AUTISM Presented by Amy Long Auburn University of Montgomery
School of Nursing Pathopharmacology Nursing 4120
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WHAT IS AUTISM? Autism is a developmental disorder that appears
in the first 3 years of life, and affects the brains normal
development of social and communication skills. National Library of
Medicine It is estimated that 1 out of every 88 children have an
Autism Spectrum Disorder (ASD). The numbers are rising..Is it more
prevalent or are more children just being classified as ASD. Autism
can be severe to mild with many variations. Some of the different
subgroups of Autism are: 1.Aspergers Syndrome 2.Pervasive
Development Disorder or PDD 3.Rett Syndrome 4.Childhood
Disintegrative Disorder
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PATHOPHYSIOLOGY There is no single etiology for Autism. Autism
involves the abnormal development of a distributed neural network
involving a number of regions in the brain. (Coleman, 2005)
Evidence suggest that oxidative stress plays a role in the
development of Autism (Chauhan 2004) Nitrogen metabolism-related
parameters may have a role. (Shamais, 2012) Glutamate signaling is
implicated in APD. Glutamatergic system plays an important role in
neurodevelopment. (Choudhary, 2012) Dysfunction of the amygdala
region in the brain.
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PATHOPHYSIOLOGY, CONT. Some researchers believe that there is
over connectivity in the brain, while others believe Autism is from
under connectivity. There is evidence that suggests that there is
an immune dysfunction that impacts neurological behaviors and
processes. (Onore, 2012) Epidermal growth factor may have a role.
There may be a nutritional component. May be an underlying disorder
of monoamine system. At this time, there is no evidence that
supports the theory that childhood immunizations cause Autism
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RISK FACTORS Boys are 4-5 times more likely to have an ASD than
girls. Thought to have a heredity component. If one child in a
family has an ASD there is an increased chance for future children
to also have an ASD. There may be a connection between advanced age
of parents and children with ASD. Children with other neurological
disorders have a higher incidence of having an ASD. Studies are
currently being done to try and link environmental factors. May be
a connection to having babies close in age.
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RISK FACTORS, CONT. Prenatal risk factors include: advanced
maternal or paternal age, firstborn, maternal prenatal medications,
and mothers status as foreign born. Perinatal and neonatal risk
factors were preterm birth, breech presentation, planned cesarean
section, low Apgar score, hyperbilirubinemia, birth defect and a
birth weight small for gestational age. (Guinchat V, 2012)
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CLINICAL Social component: a.Poor eye contact b.Lack of empathy
c.Appears not to hear you at times d.Fails to respond to his or her
name e.Seems to prefer playing alone
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CLINICAL Language a.Delayed speech b.Loses previously acquired
language skills c.Lack of eye contact when making requests
d.Pedantic speech e.Difficultly with conversation f.Difficulty with
use of words
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CLINICAL Behavior a.Rocking, spinning or flapping b.Insists on
strict rituals or routines c.Decrease or absent creative or
imaginary play d.Food aversions e.Constantly moving f.Sensitivity
to lights, sounds, and touch
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DIAGNOSTIC No current definitive diagnostic test for autism.
Children are screened by pediatrician starting at birth up to age
3. Children are sometimes diagnosed when their parents notice that
they are different than their peers and seek medical. advice A
collection of symptoms is one leading factor in diagnosis. There
are screening tools developed to aid in diagnosis. There is a
diagnostic criteria in the DSM IV which is dependent on the
behaviors of the child.
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PHARMACOLOGY There are no specific autism medications, however
several are used to treat symptoms and behaviors of individuals
with ASD. Prozac and Zoloft are used for the treatment of
depression and obsessive compulsive disorder which are two
disorders that can accompany Autism ( approved for children age 7
and up ). Risperdal sometimes used for treatment of aggressive
behavior (approved for children starting age 5). Some children with
Autism also have a seizure disorder and must take medications such
as Tegretol, Topamax, and Depakote to control their seizures. Other
off label prescriptions have been used such as Valium, Ritalin, and
Ativan.
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EVIDENCE BASED PRACTICE TREATMENT Early intervention is
extremely important Treatment with speech therapy to assist with
communication and social communication skills Treatment with
occupational therapist for improvement of coordination and gait
Treatment with behavioral specialist to aid with societal normal
behavior and expectations Treatment with psychologist for
aggressive behavior, play group therapy and depression Medication
therapy via psychiatrist
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INTERESTING FACTS Any child age 3 and under that displays
developmental delays qualifies for Early Intervention-a
governmental program Autism was added as a special education in
1991 and now is the sixth most common classified disability in the
U.S. Divorce rates are high in families with an autistic child Dogs
have been shown to improve autistic children's quality of life,
independence and safety Autism is more common than childhood
cancer, diabetes, and AIDS combined Scholars and parents debate
whether autism is a disability or whether it should be considered
merely a different kind of personality One of my children was
diagnosed with a Pervasive Developmental Disorder
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AUTISM HAS MANY FACES YOUTUBE VIDEO YOUTUBE VIDEO 2 YOUTUBE
VIDEO 3 I included three different videos because Autism has many
faces. These videos are both heartwarming and heartbreaking.
Obviously, some families have to deal with a lot more than others.
I believe the testimonials from the parents, because they are in
the trenches of caring for the children. These videos are great for
showing examples of the severity and human side of this
disorder.
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REFERENCES Coleman, Mary New York: Oxford University Press
eBook 2005 Shamais, Abu; Journal of Neurodevelopmental Disorders
2012, Feb 13; Vol 4(1) pp.4 Choudhary, P; Glutamate mediated
signaling in the pathophysiology of autism spectrum disorders.
Pharmacology Biochemistry and Behavior Onore, C. The role of immune
dysfunction in the pathophysiology of autism. Brain, Behavior, and
Immunity Vol 26, Issue 3, March 2012 pp385-392 Guinchat V.
Pre-Peri- and Neonatal risk factors for Autism. Acta Obstet
Gyneocal Scand. 2012 March, 91(3) pp 287-300