Autism. MSc MENTAL HEALTH NURSING

The word ‘Autism’ is derived from Greek word ‘autos’ means ‘self’.
Autism is a developmental disorder that is characterized by impaired development in communication, social interaction, and behavior.

1. Autism MR. VIHANG TAYDE

2. INTRODUCTION: WHO, American psychological Association classification ‘Autism’ as a developmental disability that results from central nervous system disorder.

3. The word ‘Autism’ is derived from Greek word ‘autos’ means ‘self’. Autism is a developmental disorder that is characterized by impaired development in communication, social interaction, and behavior.

4. In other words, the symptoms and characteristic of autism can present in a wide variety of combinations, from mild to severe. Children are marked by delay in their social interaction, communication, symbolic or imaginative play, exhibits lack of interest in other people.

5. INCIDENCE: Autism is a rare disorder, long term illness with a poor prognosis Generally, the onset occurs before the age of 2 ½ years. In some cases, the onset may occur later in childhood. And such cases are called as childhood onset autism.

6. DEFINITION: Quantitative impairment in social interaction, communication, restricted, repetitive and stereotyped patterns of behavior, interests and activities, delays in abnormal functioning

7. A developmental disorder characterized by total lack of responsiveness to people gross language developmental deficits or distortions, bizarre response to environmental aspects.

8. PREDISPOSING FACTORS History of perinatal complication- maternal bleeding • Anoxia during pregnancy and delivery Drug abuse in pregnancy

9. Maternal rubella infection, congenital rubella Encephalitis Meningitis Tuberous sclerosis Familial interpersonal factors

10. CAUSES: Abnormalities in the brain functioning, E.g . Defects in temporal lobe of brain, limbic system .

11. Psychosocial factors – Parental rejection, – Deviated personality, – Broken families stress, – Defective communication pattern , – Sibling conflicts.

12. Autism is not caused by an unhappy home environment, both parents working, mental stress during the pregnancy, poor handling by the mother and also some emotional trauma or other psychological factors.

13. CLINICAL MANIFESTATION : 1. Impairment of social interaction : Avoid eye contact. Prefer to play alone. Does not share interests with others. Flat or inappropriate facial expressions Avoids physical contact.

14. 2.Impairment in behavior: Plays with toys the same way every time. Likes parts of objects. Gets upset by minor changes. Has an obsessive interest. Dislike being kisses or touch. Failure to develop empathy .

15. 3.Impairment in communication Gives unrelated answer to a question. Does not understand jokes or teasing. Delayed speech and language skills. Repeated words or phrases over and over.

16. 4.Other symptoms Hyperactivity . Short attention span Lack of fear or more fear than expected. Causing self-injury. Aggression .

17. EXAMINATION AND TESTS : 1. Medical history: During the medical history interview, a doctor asks general questions about a child's development, such as whether a child shows parents things by pointing to objects.

18. Young children with autism often point to items they want, but do not point to show parents an item and then check to see if parents are looking at the item being pointed out.

19. 2.Physical exam: including head circumference, weight , and height measurements, to determine whether the child has a normal growth pattern.

20. 3. Screening test for autism (such as the Checklist for Autism in Toddlers [CHAT] or the Autism Screening Questionnaire).

21. Modified Checklist of Autism in Toddlers:

22. Valid for toddlers 16-30 months List of questions Answers determine need for referral to a developmental specialist – Developmental pediatrician – Neurologist – Psychiatrist Scoring : child requires follow up if – Answered “No” to 2 or more critical questions or Answered “No” to 3 questions

23. TREATMENT Medicines are often used to treat behavior or emotional that people with autism may have, including: Aggression, Anxiety, Attention Problems, Hyperactivity, Irritability, Mood Swings, Sleep difficulty....etc. but mostly used drug are lithium .

24. A. Behavior therapy: e.g . contingency management, positive reinforcement, self-care skills, role modeling

25. B.APPLIED BEHAVIOUR ANALYSIS(ABA) – ABA encourages the positive behaviors and discourages the negative behavior in order to improve the variety of skills.

26. – For example; a teacher might ask a child to put his toys away. If the child puts his toys away, the teacher will praise the child. If the child does not put his toys away, the teacher might guide the child’s hand or withhold a reward until the child puts the toys away.

27. C. OCCUPATIONAL THEARPY : Occupational therapy teaches skills that help the person live as independently as possible. Skills might include dressing, eating, bathing, and relating to people.

28. D. SPEECH THERAPY : – It helps to improve the person’s communication skills. – Some peoples are able to learn verbal communication .

29. E. PSYCHOTHERAPY : – Psychotherapy is not effective in treatment of autism. – However, parental counseling and supportive therapy are useful is allaying parental anxiety and guilt, and ensuring their active involvement of the therapy.

30. NURSING MANAGEMENT: 1.Impair social interaction related to self-concept disturbance as evidence by lack of eye contact and failure to development friendship. GOAL: patient will initiate social interaction with another individual by discharge.

31. 2. Impair verbal communication related to withdrawal into self as evidence by does who not speak. GOAL: patient will have established a means for communicating needs to staff discharge.

32. 3. Disturbance in self-concept related to inadequate sensory stimulation. GOAL: patient will develop ego identity by discharge.

33. INTERVENTION RATIONALE Function in one to one relationship with child. To enhance the establishment of trust. Point out and assist child in naming, own body parts. It increases the child awareness of self as separate from others. Gradually increase amount of physical contact. Trust is established.

34. CONCLUSION: The word ‘Autism’ is derived from Greek word ‘autos’ means ‘self’. Autism is a developmental disorder that is characterized by impaired development in communication, social interaction, and behavior.

35. Delay in their social interaction, communication, symbolic or imaginative play, exhibits lack of interest in other people .

36. ASSIGNMENTS : Define autism. Enlist the causes of autism

37. BIBLIOGRAPHY: 1. R. Sreevani , A guide to Mental Health & Psychiatric Nursing, JAYPEE BROTHERS, 3rd Edition 2010 ; page No – 230-234 . 2. Anbu.T ; Text book of Psychiatric Nursing; EMMESS., 1st Edition 2010; Page No- 164-167.

38. 3. R.K.Gupta , New Approach To Mental Health Nursing, 2011 Edition.

39. Thank you……