Autism Corrin Simon

Introduction O Purpose O My choice O What will be discussed

Autism Gender Genetics Treatment Autism is on the rise in the United States

Autism and Comorbidities O Care Problem: Children with autism may have as many comorbidities as children without autism, but they may be difficult to diagnose as they have a different presentation. O Comorbidity: the presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder.

Theory and justification O Theory: Jean Watson's Caring Model O Watson’s definition of health: O A high level of overall physical, mental, and social functioning O A general adaptive-maintenance level of daily functioning JUSTIFICATION O Educate O Symptoms do not always pertain to a certain disease

Methods O The study used a school-based health survey O 91 children between 6-14 years of age O Medical records of each child were reviewed O Schools that had completed the revised Autism Diagnostic Interview

Results O Over half of the children had at least one comorbidity O Most common comorbidity epilepsy or ADHD

Critique of Study O Journal of Child and Adolescent Psychiatric Nursing O 90% of resources are within the last 5 years O Cross-sectional Design O level of evidence= level C

3. UNDERSTAND… the importance of the propositions, assumptions, and confounding variables. Proposition: If symptoms are not evaluated, a child may develop or have another disorder (comorbidity) that is not being treated. If this disorder is not treated it could lead to harm or possibly death. Significance of Assumptions: If a physician, nurse, parent, or child does not look into symptoms due to the belief that the symptoms are due to the child’s autistic disorder, it could lead to the worsening of the comorbidity disorder. Possible Confounding Variables: If a parent has a fear of another disorder, or their child being sick more, they may not answer autistic treatment questions truthfully. They may also not get their child evaluated for other disorders. If a physician or nurse is not knowledgeable about autistic symptoms then they may blow any other symptoms off that are similar but different. By doing this they may let another disorder slide past with diagnosis or treatment. 2. RELATE… Or put the variables together to form propositions. Primary Proposition: “A child with autism has one or more comorbidities that cannot be identified due to the signs of similar symptoms to autistic disorder.” Possible Assumptions: “A child does not have a comorbidity and is just showing symptoms of his or hers autistic disorder.” Possible Confounding Variables: “Parent may not believe child has another disorder.” “Parent may answer questions falsely. “ “May not recognize symptoms that belong to a different disorder.” “May assume that a symptom belongs to the autistic disorder so do not check into it.” 1.IDENTIFY… the variables in this situation 91 Children between ages 6-14 Diagnosed with autism Autism Treatment Evaluation Checklist Comorbidity Parents 4. EXPLAIN… the significance of the situation to those involved based on their individual KSVME Proposition: In a way that will benefit the child, explain to the parent the importance of testing for disorders if a child is showing a symptom often, even if it is similar to an autistic symptom. Help to explain the harm an undiagnosed disorder could do. Assumptions: Confounding: Make sure all physicians, nurses, and parents are educated on autistic disorders, so they can see the slight changes that may represent a different disorder. Variables: Educate parents to relieve any fears. Educate physicians and nurses so disorders are properly diagnosed. PLAN OF CARE

5. PREDICT… what will happen in this situation if one or more variables are not changed. Proposition: If having autism increases the chances of having a comorbidity - due to changes in genetics -and the comorbidity is not diagnosed, then the child's chances of getting harmed or having an infection, disease, or dying increase. Assumptions: If a person will look at a child's symptoms more closely and not assume it is one thing, then the chance of diagnosing a second disorder will be increased, thus improving the child’s quality of life. Confounding Variables: If a parents fear can be resolved then their child will receive better care and treatment. If a healthcare team can be better educated, disorders will not go undiagnosed. 6. INFLUENCE… someone to change one or more variables in order to achieve a desired outcome or prevent an undesirable one. Proposition: Make sure parent and healthcare team understand the genetic disposition of autism. Know the increased risks of other disorders accompanying that of an autistic one. Educate on signs and symptoms so disorders can be correctly identified. Assumptions: Make sure persons are educated and understand the different symptoms for different disorders. Instruct them in what to do if a symptom persists. Confounding Variables: Share resources such as seminars, conferences, journals, articles, classes, and videos that will help to educate and build confidence in a persons understanding. 7. CONTROL… one or more variables in order to achieve a desired outcome or prevent an undesirable one. To control isn’t an issue of wanting to dominate or do what is unreasonable or unwanted, but simply a matter of changing one or more variables in order to bring about a desired outcome when influence is not possible, realistic, or advisable. - Give out pamphlets and resources

CARE O Knowledge deficit r/t undiagnosed cormobidities in autistic children aeb misinterpretation of symptoms O EDUCATION is key

Advocate Role O Disorder that is not fully understood O Mental health disorders are frowned upon by the general public O Child not cared for or diagnosed properly

Significance to Nursing O Nurses care for children with mental health disorders O Nurses need to be aware of several disorders O Be knowledgeable about symptoms and traits Famous People with Autism Beethoven Mozart Emily Dickinson Albert Einstein Charles Darwin Sir Isaac Newton

References O Colley, S. (2014) NURS 441 research in nursing [syllabus]. 6. O Kordi, R., Memari, A., Mirfazeli, F. & Ziaee, V. (2012) Investigation of autism comorbidities and associations in a school-based community sample. Journal of Child and Adolescent Psychiatric Nursing, 25, 84–90. doi: /j x O Nursing Theories (2012). Jean watsons philosophy of nursing. Retrieved June 15, 2014 from O Videbeck, S. L. (2014). Psychiatric-mental health nursing (6th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.