Autism Spectrum Disorder Comprehensive Nursing Paper Example

Autism Spectrum Disorder Comprehensive Nursing Paper Example

Signs And Symptoms According to the Dsm-5

Autism Spectrum Disorder (ASD) is a generalized term for neurodevelopmental disorders that appear as social communication impairments and repetitive behavior patterns that include the interests and tasks that one engages in (Dillon, 2019; Thapar et al., 2015; Zakhari, 2020). Therefore, any showcase of the below symptoms during development necessitates a check-up to diagnose ASD:(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

Table 1:                                                                                                      

DSM Developmental Flags (Galanter & Jensen, 2016)

DSM Developmental Flags
Monthly Age	Cognitive Capabilities	Motor Abilities	Social/emotional
4	No eye tracking, laughing, or vocals	Grasping inability, no head control while seated	No smile response or tracking people in a room
6	No sound or voice turning response	No floor movement or rolling	No spontaneous smiling
9	No babbling of consonants	sitting inability	No mimic of vocalization or face gestures
12	No name response or voice imitation	They cannot clap objects or pull themselves to stand	Cannot mimic hand gestures or focus well on something
18	Cannot undertake pointed actions or use wordings	Difficulty walking alone	No speak and gesture ability
24	Incomprehensible speech of less than half(Autism Spectrum Disorder Comprehensive Nursing Paper Example)	Cannot kick a ball or walk on steps even with assistance(Autism Spectrum Disorder Comprehensive Nursing Paper Example)	No meaningful two-word phrase or empathy
36	No 3-word sentences and half of the speech is understandable	Inability to jump or hand throw objects	No parallel play or imitation of adult activity
48	less than 75% of speech comprehension. Cannot self-identify or know pictured objects	Cannot draw a circle or stand on one foot for at least 3 seconds	Lack of imaginative play

Differential Diagnoses

Table 2:

DSM Differential Diagnostic Flash Card (Thapar et al., 2015)

Incidence

Chart 1:

DSM Developed Countries Incidence (Thapar et al., 2015)

Chart 2:

DSM Japan and Korea Incidence (Thapar et al., 2015)

Development And Course

Figure 1:

DSM Development and Course Mind Map

Prognosis

Younger patients with a moderate to severe spectrum of impairment showcase poor or no speech and non-verbal cues. They also undertake repetitive play regimes with high environmental stimuli sensitivity, including agitation (Thapar et al., 2015). For example, this can include clothes color, some noises, or even particular smells. Older patients showcase better communication and speech capabilities with some difficulties in aspects of social communication. The older patients are also obsessed with a specific interest in solitary rather than social groups (Thapar et al., 2015). The condition is seldom fatal. There exist management strategies that have worked and continue working for many.(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

Considerations Related to Culture, Gender, Age

The geographical location of parents can determine the incident rates of ASD. For example, Japan and Korea have up to 3% incidence rates. This means that nationality can also affect how likely they are to experience ASD (Thapar et al., 2015). In addition, a family’s economic status can determine whether it can afford to take care of a family member with ASD sufficiently. For example, therapy sessions can prove costly for minority groups’ families who are often economically disadvantaged.(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

The family structure, beliefs, and values of a particular community can also influence the care given to ASD members. For example, a unified family with both parents present can take better care than single-parent families as the care may be highly demanding in some intensive cases. Boys are more likely to showcase ASD than girls (Thapar et al., 2015). Therefore, a family with many boys increases the chances of manifesting ASD compared to many girls. ASD intensity wears off with age, with older patients developing the developmental shortcomings they experienced. Therefore, incident rates are observed more at a younger age compared to an older one.(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

Pharmacological Treatments, Including Any Side Effects

Pharmacological ASD treatments focus on treating irritability and comorbidities such as ADHD. In this regard, the following medications may be considered with their possible side effects:(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

Table 3:

DSM Pharmacological Treatments and Side Effects (MedlinePlus, n.d.; Thapar et al., 2015)

Medication	Uses	Possible side effects
aripiprazole	It May be used to manage ADHD comorbidities in ASD patients among a myriad of other mental health disorders and issues(Autism Spectrum Disorder Comprehensive Nursing Paper Example)	May include constipated bowels, nausea, vomiting, diarrhea, dry mouth, increased salivation, agitation, decreased libido in older patients, anxiety, gaining weight, high appetite, stomach aches, muscle and joint pain, interference with the menstrual cycle, sleep patterns interference, more dreams, being unsettled, among others. It is important to note that some symptoms might be severe and need urgent medical attention from the doctor. Therefore, patients and their loved ones should act accordingly.(Autism Spectrum Disorder Comprehensive Nursing Paper Example)
risperidone	It May be used to manage ADHD comorbidities in ASD patients among a myriad of other mental health disorders and issues	May include headaches, heartburns, fatigue, increased salivation, weight gain, appetite changes, stomach aches, muscle and joint pain, constipation, dizziness, rashes, itching, unsettling, seizures, breathing difficulties, etc. It is important to note that some symptoms might be severe and need urgent medical attention from the doctor. Therefore, patients and their loved ones should act accordingly.

