AKSUM UNIVERSITY COLLEGE OF HEAITH SCIENCE

DEPARTMENT OF NURSING POST GRADUATE PROGRAM

IN PAEDIATRIC AND CHILD HEALTH NURSING

Presentation topic Autism

Presenter Esiete mariam Gebru
Submitted to: Mr.Teklay zeru
February 2024
Axum, Tigray, Ethiopia

1
 Presentation out line
 Objective
 Definition of Autism
 Introduction
 Epidemiology
 Pathogenesis
 Risk factors
 Clinical manifestation
 Diagnosis
 Differential Diagnosis
 Treatment
 Complication
 Prevention
 Summary
2
 Reference
 Objective
After completion of this Presentation the students will be
able to
Define Autism
List the causes of Autism
Discus The clinical manifestation of Autism
List the treatment of Autism
List the risk factors

3
 Definition of Autism
Autism -also called a "spectrum" disorder a problem of
psychological development disturbing perceptions and
relationships .
The word autism comes from the Greek word auto
meaning “self” and was first used by Austrian- American
psychiatrist and physician Leo Kanner in 1943 to
describe a group of behavioral symptoms in children.

4
 Contued--
Autism (Autism spectrum disorder)
A Always
U Unique
T Totally
I Interesting
S Some times
M Mysterious

5
6
 Introduction
Autism is a complex neurobehavioral disorder that includes
impairments in social interaction and development language
and communication skills combined with rigid, repetitive
behaviors'. The disorder covers a large spectrum of
symptoms skills, and levels of impairment. It ranges in
severity from a handicap that some what limits an otherwise
normal life to a devastating (highly destructive) disability
that may require institutional care.

7
 Contued--
According to the center for disease control and prevention(CDC)
Autism spectrum disorder is a neurodevelopmental disability
attributed to brain differences. Individuals with ASD frequently
encounter social, communication, and interaction challenges and
exhibit restricted or repetitive behaviors and interests.
Additionally, people with ASD may demonstrate distinct
approaches to learning, movement, and attention. Autism is more
common in males and children born prematurely and is strongly
linked to the genetic disorder (Fragile x syndrome) which is
caused by changes in gene called Fragile x messenger.

8
 Epidemiology of Autism
.Epidemiological surveys of autism were first initiated in the
mid 1960s in England. ASDs affect more males than
females, with an average male-to-female ratio of 4.3:1.
According to the CDC report around 75 million people
have autism spectrum disorder ,that is 1% of the worlds ‘
population .

9
 pathogenesis
There is no clear path way of mechanisms directed
towards a simple pathogenesis and an established link to
autism on the symptomatic level there are how ever
several important theories (neural connectivity , neural
migration , excitatory inhibitory neural activity ,Dendrite
morphology , neuron immune calcium signaling) which
appears to offer an explanation to how Autism develops.

10
 Risk factors
Alcohol, smoking and illicit drug exposure
Endocrine factors
Maternal age above 40 years
Medications with tetratogenic properties
(thalidomide ,valporic acid).
Hazardous air pollutants like mercury, cadmium and nickel
Maternal Dietary and life style factors.
Infection & immuno dysfunction
Metals(potential endocrine disrupters)

11
 contued- -
Contributing Environmental factors
Vaccinations can trigger or exacerbate autism in some, if not
many, children, especially those who are genetically
predisposed to immune, autoimmune or inflammatory
conditions.

12
13
 Clinical manifestation
They can‘t be comfortable even with breast feeding
 They do not respond to smile.
 Limited interest
 Dislike travel
 Following the same schedule every day
 They don’t speak at all
 They aren‘t at all interested in other people
 They don’t like cuddling (physical contact)
 They resist change

14
 Contued- -
They have unusual eating habits.
They tend to cause self injuries such as skin pricking.
.They exhibit obsessive behavior.
They become busy with them self.
They find sudden loud noises un pleasant and quite
shocking .
Delay in, or lack of, learning to talk.
Stereotyped (one typed,habtual) and repetitive use of
language etc.
 They maintain poor eye contact while others are talking to
them.
15
16
 Contued- -
 Hyper focus ( the unique and defining characteristic of
autism) The cingulate gyrus (CG) is the part of the brain
which focuses attention. Dysfunction of the CG is the
suspected cause of hyper focus.

17
 Exhibit 1.cingulate gyrus

18
 Contued-
 Fear lessness hyper focus causes under functioning of the
Amygdala ,( fear center) the region of the brain which
plays a central role in the processing of emotions ,
especially fear that is why An Autistic person is in
capable of experiencing fear.

19
20
 Contued- -
Some times persons with autism spectrum disorder(ASD)
are Excellent in visual skills such as maths, art(music &
dance academic skills).

21
22
 Contued- -
Etiology the exact etiology of autism spectrum disorder is
unknown ,but strong genetic and environmental influences
appear to coexist and affect brain development in ways
irrespective of culture , race, ethnicity, or socioeconomic
group.

23
 Diagnosis
there is no lab test for Autism so doctors rely(depend) on observing The
behaviors of very young children and listening to the concerns of their
parents. For official diagnosis of autism spectrum disorder(ASD) the child
must meet the standards of the diagnostic and the statistical Manual of
mental disorders (DSM-5) published by American psychiatrist association.
A. Challenges with communication and social interaction
for kids with ASD it is hard to connect with or predict the reaction of other
people make eye contact , or have a conversation they might not begin to
speak as early as other children do.
B. Persistent and repetitive patterns of behavior.
 Children with ASD might rock(force full movement) their bodies , repeat
phrases or become upset with challenges on their routines.

