Chapter 22: Autism Spectrum Disorder (ASD) (Children)

Question 1

Autism Spectrum Disorders (ASDs)

Answer 1

-can be first diagnosed in infancy or childhood
-symptoms occur by age 3
>DSM-V definition: continuum of disorders that involve limitations in social relatedness, verbal and non-verbal communication, and the range of interests and behaviors

Question 2

Signs + Symtoms

Answer 2

• persistent qualitative impairment in social reciprocity (i.e. unable to engage in socially appropriate communication)
• impaired communication (using no language, or using deviant speech with errors in tone, prosody, pitch, grammar, or pragmatics)
• restrictive or repetitive behaviors, interests, or activities

Question 3

Diagnosis

Answer 3

ADA and CDC created a program called First Signs

-thorough developmental history

Question 4

CDC: “Learn the Signs, Act Early”

Answer 4

CDC’s initiative
-three-pronged approach to improving detection and care of children with ASD and other developmental disorders
-focuses on health education, early screening and intervention, and research and evaluation
>CDC offers education related to helping parents understand and track early developmental milestones, encouraging them to act early if they have questions or concerns about their child’s progress
>Acronym Autism A.L.A.R.M.

Question 5

CDC acronym Autism A.L.A.R.M.

Answer 5

> Autism is prevalent:
Listen to patients:
-early signs of autism are often present before 18 months; parents usually do have concerns that something is wrong; parents generally do give accurate and quality information; when parents do not spontaneously raise concern, ask if they have any concerns
Act early:
-know the subtle differences between typical and atypical development; learn to recognize red flags; improve the quality of life for children and their families through early and appropriate intervention
Refer:
-to the Web for sources r/t early intervention of autism or a local school program; to an autism specialist, for a definitive diagnosis; to audiology to rule out a hearing impairment; to local community resources for help and family support
Monitor:
-schedule a follow-up appointment to discuss concerns; look for other features known to be associate with autism; educate parents and provide them with up-to-date information; advocate for families with local early intervention programs, schools, respite care agencies, and insurance companies; continue surveillance and watch for additional late signs of autism and/or other developmental disorders

Question 6

Nursing Care

Answer 6

• awareness of the need for early intervention (b/c of the tissues to grow during early brain development)
• early language development
• poor functional communication skills can contribute to the problematic behaviors some autistic children display (e.g. poor frustration tolerance and aggression toward self or others)
• interventions that address social competence; can teach parents that social skills training ad acquisition groups provide the child with an opportunity to learn and practice appropriate social relatedness
• assist the family in coping with the disorder; children with ASD respond best to structure and predictability
• learning and social interactions is approach systematically and gradually, allowing the child to develop comfort with the concepts
• stay aware of child’s physical boundaries and reluctance to be touched

Question 7

Education/Discharge

Answer 7

-parents taught the A.L.A.R.M acronym as a means of understanding ASD and treatment