Slide 1

Slide 2

AUTISM Presented by Amy Long Auburn University of Montgomery School of Nursing Pathopharmacology Nursing 4120

Slide 3

WHAT IS AUTISM? Autism is a developmental disorder that appears in the first 3 years of life, and affects the brains normal development of social and communication skills. National Library of Medicine It is estimated that 1 out of every 88 children have an Autism Spectrum Disorder (ASD). The numbers are rising..Is it more prevalent or are more children just being classified as ASD. Autism can be severe to mild with many variations. Some of the different subgroups of Autism are: 1.Aspergers Syndrome 2.Pervasive Development Disorder or PDD 3.Rett Syndrome 4.Childhood Disintegrative Disorder

Slide 4

PATHOPHYSIOLOGY There is no single etiology for Autism. Autism involves the abnormal development of a distributed neural network involving a number of regions in the brain. (Coleman, 2005) Evidence suggest that oxidative stress plays a role in the development of Autism (Chauhan 2004) Nitrogen metabolism-related parameters may have a role. (Shamais, 2012) Glutamate signaling is implicated in APD. Glutamatergic system plays an important role in neurodevelopment. (Choudhary, 2012) Dysfunction of the amygdala region in the brain.

Slide 5

PATHOPHYSIOLOGY, CONT. Some researchers believe that there is over connectivity in the brain, while others believe Autism is from under connectivity. There is evidence that suggests that there is an immune dysfunction that impacts neurological behaviors and processes. (Onore, 2012) Epidermal growth factor may have a role. There may be a nutritional component. May be an underlying disorder of monoamine system. At this time, there is no evidence that supports the theory that childhood immunizations cause Autism

Slide 6

RISK FACTORS Boys are 4-5 times more likely to have an ASD than girls. Thought to have a heredity component. If one child in a family has an ASD there is an increased chance for future children to also have an ASD. There may be a connection between advanced age of parents and children with ASD. Children with other neurological disorders have a higher incidence of having an ASD. Studies are currently being done to try and link environmental factors. May be a connection to having babies close in age.

Slide 7

RISK FACTORS, CONT. Prenatal risk factors include: advanced maternal or paternal age, firstborn, maternal prenatal medications, and mothers status as foreign born. Perinatal and neonatal risk factors were preterm birth, breech presentation, planned cesarean section, low Apgar score, hyperbilirubinemia, birth defect and a birth weight small for gestational age. (Guinchat V, 2012)

Slide 8

CLINICAL Social component: a.Poor eye contact b.Lack of empathy c.Appears not to hear you at times d.Fails to respond to his or her name e.Seems to prefer playing alone

Slide 9

CLINICAL Language a.Delayed speech b.Loses previously acquired language skills c.Lack of eye contact when making requests d.Pedantic speech e.Difficultly with conversation f.Difficulty with use of words

Slide 10

CLINICAL Behavior a.Rocking, spinning or flapping b.Insists on strict rituals or routines c.Decrease or absent creative or imaginary play d.Food aversions e.Constantly moving f.Sensitivity to lights, sounds, and touch

Slide 11

DIAGNOSTIC No current definitive diagnostic test for autism. Children are screened by pediatrician starting at birth up to age 3. Children are sometimes diagnosed when their parents notice that they are different than their peers and seek medical. advice A collection of symptoms is one leading factor in diagnosis. There are screening tools developed to aid in diagnosis. There is a diagnostic criteria in the DSM IV which is dependent on the behaviors of the child.

Slide 12

PHARMACOLOGY There are no specific autism medications, however several are used to treat symptoms and behaviors of individuals with ASD. Prozac and Zoloft are used for the treatment of depression and obsessive compulsive disorder which are two disorders that can accompany Autism ( approved for children age 7 and up ). Risperdal sometimes used for treatment of aggressive behavior (approved for children starting age 5). Some children with Autism also have a seizure disorder and must take medications such as Tegretol, Topamax, and Depakote to control their seizures. Other off label prescriptions have been used such as Valium, Ritalin, and Ativan.

Slide 13

EVIDENCE BASED PRACTICE TREATMENT Early intervention is extremely important Treatment with speech therapy to assist with communication and social communication skills Treatment with occupational therapist for improvement of coordination and gait Treatment with behavioral specialist to aid with societal normal behavior and expectations Treatment with psychologist for aggressive behavior, play group therapy and depression Medication therapy via psychiatrist

Slide 14

INTERESTING FACTS Any child age 3 and under that displays developmental delays qualifies for Early Intervention-a governmental program Autism was added as a special education in 1991 and now is the sixth most common classified disability in the U.S. Divorce rates are high in families with an autistic child Dogs have been shown to improve autistic children's quality of life, independence and safety Autism is more common than childhood cancer, diabetes, and AIDS combined Scholars and parents debate whether autism is a disability or whether it should be considered merely a different kind of personality One of my children was diagnosed with a Pervasive Developmental Disorder

Slide 15

AUTISM HAS MANY FACES YOUTUBE VIDEO YOUTUBE VIDEO 2 YOUTUBE VIDEO 3 I included three different videos because Autism has many faces. These videos are both heartwarming and heartbreaking. Obviously, some families have to deal with a lot more than others. I believe the testimonials from the parents, because they are in the trenches of caring for the children. These videos are great for showing examples of the severity and human side of this disorder.

Slide 16

REFERENCES Coleman, Mary New York: Oxford University Press eBook 2005 Shamais, Abu; Journal of Neurodevelopmental Disorders 2012, Feb 13; Vol 4(1) pp.4 Choudhary, P; Glutamate mediated signaling in the pathophysiology of autism spectrum disorders. Pharmacology Biochemistry and Behavior Onore, C. The role of immune dysfunction in the pathophysiology of autism. Brain, Behavior, and Immunity Vol 26, Issue 3, March 2012 pp385-392 Guinchat V. Pre-Peri- and Neonatal risk factors for Autism. Acta Obstet Gyneocal Scand. 2012 March, 91(3) pp 287-300