24
 Contued- -
 they are often deeply ,interested in one subject they also have sensory issues.
 Stereo typed or repetitive motor movements ,use of objects or speech .
There are also diagnostic check lists that enable us to diagnose ASD
 Feeling anxious
 Repeating words or phrases but upset by minor changes
 Preferring to play alone
 No real fear of dangers
 Give un related answer to questions
 Having difficulty to talk about feeling .
 Difficulty to make friends.
 Not responding to their name.

25
 Differential Diagnosis
Obsessive compulsive disorder(OCD)
Attention Deficient Hyperactivity Disorder(ADHD)
Post traumatic stress Disorder(PTSD)
Trichotillo mania( frequent hair pulling disorder)
Rett’s syndrome( a neuro developmental disorder) etc.

26
27
 Treatment
Children with Autism(Autism spectrum disorder) should
Receive comprehensive behavioral based educational
Intervention i.e. addressing all the core features of the
Disorder s and associated problems at a minimum
Threshold number of hours per week. Psychotropic
Medications such as risperidone and aripiprazole are
prescribed to address co morbidity, Behaviors' such as
short attention span ,hyperactivity, sleep problems ,
anxious mood and self injurious behaviors.

28
29
 Contued- -
The main goal of treating children with autism is
 To lessen associated defects
 To decrease family stress
 To increase quality of life and
Maximizing the child's ability to function independently and
enhancing their development.

30
 Complication
 Hair loss , obesity
 Epilepsy, food allergy
 Developmental delay
 Learning disorders , hearing loss
 Seizures
 Chronic pain
 Un usual eating habits ,Aggression
 Attention deficit , bipolar disorder
 Obsessive compulsive disorder , schizophrenia
 Food allergy or sensitivity which can lead to a limited diet
further complicating the child’s life.
31
 Contued- -
 Gastro intestinal disorders
 Sensory input problems
 Low birth weight
 Obesity
 Tuberous sclerosis( a rare genetic condition that causes
mainly non .cancerous benign tumors to develop in
different parts of the body).
 Diabetes
 Unusual sleeping habits.

32
Diagram of using hearing aid and

33
 Nursing intervention
Provide education & support to the patients
family ,promoting independence and quality of life.
Foster collaborative approach care by working ,closely with
a multidisciplinary team including , psychologists ,speech
therapists ,occupational therapists, and educators.
Create safe environment.
Respect boundaries.
Early screening.

34
 Prevention approaches
 Prevention of exposure to harmful chemicals and drugs in pre and peri
natal periods.
 Early detection and treatment of maternal infections.
 Nutritional supplementation in the mothers during pregnancy and breast
feeding and adding nutrient supplements in infancy. along with this
interventions can be done In the early child hood to prevent severity of
symptoms.
 premarital counseling and increasing awareness among the general
population regarding the effect of parental age at conception can help to
Some what reduce the incidence of Autism.
 Regular exercise.

35
 Summary
Autism (Autism spectrum disorder) is A is a complex
neurobehavioral disorder that includes impairments in
social interaction and development language and
communication skills combined with rigid, repetitive
behaviors'. As researchers suggestion it develops from
combination of genetic and non genetic or environmental
influences. And it is treated by cognitive behavioral therapy
and psychotherapy is given especially for those who have
sleep disorders , hyper active and self injurious .

36
 Reference
1. Autism spectrum disorder. (2018). Accessed: April 24, 2023:
https://www.mayoclinic.org/diseasesconditions/autism-spectrum-disorder/symptoms-causes/syc-20352928 .. Amadi, C. N., Orish, C. N.,
Frazzoli, C. and Orisakwe, O. E., "Dietary interventions for autism
spectrum disorder: An updated systematic review of human studies," Psychiatriki 33, 228–
242 (2022).
Pdf coffee.com-10-pDf – free
Araghi-Niknam, M. and Fatemi, S.H. 2003. Levels of Bcl-2 and P53 are
altered in superior frontal and cerebellar cortices of autistic subjects.
Cell Mol. Neurobiol., 23:945–52.
Aschner, M., Allen, J.W., Kimelberg, H.K. et al. 1999. Glial cells in neurotoxicity development. Annu. Rev. Pharmacol. Toxicol., 39:151–
73
Rodgaard E, Jensen K, et al. Temporal changes in effect sizes of studies comparing individuals
with and without autism: A meta-analysis. JAMA Psychiatry online; 2019.
DOI: 10.1001/jamapsychiatry.2019.1956.
Aschner, M., Allen, J.W., Kimelberg, H.K. et al. 1999. Glial cells in neurotoxicity development. Annu. Rev. Pharmacol. Toxicol., 39:151–
73.
Centers for Disease Control and Prevention
(CDC). Diseases and Conditions, Autism.
Available at: www.cdc.gov/ncbddd/autism/index.html. Accessed Sept. 20, 2011.
Hyman SL, Levy SE and Myers SM. Identification, evaluation and management of children
with autism spectrum disorder. Pediatrics
2020; 145: e20193447
Kodak T, Bergmann S. Autism Spectrum Disorder: Characteristics, Associated Behaviors, and Early Intervention. Pediatr Clin
North Am. 2020;67(3):525-35. doi: 10.1016/j.pcl.2020.02.007
.
Koegel RL, Koegel LK. Pivotal response treatments for autism:
communication, social, & academic development: Paul H
Brookes Publishing; 2006

37
 THANK YOU FOR YOUR
ATTENTION !

38