Assignment: Study Guide Forum – Autism Spectrum Disorder. Includes Signs and symptoms according to the DSM-5, Differential diagnoses, Incidence, Development and course, Prognosis, Considerations related to culture, gender, age and Pertinent patient education considerations. (Autism Spectrum Disorder)
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To Prepare
- Your Instructor will assign you to a specific neurodevelopmental disorder from the DSM-5.
- Research your assigned disorder using the Walden Library. Then, develop an organizational scheme for the important information about the disorder.(Autism Spectrum Disorder)
The Assignment
Create a study guide for your assigned disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the DSM-5 but also supported by at least three other scholarly resources.(Autism Spectrum Disorder)
Areas of importance you should address, but are not limited to, are:
- Signs and symptoms according to the DSM-5
- Differential diagnoses
- Incidence
- Development and course
- Prognosis
- Considerations related to culture, gender, age
- Pharmacological treatments, including any side effects
- Nonpharmacological treatments
- Diagnostics and labs
- Comorbidities
- Legal and ethical considerations
- Pertinent patient education considerations
Assignment: Study Guide Forum – Autism Spectrum Disorder
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)
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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(Autism Spectrum Disorder) |
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 | Cannot kick a ball or walk on steps even with assistance | 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(Autism Spectrum Disorder) | 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(Autism Spectrum Disorder) |
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 (Assignment: Study Guide Forum – Autism Spectrum Disorder)
Incidence (Assignment: Study Guide Forum – Autism Spectrum Disorder)
Chart 2:
DSM Japan and Korea Incidence (Thapar et al., 2015)
Development And Course
Figure 1:
DSM Development and Course Mind Map
Prognosis (Assignment: Study Guide Forum – Autism Spectrum Disorder)
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)
Considerations Related to Culture, Gender, Age (Assignment: Study Guide Forum – Autism Spectrum Disorder)
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)
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)
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Pharmacological Treatments, Including Any Side Effects (Assignment: Study Guide Forum – Autism Spectrum Disorder)
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:
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 | 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. |
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 (Assignment: Study Guide Forum – Autism Spectrum Disorder)
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)
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)
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 |
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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)
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)
References
Dillon, K. (2019, March 23). DSM-5 neurodevelopmental disorders. [Video]. YouTube. https://www.youtube.com/watch?v=Ydr9s_UwACo
Galanter, C. A., & Jensen, P. S. (2016). DSM-5® casebook and treatment guide for child mental health. American Psychiatric Pub.
Graf, W. D., Miller, G., Epstein, L. G., & Rapin, I. (2017). The autism “epidemic.” Neurology, 88(14), 1371-1380. 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. Retrieved January 18, 2022, from https://medlineplus.gov/druginfo/meds/a694015.html
The National Center for Learning Disabilities. (2013, February 20). What is ADHD? [Video]. YouTube. https://youtu.be/0Wz7LdLFJVM
Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer
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