Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example

Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example

Signs and symptoms according to the DSM-5-TR

Autism spectrum disorder is a neurological disorder marked by communication problems, social interaction impairment, and restricted repetitive behavior patterns and interests. Per the DSM-5-TR, for a patient to meet the ASD criteria, they must present with persistent deficits in every area of social communication and interaction and a minimum of two of the four forms of restricted, repetitive behaviors, including a) pervasive deficits in social communication and social interaction in a myriad of contexts, as demonstrated by current or history of social-emotional reciprocity deficits, non-verbal communicative behaviors utilized in social interaction deficits, deficits in establishing, sustaining, and comprehending relationships, b) restricted, repetitive behavioral patterns, interests, or activities, as demonstrated by a minimum of the following current or history of stereotyped or repetitive motor movements, objects’ use, or speech, insisting on sameness, inflexibility in routine adherence, or normalized verbal and nonverbal behavioral patterns, highly restricted, fixated interests with unusual intensity or focus, and hyper- or hypoactivity to sensory input or atypical interest in the environments’ sensory aspects, c) symptoms should be present in an individual’s early development phases, d) symptoms should lead to clinically significant impairment in occupational, social, and other current functioning area, and e) the disturbances should not be better explained by another intellectual disability or global development delay (CDC, 2022).(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Differential diagnoses

Differential diagnoses for autism spectrum disorder include learning disability/intellectual disability (LD/ID), ADHD, social communication disorder (SCD), gifted and talented, anxiety, language disorder, hearing impairment, attachment disorder, or genetic disorders and syndromic. Intellectual disability describes individuals with considerable global developmental delay (Gada, 2020). It is the most common differential diagnosis for autism because autistic children demonstrate some learning disability, which warrants conducting an LD/ID assessment during ASD evaluation. Another reason is increased cases of LD diagnosis being confused with ASD diagnosis because children with LD demonstrate repetitive behavior for various reasons (Gada, 2020). Autism is mostly confused with ADHD due to similar symptoms like anger outbursts, repetitive behaviors, hyperactivity, and social functioning impairment (Gada, 2020). Social communication disorder is a common differential diagnosis for autism because both disorders lead to impaired verbal and non-verbal communication abilities. Children with gifted and talented abilities can also be misdiagnosed with autism because autistic children often demonstrate high intelligence and significantly good memory.  (Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)  

Figure 1: Differential Diagnosis

Incidence

According to the CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network, approximately 1 in 36 children have been diagnosed with autism spectrum disorder. ASD affects all racial, ethnic, and socioeconomic groups (CDC, 2022). It affects boys more than, with it occurring four times more in boys. Approximately 1 in 6 or 17% of children aged 3-17 are diagnosed with a developmental disability like ADHD, autism, blindness, and cerebral (CDC, 2022). Studies also indicate an increasing prevalence attributed to increased awareness of the disease, overdiagnosis, or overinclusive diagnostic criteria.(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Figure 2: Incidence

Development and course

The primary cause of autism spectrum disorder is still unknown, and the onset is varied because no clearly demarcated onset is linked to its indigenous development. Childhood disintegrative disorder, an ASD subtype, is linked to subacute sclerosing panencephalitis, tuberous sclerosis, leukodystrophy, and lipid storage diseases (Mughal et al., 2021). Additionally, causes are multifactorial and can be both genetic and non-genetic. The condition can also be syndromic or non-syndromic, with syndromic ASD linked to chromosomal abnormalities or monogenic alterations like Rett syndrome, MECP2, and fragile X syndrome (Mughal et al., 2021). Non-syndromic ASD has an undefined etiology attributed to genetic heterogeneity, combined with novo mutations and prenatal plus postnatal environmental factors.(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Figure 3: Etiology

Prognosis

Autism begins in childhood and progresses into adolescence and adulthood. Some autistic individuals can live independently, but others require help and life-long support due to disabilities that impact functionalities like the ability to engage in activities of daily living (Mughal et al., 2021). The long-term outcome of ASD varies, and it is almost impossible to determine future abilities in the first or second year after diagnosis. The disease has no cure, but there are treatment options to reduce the effects of symptoms in autistic individuals.(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Considerations related to culture, gender, age

Cultural factors impact how a family or community treats an individual with autism, including acceptance of the diagnosis or the person with this condition. Some cultural practices and beliefs might lead to autistic children being denied by society and family and the resources needed to live, adapt, and develop (Children’s Hospital Los Angeles, 2022). Cultural myths regarding ASD and other developmental disabilities can deter families from seeking help for their autistic children. Public education is needed to raise awareness about autism. Males and females below four years have no difference in core symptoms. Also, gender or sex does not impact the possibility of being diagnosed early (Napolitano et al., 2022). Autism affects males more than females, occurring four times more in boys than girls.(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Pharmacological treatments, including any side effects

