Autism

Tammy Marie Baker RN Pediatric Series March 1st 2012

What is autism Autism Spectrum Disorders

A Complex group of Neuro developmental disorders characterized by:

Social impairments

communication difficulties

repetitive behaviors

patterned behaviors

The spectrum

Autism ( more sever form )

Aspergers ( higher functioning)

Child disintegrative disorders

Pervasive Developmental Disorders

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)

Statistical ratio’ of autism

6 out of every 1000 children will be affected

Boys are 4 times more likely to be affected than girls.

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

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

characteristic findings:

repetitive movement such as rocking or twirling

self abusive behaviors biting, head banging

communication delays

sing/song verbalizations

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

common related concuring syndromes

fragile X syndrome

tubularsclerosis

Turets syndrome

seizure disorders new or latent onset

learning disabilities

ADD

testing should be multidisciplinary in format and include:

psychologist

psychiatrist evaluation

Neurologist

speech and language evaluation

hearing screening

cognitive testing

Physical therapist evaluationChild Study Team

Evaluation

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

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.

Communcation 101just because its not spoken doesn’t 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)

communication 102a non verbal child is not “dumb”intelligence is not measured of words

Autistic children can be highly intelligent with high IQ function

Standardized testing isn’t 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 his”tmb

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.

Sensory Integration

Learning to tolerate the environment can be over whelming

Autism Awareness

making a differenceEducation opens doors , changes perceptions and cans change lives......

Awareness

Understanding

Tolerance

Intervention

Support

Make a Difference

Educational terms

Acronyms and terms used in association with autism treatment

AcronymWhat It Stands For

ABAApplied Behavioral AnalysisASAsperger SyndromeASDAutism Spectrum DisorderBIPBehavior Intervention PlanBMPBehavior Management PlanESYExtended School YearFAPEFree and Appropriate Public EducationFERPAFamily Educational Rights and Privacy ActIDEAIndividuals with Disabilities Education ActIEPIndividualized Education ProgramIFSPIndividualized Family Service PlanIPPIndividual Program PlanISPIndividual Service PlanLRELeast Restrictive EnvironmentNTNeurotypical