Autism: Conversations With the Pioneers

This term paper discusses autism in relation to nursing. Its aims are:  (1) to define autism and its causes, (2) to describe the process of evaluating if a child has autism, (3) to report abnormal findings observed among autistic patients, and (4) to describe appropriate treatments, including medical and nursing treatments, as well as prognosis and chances for recovery.

What is Autism?

I was 2 ½ years old when I began to show symptoms of autism; not talking, repetitious behavior, and tantrums. Not being able to communicate in words was a great frustration, so I screamed. Loud, high pitched noises hurt my ears like a dentist’s drill hitting a nerve. I would shut out the hurtful stimuli by rocking or staring at sand dribbling through my fingers (Grandin, 2002)
Temple Grandin, one of the thousands of individuals with autism, described aptly what was happening to her then. It has been reported that autistic children and adults are lacking in verbal and non-verbal communication, social interaction, and leisure or play activities. It is hard for them to communicate with others and relate to the outside world.
They exhibit repeated body movements, unusual responses to people or attachment to objects and resist any changes in routines. In some cases, aggressive or self-injurious behavior may be present (Autism Society of America, 2006).
According to the Autism Society of America (2006), autism occurs in approximately 15 of every 10,000 individuals, four times more prevalent in boys than girls, and conservatively estimated that nearly 400,000 people in the United States have some form of autism.
Autism is defined as a “complex childhood disorder that involves abnormal emotional, social and linguistic development “(Ball & Blinder, 1995).  It is a developmental disability that typically appears during the first three years of life as a result of a neurological disorder that affects the functioning of the brain (Autism Society of America).
 Studies have shown abnormalities in different areas of the brain, including the cerebellum which participates in the execution of organized movements such as walking, running, eating, dressing and writing (Isaac, et al. 2005).
The major brain structures implicated in autism are the cerebral cortex, amygdala, hippocampus, basal ganglia, brain stem, corpus callosum and cerebellum (Strock, 2004).  Many of these brain structures are responsible for higher mental functions, general movement, perception, behavioral reactions, speaking and other bodily functions.
What causes autism?
According to Jennifer Humphries (2000), the cause of autism remains unknown. It has been attributed to damage to the brain, but she said it is not conclusively proven.  She enumerated five factors cited by Frith (1989) that may be responsible for it, which are as follows: genetic or chromosomal abnormality, viral agents, metabolic disorders, immune intolerance and perinatal anoxia.
Family studies show that autism is 50 times more frequent in the siblings of autistic people than in the general population. Siblings who are not autistic themselves show an increased incidence of other cognitive impairments.
Infections like German measles (rubella) and herpes encephalitis may damage the brain during pregnancy and childhood.  Children with autism have shown elevated blood serotonin (a chemical in the brain) levels, although this is not specific to autism. It is postulated that there is delayed maturation in the central nervous system functioning (Isaac, et al, 2005).
How is autism diagnosed?
There is no specific universal diagnostic or laboratory test to detect autism. Diagnosis is often made by a psychiatrist using established criteria by the American Psychiatric Association (2000) which focus on communication skills, social interactions as well as repetitive and stereotyped patterns of behavior.
Moreover, “clinicians can use behavioral observation instruments and ask parents and/or teachers to fill out behavior checklists (Hallahan and Kauffman, 2006).