Autism 2025 PDF

AUTISM Prepared by: Dr: Entisar Mohammed Assist prof. Psychiatric Mental Health Nursing Department : At the end of this lecture the student will be able to  Understand autism  List causes of autism  Identify signs and symptoms of autism  Apply the nur...

AUTISM Prepared by: Dr: Entisar Mohammed Assist prof. Psychiatric Mental Health Nursing Department : At the end of this lecture the student will be able to  Understand autism  List causes of autism  Identify signs and symptoms of autism  Apply the nursing process to autism clients  Develop health education to clients, families, teachers, caregivers, and community members.  Evaluate your feelings, beliefs, and attitudes about clients with autism and their parents and caregivers. Out lines Autism Introduction. Definition. Epidemiology of Autism. Causes of Autism Signs and Symptoms of Autism. Treatment of Autism. Role of nurse according to three level of prevention.  Introduction WHO, American psychological Association classification ‘Autism’ as a developmental disability that results from central nervous system disorder. The word ‘Autism’ is derived from Greek word ‘autos’ means ‘self’. Autism is a developmental disorder that is characterized by impaired development in communication, social interaction, and behavior. In other words, the symptoms and characteristic of autism can present in a wide variety of combinations, from mild to severe. INCIDENCE: Autism is a rare disorder, long term illness with a poor prognosis Generally, the onset occurs before the age of 2 ½ years. In some cases, the onset may occur later in childhood. And such cases are called as childhood onset autism. DEFINITION: Quantitative impairment in social interaction, communication, restricted, repetitive and stereotyped patterns of behavior, interests and activities, delays in abnormal functioning A developmental disorder characterized by total lack of responsiveness to people gross, language developmental deficits or distortions, bizarre response to environmental aspects. PREDISPOSING FACTORS History of perinatal complication- maternal bleeding Anoxia during pregnancy and delivery Drug abuse in pregnancy Maternal rubella infection, congenital rubella Encephalitis Meningitis Tuberous sclerosis Familial interpersonal factors CAUSES: Abnormalities in the brain functioning, E.g. Defects in temporal lobe of brain, limbic system. Psychosocial factors – Parental rejection, – Deviated personality, – Broken families stress, – Defective communication pattern, – Sibling conflicts.  Autism is not caused by  an unhappy home environment,  both parents working,  mental stress during the pregnancy,  poor handling by the mother and  also some emotional trauma or other psychological factors. CLINICAL MANIFESTATION: Typically developing infants are social by nature. They gaze at faces, turn toward voices, grasp a finger and even smile by 2 to 3 months of age. By contrast, most children who develop autism have difficulty engaging in the give and take of everyday human interactions. By 8 to 10 months of age, many Infants who go on to develop autism are showing some symptoms such as: 1. Impairment of social interaction: Avoid eye contact. Prefer to play alone. Does not share interests with others. Flat or inappropriate facial expressions Avoids physical contact. 2.Impairment in behavior: Plays with toys the same way every time. Likes parts of objects. Gets upset by minor changes. Has an obsessive interest. Dislike being kisses or touch. Failure to develop empathy. 3.Impairment in communication Gives unrelated answer to a question. Does not understand jokes or teasing. Delayed speech and language skills. Repeated words or phrases over and over. 4.Other symptoms Hyperactivity. Short attention span Lack of fear or more fear than expected. Causing self-injury. Aggression. EXAMINATION AND TESTS: 1. Medical history: During the medical history interview, a doctor asks general questions about a child's development, such as whether a child shows parents things by pointing to objects. Young children with autism often point to items they want, but do not point to show parents an item and then check to see if parents are looking at the item being pointed out. 2.Physical exam: including head circumference, weight, and height measurements, to determine whether the child has a normal growth pattern. 