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Autism

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Title: Autism


1
Autism
  • Tammy Marie Baker RN
  • The Pediatric Educational Series
  • March 1st 2012

2
What is autism Autism Spectrum Disorders
  • A Complex group of Neuro developmental disorders
    characterized by
  • Social impairments
  • communication difficulties
  • repetitive behaviors
  • patterned behaviors

3
The spectrum
  • Autism ( more sever form )
  • Aspergers ( higher functioning)
  • Child disintegrative disorders
  • Pervasive Developmental Disorders

4
Causes and theories
  • Environmental's
  • genetics variances
  • variants of Serotonin and neurotransmitters in
    the brain itself ?
  • disruption of normal brain development in early
    fetal stages?
  • Speculative theories include diet Digestive
    tract change Mercury poisoning The body's
    inability to properly use vitamins and minerals (
    these are not proven)

5
Statistical ratio of autism
  • 6 out of every 1000 children will be affected
  • Boys are 4 times more likely to be affected than
    girls.

6
most common signs of autism
  • lack of social engagement
  • fixation on objects
  • patterned behaviors
  • avoid eye contact
  • unresponsive to name
  • disengaged or intently focused on something
  • cant interpret social cues from others
  • parallel play verses interactive

7
early signs of autism
  • no babbling or pointing by age 1
  • no single words by 16 months or two-word phrases
    by age 2
  • no response to name
  • loss of language or social skills
  • poor eye contact
  • excessive lining up of toys or objects
  • no smiling or social responsiveness.

8
characteristic findings
  • repetitive movement such as rocking or twirling
  • self abusive behaviors biting, head banging
  • communication delays
  • sing/song verbalizations

9
Latent signs of autism
  • impaired ability to establish friends with peers
  • impaired ability to initiate or sustain a
    conversation with others
  • absence or impairment of imaginative and social
    play
  • stereotyped, repetitive, or unusual use of
    language
  • restricted patterns of interest that are abnormal
    in intensity or focus
  • preoccupation with certain objects or subjects
  • inflexible adherence to specific routines or
    rituals.

10
common related concuring syndromes
  • fragile X syndrome
  • tubularsclerosis
  • Turets syndrome
  • seizure disorders new or latent onset
  • learning disabilities
  • ADD

11
testing should be multidisciplinary in format and
include
  • psychologist
  • psychiatrist evaluation
  • Neurologist
  • speech and language evaluation
  • hearing screening
  • cognitive testing
  • Physical therapist evaluation

Child Study Team Evaluation
12
treatment
  • Behavioral Assessment
  • Behavioral Intervention Plan/Tool
  • Social skills classes
  • Speech and Language intervention
  • Structured Environment
  • one one therapy with psychologist/ psychiatrist
  • IEP Individualized Educational Plan ( school )
  • Medications for coexisting diagnosis

13
nursing care of the autistic child
  • Follow Behavioral plan
  • Approach child slowly
  • Allow child time to get to know you and establish
    a rapport with child
  • Encourage eye contact ( eyes on me, cup child's
    chin and encourage eye contact)
  • Praise child for positive social interactions
  • Awareness of speech processing delays and
    communication variables
  • Maintain routines and structure ( autistic
    children do not respond well to changes)
  • Be aware of Autistic sensory issues, avoid loud
    noises, tactile defensiveness smell and taste
    aversions. introduce new things slowly to the
    child.

14
Communcation 101just because its not spoken
doesnt mean its not there.......it is essential
that we recognize the non verbal and us
alternative methods to foster the unspoken
voice
  • non verbal cues to include eye gaze , lips facial
    expression, head nodding, and body language
  • Alphabet boards
  • Picture board
  • computer Enhanced technological communication
    devices ( switches, pc programs)

15
communication 102
  • a non verbal child is not dumbintelligence is
    not measured of words
  • Autistic children can be highly intelligent with
    high IQ function
  • Standardized testing isnt standard with a child
    in the Autistic Spectrum and not always a true
    measure of his/ her ability verses disabilities.
  • Autism is out of the box
  • Verbal expression of the care giver/ skilled
    nurse should always respect the child's and
    families feelings.
  • Children although non verbal may possess a higher
    level of understanding and interpretation of our
    verbal expression. The child maybe staring or
    appear non engaged and at the same time be
    internalizing his environment quietly within his
    world .

The Autistic Child Spins inside himself self as
our world rotates around him... Our galaxy may
only be a small universe in histmb
16
Sensory integration Dysfunction
  • The Care giver/ nurse must be aware that Children
    with Autism present with Sensory issues
  • Their neurological system functions differently
    in interpreting the world around them.
  • Hypersensitivity and Hyposensitivity to external
    stimuli can cause great discomfort and behavioral
    issues
  • Loud noises, large environments, thermoregulation
    hot/cold intolerances,tastes, smells ect.
    Environmental input can be overwhelming to them.
  • Communication impairment can impede their ability
    to tell us what is wrong or bothering them. A non
    verbal child may pull away from stimuli, cover
    their ears or retreat into them selfs when over
    stimulated.
  • Retrospect-fully the child may crave neurological
    input and stim off the environment as well.
  • Occupational therapist can work with the child to
    increase tolerance to environmental Factor as
    well as offer deep pressure activities to sooth
    the child. A technique involved may include
    brushing, deep pressure, texture tolerance
    exercises ect.
  • some sensory issues can be outgrown or the child
    may mature to a point of higher tolerance to the
    environmental stimuli that irritate or stimulate
    him.

17
Sensory Integration
Learning to tolerate the environment can be over
whelming
18
Autism Awarenessmaking a differenceEducation
opens doors , changes perceptions and cans change
lives......
  • Awareness
  • Understanding
  • Tolerance
  • Intervention
  • Support
  • Make a Difference

19
Educational terms
  • Acronyms and terms used in association with
    autism treatment

Acronym What It Stands For ABA Applied Behavioral
Analysis AS Asperger Syndrome ASD Autism Spectrum
Disorder BIP Behavior Intervention
Plan BMP Behavior Management Plan ESY Extended
School Year FAPE Free and Appropriate Public
Education FERPA Family Educational Rights and
Privacy Act IDEA Individuals with Disabilities
Education Act IEP Individualized Education
Program IFSP Individualized Family Service
Plan IPP Individual Program Plan ISP Individual
Service Plan LRE Least Restrictive
Environment NT Neurotypical
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