Autism rates are increasing in Minnesota and nationally. In Minnesota, approximately 2.7% of children have autism, with similar rates between Somali and white children. Research has not identified clear causes of autism, though genetics and environmental factors like nutrition are thought to play a role. Nurse interventions focus on early identification, individualized care, and advocacy to reduce stigma and restraints in care environments.
Bernadette Madrid, University of the Philippines, Director of the Child Protection Unit, Philippines - Parenting support in the context of violence prevention, Expert Consultation on Family and Parenting Support, UNICEF Office of Research – Innocenti Florence 26-27 May 2014
Bernadette Madrid, University of the Philippines, Director of the Child Protection Unit, Philippines - Parenting support in the context of violence prevention, Expert Consultation on Family and Parenting Support, UNICEF Office of Research – Innocenti Florence 26-27 May 2014
Lorraine Sherr, Professor, University College London– Parenting support in the context of HIV, Expert Consultation on Family and Parenting Support, UNICEF Office of Research – Innocenti Florence 26-27 May 2014
Maternal Alcohol Use Disorder and Risk of Child Contact with the Justice Syst...BARRY STANLEY 2 fasd
These finding were actually first described in - Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome [FAS] and Fetal Alcohol Effects [FAE] - Final Report, August 1996: Ann P Streissguth et.al. Often ignored, but never refuted.
Perhaps the most important point of this 20 year old report was that early diagnosis was a major contributing factor in reducing subsequent involvement with the justice system.
I was disappointed, but not surprised, that this paper did not mention the importance of an early diagnosis.
Barry Stanley
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Maternal Mental Health What All Employers Should Know Joy Burkhard
This webinar was presented on 5-4-2017 to employers and business groups on health, with the support of the Zoma foundation. One in 5 women will experience a maternal mental health disorder like postpartum depression yet most are never diagnosed or treated. Learn what both these groups can do to move the needle in addressing mental health and wellbeing of new mothers and families.
Transforming Care: Share and Learn Webinar – 29 March 2018NHS England
Topic One: "The ERIN Initiative"
Guest speakers: Susan Holloway, NHS Chorley & South Ribble CCG and NHS Greater Preston CCG and Sheila Roberts, Lancashire Care NHS Foundation Trust
The aim of "The ERIN (Education, Resources, Interventions and Networking) Initiative" is to provide a local, accessible, responsive, early assessment and intervention service for children aged 0-5 years who may be placed on the pre-school Autism Spectrum Disorder (ASD) pathway.
This webinar reports on the progress made during a pilot which commenced on 1st October 2017 to implement a service which deals with complex/challenging behaviors of children who may or may not go on to have a diagnosis with autism.
Topic Two: An introduction and brief overview of the Source4Networks platform
Session led by Rob Cockburn, Sustainable Improvement Team, NHS England
This topic provides an introduction and brief overview of the Source4Networks platform and its potential to support the Transforming Care Programme.
Lorraine Sherr, Professor, University College London– Parenting support in the context of HIV, Expert Consultation on Family and Parenting Support, UNICEF Office of Research – Innocenti Florence 26-27 May 2014
Maternal Alcohol Use Disorder and Risk of Child Contact with the Justice Syst...BARRY STANLEY 2 fasd
These finding were actually first described in - Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome [FAS] and Fetal Alcohol Effects [FAE] - Final Report, August 1996: Ann P Streissguth et.al. Often ignored, but never refuted.
Perhaps the most important point of this 20 year old report was that early diagnosis was a major contributing factor in reducing subsequent involvement with the justice system.
I was disappointed, but not surprised, that this paper did not mention the importance of an early diagnosis.
Barry Stanley
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Maternal Mental Health What All Employers Should Know Joy Burkhard
This webinar was presented on 5-4-2017 to employers and business groups on health, with the support of the Zoma foundation. One in 5 women will experience a maternal mental health disorder like postpartum depression yet most are never diagnosed or treated. Learn what both these groups can do to move the needle in addressing mental health and wellbeing of new mothers and families.
