Autism Spectrum Disorder

Autism Spectrum
Disorder
Introduction
❑Autism spectrum disorders (ASDs) are complex neurobiological and
developmental disabilities that typically appears during a child’s first
three years of life.
❑Autism affects the normal development of the brain in social
interaction and communication skills.
❑ It ranges in severity from mild to moderate to severe.
❑Previously known as Asperger’s syndrome,
Clinical Picture:
❖Significant deficits in social
relatedness, including communication,
nonverbal behaviour, and age-
appropriate interaction.
❖There are deficits in developing and
maintaining relationships
❖Other behaviours include stereotypical
repetitive speech, use of objects, over
adherence to routines or rituals,
❖Fixations with particular objects,
❖ Hyper- or hypo-reactivity to sensory
input, and extreme resistance to
change.
• No response to their name by 12 months
• Not pointing at objects to show interest (e.g., not
pointing at an airplane flying over) by 14 months
• Not playing “pretend” games (e.g., pretending to “feed”
a doll) by 18 months
• Avoiding eye contact and wanting to be alone
Children • Having trouble understanding other people’s feelings or
talking about their own feelings
with ASD • Delayed speech and language skills
commonly • Repeating words or phrases over and over (echolalia)
exhibit the • Giving unrelated answers to questions
following • Getting upset by minor changes
symptoms: • Obsessive interests

• Flapping their hands, rocking their body, or spinning in
circles Unusual reactions to the way things
• sound, smell, taste, look, or feel
• Appearing to be in their own world
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Prevalence and Incidence
Prevalence:
Global The estimated global prevalence of ASD is about 1 in 160
children, according to the World Health Organization (WHO).
In India, the prevalence of ASD is estimated to be about 1 in 100
children, though studies and data collection methods vary.
This estimate suggests that around 2 million individuals in India
might be affected by ASD.
It occurs in boys more often than girls, with the ratio ranging
from 2:1 to 5:1.
About half of children with autism are mentally retarded, and
about 25% have seizure disorders
Aetiology
❖Causes of autism are not confirmed.
❖Genetics, viral infections, and chemicals found in
the environment are suspected causes or
contributors to development of autism.
❖For parents with one autistic child, there is about
a 5% chance of having a second child with autism.
❖ Serotonin levels have been shown to be
diminished in the left frontal lobe of many with
autism.
❖Fragile X syndrome, congenital rubella, exposure
to some medications in utero, and tuberous
sclerosis have been suggested as possible causes of
ASD.
Management
Autism Spectrum
Disorder
Assessment
1. Assess for developmental delays, uneven development, or loss of
acquired abilities. Use baby books and diaries, photographs, videotapes,
or anecdotal reports from nonfamily caregivers.
2. Assess the parent-child relationship for evidence of bonding, anxiety,
tension, and fit of temperaments.
3. Assess for physical and emotional signs of possible abuse. Be aware
that children with behavioural and developmental problems are at risk
for abuse.
4. Be knowledgeable about community programs providing support
services for parents and children, including parent education,
counselling, and after-school programs.
Nursing Diagnosis
•Risk for self-mutilation related to neurological alterations; history of self-
mutilative behaviors; hysterical reactions to changes in the environment
• Impaired social interaction related to inability to trust; neurological
alterations, evidenced by lack of responsiveness to, or interest in, people
• Impaired verbal communication related to withdrawal into the self;
neurological alterations, evidenced by inability or unwillingness to speak; lack
of nonverbal expression
•Disturbed personal identity related to neurological alterations; delayed
developmental stage, evidenced by difficulty separating own physiological
and emotional needs and personal boundaries from those of others
Intervention- Psychosocial
❑Children with ASD are referred to early intervention programs once
communication and behavioural symptoms are identified, typically in the
second or third year of life.
❑Treated in- therapeutic nursery schools, day treatment programs, and special
education classes in public or specialized private schools.
❑Treatment plans include behaviour management with a reward system,
teaching parents to provide structure, rewards, consistency in rules, and
expectations at home in order to shape and modify behaviour and foster the
development of socially appropriate skills
❑Children with ASD may receive physical, occupational, and speech therapy as
part of the plan of care
❑Especially with the management of chronic health conditions, it is important
that the nurse recognize and capitalize on the individual’s and family’s
strengths
Psychobiological-
Interventions
Pharmacological agents target specific symptoms and may be used to
improve relatedness and decrease anxiety, compulsive behaviours, or
agitation.
The unconventional agents such as risperidone, olanzapine, quetiapine,
and aripiprazole have been shown to reduce harmful behaviours.
The SSRIs are the most popular psychotropic agent used in this
population, improving mood and reducing anxiety

Autism Spectrum Disorder

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Autism Spectrum

symptoms: • Obsessive interests

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