Autism Spectrum Disorder Notes

Describe clinical manifestations, prevalence, and health disparities related to ASD.
Identify ways nurses and health professionals can address inequities by minimizing challenges faced by individuals with ASD and their families in healthcare settings.
Strategize methods to provide accessible, patient-centered care in any health setting.

Autism Spectrum Disorder (ASD) is a developmental disability caused by differences in the brain.
Individuals with ASD may behave, communicate, interact, and learn differently from most.
Global Developmental Delay (GDD): Significant delays in multiple developmental areas like cognitive, motor, speech/language, and social skills. Children with GDD are behind peers in developmental milestones.

National: 1 in 36
Minnesota: 1 in 34 (higher than national average)
CDC data (March 23, 2023) shows an increase in Minnesota from 1 in 36 (two years prior) to 1 in 34.
3% of 8-year-old children in Minnesota were identified with ASD in 2020.
Prevalence is higher among boys (4.4 times more likely) compared to girls.
White children (3%) are slightly more likely to be identified with autism than Black children (2.8%), while the rate among Hispanic children is 4% and the rate for Asian/Pacific Islander children is 2.4%.
Overall, more Minnesota children are being identified with ASD earlier.

Causes: Tuberous sclerosis, Trisomy 21, Angelman syndrome, Rett syndrome.
Other comorbidities: Epilepsy
Affects 1 in 68 kids (1%)
Males are 5 times more likely to be affected.
Other factors: reproductive technologies, low birth weight/complications at birth, maternal stress

Amygdala: Responsible for emotional responses, including aggressive behavior.
Hippocampus: Enables remembering new information and recent events.
Cerebral Cortex: Thin layer of gray matter responsible for higher mental functions, general movement, perception, and behavior reactions.
Basal Ganglia: Gray masses that connect the cerebrum and cerebellum, regulating automatic movement.
Corpus Callosum: Bundles of fibers connecting the right and left hemispheres, allowing communication.
Brain Stem: Relays messages between body parts and the cerebral cortex; controls primitive functions like breathing and heart rate.
Cerebellum: Fine-tunes motor activity, regulates balance, body movements, coordination, and muscles used for speaking.

If you point at something across the room, does your child look at it?
Have you ever wondered if your child might be deaf?
Does your child play pretend or make-believe?
Does your child make unusual finger movements near his or her eyes?
Does your child point with one finger to ask for something or to get help?
Does your child point with one finger to show you something interesting?
Is your child interested in other children?
Does your child show you things by bringing them to you or holding them up for you to see - not to get help, but just to share?
Does your child respond when you call his or her name?
When you smile at your child, does he or she smile back at you?
Does your child get upset by everyday noises?
Does your child look you in the eye when you are talking to him or her, playing with him or her, or dressing him or her?
If you turn your head to look at something, does your child look around to see what you are looking at?
Does your child try to get you to watch him or her?
If something new happens, does your child look at your face to see how you feel about it?

Autism exists across the lifespan, in all genders, ethnicities, and socioeconomic statuses; often undiagnosed.
Significant health disparities exist in this population; health professionals in all settings should be aware.
Patient-centered care positively affects the experience of those with ASD.
Risk for mortality is 2-3 times higher than comparison groups.
Challenges with communication, processing, social rules, executive function, and sensory processing.

Set limits and hold the patient responsible for behaviors.
Ignore inappropriate behaviors; praise self-control efforts.
Use concrete language.
Slow down communication.
Use a low-pitched voice and remain calm.
Ask how best to communicate; support their devices.
Use visual aids.
Do not argue, bargain, or negotiate about the limits set.
Teach to developmental level.
Provide consistent caregivers and establish a daily routine.
Give warnings before transitions; tell what is to come ("First…then…").
Check on them frequently, especially if waiting; redirect attention when needed.
Watch for sensory issues (lights, sounds, touch, smells, others in the waiting room).
Use restraints only when necessary.