Case study description
This poster describes an eight-year-old boy called Jim. While at the psychiatric room, Dr. Meddy, together with Jim’s mother, entered the consultation room for a consultation to examine what could be the issue with the second-born child in the family. Just before the Dr. expresses her observation about Jim, the child is so restless and wailing so loudly that everyone in the room gets amused and distracted from their activities. It took so long for Jim to calm down, and we could observe that the child was suffering from a mental defect. The mother tried her best to get Jim arrested for such restlessness, but it was not easy as Jim was moving up and down, running all over the room, becoming chaotic, and pulling the cushions. Apart from the behavioral aspects, Jim was also very slow in recognizing some of the preliminary figures and objects and could not correctly pronounce some of the syllables properly, thus making it difficult for him to engage in propitiate play with his peers and participate in school activities. The parent was so concerned and ensured that she took immediate action to diagnose the problem Jim could be enduring. Jim was then diagnosed with Autism Spectrum Disorder(ASD).
Symptoms
Jim’s case of ASD and his symptoms depict the DSM-5 criteria for ASD. For example, Jim has poor verbal and non-verbal communication that prevents him from constructing complete sentences at school and during play sessions. The DMS-5 also requires that for an individual child to pursue a diagnosis of ASD, one must be experiencing restricted behaviors in communication that include having poor body language as well as the lack of maintained eye contact during a one–on–one conversation (Eslami et al., 2021). In addition, Jim shows symptom of the social repository that includes behaving in a way that is not normal for a healthy individual. Jim was fond of creating chaos in the consultation room; He also showed a lack of interest in responding to the mother trying to calm him down, achieving the DMS-5 classification criteria for ASD. In addition, Jim’s ASD condition meets the DMS-5 classification since he cannot adjust to social relationships and behave in a way that will help maintain, develop, and understand such social contexts of relationships (Eslami et al., 2021). Jim also shows repetitive movements that apply to the DMS-5 criteria, such as the increased and repetitive motor movement that includes using objects and flipping objects that caused the chaos observed.
Courses on Autism and the existence
While interacting with Jim’s mother, she remembered that Jim began to suffer from the disorder immediately six months after birth since she experienced certain complications. Eight years later, Jim has been suffering from behavioral issues that made the mother visit the hospital for assistance, where she was informed about the child who has ASD.
Possible Causes of ASD
According to the DMS-5 and other recognized mental health articles, there are no clear causes of Autism Spectrum Disorder(ASD) hence leading to various hypothetical pieces of evidence to describe various possible causes of ASD. Therefore, there is significant hypothetical evidence describing the possible causes that include; genetic, environmental, and biological aspects.
The genetic factors are those that study the homozygous twins as having a close relationship with ASD. Autism is a genetic disorder that can be inherited from one individual to another within members of the same family tree, making individuals from such families much more susceptible to the disease than any other general population. The evidence on the possibility of genetic causes of ASD is still not standalone and primarily relies on other factors. Additionally, environmental factors are a significant cause of ADS, especially for the child. Children born during unfavorable periods at birth may have ASD caused by poor environmental conditions (Hodges et al., 2020). Such unfavorable environmental conditions at birth may include suffering from mechanical damages resulting from poor handling of the newborn by the mother or the midwife.
The biological factors are those related to neurological compositional and gender. Most studies on the cause of ADS show that female children with more grey matter in their brains have the highest susceptibility to ADS. Other female subjects with ADS also showed a higher cortical volume and an increased cerebellar volume (Hodges et al., 2020). A similar study on the general population with limited cerebellar volume and limited grey matter shows they are too susceptible to ADS. In addition, there is a possibility that the Purkinje cells in the brain are a factor causing the disorder. Individuals with fewer of these cells show more fantastic positive results of ADS (Manning et al., 2020). inactivation of the frontal lobe is also a significant cause of the disorder since there is no proper coordination of the information received by the nerve cells within the brain’s frontal lobe, including cognitive and motor impulses.
Diagnosis
DMS-5 diagnostic criteria show that ASD affects individuals differently, but the primary baseline of its impacts is on their behavioral life. In most cases, DMS-5 recommends that the diagnosis of the disorder should exist before the child reaches six years so that adequate behavioral, cognitive, and intellectual aspects of the abnormal behaviors of the child can be visible. It is also vital for the diagnosis of ASD to first analyze the differential diagnosis. Other disorders exhibit similar symptoms of ASD, such as Schizophrenia (Hopwood, 2019), Avoidant Personality Disorder, and Social Communication Disorder. As a result, to dismiss this differential diagnosis, it is essential first to carry out a diagnosis of intellectual development or delay that is not always present in this differential diagnosis. Other forms of diagnosis for ASD include; past behaviors and persistent current behavior across many setting that shows a shortfall in social and emotional stability in maintaining close relationships.
