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Autism Spectrum Disorders

Autism Spectrum Disorders. Lewis, pp. 1198-1201. Incidence and Types. 24 to 48 months of age; males > females; females are more severely affected No relation to socioeconomic level or parenting style Mild to severe types are: Autistic Disorder Asperger’s Syndrome

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Autism Spectrum Disorders

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  1. Autism Spectrum Disorders Lewis, pp. 1198-1201

  2. Incidence and Types • 24 to 48 months of age; males > females; females are more severely affected • No relation to socioeconomic level or parenting style • Mild to severe types are: • Autistic Disorder • Asperger’s Syndrome • Pervasive Developmental Disorder

  3. Etiology • Genetic disorder of brain development • Autosomal recessive pattern • Immune and environmental factors along with genetics may increase chances • No evidence of link to thimerosal-containing vaccines

  4. Manifestations • Abnormal EEG • Seizures • Delayed development of hand dominance • Persistence of primitive reflexes • Elevated serum serotonin levels • Brain hypoplasia • Large head

  5. Manifestations • Shows unusual attachments to objects • Overly sensitive to light, touch, sound, hearing, smell, taste • Performs repeated body movements • Language delays or regression • Nonsense rhyming or word repetition • Communicates with gestures • Cannot start or maintain conversation

  6. Manifestations • Behavioral outbursts, preoccupation • Limited pretend play • GI/nutritional issues—constipation, megarectum, willful starvation, gagging, mouthing objects, eating non-edibles, smelling and throwing food • Screening for manifestations are main way of diagnosing (see Box 42-8, p. 1200)

  7. Reported Associations • Fragile X syndrome (chromosomal abnormality) • Tuberous sclerosis (skin lesions and various tumors) • Metabolic disorders (thyroid) • Fetal rubella syndrome

  8. Reported Associations • H. influenzae meningitis • Structural brain abnormalities • Parents over 40 • Perinatal complications (uterine bleeding, fetal distress, low Apgars, hyperbilirubinemia)

  9. Nursing Management • Highly structured behavior modification with routines, consistency, and positive reinforcement • Increase social awareness of others • Teach verbal communication skills • Decrease unacceptable behaviors

  10. Pharmacologic Therapy • Meds to decrease irritability, aggression, anxiety, mood swings, hyperactivity • Risperidol • SSRIs • Divalproex • Ritalin

  11. Hospitalized Autistic Child • Parents present • Encourage parents to bring in favorite possessions • Limit physical contact when possible • Private room with low stimulation

  12. Parental Support • Feel guilt and shame—need counseling and support • Encourage parents to care for child in home with family support, if possible. If not, then institutional care • Refer to mental health facilities and facilities for developmental disabilities • Refer to Autism Society of America: www.autism-society.org

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