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Autism a Pervasive Developmental Disorder and Its Assessment:Nursing Case Study

Saturday, 8 March 2014

Autism is a pervasive developmental disorder characterized by inappropriate responses to the environment and pronounced impairments in language, communication skills, and social interaction. It begins during childhood and lasts throughout life.

Autism's three main presentation types are: language abnormalities (impaired communication and poorly developed language skills); repetitive actions (self-injurious or other abnormal behaviors); and socially isolated behavior (a lack of interest in social interactions and preference for inanimate objects to human companionship along with possible inappropriate attachment to such objects).

Pathophysiology
No consistent pathophysiologic pattern has been found with autism. It's believed that varying underlying neurobiologic and genetic processes, or possibly obstetric complications, may be causes.

Complications
■ Injury
■ Abuse
■ Depression
■ Adjustment disorder
■ Seizures

Assessment
Health perception and management

■ Extreme resistance to change
■ Inappropriate attachment to objects
■ Self‑stimulating behavior
■ Abnormal response to pain
■ Lack of symbolic play; odd play
■ Destructive behavior toward self and others
■ Frequent tantrums
■ Attention to soft sounds rather than speech

Nutrition and metabolism
■ Refusal to eat lumpy foods
■ Failure to cry when hungry
■ Decreased appetite

Activity and exercise
■ Difficulty participating in group activities

Cognition and perception
■ Abnormal reaction to sensory stimuli

Sleep and rest
■ Irregular sleep patterns

Roles and relationships
■ Little interaction with family members

Coping and stress management
■ Possible catatonic or psychotic reaction to stress
■ Comfort in repetitive movement

Physical examination
General appearance and nutrition
■ Delayed smiling response
■ Inability to remain still
■ Purposeless, repetitive, patterned motions, postures, or sounds

Mental status and behavior
■ Poor eye contact
■ Withdrawal
■ Minimal social interaction (or none)
■ Decreased verbalization; echolalia

Neurologic
■ Inappropriate responses to stimuli
■ Poor sucking reflex

Gastrointestinal
■ Weight loss

Musculoskeletal
■ Clumsiness; poor motor skills
■ Repetitive movement

Teaching checklist
■ Child's status and assessment findings upon admission
■ Change in the child's status
■ Fluid intake and output
■ Nutritional intake
■ Environmental structure
■ Behavior modification therapy
■ Family involvement and therapy
■ Discharge planning guidelines
■ Guidelines for long-term therapy and parenting
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