3. Screening test for autism (such as the Checklist for Autism in Toddlers [CHAT] or the Autism Screening Questionnaire). Modified Checklist of Autism in Toddlers: Valid for toddlers 16-30 months List of questions Answers determine need for referral to a developmental specialist – Developmental pediatrician – Neurologist – Psychiatrist Scoring: child requires follow up if – Answered “No” to 2 or more critical questions or Answered “No” to 3 questions TREATMENT Medicines are often used to treat behavior or emotional that people with autism may have, including: Aggression, Anxiety, Attention Problems, Hyperactivity, Irritability, Mood Swings, Sleep difficulty....etc. but mostly used drug are lithium. A. Behavior therapy: e.g. emergency management, positive reinforcement, self-care skills, role modeling B.APPLIED BEHAVIOUR ANALYSIS(ABA) – ABA encourages the positive behaviors and discourages the negative behavior in order to improve the variety of skills. For example; a teacher might ask a child to put his toys away. If the child puts his toys away, the teacher will praise the child. If the child does not put his toys away, the teacher might guide the child’s hand or withhold a reward until the child puts the toys away.  What Skills are Important? Sustained Activities Attention & Learning & of Daily Motor Concentrati Problem Living C oordinati on Solving (ADLs) on Comprehensi Expressive Fine & on & Language Communicati Gross Understandin (any on skills (any Motor g of mode) mode) skills Language Social Skills Reading (behaviour & Self- Hobbies and Written Managemen & leisure language communicati t skills skills on) (IADLs)  C. OCCUPATIONAL THEARPY: Occupational therapy teaches skills that help the person live as independently as possible. Skills might include dressing, eating, bathing, and relating to people. D. SPEECH THERAPY: – It helps to improve the person’s communication skills. – Some peoples are able to learn verbal communication. E. PSYCHOTHERAPY: – Psychotherapy is not effective in treatment of autism. – However, parental counseling and supportive therapy are useful is allaying parental anxiety and guilt, and ensuring their active involvement of the therapy. Educational programming provisions may vary from simple to complex, as follows: Help parents understand it is NOT a result of "bad parenting". a- Family support. 1- provide caregivers with information that will help them to understand of their child`s behavior and need 2- Offer resources, support and training that enable parent to work and play with their child more effectively 3- The family provide social support to help the patient handle and adapt to stress 4- Emotional support from family member allow open expression of feeling and meets love 5- Inclusion of family member in problem solving, teaching learning activity and physical care helps maintain self esteem. 6- Provide health teaching about development crisis and threating events  Nursing care plan of autistic child: Nursing diagnosis Objectives Nursing intervention Impaired social Short term: the patient will Initiate a one-0n-one interaction related to show interest and seek out Focus on –relationship sustaining the eye contact insufficient social the caregiver. - Provide positive reinforcements for effort made exchange Long term: the patient will -Monitor for signs and participate in at least two symptoms of anxiety and distress activities that reflect social - Provide emotional support and guidance interaction - Role-model social interaction - Use appropriate emotional expression - Role-model situations that cause conflicts and handle them - Help the child identify one person in his circle as special person to relate with  Nursing care plan of autistic child: Nursing diagnosis Objectives Nursing intervention Impaired verbal Short term: the child will Using 1:1 interaction initiate communication communicate through facial nonverbal interaction related to disturbance expression and eye contact -Begin eye to eye contact that needs to in attachment, Long term: the child will first be established neurological deficit communicate at least four -Use validation to understand basic needs by discharge the verbal and nonverbal communication Play games that involve vocalization -Use the name of the things frequently and encourage the child to pronounce correctly -Encourage verbal interaction with the parent, siblings and peers  Nursing care plan of autistic child: Nursing diagnosis Objectives Nursing intervention Disturbed personal Short term: the child will -using 1:1 interaction to engage the identity related to seek comfort and physical patient in safe relationship with inadequate sensory contact from others others stimulation Long term: the child will describe the name of the things in the demonstrate recognition of environment self-boundaries and being -direct child's attention to activities of separate from others others in the environment -limit self-stimulation and ritualistic behavior by diverting his attention to other things -provide comfort, reassurance, and security during the time of anxiety