Autism Pediatric Series 2012

1. Autism
Tammy Marie Baker RN
Pediatric Series
March 1st 2012

2. What is autism
Autism Spectrum Disorders
A Complex group of Neuro developmental
disorders characterized by:
Social impairments
communication difficulties
repetitive behaviors
patterned behaviors

3. The spectrum
Autism ( more sever form )
Aspergers ( higher functioning)
Child disintegrative disorders
Pervasive Developmental Disorders

4. Causes and theories
Environmental's
genetics variances
variants of Serotonin and neurotransmitters in the brain itself ?
disruption of normal brain development in early fetal stages?
Speculative theories include diet; Digestive tract change ; Mercury poisoning; The
body's inability to properly use vitamins and minerals ( these are not proven)

5. Statistical ratio’ of autism
6 out of every 1000 children will be affected
Boys are 4 times more likely to be affected than
girls.

6. most common signs of autism
lack of social engagement
fixation on objects
patterned behaviors
avoid eye contact
unresponsive to name
disengaged or intently focused on something
cant interpret social cues from others
parallel play verses interactive

7. early signs of autism
no babbling or pointing by age 1
•no single words by 16 months or two-word
phrases by age 2
•no response to name
•loss of language or social skills
•poor eye contact
•excessive lining up of toys or objects

8. characteristic findings:
repetitive movement such as rocking or
twirling
self abusive behaviors biting, head banging
communication delays
sing/song verbalizations

9. Latent signs of autism
impaired ability to establish friends with peers
•impaired ability to initiate or sustain a conversation with
others
•absence or impairment of imaginative and social play
•stereotyped, repetitive, or unusual use of language
•restricted patterns of interest that are abnormal in intensity
or focus
•preoccupation with certain objects or subjects

10. common related concuring
syndromes
fragile X syndrome
tubularsclerosis
Turets syndrome
seizure disorders new or latent onset
learning disabilities
ADD

11. testing should be multidisciplinary in format
and include:
psychologist
psychiatrist evaluation
Neurologist
speech and language evaluation
hearing screening
cognitive testing
Child Study Team
Physical therapist evaluation
Evaluation

12. treatment
Behavioral Assessment
Behavioral Intervention Plan/Tool
Social skills classes
Speech and Language intervention
Structured Environment
one one therapy with psychologist/ psychiatrist
IEP Individualized Educational Plan ( school )
Medications for coexisting diagnosis

13. nursing care of the autistic child
Follow Behavioral plan
Approach child slowly
Allow child time to get to know you and establish a rapport with child
Encourage eye contact ( eyes on me, cup child's chin and encourage eye contact)
Praise child for positive social interactions
Awareness of speech processing delays and communication variables
Maintain routines and structure ( autistic children do not respond well to changes)
Be aware of Autistic sensory issues, avoid loud noises, tactile defensiveness; smell
and taste aversions. introduce new things slowly to the child.

14. Communcation 101
just because its not spoken doesn’t mean its not there.......
it is essential that we recognize the non verbal
and us alternative methods to foster the
unspoken voice
non verbal cues to include eye gaze , lips facial
expression, head nodding, and body language
Alphabet boards
Picture board
computer Enhanced technological communication
devices ( switches, pc programs)

15. communication 102
a non verbal child is not “dumb”intelligence is not measured of words
Autistic children can be highly intelligent with high IQ function
Standardized testing isn’t standard with a child in the Autistic Spectrum and not
always a true measure of his/ her ability verses disabilities.
Autism is “out of the box”
Verbal expression of the care giver/ skilled nurse should always respect the child's
and families feelings.
Children although non verbal may possess a higher level of understanding and
interpretation of our verbal expression. The child maybe staring or appear non
engaged and at the same time be internalizing his environment quietly within his
“The Autistic Child Spins inside himself self as our
world .
world rotates around him... Our galaxy may only be a
small universe in his” tmb

16. Sensory integration Dysfunction
The Care giver/ nurse must be aware that Children with Autism present with Sensory issues
Their neurological system functions differently in interpreting the world around them.
Hypersensitivity and Hyposensitivity to external stimuli can cause great discomfort and behavioral issues
Loud noises, large environments, thermoregulation hot/cold intolerances,tastes, smells ect. Environmental
input can be overwhelming to them.
Communication impairment can impede their ability to tell us what is wrong or bothering them. A non verbal
child may pull away from stimuli, cover their ears or retreat into them selfs when over stimulated.
Retrospect-fully the child may crave neurological input and “stim” off the environment as well.
Occupational therapist can work with the child to increase tolerance to environmental Factor as well as offer
deep pressure activities to sooth the child. A technique involved may include: brushing, deep pressure,
texture tolerance exercises ect.
some sensory issues can be outgrown or the child may mature to a point of higher tolerance to the
environmental stimuli that irritate or stimulate him.

17. Sensory Integration
Learning to tolerate the environment can be over whelming

18. Autism Awareness
making a difference
Education opens doors , changes perceptions and cans change lives......
Awareness
Understanding
Tolerance
Intervention
Support
Make a Difference

19. Educational terms
Acronym
What It Stands For
ABA
Applied Behavioral Analysis
AS
Asperger Syndrome
ASD
Autism Spectrum Disorder
BIP
Behavior Intervention Plan
BMP
Behavior Management Plan
ESY
Acronyms and terms used in association with
Extended School Year
FAPE
Free and Appropriate Public Education
FERPA
autism treatment Family Educational Rights and Privacy Act
IDEA
Individuals with Disabilities Education Act
IEP
Individualized Education Program
IFSP
Individualized Family Service Plan
IPP
Individual Program Plan
ISP
Individual Service Plan
LRE
Least Restrictive Environment
NT
Neurotypical