Adolescent Speed Session

Considerations When Caring for Adolescents with Autism

Speaker Disclosure

• None

Learning Objectives

• Describe characteristics of adolescents with autism spectrum disorder (ASD).

• Identify common co-occurring conditions.

• Describe strategies for working with teens who have ASD.

Characteristics of ASD

• Spectrum Disorder: Developmental disability affecting communication, learning, behavior, and social interaction.

  • Difficulty with communication and social interaction.

  • Restricted interests and repetitive behaviors.

  • Different learning, movement, and attention mechanisms.

  • Obsessive interests.

  • Self-stimulating behaviors (stimming) such as hand flapping or rocking.

  • Delayed skills in language, movement, and cognition.

  • Sleep and eating habit issues.

Severity Levels of ASD

• Level 1: Requires support

  • Marked deficits in social communication.

  • Inflexibility and difficulty coping with change.

• Level 2: Requires substantial support

  • Severe deficits in verbal and nonverbal communication.

  • Extreme difficulty coping with change affecting functionality.

• Level 3: Requires very substantial support

  • Severe deficits in communication; may necessitate multiple medications and transitioning planning.

Interventions for Adolescents with ASD

Level 1 Autism

• Provide organizational support at school and home.

• Accommodations in test-taking and homework.

• Discuss social media with parents and teens.

• Facilitate social skill groups and connections with peers.

Level 2 Autism

• Higher organizational aid and potential IEP features like special education classes.

• Continuation of therapy (speech, occupational).

• Social media monitoring discussion with parents.

• Employment transition planning within IEPs.

Level 3 Autism

• More comprehensive IEP involvement; may involve special education settings.

• Continuous speech and occupational therapy.

• Planning for adult living support and possible guardianship.

Medications for Co-Morbid Conditions

• SSRIs: Effective for anxiety and associated symptoms (e.g., perseveration, irritability).

• Psychostimulants: Helpful for inattention, impulsivity.

• Alpha-2 Agonists (Clonidine, Guanfacine): Aid sleep issues but should be monitored closely.

• Refer to psychiatry for unresponsive cases.

Addressing Grief in Adolescents

Speaker Disclosure

• No disclosures.

Learning Objectives

• Describe cognitive differences in teens coping with grief.

• Recognize and differentiate prolonged grief disorder (PGD) from typical bereavement using evidenced-based tools.

• Discuss strategies for facilitating grief support.

Facts about Grief

• Unique emotional responses that significantly impact individuals.

• Important role of Nurse Practitioners in grief support for teens.

• Estimated 6.3 million children in the U.S. experience parental bereavement by age 18.

• Approximately 10% of bereaved individuals may suffer from PGD.

Grief Responses in Teens

• Understanding death's universality and finality through abstract thinking.

• Physical, emotional, behavioral, and cognitive responses to grief.

• Complicated grief in surviving parents can influence teens' grief experiences.

Strategies for Grief Facilitation

• Practical strategies include communication, psych-education, anticipatory guidance, and collaborative approaches using referral to behavioral therapies as needed.

Screening Tools for Youth Grief

• PHQ-9 Modified for Teens: High sensitivity and specificity for detecting depression.

• Adolescent Grief Inventory: Valid measure for adolescent grief assessment.

• Inventory of Complicated Grief (ICG-RC): Assists in identifying complicated grief in bereaved youth.

Doxycycline Post-Exposure Prophylaxis (DoxyPEP)

Overview

• Doxycycline is a broad-spectrum antibiotic effective against certain STIs (e.g., Chlamydia).

• DoxyPEP can prevent STIs if administered within 72 hours post-exposure.

Usage Guidelines

• Dosage: 200 mg orally once; repeat once a day based on sexual frequency.

• Use in populations such as Transgender Women (TGW) and Men who have Sex with Men (MSM).

• Essential discussions for patients to enhance awareness of benefits and risks.

Adult Transition for Children with Special Health Care Needs

Health Care Transitions (HCT)

• Transition patients from pediatric to adult care should begin discussions around 13-14 years.

• Only 17% of patients with ID/DD received full HCT guidance.

• Resources discussed include Got Transition® and assessments for readiness.

Assessing Adult Needs

• Query state requirements for adult services, including parental support roles post-18 and guardianship issues.

• Importance of thorough legal counsel on estate planning and implications for adulthood.

Opill: Progestin-Only Birth Control Pill

FDA Approval and Availability

• Opill became available OTC in 2023 after years of research.

• Safety and effectiveness were established for consumer use without supervision.

Mechanism and Efficacy

• Opill works by suppressing ovulation and thickening cervical mucus.

• Efficacy rates: 98% perfect use, 93% typical use.

New Meningococcal Vaccines

Meningococcal Disease Overview

• Caused by Neisseria meningitidis; severe outcomes can include long-term disabilities.

• Specific vaccine recommendations for adolescents from age 11-12 and boosters at age 16.

Vaccine Types

• Quadrivalent vaccine covers serotypes A, C, W & Y; recommended for adolescents and those at risk.

• New Pentavalent vaccine approved for broader protection against these serotypes.