Nonpharmacological Treatments

Researchers have proposed sensory integration therapy (SIT) for sense hyper- or hypo-activity, while they propose auditory integration therapy (AIT) for hearing irritability (Thapar et al., 2015). Nevertheless, there is no scientific evidence of the effectiveness of these strategies. There are also concerns of harm from AIT which can lead to deafness due to the patients often listening to high volumes. Researchers also propose visual therapies, restricted diets, and nutrition supplements for primary ASSD care and comorbidities such as ADHD (Thapar et al., 2015). For example, the diet is made gluten-free or supplemented with omega-3 acids. Still, there is a lack of enough scientific evidence to back the effectiveness of these strategies.(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

Diagnostics and Labs

ASD typically manifests as language, cognitive, and social abilities developmental regression through the early months and years. Symptoms vary between patients, with some showcasing the symptoms later on in life. Some aspects of the regressions may improve with time, with patients developing the capabilities, while some aspects stick for life (Thapar et al., 2015). Therefore, the symptoms and diagnostics used on ASD are diverse to include all the possible manifestations of the condition. Researchers are also discovering new manifestations of ASD, which adds to the growing diagnostic tools that doctors can use. For example, a quarter to half of ASD cases involves intellectual disability (Thapar et al., 2015). The most common diagnostic tool is the manifestation of poor language and social skills. Repetitive stimuli are another top diagnostic symptom. The DSM-5 diagnostic tool is the most current ASD diagnostic tool as it updates any ambiguity on the previously used tools (Thapar et al., 2015). However, the tool still has flaws as new scientific information on ASD and comorbidities gets discovered.(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

Comorbidities

Table 4:

DSM Comorbidities (Thapar et al., 2015; The National Center for Learning Disabilities, 2013)

Mental and Behavioral Comorbidities	Neurodevelopmental Comorbidities	Medical/genetic Conditions	Functional Comorbidities
ADHD	Intellectual disability or delays	Epilepsy	Feeding issues
Anxiety conditions range	Motor problems or DCD	Chromosome disorders	Enuresis
Mood disorders	Learning disabilities	Genetic abnormalities	Constipation and other bowel issues
Defiant issues	Speech and language disability	Tuberous sclerosis	Sleep issues
Tourette’s syndrome		Muscular dystrophy	Vision impairment
OCD		Neurofibromatosis	Auditory impairment
Self-harm issues

Legal and Ethical Considerations

In the pretext of ASD, three parties have the primary legal and ethical obligations. These are the families and legal assistance of ASD patients, health care professionals, and government entities (Graf et al., 2017). The aspects considered legally and ethically include but are not limited to screening, diagnosing, testing, and intervening in ASD cases. All parties must facilitate timely diagnosis to get the best available care for their condition (Graf et al., 2017). The patient has a right to decide the best care alternative, and if they are children, their guardians or parents have the right to decide for them. There is also scientific evidence backing the available interventions. All parties, especially the government, should implement the necessary policies and measures to ensure that the interventions are supported by sufficient scientific evidence to avoid making patients Guinea Pigs (Thapar et al., 2015). Legally, a patient can sue all the involved parties if a particular intervention goes wrong and leaves them in a worse state than they were.(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

Pertinent Patient Education Considerations

ASD cases showcase irritability, especially under unfamiliar stimuli. Therefore, the education of these patients must take place in a highly stable and predictable environment. This can include a special school environment or hiring qualified tutors for ASD patients (Thapar et al., 2015). However, the cost implications of such a move may be high, and adequate economic support should be provided if needed.(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

References

Dillon, K. (2019, March 23). DSM-5 neurodevelopmental disorders. [Video]. YouTube. https://www.youtube.com/watch?v=Ydr9s_UwACo(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

Galanter, C. A., & Jensen, P. S. (2016). DSM-5® casebook and treatment guide for child mental health. American Psychiatric Pub.(Autism Spectrum Disorder Comprehensive Nursing Paper Example)

Graf, W. D., Miller, G., Epstein, L. G., & Rapin, I. (2017). The autism “epidemic.” Neurology, 88(14), 1371-1380.(Autism Spectrum Disorder Comprehensive Nursing Paper Example) https://doi.org/10.1212/wnl.0000000000003791

MedlinePlus. (n.d.). Aripiprazole: MedlinePlus drug information. Retrieved January 18, 2022, from https://medlineplus.gov/druginfo/meds/a603012.html

MedlinePlus. (n.d.). Risperidone: MedlinePlus drug information. MedlinePlus – Health Information from the National Library of Medicine. (Autism Spectrum Disorder Comprehensive Nursing Paper Example)Retrieved January 18, 2022, from https://medlineplus.gov/druginfo/meds/a694015.html

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

The National Center for Learning Disabilities. (2013, February 20). What is ADHD? [Video].(Autism Spectrum Disorder Comprehensive Nursing Paper Example) YouTube. https://youtu.be/0Wz7LdLFJVM

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer