from mild to severe. While the exact causes of autism are unknown, it is generally thought to involve abnormalities in brain development and genetics. Autism is diagnosed through observation and evaluation by a team of professionals. Characteristics include difficulties with social interaction, communication delays or lack of language, repetitive behaviors, and sensitivity to sensory stimuli. Treatment focuses on individualized early intervention, social skills training, positive behavior support, and in some cases medication management of associated symptoms. Caring for autistic children requires a structured and predictable environment with visual schedules

1. Autism
Prepared by
Raveen Isamel Abdullah
B.CS.in Nursing
Hawler medical university
College of nursing
2016-2017

2. Overview
What is Autism?
Is there more than one type of Autism?
What causes Autism?
How is Autism diagnosed?
What are the characteristics of Autism?
What are the most effective approaches to treating
Autism?
Tips in caring for autistic children
Medical managment

3. WHAT IS AUTISM?
Very complex, often confusion
developmental disability
First described by Leo Kanner
in 1943 as early infantile autism
“Auto” – children are “locked
within themselves.”
For next 30 years, considered
to be an emotional disturbance

4. WHAT IS AUTISM?
Today, autism is a severe form of a
broader group of disorders
These are referred to as pervasive
developmental disorders delays in
the development of multiple basic
functions including socialization and
communication(later)
Typically appears during the first 3
years of life

5. WHAT IS AUTISM?
Prevalence is 2-6/1000 individuals (1/2
to 1 ½ million affected)
4 times more prevalent in boys
No known racial, ethnic, or social
boundaries
No relation to family income, lifestyle

6. WHAT IS AUTISM?
Autism impacts normal development of
the brain in areas of social
interaction and communication
skills.
Difficult to communicate with others and
relate to the outside world.
Occasionally, aggressive and/or self-
injurious behavior may be present.

7. WHAT IS AUTISM?
May exhibit repeated body
movements (hand flapping, rocking).
Unusual responses to people
Attachment to objects
Resistance to change in routine
Sensory sensitivities

8. WHAT ARE THE TYPES?
Actually, the “umbrella” heading is
Pervasive Developmental
Disorder (PDD).
Differ in terms of severity

9. 1. Autistic Disorder
Impairments in social interaction,
communication, and imaginative
play.
Apparent before age 3.
Also includes stereotyped behavior
(sphysical movements that are both
aimless and repetitive), interests, and
activities

10. 2. Asperger’s Disorder
Impairments in social interactions, and
presence of restricted interests and
activities
No clinically significant general delay in
language
Average to above average intelligence

11. 3. Pervasive Developmental
Disorder – Not Otherwise Specified
Often referred to as atypical autism
Used when a child does not meet the
criteria for a specific diagnosis, but
there is severe and pervasive
impairment in specified behaviors

12. 4. Rett’s Disorder
Progressive disorder which, to date,
has only occurred in girls.
Period of normal development and then
the loss of previously acquired skills
Also loss of purposeful use of hands,
which is replaced by repetitive hand
movements
Beginning at age of 1-4 years

13. 5. Childhood Disintegrative
Disorder
Normal development for at least the first
2 years
Then significant loss of previously
acquired skills

14. Conclusions on Types
Autism is a spectrum disorder
This means that symptoms and
characteristics can present themselves in
wide variety of combinations, from mild to
severe
Autistic individuals can be very different from
each other

15. What causes (and doesn’t
cause) autism?
Good agreement in general that autism
is caused by abnormalities in brain
development, neurochemistry, and
genetic factors

16. How is Autism Diagnosed?
No definitive medical test
Team uses interviews, observation, and
specific checklists developed for this purpose.
Team might include neurologist, psychologist,
developmental pediatrician, speech/language
therapist, learning consultant, etc.
Must rule out MR, hearing impairment,
behavior disorders, or eccentric habits

17. CHARACTERISTICS
1. Communication/Language
2. Social Interaction
3. Behaviors
4. Sensory and movement disorders
5. Resistance to change (predictability)
6. Intellectual functioning

18. 1. Communication/language
Broad range of abilities, from no verbal
communication to quite complex skills
Two common impairments:
A. Delayed language
B. Echolalia

19. Elements of Facilitated
Communication
1. Physical Support
2. Initial training/introduction
3. Maintaining focus
4. Avoiding competence testing
5. Generalization
6. Fading

20. A. Delayed language
50% of autistic individuals will eventually
have useful speech
Pronoun reversal: “You want white icing
on chocolate cake.”
Difficulty in conversing easily with others
Difficulty in shifting topics
Look away; poor eye contact

21. B. Echolalia
Meaningless repetition of another
persons spoken words
Common in very young children (Age 3)
Immediate or delayed (even years)

22. 2. Social Interaction
One of hallmarks of autism is lack of
social interaction
1. Impaired use of nonverbal behavior
2. Lack of peer relationships
3. Failure to spontaneously share
enjoyment, interests, etc. with others
4. Lack of Exchange