Transforming Care: Share and Learn Webinar – 29 March 2018NHS England
Topic One: "The ERIN Initiative"
Guest speakers: Susan Holloway, NHS Chorley & South Ribble CCG and NHS Greater Preston CCG and Sheila Roberts, Lancashire Care NHS Foundation Trust
The aim of "The ERIN (Education, Resources, Interventions and Networking) Initiative" is to provide a local, accessible, responsive, early assessment and intervention service for children aged 0-5 years who may be placed on the pre-school Autism Spectrum Disorder (ASD) pathway.
This webinar reports on the progress made during a pilot which commenced on 1st October 2017 to implement a service which deals with complex/challenging behaviors of children who may or may not go on to have a diagnosis with autism.
Topic Two: An introduction and brief overview of the Source4Networks platform
Session led by Rob Cockburn, Sustainable Improvement Team, NHS England
This topic provides an introduction and brief overview of the Source4Networks platform and its potential to support the Transforming Care Programme.
Parents perceptions of autism and theirhealth-seeking behavemelyvalg9
Parents' perceptions of autism and their
health-seeking behaviors
Maria Isabel O. Quilendrino a,*, Mary Anne R. Castor a,
Nenacia Ranali Nirena P. Mendoza b, Jacqueline R. Vea c,
Nina T. Castillo-Carandang c
a Department of Clinical Epidemiology and Department of Pediatrics, College of Medicine, University of the Philippines,
Manila, Philippines
b Department of Clinical Epidemiology and Department of Family and Community Medicine, College of Medicine,
University of the Philippines, Manila, Philippines
c Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines
c l i n i c a l e p i d e m i o l o g y a n d g l o b a l h e a l t h 3 ( 2 0 1 5 ) s 1 0 – s 1 5
a r t i c l e i n f o
Article history:
Received 15 September 2015
Accepted 13 November 2015
Available online 7 December 2015
Keywords:
Autism
Autistic disorder
Behavior
Perception
a b s t r a c t
Background: Parents' health-seeking behaviors, which in turn may be related to their per-
ceptions, are hypothesized to be the major determinant of the timing of diagnosis and
subsequent intervention for children with autism.
Objective: The primary objective of this study was to describe parental perceptions of autism
and health-seeking behaviors for urban Filipino children aged 2–6 years.
Methods: This was a cross-sectional study conducted in several phases. The first phase
involved collection of qualitative data from key informant interviews and small group
discussions. The second phase involved the development of a validated and reliable ques-
tionnaire, which was administered to 41 parents of children with autism, aged 2–6 years.
Results: Parents had varying perceptions of autism. They were generally undecided with
regard to the etiology of autism, but were in agreement that psychosocial factors, such as
parental sins and curses, were unlikely to be associated with autism. The most common
presenting symptom noted by parents was a qualitative impairment in social interaction.
There was a noted trend towards earlier age of symptom recognition (mean of 24 months)
and diagnosis of autism (mean of 39 months) among parents with younger children.
Conclusion: The results of this study showed some trends: There is improved awareness
regarding autism and the needs of children with autism. Parents tend to disagree with
previous myths about autism. There was an observable trend toward earlier diagnosis for
this group.
# 2015 INDIACLEN. Published by Elsevier, a division of Reed Elsevier India, Pvt. Ltd. All
rights reserved.
* Corresponding author. Tel.: +63 9178033888; fax: +63 27311631.
E-mail address: [email protected] (M.I.O. Quilendrino).
Available online at www.sciencedirect.com
ScienceDirect
journal homepage: www.elsevier.com/locate/cegh
http://dx.doi.org/10.1016/j.cegh.2015.11.003
2213-3984/# 2015 INDIACLEN. Published by Elsevier, a division of Reed Elsevier India, Pvt. Ltd. All rights reserved.
http://crossmar ...
