Autism

psychiatric condition
i will think that this ppt is helpful for 3rd year bsc nursing

1. INTRODUCTION Autism, or autism spectrum disorder, refers to a range of conditions characterized by challenges with social skills, repetitive behaviors , speech and nonverbal communication, as well as by unique strengths and differences.

2. Definition Autism is a complex neurobehavioral condition that includes impairments in social interaction and developmental language and communication skills combined with rigid, repetitive behaviors . Because of the range of symptoms, this condition is now called  autism spectrum disorder  (ASD). Autism the condition is the result of a neurological disorder that has an effect on normal brain function, affecting development of the person's communication and social interaction skills.

3. EPIDEMIOLOGY IN WORLD Every 20 minutes, a child is diagnosed Autism affects four times as many boys as girls An estimated 50,000 children and 150,000 adults in Canada have autism The diagnosis rate in North America is currently 1 in 88 children. IN INDIA Over 18 million people with autism 1 in 68 have autism spectrum disease. The third most common developmental disorder Autism Resource Centre in Tamil Nadu reports ~ 1 in 150 children affected

4. Cause inherited genetically result of environmental toxins (heavy metals, chemicals, pesticides, viruses) Neurological Implications MRI studies have suggested - rapid overgrowth in the first year and minimal growth after age 2 until approx. age 4 and lack of overgrowth Frontal Cortex - rapid overgrowth until age 4 (cognitive language functions, social-emotional processing) Visual cortex - relatively intact.

5. Cause There are several theories. Researchers are exploring various explanations but, to date, no definitive answers or specific causes have been found . Current research studies say it may be inherited genetically. May also be a result of environmental toxins (heavy metals, chemicals, pesticides, viruses)

6. Possible signs of autism in babies and toddlers: By 6 months, no social smiles or other warm, joyful expressions directed at people By 6 months, limited or no eye contact By 9 months, no sharing of vocal sounds, smiles or other nonverbal communication By 12 months, no babbling By 12 months, no use of gestures to communicate (e.g. pointing, reaching, waving etc.) By 12 months, no response to name when called By 16 months, no words By 24 months, no meaningful, two-word phrases Any loss of any previously acquired speech, babbling or social skills

7. Possible signs of autism at any age: Avoids eye contact and prefers to be alone Struggles with understanding other people’s feelings Remains nonverbal or has delayed language development Repeats words or phrases over and over (echolalia) Gets upset by minor changes in routine or surroundings Has highly restricted interests Performs repetitive behaviors such as flapping, rocking or spinning Has unusual and often intense reactions to sounds, smells, tastes, textures, lights and/or colors

8. well-baby or well-child visit, your child’s doctor should perform a “developmental screening,” asking specific questions about your baby’s progress. The National Institute of Child Health and Human Development (NICHD ) lists five behaviors that warrant further evaluation: Does not babble or coo by 12 months Does not gesture (point, wave, grasp) by 12 months Does not say single words by 16 months Does not say two-word phrases on his or her own by 24 months Has any loss of any language or social skill at any age Any of these five “red flags” does not mean your child has autism. But  because the disorder’s symptoms vary so widely, a child showing these behaviors should be evaluated by a multidisciplinary team.  This team might include a neurologist, psychologist, developmental pediatrician , speech/language therapist, learning consultant or other professionals who are knowledgeable about autism.

9. Diagnosing an ASD takes two steps: Developmental Screening Comprehensive Diagnostic Evaluation Developmental Screening : i )All children should be screened for developmental delays and disabilities during regular well-child doctor visits at: 9 months 18 months 24 or 30 months Additional screening might be needed if a child is at high risk for developmental problems due to preterm birth, low birth weight or other reason

10. Contd.,.. ii)In addition, all children should be screened specifically for ASD during regular well-child doctor visits at: 18 months 24 months Additional screening might be needed if a child is at high risk for ASD (e.g., having a sister, brother or other family member with an ASD) or if behaviors sometimes associated with ASD are present

11. 2.Comprehensive Diagnostic Evaluation Developmental Pediatricians (doctors who have special training in child development and children with special needs) Child Neurologists (doctors who work on the brain, spine, and nerves) Child Psychologists or Psychiatrists (doctors who know about the human mind)

12. Risk factors Your child's sex .  Family history.  Other disorders.  ( fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability) Extremely preterm babies . Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder. Parents' ages. There may be a connection between children born to older parents and autism spectrum disorder .

