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Understanding Autism Spectrum Disorders: Types, Incidence, and Management Strategies

Autism Spectrum Disorders (ASD) manifest in various forms, affecting boys more than girls and showing no correlation with socioeconomic status. Types include Autistic Disorder, Asperger's Syndrome, and Pervasive Developmental Disorder. These conditions arise from genetic influences and environmental factors but are not linked to vaccines. Common symptoms include language delays, unusual sensory sensitivities, and repetitive behaviors. Effective management involves structured behavior modification, communication skills training, and pharmacologic therapy. Parental support is crucial for coping and care.

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Understanding Autism Spectrum Disorders: Types, Incidence, and Management Strategies

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  1. Autism Spectrum Disorders Lewis, pp. 1198-1201

  2. Incidence and Types • 24 to 48 months of age; males > females; females are more severely affected • No relation to socioeconomic level or parenting style • Mild to severe types are: • Autistic Disorder • Asperger’s Syndrome • Pervasive Developmental Disorder

  3. Etiology • Genetic disorder of brain development • Autosomal recessive pattern • Immune and environmental factors along with genetics may increase chances • No evidence of link to thimerosal-containing vaccines

  4. Manifestations • Abnormal EEG • Seizures • Delayed development of hand dominance • Persistence of primitive reflexes • Elevated serum serotonin levels • Brain hypoplasia • Large head

  5. Manifestations • Shows unusual attachments to objects • Overly sensitive to light, touch, sound, hearing, smell, taste • Performs repeated body movements • Language delays or regression • Nonsense rhyming or word repetition • Communicates with gestures • Cannot start or maintain conversation

  6. Manifestations • Behavioral outbursts, preoccupation • Limited pretend play • GI/nutritional issues—constipation, megarectum, willful starvation, gagging, mouthing objects, eating non-edibles, smelling and throwing food • Screening for manifestations are main way of diagnosing (see Box 42-8, p. 1200)

  7. Reported Associations • Fragile X syndrome (chromosomal abnormality) • Tuberous sclerosis (skin lesions and various tumors) • Metabolic disorders (thyroid) • Fetal rubella syndrome

  8. Reported Associations • H. influenzae meningitis • Structural brain abnormalities • Parents over 40 • Perinatal complications (uterine bleeding, fetal distress, low Apgars, hyperbilirubinemia)

  9. Nursing Management • Highly structured behavior modification with routines, consistency, and positive reinforcement • Increase social awareness of others • Teach verbal communication skills • Decrease unacceptable behaviors

  10. Pharmacologic Therapy • Meds to decrease irritability, aggression, anxiety, mood swings, hyperactivity • Risperidol • SSRIs • Divalproex • Ritalin

  11. Hospitalized Autistic Child • Parents present • Encourage parents to bring in favorite possessions • Limit physical contact when possible • Private room with low stimulation

  12. Parental Support • Feel guilt and shame—need counseling and support • Encourage parents to care for child in home with family support, if possible. If not, then institutional care • Refer to mental health facilities and facilities for developmental disabilities • Refer to Autism Society of America: www.autism-society.org

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