1
RUNNING HEAD: MILESTONE 2
Milestone 2: Outside Factors & Effective Treatment
LaChelle Prince
Southern New Hampshire University
There are many factors that can influence the treatment for autistic children. These factors include environmental, culture and family. Environmental factors concerning the onset of autism is an essential area of study. Genetic factor has been associated with the onset of autism as well. Parents who have been exposed to teratogens have substantiated factors that stimulate the chance of autism (Castro et al., 2016). Environmental factors of autism include maternal age, multiple pregnancies in a short period, inadequate prenatal care and low birth weight. Children who are associated with autism can experience a delay in brain development. There are many risk factors that are associated with autism. They include the parents age during the time of conception, maternal nutrition, inflection during pregnancy and prematurity.
In some cases individuals’ can be hereditarily prone to autism. Children can develop symptoms of autism based on their environment. Vaccines have been linked to the onset of autism. Also, an individual's genetic predisposition can cause autism (Reynolds & Dombeck, 2006).
Parents of autistic children tend to suffer from multiple factors. Parents can exhibit an increase in stress, a poor quality of marriage, depression, anxiety and increased anger (Magana & Smith, 2006). Clinicians consider how cultural values, such as religion, can influence the diagnosis, treatment and welfare of families. Religion can also influence the treatment of a child with autism. South Asian Muslim’s believe that doctors undermine their children (Ennis-Cole, Durodoye & Harris, 2013). In some culture and religion, parents believe that an autistic child is a punishment from God. Also, some cultures are less likely than others to receive regular visits to the physicians. Culture can also play a role when viewing signs and symptoms of autism. Some parents do not realize that their child is experience symptoms of autism. Parents are more likely to experience developmental delays before social issues (Mandell & Novak, 2005). Cultures conflicts in the treatment options for children who have been diagnosed with autism. Some cultures will reach out to non-professionals before seeking professional help.
Parents of individuals with ASD have also shown a willingness to persist with this strategy of using diverse treatments that include those without empirical support, or even those that are harmful, despite evidence of ineffectiveness (Offit & Jew, 2003). Parents use treatments that work at cross-purposes to each other. Having children conduct in multiple treatments make it difficult to evaluate the effectiveness of any single treatment or specific combination of treatments for a given individual (Green et al, 2006). Parents can be dissatisfied with certain treatment options.
Since cultural factors are.
Maternal Mental Health: CA Department of Public Health Nov 6, 2014Joy Burkhard
Maternal Mental Health is an underground health crisis impacting women, infants and families. This presentation was provided Nov. 6 2014 to the California Department of Public Health and discusses symptoms, risk factors and prevalence; impact on child development, why providers don't routinely screen/diagnose and treat, and what we can do to collectively change this course.
The slide content for the seminar done by Group 1, UM Masters in Public Health 2017/2018 students entitled, People With Special Needs: Children With Disability.
Disclaimer
All of the information is mainly for educational purposes.
Youtube link for the presentation:
https://youtu.be/U-B6AwjVKeU
1 DQ 1When a baby is born, one of the first concerns is thei.docxcuddietheresa
1 DQ 1
When a baby is born, one of the first concerns is their weight. A baby with an extremely low birth weight (ELBW) alerts the physician to a possible problem. The extremely low birth weight infants are those born with less than 1,500g (James, Wood, Nair, & Williams, 2018). According to Robbins, Hutchings, Dietz, Kuklina, & Callaghan (2014), about 40% of babies born with extremely low birth weight end up with a fairly significant disease. The diseases are cerebral palsy, mental retardation, blindness in both eyes, hearing loss, significant chronic disease that requires special medication, and often frequent hospitalization. Getting prenatal care before and during pregnancy ensures the well-being of the mother and a healthy baby.
