Pervasive developmental disorders - Childhood Autism

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Pervasive developmental disorders
Meaning
            Group of disorders characterized by abnormalities in communication and social interaction and by restricted repetitive activities and interests.
Epidemiology
      Prevalence- 60-70/10000 population around the world(Fombonne E . 2009)
      Autism 62/10000 population
      Male:Female-5:1 ratio
Types
v  Childhood autism
v  Rett’s disorder
v  Asperger’s syndrome
v  Childhood disintegrative disorder
v  other PDD
Childhood autism

Meaning
Autistic disorder is characterized by symptoms from each of the following three categories: qualitative impairment in social interaction, impairment in communication, and restricted repetitive and stereotyped patterns of behavior or interests.
 Etiology
      Genetic
v  Sibilings
v  Monozygotic twins-36%
v  Fragile X chromosome
      Biological
v  Mental retardation
v  Seizure disorder
v  Congenital rubella
v  Phenyl ketonuria
      Immunological
v  Maternal antibodies directed to fetus
      Prenatal
v  Respiratory distress
v  Neonatal anemia
v  Post term delivery
      Neuro anatomical
v  Increased brain volume
v  Temporal lobe damage
      Biochemical
v  Elevated plasma serotonin
      Parental factors
v  Parental rejection
v  Family break up
v  Family stress
v  Insufficient stimulation
v  Lack of warmth and affectionate behaviour
v  Fixation in pre symbiotic phase
      Theory of mind
v  Mind blind- Children with autism lack ability to put themselves in the place of another person.
Clinical features
      Behavioural characteristics
v  Autistic aloofness- Unresponsiveness to affection
v  Gaze avoidance
v  Poor eye contact
v  Anxious on disruptions of regular routine
v  No separation anxiety when left alone with strangers
v  Inappropriate social play
v  Limited or no friends
v  Lack of empathy and feelings to others
v  Anger or fear without reason
v  No fear of danger
      Communication and language
v  Poor language development
v  Lack babbling in infantile period
v  Produce noises like clicks and nonsense syllabels
v  Difficulty in articulation of speech
v  Echolalia
v  Absence of imaginative play
v  Abnormality in production of speech.
      Activities
v  Rigid, repetitive and monotonous play
v  Restricted, repertoire of activities
v  Pre occupation with parts of objects
v  Fear or panic when there is change in environment
v  Response to stimuli
v  Reluctance to change
v  Over or under responsive to stimuli
v  Altered response to pain
v  Enjoy vestibular stimulation
       Instability of mood and affect
v  Sudden mood changes
      Other behavioural symptoms
v  Hyperkinesis
v  Self injurious behaviour
v  Poor attention span
v  Idiot Savant syndrome
Treatment
Pharmacological
v  CNS stimulants
v  Antipsychotics
v  Anti epileptics
v  SSRIs
Psychological Management
v  Contingency management
v  Special schooling
v  Supportive Counselling
Nursing management
      Assessment
      Interventions
v  Nursing interventions
v  Work on one to one basis
v  Diversion of attention to reduce anxiety
v  Ensure warmth and care
v  Familiar toys
v  Positive reinforcements
v  Identify and fulfill the needs
v  Encourage expression verbally
v  Teach self care needs
v  Language training
v  Teach by naming own body parts
v  Involve family in care.



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notes.nursium.com: Pervasive developmental disorders - Childhood Autism
Pervasive developmental disorders - Childhood Autism
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