13. Complications Problems with social interactions, communication and behavior can lead to: Problems in school and with successful learning Employment problems Inability to live independently Social isolation Stress within the family Victimization and being bullied

14. PSYCHO PHARMACO-THERAPY Hyperactive behaviour   Ritalin and  Concerta Anxiety and obsessional behaviour   Selective serotonin re-uptake inhibitors (SSRIs) can help reduce anxiety Tics  antipsychotics and noradrenergic agents like clonidine Trouble sleeping   Melatonin maintains your circadian rhythm, which is your internal 24-hour clock Seizures   :- effectively with anti-epilepsy medication.

15. Behavioral Therapies APPLIED BEHAVIOR ANALYSIS (ABA):-    teaches play, communication, self-care, academic and social living skills, and reduces problematic behavior VERBAL BEHAVIOR THERAPY (VBT) :- VBT seeks to move children beyond labeling , a first step of learning language, and gesturing to vocalizing their requests – “I want a cookie.” COGNITIVE BEHAVIORAL THERAPY (CBT) :- focus more on developing skills a child already has and working on their deficiencies   DEVELOPMENTAL AND INDIVIDUAL DIFFERENCES RELATIONSHIP (DIR)  therapy (also called Floortime ) motivation to engage and interact with others. The therapist follows a child’s lead in working on new skills.

16. Contd.,..   RELATIONSHIP DEVELOPMENT INTERVENTION (RDI):-   RDI breaks its various objectives down into step-by-step paths adults use to prompt development, such as building eye contact or back-and-forth communication. TREATMENT AND EDUCATION OF AUTISTIC AND RELATED COMMUNICATION HANDICAPPED CHILDREN:-   is a classroom-based program that customizes academic instruction and social development to a child’s strengths. SOCIAL SKILLS GROUPS:-  help children engage in pragmatic language and manage real-world difficulties with peers

17. Various other therapies Music Therapy Auditory Therapy Vitamin/Mineral Therapy Holding Therapy Daily Life Therapy Picture Exchange Communication System (PECS) Speech –Language Therapy Occupational Therapy Swimming Therapy Animal Therapy

18. Autism is still not recognized as a separate form of disability  in the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995, the primary piece of legislation that provides for the rights of and benefits for persons with disabilities in India.

19. Prevention No way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behavior , skills and language development. However, intervention is helpful at any age. Though children usually don't outgrow autism spectrum disorder symptoms, they may learn to function well.

20. savant syndrome Children who display savant syndrome have traditionally been referred to as idiot, retarded, or autistic savants. The negative connotations of the term "idiot" have led to the disuse of idiot savant. Because the syndrome is often associated with  autism, the term autistic savant is more frequently heard. The first known description of a person displaying savant syndrome occurred in a  German psychology journal in 1751. The term savant was first used in 1887 by J. Langdon Down 

21. Definition Savant syndrome is exceedingly rare, but a  remarkable  condition in which persons with autism, or other serious mental  handicaps , or major mental illness, have astonishing   islands of   ability  or  brilliance  that stand out in stark  contrast  to their overall  disability . Savant  syndrome occurs when a person with below normal  intelligence   displays a special talent or ability in a specific area.

22. symptoms have an exceptional talent or skill in a particular area, such as the ability to process  mathematic calcalculations at a phenomenal speed music , visual art common skill demonstrated by savants is extraordinary memory. Children with savant syndrome may be able to memorize extensive amounts of data in such areas as  sports   statistics, population figures, and historical or biographical data.

23. Diagnosis Savant syndrome is diagnosed when a child's ability in one area is exceptionally higher than would be expected given his or her IQ or general level of functioning. Treatment making use of the special talent of the child with savant syndrome may help treat the child's underlying developmental disorders.

24. Nursing interventions Engage the child in therapeutic alliance begining with non-verbal play Provide individualized care Meet the basic needs –the child unable to express Teach the child self- care activities Motivate the child to express it needs Encourage to vocalize with sound ,games and songs. Identify desired behaviour and reward it. Motivate the child express or communicate his needs.

25. Contd.,.. Facilitate super ego development by role modeling Provide language training Demonstrate communication &social skills Foster ego development by reinforcing self identity ego boundaries through drawing, stories and play activities. Teach the patient about disease and prognosis Teach the parent how to facilitate speech development in order to continue behavior modification.

26. Thank you