1. PRESENTED BY:
A.PRIYADHARSHINI M.Sc(N)
LECTURER,
JAI INSTITUTE OF NURSING AND RESEARCH,GWALIOR.

2. How do they present?
Parents worried about:
◦ Speech and language delay
◦ Abnormal behaviour
◦ Lack of understanding

3. DEFINITION
A disorder of neural development
characterized by
impaired social interaction
impaired communication skills
impaired imagination with restricted
interests and repetitive stereotypical
behavior

4. Contd..
Itis a complex developmental disability
that typically appears during the first
three years of life.
Autism is also called as kanner syndrome.

5. AETIOLOGY
UNKNOWN AETIOLOGY (problems in
neural maturation)
STRONG GENETIC BASIS
ONSET BEFORE 36 MONTHS OF AGE
Autism is 4 times more prevalent in boys
and girls.
Classic autism occurs in 10-30 per 10,000

6. CLINICAL PRESENTATION
The symptoms occur first during the
infancy period.
The symptoms of autism vary greatly but
follow a general pattern.
Not all symptoms are present in all
autistic children.

7. Contd…
VARIED SPECTRUM
NO EYE CONTACT<------------->INTERMITTENT
EYE CONTACT,
SMILE AND HUG
MENTAL RETARD.<------------->SUPERIOR IQ IN
SELECT AREAS
NO SPEECH<--------------------->ADVANCED
SPEECH
IMITATE SONGS;

8. Impaired social interaction
Avoid eye contact
Avoids cuddling by parents (resists or
becomes stiff)
Reduced recognition of others happiness,
distress or anger (respond same to anger
and love)
Lack of interest in other children
Prefers solitary play

9. EYE CONTACT

10. NORMAL RESPONSE –
ATTEMPT TO LIFT RESPONSE TO CUDDLING

11. Contd...
Unable to join in with others (GROUP
PLAY)
Resists invasion of personal space or
being hurried
Lack of awareness of classroom norms
e.g. criticises teacher, unwilling to
cooperate, doesn’t fit in.
May not smile in recognition of their
parents faces.

12. Contd..
Speech and facial expressions deveop
peculiarly.
Resistance to change. E.g. moving the
chair.

13. Impaired communication skills
Delayed language development especially
understanding.
Poor response to name (apparently deaf).
Lack of pointing or pointing only for what
they need; and not to share interest
Lack of empathy; Failure to respond to
others’ smiles/ anger

14. Contd..
Echolaliabeyond expected age
Reversing pronouns using ‘he’ for self beyond
3yrs
Unusual or advanced vocabulary
Unusual use of language or tendency to talk
only on specific (often factual) topics.

15. ECHOLALIA
REPEATING WORDS OR
PHRASES LIKE A PARROT
(beyond 3 years)

16. Impaired imagination
• Limited variety of imaginative play
• Repetitive play e.g. lining up toys,
spinning, flicking, switching on and off
• Liking for sameness and/or resists change
more than expected for age
• More interested in how things work than
playing with them.

17. UNUSUAL TENDENCY TO LINE UP
TOYS

18. OTHER BEHAVIOURS
• UNDER OR OVERSENSITIVITY TO SOUND,
TOUCH, PAIN OR OTHER SENSES
• UNUSUAL PROFILE OF SKILLS WITH SOCIAL
AND MOTOR SKILLS BELOW EXPECTED
• GENERAL KNOWLEDGE, READING OR
VOCABULARY IS ABOVE EXPECTED(THOUGH
MAY NOT UNDERSTAND WHAT IS READ)
• UNUSUAL MOVEMENTS (CLAPPING, HEAD
BANGING, ROCKING MOVEMENTS, EXCESSIVE
MOUTHING..)

19. NOT RESPONDING APPROPRIATELY
TO PAIN

21. Possible Indicators of Autism
Spectrum Disorders
• Poor eye contact
• Doesn't smile
• Does not respond to name
• Does not babble, point, or make meaningful
gestures by 1 year of age
• Does not speak one word by 16 months
• Does not combine two words by 2 years
• Loses language or social skills
• Doesn't seem to know how to play with
toys
• Is attached to one particular toy or object

22. Diagnosis
• Based on history, assessment and
investigation.
• Audiometry.
• Rating scales and formal interviews may
help in certain cases (CHAT, M-CHAT)
• Assessment must be multiprofessional
and in more than one setting. (SCHOOL,
HOME, PEERS)

23. PHARMACOLOGICAL THERAPY:
Medications for seizures, hyperactivity,
extreme mood changes.
FENFLURAMINE- it is a drug that
decreases blood serotonin
concentrations. Some autistics have
abnormally high blood serotonin
concentrations.
PIRACETAM- it helps autistic child to
become more talkative, sociable, less
aggressive and increases the attention
span.

24. SUPPORTIVE TREATMENT:
Earlyintervention is essential.
Encourage and support the parents.
Special education class.
Clear instructions to the child prompting to
perform specific behaviours.
Immediate praise the child and rewards for
performing those behaviors.
Behavior therapy
Speech therapy

25. Contd..
Music therapy
Play therapy
Sensory integration therapy
Auditory integration training- for
different sound frequencies.
Eliminating dietary gluten and milk and
dairy products.

26. PROGNOSIS:
The outlook for each child depends on
the intelligence and language ability.
Some people with autism become
independent adults.

28. THANK YOU