Effect of Extremely Low Birth Weight Babies on Family and Community
Babies born with extremely low birth weight have various health and developmental complications. The birth of a baby with ELBW can result in substantial emotional and economic costs to the families. Also, the public sector services can be strained as a result. These services include social support systems, educational, and health insurance services. In the short term, the babies may require life support in the neonatal care unit because readmission risk is high. Often, the babies have immature brains and respiratory distress that will need ventilators.
Premature babies may have long-term impacts like poor health and growth, mental retardation, visual and hearing impairments, and cerebral palsy. The majority of the babies will have issues relating to breathing and feeding. The more premature the baby is, the system in the baby is premature. They will therefore have unique and life-threatening problems with each one of those systems. The babies born premature may exhibit learning difficulties, high risk of Sudden Infant Death Syndrome, high risk of Attention Deficit-Hyperactivity Disorder, socioemotional and behavioral problems. The loss of an infant is a demoralizing experience for a family.
There are significant disparities in premature and low birth weights of infants. Minority groups, the marginalized, and the poor are at a greater risk of premature and extremely low birth weight. An example of the disparities among minority populations is native Americans and African Americans to non-Hispanic white births. According to Martin, Hamilton, Osterman, and Driscoll (2019), the preterm birth rate was 10.23 in 2019. In the same year, the preterm birth rate for non-Hispanic black mothers was 14.39% as compared to 8.72% of non-Hispanic Asian mothers and 11.51% for the Hispanic subgroups. Infants born of mothers of low socioeconomic rank are more likely to be born prematurely. African Americans are at a higher risk due to a higher population of low socioeconomic status.
Prematurity is associated with increased risks for developmental delay, vision problems, hearing problems, and family stress. To assist with the problem of preterm infants in both f.
Lambeth Healthy Weight Project:
Dr Claire Dempster - Project Lead, Family & Systemic Psychotherapist
Dr. Vanessa Impey - Community Paediatric ST8
Ms Hayley Tuffin - Project Family & Systemic Psychotherapist
1. Autism in Minnesota
Heather Fast, Nancy Feist, Jenna Henricks, Sario Omar
Population Based Healthcare, Winona State University
Modifiable Risk
Factors: television,
exercise,
environment,
lifestyle, nutrition
Non
modifiable
risk factors:
genetics,
race, gender
National, State, and Local Data
• Nationally, prevalence is 14.7 per 1000 births for infants born in 2002
• According to the Minnesota Department of Health, in 2007, 1.8% of children had autism, and in
2010-2011, 2.7% or approximately 30,928 children.
• University of Minnesota Somali Autism Spectrum Disorder Prevalence Project
• Somali and white children in Minneapolis are equally as likely to be identified as
having autism spectrum disorder
• 1 in 32 Somali Children
• 1 in 36 white children
• 1 in 62 black children
• 1 in 80 Hispanic children
• Overall 1 in 48 children between ages of 7-9 identified as having
autism spectrum disorder in Minneapolis
• However, Somali children more likely to have intellectual disability when compared
with children in all other racial and ethnic groups, and researchers do not yet know
why
• The study also examined when children were diagnosed
• Around 5 years for Somali, white, black and Hispanic Children
• Children with ASD can be reliably diagnosed at
approximately age 2
Gaps in Care
Research
Modifiable Risk factors not being addressed
Primary Prevention Strategies: “Help me Grow Minnesota”
Secondary Prevention: Follow Along Baby Development Tracker
CDC: Learn the Signs, Act Early
School Screening
Reducing community stigma and perception of ASD
Tertiary Prevention: Early Childhood Special Education Citywide ASD Prevention Program
Individualized Education Plan (IEP)
Free public education from birth to 21 years old
Owatonna Parents Support Group
Rugters: College Support Program for Students on the Autism Spectrum. Fee based program allowing students with ASD
diagnosis thrive and participate in University life.
Levels of Prevention
Nursing Intervention
• U.S. preventative services issued a draft recommendation
stating that there is not enough evidence to support autism
screening for every child.
