Autism spectrum disorder:

Rebecca Mickel RN, MSN,

CWCN

University of Portland

Instructor

October 2016

Objectives for presentation Categorize behaviors in children with autism spectrum disorder (ASD) which differ from typical neurological development.

Develop interventions to providing safe and effective medical care for a child with ASD in the health care setting.

Consider non medication treatment options for ASD to ease an office visit.

Inappropriate play with toys.

Inability to relate to others

Hyperactive or passive

inappropriate laughing or crying

Over sensitivity

Strange attachments to objects

Poor speech or lack of speech

Difficulty dealing with change

Lack of awareness of danger

Behaviors serve a purpose

To escape and avoid

Examples:

Throwing food to get to

leave the dinner table

Falls on the ground

when it is time to come

in

Hits other people to

get someone else to

leave

To obtain

Examples:

Scream to get favorite food,

Hits sibling to get attention from

parent

Starts to scream when unable

to open something

Flaps hands for positive sensory

input

Seizures

Gastro – intestinal

problems

Pain/touch sensitivity

Hand flapping

Thinking in

pictures

https://www.youtube.com/watch?v=hFby

ujLT8HQ

Practical tips

Schedule the first visit of the day

Look at the environment

Quick tips profile card

Picture schedule

Supports during exams: Sing, blow bubbles, distraction

toys,

Allow hand flapping, spinning, rocking

Allow time for adaptation

Communication tips

Not as friendly More autism friendly

How could you modify this

environment to be more autistic

friendly?

The puzzle board on the wall is a

great way to provide a sensory

break or a reward

Communication tips

Avoid idioms: Use first and then

First we will do

this

Then we will

do that

Be creative

Jump up and down

Stretch

Touch toes

Spin

Rock

Autism Video Model- Going to the

Dentist (Look at Me Now!®) https://www.youtube.com/watch?v=s_n1aZy1NV8

https://www.youtube.com/watch?

v=UE_rElU3BS0 Autism behaviors at

a visit

https://www.youtube.com/watch?v=EAGe9cgI5e0 Severe autism meltdown

From an ear infection and sore throat

Ways to protect your self form

problem behaviors

https://www.youtube.com/watch?v=RdHxMQJ1zCY

Autism help- Pinching, Biting and Hitting - The Son-Rise Program

https://www.youtube.com/watch?v=6GD8reBVc4A

Autism Help- Tantrums - The Son-Rise Program

https://www.youtube.com/watch?v=WVFEo0ttSLM

Autism Help with Flexibility - The Son-Rise Program

References Bultas M., McMillins S., & Zand D. (2016). Reducing Barriers to Care in the Office-Based Health Care Setting for Children With Autism.Available online 31 October 2015 Journal of Pediatric Health Care. 30 (1) 5-14. retrieved 5/31/16 from http://www.sciencedirect.com.ezproxy-eres.up.edu:2048/science/article/pii/S089152451500Available online 9 October 2015

Bultas M. (2012). The Health Care Experiences of the Preschool Child with Autism. Journal of Pediatric Nursing. 27 (5) 460-470. Retrieved 5/31/16 from http://www.sciencedirect.com.ezproxy-eres.up.edu:2048/science/article/pii/S0882596311002831

Chebuhar A. , McCarthy A., Bosch J., Baker S. (2013). Using Picture Schedules in Medical Settings for Patients with an Autism Spectrum Disorder. Journal of Pediatric Nursing. 28, (2) 125 – 134. retrieved 5/31/16 from http://www.sciencedirect.com.ezproxy-eres.up.edu:2048/science/article/pii/S0882596312001844

Johnson N., Burkette K., Reinhold J., & Bultas M. (2016). Translating Research to Practice for Children with Autism Spectrum Disorder: Part I: Definition, Associated Behaviors, Prevalence, Diagnostic Process, and Interventions. Available online 31 October 2015

Journal of Pediatric Health Care. 30 (1) 15–26. retrieved 5/31/16 from http://www.sciencedirect.com.ezproxy-eres.up.edu:2048/science/article/pii/S0891524515003454

Johnson N., Burkette K., Reinhold J., & Bultas M. (2016). Translating Research to Practice for Children with Autism Spectrum Disorder: Part 2: Behavior Management in Home and Health Care Settings. Available online 31 October 2015

Journal of Pediatric Health Care. 30 (1) 27–37. retrieved 5/31/16 from http://www.sciencedirect.com.ezproxy-eres.up.edu:2048/science/article/pii/S089152451500