23. 3. Behaviors
Repetitive behaviors, including
obsessions, tics, and perseveration
Impeding behaviors (impede their
learning or the learning of others)
Will need positive behavior supports
A. Self-injurious behavior
B. Aggression

24. 4. Sensory and movement
disorders
Very common
Over- or under-sensitive to sensory stimuli
Abnormal posture and movements of the
face, head, trunk, and limbs
Abnormal eye movements
Repeated gestures and mannerisms
Movement disorders can be detected very
early – perhaps at birth

25. 5. Predictability
Change in routine is very stressful
May insist on particular furniture
arrangement, food at meals, TV shows
Symmetry is often important
Interventions need to focus on
preparing students for change if
possible

26. 6. Intellectual functioning
Autism occurs in children of all levels of
intelligence, from those who are gifted
to those who have mental retardation
In general, majority of individuals with
autism are also identified as having
mental retardation – 75% below 70
Verbal and reasoning skills are difficult

27. Tips in Caring for Autistic Children
1. Secure a non-stimulating environment
During physical examination to pediatric patients with
autism, place them in a quiet room.
Preferably, there should be no medical equipments
inside so that there are less distractions for them.
Dim the lights and regulate room temperature to
promote a relaxing environment.

28. 2. Talk with the child’s parents first
Before approaching the patient, talk with the child’s
parents first to get a baseline expectation on how the
patient would react to you.
Ask the parent about the child’s past medical history,
activities that help sooth him and the best way of
communication fit for him.
Let the child observe as you talk with the parent to
initially establish trust with the patient.

29. 3. Doing physical assessment away from the
child but progressively moving centrally
Starting first with visual inspection.
As the child shows cooperation, move forward with
hands and feet. Then continue doing assessment by
progressively moving centrally until you can assess
the child’s body or trunk.
Autistic children get easily stressed by sudden
intimate touch so you need to have a tailored
approach in doing physical assessment to them.

30. 4. If you need to use medical
equipment, use them on the
child’s parent first
Autistic children get easily stressed with
new or unfamiliar objects.
If you need to use medical equipment,
let the patient see that you are using it
on someone else he trusts. With this
strategy, the patient will expect that the
medical equipment will also be used to
him and you can get his cooperation.

31. 5. Lower yourself to the child’s
height level when providing care
Sit down with the child or lower down
your posture as you provide nursing
care to the child.
Autistic children cooperate best with
people in the same level of their visual
perspective.
Looking up or down to them may initiate
trust issues with them.

32. 6. Be gentle and consistent with
your actions and behavior around
the child
Autistic children have a strong need for
sameness and routines.
Anything inconsistent with the first
actions or behaviors they observed
from you may cause stress and
tantrums.

33. 7. As much as possible, limit the
healthcare workers caring for the
child
The nurses who cared for the child
during the first day of hospitalization
should be the ones continuously
assigned to the patient.

34. 8. Stick to a schedule
Autistic children work best with
structured routines or schedules.
Create a schedule when planning
nursing care for the patient.
If there will be an unavoidable
schedule change like adjustments in
medication administration, discuss it
with the patient first.

35. 9. Reward good behaviors
Positive reinforcement means a lot to
autistic children as they will be inspired
to become more cooperative as well.
Praise or reward them with a simple
sticker with every good behavior they
display.
They will also like the good attention
being given to them so they will trust
you more.

36. 10. Make the child’s parents part of
your nursing care
The child’s parents are the usual
companions of children with autism so
they know the best approach in getting
their child’s attention and cooperation.
Involve them in nursing care so they will
also learn new strategies in caring for
the health of their child.

37. Interventions
1. Individualization and early
intervention are the keys
2. Include life skills, functional
academics, and vocational preparation
3. Positive behavior support
4. Social stories (music therapy)

38. Medical Management
1. Prescription of anti-psychotic drugs, anxiolytics
and anticonvulsant drugs.
2. The medical management mostly involves
management of the symptoms as well as repetitive
behavior that may harm the child.
3. Diet modification must also be stressed since
these children must have some kind of special diet
that will fit to their lifestyle. Changing the diet or
adding vitamin supplements may improve digestion
and eliminate food intolerances or allergies, which
may contribute to behavioral problems in autistic
patients.

39. 4. The physician must provide many information
about the special needs of the child and the available
resources for the family to get in the community.
5. Proper follow-up on psychiatrists and child
developmental specialists must be done routinely in
order to prevent untoward physical and mental
disabilities. Children with autism may have medical
problems, mostly cardiac problems that must also be
addressed equally during the course of care.

40. With early intervention and
appropriate treatment, some
autistic patients can function
productively and attain some
degree of independence. Most
patients require lifelong
assistance

41. Thanks