Moreover, individuals with ASD show aspects of a lack of interest in daily activities with an extreme inflexibility that originates from poor sensory alertness (Hopwood, 2019). Classifying ASD involves using DMS-5 classification criteria from levels one to three. Level one implies that the individual needs support, especially from the family member. In contrast, the third level is more severe, and the individual requires more substantial assistance, especially from the medical personnel. Some of the assessment data that Jim presented include the age of eight, but the child cannot pronounce syllables of words correctly. In addition, the repetitive behaviors, including the flipping of objects with chaotic behavior, clearly reflect the ASD diagnosis in this case study.
Nursing interventions
There rea three nursing interventions for individuals suffering from Autism Spectrum Disorders, i.e., behavioral, communication, and medical interventions. Behavioral interventions include the use of Hippotherapy(HPT), which applies the use of equine movement techniques that offer therapeutic benefits. The nurses can use the HPT on the patient for 45 minutes weekly for about 12 weeks. When properly used by the nurse, the HPT shows improved postural control additive behaviors (Manning et al., 2020). in addition, communication interventions involve strategies that help enhance the patient’s cognitive or learning aspect. They include; participating in social skills organized by the therapist. The therapist thus groups children suffering from similar strategies of the disorder together and leads them in the social training programs that will, at long last, help them improve their interaction and communication skills. Evidence of the success of this intervention shows that it has been successfully used in clinical and school settings to increase positive interactions, autistic behaviors, and social skills.
Medications
The primary type of medications that can help in the treatment of ASD are Antipsychotic drugs. Some therapeutic drugs used in treating ASD involve Antipsychotic drugs such as risperidone, clozapine, and paliperidone, which all help treat psychosis. These antipsychotic drugs, therefore, are used in the treatment of ASD because they can arrest irritability and other behaviors that may initiate self-injury and aggression. In addition, antipsychotic drugs prevent stereotyped and hyperactive behaviors by blocking the DAD2 receptors that are inhibitory factors for G-protein.
Other therapeutic interventions
Apart from the medical interventions, other treatment inventions are applicable for those experiencing chemical allergies present in some drugs. Occupational therapies help train ASD patients on specific skills to enable independent living. For example, sensory integration is a therapy used to improve an individual’s response to sensory input that may overwhelm the patient. In addition, occupational therapies include physical therapy that enables the activity of the physical body muscles, bones, and joints towards enhancing coordinated movement (Nurnberger, 2019). Other non-medical interventions include; participating in social stories, social group activities, and relationship development strategies. Alternative and complementary treatment models that include herbal and art therapies (musical dance) are also applied.
The use of art therapy for the treatment of ASD has been in existence for many years, especially in Asian countries (Manning et al., 2020). The musical dance enables ASD patients to identify and express their emotions appropriately. Music processing always occurs in the brain’s two hemispheres; it must help provide appropriate language and speech development. Since dance is a form of movement and therapy, it facilitates the involvement of the whole body and the brain in connecting with music. It is also valuable for treating ASD since it carries no cultural barriers and only expresses the emotional aspects of the individual. Most ASD patients suffer from stigmatization, and it is too difficult to assist them in the contemporary environment without feeling belittled. Music and dance are, therefore, valuable aspects of therapy that will not discriminate against them based on their inability to construct verbal communication clearly for identification.
Special considerations
There are special considerations needed when dealing with children or elderly patients. Children with ASD require special treatment from their parents and caregivers since they are too vulnerable to control. They require adequate support with time management, relationships, information, and materials needed for movement. Children are still at low development stages and require parents to support them in developing proper communication and movement skills (Nurnberger, 2019). On the other hand, older adults with ASD have become weak and require immediate care from family members. Since they cannot move long distances, it is essential to have close family members taking care of them at the residential homes through constant collaboration with the professionals who understand the etiology and physiopathology of Autism, including preventing falls.
References
Eslami, T., Raiker, J. S., & Saeed, F. (2021). Explainable and scalable machine learning algorithms for detecting autism spectrum disorder using fMRI data. Neural Engineering Techniques for Autism Spectrum Disorder, 39-54. https://doi.org/10.1016/b978-0-12-822822-7.00004-1
Hodges, H., Fealko, C., & Soares, N. (2020). Autism spectrum disorder: Definition, epidemiology, causes, and clinical evaluation. Translational Pediatrics, 9(S1), S55-S65. https://doi.org/10.21037/tp.2019.09.09
Hopwood, C. J. (2019). Research and Assessment with the AMPD. The DSM-5 Alternative Model for Personality Disorders, 77-95. https://doi.org/10.4324/9781315205076
Manning, J., Billian, J., Matson, J., Allen, C., & Soares, N. (2020). Perceptions of families of individuals with autism spectrum disorder during the COVID-19 crisis. Journal of Autism and Developmental Disorders, 51(8), 2920–2928. https://doi.org/10.1007/s10803-020-04760-5
Nurnberger, J. (2019). Faculty opinions recommend identifying common genetic risk variants for autism spectrum disorder. Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature. https://doi.org/10.3410/f.735152734.793563005
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