autism-Nursing III-Exam 1

Autism

Autism spectrum disorders cause:

-deficit in social communication and interaction

-restrictive/repetitive patterns of behavior, interests, or activities

-symptoms present in early developmental period and cause impairment in social, occupational functioning

Describe the pathophysiology of autism

-RESULTS from defects in genes and gene expression, and atypical brain construction

-Neurons in cerebral cortex are abnormal (seen on MRI)

-Frontal and temporal lobes are susceptible

Frontal lobe

responsible for problem solving and motor skills

temporal lobe

responsible for sensory input, processing, and languageW

Why are early interventions for autism important?

Because the brain can develop neuron networks around abnormalities

Describe the etiology of Autism

It is unknown, but has a higher risk and occurrence in boys (x5), and is believed to be due to mix of genetic, hereditary, and exposure factors

Exposures: environmental-maternal rubella or cytomegalovirus; chemical: thalidomide, misoprostol, valproate during pregnancy

what are risk factors for autism

-Advanced maternal/paternal age

-maternal smoking, alcohol use, exposure to pollution/pesticides, certain medication use

-Maternal obesity, diabetes, immune system disorders

-Increased risk with fragile X syndrome, neurofibromatosis, congenital rubella syndrome, down syndrome

-premature, LBW, birth complications (O2 deprivation)

How to decrease risk of autism prenatally

-excellent prenatal care

-folic acid and good maternal health before pregnancy

-consider benefits/risks of medications (including antiepileptics)

-avoid alcohol, tobacco, infection, toxic substances

What clinical manifestations present with autism?

Impairments in social interactions, communication, cognitive development, ability to adapt to new situations, attention span

What social signs present with autism?

-avoiding eye contact

-trouble engaging or relating to others

-difficulty play social games or using toys appropriately

-difficulty regulating or showing emotions

What communication signs can indicate autism?

-delay in babbling/speaking

-significant delays in understanding language

-repeating words or phrases

-flat or even tone of voice

What behaviors and other disorders are associated with autism?

Repetitive behaviors

fixation or engaging in a singular activity over and over

GI disorders

seizure disorders

difficulty sleeping

pica

sensory issues

How is autism diagnosed?

Based on presence of criteria in DSM-5; symptoms are typically noticed when the child is 24-48 months old

What is the modified checklist of autism in toddlers revised?

-It is valid for toddlers 16-30 months

-AAP recommends that all children receive autism screening at 18 and 24 months

-Child requires follow up if they answered no to 2 or more critical questions or answered no to 3 questions

Ritalin

Stimulant; decreases impulses and hyperactivity

Valium and ativan

Antidepressants

Zoloft, Prozac, and Luvox

SSRIs; treat anxiety, depression, OCD; help decrease repetitive behaviors, improve eye contact

Haldol, risperidol, zyprexa, geodon

-Antipsychotics

-treat behavioral problems

decrease brains use of dopamine

Tegretol, lamictal, topamax

-Anticonvulsants

-monitor drug serum levels

Behavior modification programs

-promote positive reinforcement

-increase social awareness

-teach verbal communication skills

-decrease unacceptable behavior

Goals of treatment

reduce rigidity and maladaptive behaviors

What complementary and alternative therapies can be used in the treatment of autism?

Dietary therapy: gluten free (thought to help improve behavior_, supplements (melatonin, omega-3 fatty acid to improve brain growth and help with focus)

touch therapy

music therapy

hyperbaric oxygen treatents

Warning signs in assessment

No babbling or communication gestures by 12 months of age

no single word by 16 months of age

no spontaneous two words by 24 months

loss of language or social skills previously achieved