Autism has no cure, and no medications are available to treat this condition. However, medications to treat or minimize the effects of symptoms exist, including risperidone and aripiprazole, the only FDA-approved drugs for autistic children (Bhandari, 2023). However, risperidone can lead to drowsiness during the day, trouble sleeping at night, mobility issues like stiff muscles, headaches, and weight or appetite changes. Aripiprazole can lead to uncontrolled twitching or jerking movements, increased anxiety and restlessness, abdominal discomfort or pain, lightheadedness, and trouble sleeping. Selective serotonin reuptake inhibitors (SSRIs), anti-anxiety medications, or stimulants can also be prescribed to address autism symptoms. (Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Nonpharmacological treatments

Most individuals with autism benefit from nonpharmacological therapy like behavioral management therapy, cognitive behavioral therapy, education and school-based therapies, nutritional therapy, and occupational therapy (Jiang et al., 2022). CAM modalities like yoga, acupuncture, massage, music therapy, and manual therapy have also demonstrated effectiveness in helping autistic children adapt and develop (Jiang et al., 2022). These therapies can effectively alleviate autism symptoms, including social and communication impairments and stereotyped behaviors. (Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Diagnostics and labs

No medical tests like blood work or brain scans are available for determining autism. Accurate diagnosis relies on a comprehensive patient assessment by observing the client’s communication, social interaction, and activities they are interested in (CDC, 2022). Physicians also rely on the child’s developmental history and current behavior to establish a diagnosis.  (Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Comorbidities

Major depressive disorder is a common comorbid condition in people with autism, occurring mostly in high-functioning individuals during adolescence when they have increased insight into their differences from other people (Al-Beltagi, 2021). Other common comorbidities include anxiety disorders and ADHD. Additionally, autistic children can have epilepsy and seizures, sleep disorders or disturbance, gastrointestinal disorders like chronic constipation, diarrhea, gastroesophageal reflux, nausea and vomiting, chronic bloating, and abdominal discomfort, which affect between 46% to 80% of autistic individuals, feeding or eating difficulties, and obesity (Al-Beltagi, 2021). Generally, autistic children are prone to many neurological, genetic, and physical conditions and disabilities. (Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example) 

Figure 4: Comorbidities

Legal and ethical considerations

Most autistic children and individuals rely on surrogates for decision-making, raising the possibility of power imbalance. It is critical to ensure that all decisions are in the patient’s best interests by minimizing the power imbalance. These individuals should be treated with dignity and respect because their lives are meaningful and valuable. Parents should be involved fully in their children’s lives and demonstrate the same level of respect and care extended to normal children. Autistic individuals can have occupational difficulties, and organizations should ensure non-discriminatory and anti-harassment policies to protect them from unethical and illegal treatment and avoid legal consequences. (Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)  

Pertinent patient education considerations

Autistic individuals might rely on behavioral and skills training to help them socialize and communicate appropriately. This training minimizes behavior problems and allows autistic individuals to adapt to various environments (Mughal et al., 2021). Parental management training is also required to help parents learn how to deal with and care for children with autism, including addressing behavioral problems. Additionally, these children might require special education services to engage in the education curriculum. (Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

References

Al-Beltagi M. (2021). Autism medical comorbidities. World journal of clinical pediatrics, 10(3), 15–28. https://doi.org/10.5409/wjcp.v10.i3.15(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Bhandari, S. (2023, January 12). What are the treatments for autism spectrum disorder? WebMD. https://www.webmd.com/brain/autism/understanding-autism-treatment(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

CDC. (2022, April 29). Screening and diagnosis | Autism spectrum disorder (ASD) | NCBDDD. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/screening.html(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

CDC. (2022, March 4). Data and statistics on autism spectrum disorder | CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/data.html(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

CDC. (2022, November 2). Diagnostic criteria. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/hcp-dsm.html(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Children’s Hospital Los Angeles. (2022, December 15). Cultural factors influence how we experience autism. https://www.chla.org/blog/advice-experts/culture-factors-influence-how-we-experience-autism

Gada, D. S. (2020, May 30). Differential Diagnoses of an Autism Spectrum Disorder. Dr Srinivas Gada. https://www.drsrigada.co.uk/differential-diagnoses-of-an-autism-spectrum-disorder/

Jiang, X., Song, M., Qin, W., Xiao, J., Xu, X., & Yuan, Q. (2022). Nonpharmaceutical therapy for autism spectrum disorder: A protocol for systematic review and network meta-analysis. Medicine, 101(7), e28811. https://doi.org/10.1097/MD.0000000000028811(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

Mughal, S., Faizy, R. M., Saadabadi, A., & Doerr, C. (2021). Autism Spectrum Disorder (Nursing). In: StatPearls [Internet]. Treasure Island (FL). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK568713/

Napolitano, A., Schiavi, S., La Rosa, P., Rossi-Espagnet, M. C., Petrillo, S., Bottino, F., Tagliente, E., Longo, D., Lupi, E., Casula, L., Valeri, G., Piemonte, F., Trezza, V., & Vicari, S. (2022). Sex Differences in Autism Spectrum Disorder: Diagnostic, Neurobiological, and Behavioral Features. Frontiers in psychiatry, 13, 889636. https://doi.org/10.3389/fpsyt.2022.889636(Neurodevelopmental Assignment on Autism Study Guide Forum Comprehensive Nursing Paper Example)

https://www.ncbi.nlm.nih.gov/