• Autism advocates are concerned about this, as
autism can be identified as early as 18 months,
and earlier diagnosis leads to earlier intervention
(Fraser, 2015).
Ethical & Political Gaps: False conclusions reached about
environmental contaminants consumed research dollars and
energy to disprove it; setting back research on potential
environmental causes.
Schools have used restraint and seclusion 267,000 times for
non-emergency situations (McIlwan, 2015)
Sociocultural issues: Individuals with autism still face stigma and
misunderstanding about their disorder and hope for
treatment/recovery. In the Somali community: “In our culture, you
are either sane or you are crazy, there is no grey area. So
there is a fear someone will call your child a name behind
your back.” –Somali parent
Economic Issues: Therapy costs money, and most insurance
companies do not pay for therapy costs. Being autistic and from a
lower income background can affect outcomes, which can also be
an ethical issue.
Risks of mortality: Drowning is the leading cause of death with
autism. In 2009, 2010 and 2011, drowning accounted for 91% of
total U.S death in children with an ASD ages 14 years of age and
younger following wandering / elopement (National Autism
Association, n.d.). Also vulnerable to bullying and sexual abuse.
Risks of Morbidity: high comorbidity with epilepsy. Up to 30 % of
children with ASD also have epilepsy. As many as 1 in 20 children
who have ASD either have epilepsy or develop it later in life
(Autism Speaks, 2011).
• Research has had difficulty in identifying which risk
factors lead to autism, and has had contrary results
with regards to folic acid, and has blamed everything
from antidepressant use to air pollutants,, and even
too long or too short of a gap between children
(DeWeerdt, 2015).
• Research thinks that modifiable causes are
environmental, but they have had little evidence
about which environmental factors.
• No clear link between cause and effect has been
demonstrated.
• The discredited research about vaccines and autism
has contributed to skepticism about other
environmental causes.
• You can blood test for genetics, but not for
environment
• Hildegaard Peplau, the “mother of psychiatric nursing” believed in the focus on the nurse-patient
relationship, and when this was introduced, there was no concept of patients actively participating in
their own care (ANA, 2015).
• This is particularly relevant when dealing with individuals who are autistic, when nurses must relinquish
some control in the patient-nurse relationship.
• The nursing intervention for this patient population would involve treating the autistic patient and their
family as unique individuals with unique needs.
• When providing care, this would involve allowing and encouraging caregiver/parental involvement,
using a private room, meeting the patient at their level by allowing them to bring a toy, being careful
with touch and eye contact, allowing extra time for the exam, and using clear and simple language
• An additional nursing intervention would be to utilize early testing, since this would identify the disease
in early childhood when coping strategies and treatments can begin, giving the child greater tools to
cope and succeed in school and interpersonal relationships.
• Nurses should also advocate for healthcare environments to be more accommodating for patients with
autism. These interventions include carefully assessing for pain, since some children with autism have
a higher pain threshold, planning for consistency amongst care providers, and using dolls/diagrams to
avoid confusion and surprises. In addition, care environments should be calming and avoid excessive
stimulation.
• Reducing the need for seclusion and restraints: educating families to help avoid the need for seclusion
and restraints, which can be used in some school environments by staying P.O.S.I.T.I.V.E.
• Prepare to address safety concerns ahead of time by identifying any known meltdown
triggers
• Open the discussion about seclusion and restraint policies. “What is your classroom’s
policy on the use of restraint and seclusion.”
• Submit a letter outlining your specific safety requirements and requests, such as never
using seclusion, requesting that restraints only be used when immediately necessary,
and notification of any health risks.
• Inform: provide teachers with a “do and don’t” sheet for your child including basic
information and asking them to call you instead of the police in case of a meltdown.
• Team up with educators to know and understand what’s happening inside the classroom.
• Invite feedback and recommendations from school staff. They may be seeing behaviors
you don’t in the classroom.
• Volunteer in the classroom and be active in the classroom to promote positive
relationships and allies.
