1. Autism
Ivy S. Gementiza, RN

2. OVERVIEW

3. Autism
• A complex neurobiological developmental disorder
that most typically appears during the first 2 years of
life
• The diagnosis of autism is based on the display of at
least 6 out of 12 symptoms in three categories
• The core features of autism must be present for a
diagnosis to be made

4. CORE FEATURES
– Social impairment
– Verbal and nonverbal communication impairment
– Characteristic patterns of behavior that tend to be
repetitive and ritualistic
• Autism is a lifelong disorder defined by the
individual's interactive difficulties, which can range
from mild to severely impaired

5. • 4-5x more common in males than females
• Affected females tend to be more severely impaired
• There is strong evidence to suggest a genetic etiology
• Approximately 75% of people with autism are
cognitively impaired, with a wide range of potential
IQ's.
• Autism is seen in approximately 60 - 70 per 10,000
live births.

6. PATHOPHYSIOLOGY
AND ETIOLOGY

7. • A clear cause has not been identified
• However, evidence suggests a genetic predisposition
• Studies have shown that measles, mumps, and
rubella vaccine do not cause autism.
• Likewise, thimerosal, a preservative found in many
vaccines, does not cause autism
• .

8. • Before diagnosis, parents may be initially concerned
about their infant's social interactions, delayed or
unusual speech development, and reactions to
various stimuli (ie, tactile defensiveness)
• Individuals with ASD have neuroanatomical
differences, including small neuron cell size,
increased cell packing, relative macrocephaly, and
large third ventricles.

9. DIAGNOSIS AND
MANAGEMENT

10. • Early diagnosis leads to earlier interventions,
resulting in improved outcomes for these children.
• The two major diagnostic challenges in the
evaluation of ASD include making the differential
diagnosis and searching for the etiologic disorder
associated with ASD (ie, 3% to 5% of children with
ASD will also have a diagnosis of fragile X syndrome.)

11. • Comprehensive standardized assessment tools
specific for ASD usually require specialized training;
these tools include Childhood Autism Rating Scale
(CARS), Diagnostic Interview of Social and
Communication Disorders (DISCO), Autism Diagnostic
Interview (ADI), and Autism Diagnostic Interview
Schedule (ADOS)
• Alternative treatments, such as nutrition and vitamin
therapy, are being investigated but no definitive
research has been conclusive to date

12. • Many children with ASD also have psychiatric
comorbidities with such conditions as obsessive
compulsive disorder, attention deficit hyperactivity
disorder (ADHD), depression, mood disorders, and
Tourette syndrome
• These conditions can be challenging to diagnose as it
may be difficult to assess the child with
communication and behavioral problems

13. • Indeed, health care providers need to be vigilant in
screening and monitoring for these comorbidities in
order to appropriately ensure optimal functioning of
the child with ASD.
• Medical comorbidities are also common in children
with ASD, such as seizure disorders, sleep
disturbances, GI disorders, and dental problems

14. • As with psychiatric comorbidities, health care
providers need to be vigilant in their assessment as it
can improve behavior and functioning of the child
with ASD
• A multidisciplinary team, including primary care
provider; medical subspecialists; occupational,
speech, and physical therapists; and educational
specialist is essential for optimal care

15. Thank You!