GillianChurch

MedicalDefinition:
Autismspectrumdisordersarecomplex
neurodevelopmentaldisordersof
unknownetiologycomposedof
qualitativealterationsinsocial
interactionandverbalimpairmentwith
repetitive,restricted,andstereotype
behavioralpatterns.(Wongp.590)

Autism SpectrumDisorders(ASD)
Etiology:
Thecauseofautismspectrumdisordersisunknown.
Researchersareinvestigatinganumberoftheories,
includingalinkbetweenhereditary,genetic,andmedical
problems.Immuneandenvironmentalfactors(e.g.,viral
infections)mayinteractwithgeneticsusceptibilityto
increasetheincidenceofASD.IndividualswithASDmay
haveabnormalEEGs,epilepticseizures,delayed
developmentofhanddominance,persistaenceofprimitive
reflexes,metabolicabnormalities,cerebellarvermal
hypoplasia,andinfantileabnormalheadenlargement.
Between516%ofboyswithASDarepositiveforthe
fragileXchromosome.Thereisalsoarelativelyhighrisk
ofrecurrenceofASDinfamilieswithoneaffectedchild.
Severalgeneshavebeensuggestedaspossiblecausative
factorsinASD.Thereisnoscientificevidencethatthereis
alinkbetweenvaccinesandASD.Recentreportshave
retrospectivelytieditwithprenatalandperinataleventslike
motherandfatheragesover40year,uterinebleeding
duringpregnancy,lowApgarscores,fetaldistress,and
neonatalhyperbilirubinemia.(Wongp.590591)

AssociatedConditions:

NursingCare:

FragileXsyndrome;Tuberous
sclerosis;Metabolicdisorders;Fetal
rubellasyndrome;Hflumeningitis;
Structuralbrainanomalies
(Wongp.591)

Highlystructuredandintensivebehaviormodification
programs;Slowlyintroducenewsituations;Promote
positivereinforcement;Increasesocialawarenessof
others;Decreaseunacceptablebehaviors;Takeextra
carewhengivingmedicationsandfeeding;Encourage
parentstobringpossessionstheyareattachedtowhen
theyarehospitalized;Avoidextraneousauditoryand

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Signs&Symptoms:
ASDhavevaryingdegrees,rangingfrommildtosevereforms,
thereforechildrenhavevaryingclinicalmanifestations.Some
possiblemanifestationsinclude:
Inabilitytomaintaineyecontact;Avoidanceofbodycontact;
Languagedelay,repetitiveuseoflanguage;Displaylimited
functionalplayandmayinteractwithtoysinanunusualorodd
manner;Lackofmakebelieveplay;Constipation;Lackofsocial
oremotionalreciprocity;Lackofspontaneousseekingtoshare
enjoyment,interests,orachievementswithothers;Inflexible
adherencetospecificroutinesorrituals;Stereotypedand
repetitivemotormannerisms;Persistentpreoccupationwithparts
ofanobject.(Wongp.591)

Pathophysiology:Currentlyunknown

Diagnosis:
Earlyrecognition,referral,diagnosis
andintensiveearlyinterventiontendto
improveoutcomesforchildrenwith
ASD.Unfortunatelydiagnosisisnot
madeuntil23yearsaftersymptomsare
firstrecognized,whichisbasedonthe
diagnosticcriteriainDSM.

visualdistractions;Giveconcisedirections;
Communicatewithchildsdevelopmentlevel,brief,
andconcrete;Providestructuralroutineforchildto
follow;Useprivateroomtodecreasestimulation;
RecognizeallchildrenwithASDarenotthesameand
requireindividualassessmentandtreatment;Minimal
holdingandeyecontacttoavoidbehavioraloutbursts;
Teachverbalcommunicationskills;Keepvisitswith
staffcaregiversshortwhenpossible.(Wongp.593)

References:
Wongp.590593