• Educate your child about ways to stay safe in the classroom and about consequences to
behaviors and teach them to communicate if they are unsafe in the classroom (McIlwan,
2015).
• Advanced maternal age at birth
• Maternal prenatal medication use
• Antipsychotics and mood stabilizers-a balance between what is best for
baby and safety of mother
• Valproic Acid (VPA): mood stabilizer and antiepileptic drug shown to
increase autism spectrum disorder. Timing of exposure appears to be key
to extent of risk.
• Nutrition
• Linkage between poor maternal folic acid status and autism related
disorders
• Periconceptional folic acid intake has shown strong evidence for reducing
ASD.
• Fatty acids: decreased ASD risk with maternal polyunsaturated fat intake
• Exposure to environmental agents
• Pesticides, air pollution, especially heavy metals and particulate matter
• Other potential risk factors
• Metabolic syndrome
• Vitamin D intake
• Smoking
There is not a single, identifiable cause for autism.
References
American Nurses Association. (n.d.) Hildegaard Peplau (1909-1999) 1998 Inductee. Retrieved from http://www.nursingworld.org/HildegardPeplau
Autism Speaks. (2011, April 15). Mortality rate is increased in persons with autism who also have epilepsy. Retrieved from https://www.autismspeaks.org/about-us/press-releases/mortality-rate-increased-persons-autism-
who-also-have-epilepsy
Centers for Disease Control. (2015). Data and Statistics. Retrieved from http://www.cdc.gov/ncbddd/autism/data.html
Child Trends. (2013). Autism Spectrum Disorders. Retrieved from http://www.childtrends.org/?indicators=autism-spectrum-disorders
DeWeerdt, S. (2015, November 4). What environmental factors cause autism? Slate.com, retrieved from
http://www.slate.com/articles/health_and_science/medical_examiner/2015/11/what_causes_autism_environmental_risks_are_hard_to_identify.html
Dietert, R.R., Dietert, J.M., & Dewitt, J.C. (2011). Environmental risk factors for autism. Coaction Publications. US National Library of Medicine National Institutes of Health. doi: 10.3402/ehtj.v4i0.7111
Fraser. (2015). Fraser responds to U.S. Preventative Services Task Force recommendation. Retrieved from http://www.fraser.org/About-Fraser/News-Room/Fraser-Responds-to-U-S--Preventive-Services-Task-F
Gardener, H., Spiegelman, D., & Buka,S.L. (2013). Prenatal Risk Factors for Autism: A Comprehensive Meta-analysis. Br J Psychiatry. doi: 10.1192/bjp.bp.108.051672.
Lyall, K., Schmidt, R.J., & Hertz-Picciotto, I-H. (2014). Maternal lifestyle and environmental risk factors for autism spectrum disorders. International Journal of Epidemiology. doi: 10.1093/ije/dyt282.
McIlwain, L. (2015, January 21). Restraint and seclusion: a guide for autism parents. National Autism Association Autism Atrium. Retrieved from http://nationalautismassociation.org/restraint-seclusion-a-guide-for-autism-
parents/
Minnesota Department of Health. (n.d.) Facts and figures: autism spectrum disorder. Retrieved from https://apps.health.state.mn.us/mndata/dev_asd
National Autism Association. (n.d.). Autism and Safety Facts. Retrieved from http://nationalautismassociation.org/resources/autism-safety-facts/
Ohio Nurses Association. (2013.) Understanding Autism Spectrum Disorder. [Continuing Education]. Retrieved from https://ce4nurses.org/understanding-autism-spectrum-disorder
Rutgers Student Affairs. (2015). Autism Spectrum-College Support Program. Retrieved from http://rhscaps.rutgers.edu/services/autism-spectrum-college-support-program/
University of Minnesota. (2013). Minneapolis Somali autism spectrum disorder prevalence project. Retrieved from http://rtc.umn.edu/autism/