AUTISM. AS UNIQUE AS A SINGLE SNOWFLAKE Kimberly Martin , RN, BSN. Autism.
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AS UNIQUE AS A SINGLE SNOWFLAKE
Kimberly Martin, RN, BSN
As Autism Spectrum Disorder rises in prevalence, it is imperative nurses in any setting to understand the unique challenges of this population. There has been very little information and many misconceptions about best practices for improving care to children with ASD
Autism affects 1 in every 110 children (Center for Disease Control and Prevention [CDC], 2010). As the incidence of Autism increases, nurses will experience increased interactions with patients with Autism. Little awareness or education has been devoted to this complex neurological disorder and health professionals are left with unsuitable knowledge or tools available to properly care for this population of patients.
A course is designed to educate nurses about Autism, levels of impaired social interaction, communication needs, stereotypical behaviors, learning barriers, therapies, and nursing adaptations and tools that will increase the ability to provide integrated care for a child and family with Autism in the acute care setting.
Purpose: The health care provider will demonstrate holistic care to a person with Autism in the hospitalized setting.
Goal: To provide information, knowledge, and awareness about Autism so the health care provider can effectively provide care for patient with Autism.
After completion of the course participants will be able to:
Assumptions about the child’s ability cannot be solely based on their diagnosis. There are many misconceptions regarding autism such as:
ASD varies significantly in character and severity; it occurs in all ethnic and socioeconomic groups and affects every age group. Experts estimate that 1 out of every 96 children are being diagnosed with autism.
What is Autism?
Autism Society of America
Which of the following is a behavior commonly associated with an ASD?
a. Cooing and smiling
b. Telling a story to another person
c. Sharing toys with others
d. Spinning objects
Communication:difficulty with verbal and non –verbal communication
Social Interaction: difficulty with verbal and non- verbal communication lead to social impairment
take social cues in and form interpretation
Social Interaction (cont)
Behavioral Flexibility: difficulty with interpersonal play and imagination (i.e. thinks in concrete images,) copied and pervasive rigidity with repetitive movements, routines and tasks.
Behavioral Flexibility (continued)
Which of the following deficit is least often associated with autism spectrum disorder?
Visual learners, not linguistic
Information stored in visual “pictures” and in chunks received, not unified in past experience based on like or dislike
In ability to compose their information about the world in an orderly fashion based on like or similar concepts.
Impaired abstraction (cont)
In addition to this triad, repetitive behavior, and resistance to change in routine are often characteristic. They may also appear hyper- or hypo-sensitive to sound, touch, pain, lights, environmental stimuli.
Sensory Integration (continued)
When caring for a person with ASD one should
a. Create a quiet, non- cluttered and calming environment
b. Put them close to the nurse’s station and in the open as to monitor them closely
c. Have multiple caregivers gather history and physical in order to obtain an accurate assessment
d. Provide quick, rapid, care as any socialization causes anxiety
Pet Therapy (continued)
If you have all these sights and sounds coming at you but you can't put them together in a meaningful way, the world can be an overwhelming place.” Sophie Molholm, Ph.D., associate professor in the Dominick P. Purpura Department of Neuroscience and of pediatrics.
Sensory Integration (continued)
Physical Therapy/Occupational Therapy
A written story to assist with everyday social events; what will happen and the “rules” of social behavior.
For example: A birthday party.
Kara is invited to Sheena's birthday party. Kara needs to bring a gift for Sheena. There will be other people there. Sometimes games are played, sometimes music is loud. There will be lots of noise. This is Sheena’s special day. The presents are for Sheena. The cake is for Sheena. Everyone is laughing because they are happy.
Doctors may prescribe medications for treatment of specific ASD-related symptoms, such as anxiety, depression, or obsessive-compulsive disorder. Antipsychotic medications are used to treat severe behavioral problems. Seizures can be treated with one or more anticonvulsant drugs. Medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity
Therapies that are implemented for a person with ASD could include:
b. Pet therapy
c. Low cholesterol, high fiber diet
d. Sensory integration therapy
e. Communication adaptations
f. Speech therapy
g. Aroma therapy
Children’s type of communication:
Behavioral mannerisms and protocol for compliance
Medical procedures (continued)
When caring for a school age child with an ASD, it is priority to determine:
a.What type of ASD the child has
b. How many words the child can speak
c. What words are used for toileting
d. The child’s specific routines
Enlist caregivers/parents help whenever possible, especially if the patient is non-verbal or uses an alternative communication method or aid.
Your Language (continued)
Sensory Overload (continued)
A nine year old boy is admitted to the pediatric floor with vomiting and dehydration. Mother states that the child has a history of Autism. He has limited communication skills, anxiety, is a picky eater and loves Legos. He participates in Speech therapy, music therapy, sensory integration and medication management. Develop a nursing care plan that will meet this child’s medical and behavioral needs.
If the music cannot be heard, the dance will seem insane.
If one does not understand the behaviors and neuro- deficits of a person with Autism, their behavior and social communication will seem insane.
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