Autism has been defined as a developmental disability characterised by impairment in social interaction and communication with others, and by a preference for repetitive stereotyped behaviours.
The condition occurs in differing degrees of severity and in a variety of forms and the term ‘autistic spectrum disorder’ is used to describe the whole range. Asperger syndrome refers to people at the higher-functioning end of this spectrum.
AETIOLOGY AND INCIDENCE
- The exact cause is not known. Genetic factors are believed to be important, as are conditions affecting brain development such as maternal rubella and encephalitis.
- Three to six per cent of the siblings of individuals with autism also have autism or a related developmental disorder.
- There is good epidemiological evidence that the MMR vaccine is not an environmental risk factor for autism.
- There is no central register of all people with autism. However, research and clinical work - particularly in the last decade - has led to the broadening of the concept of autistic disorders. Estimates of prevalence have increased considerably in that time.
- The current estimated population of people with autistic spectrum disorders in the UK is over 500,000 - a prevalence of 63 in every 10,000.
- Autism affects four times as many boys as girls.
- Onset of autism is in infancy - from birth or before the age of three.
- Social interaction: autistic people may appear indifferent to others, or willing to receive gestures of social contact but unlikely to instigate them; lack of eye contact and facial expressions in social situations is common.
- Communication: difficulties with verbal and non-verbal communication. Nearly all affected children have language delay - both in understanding and speaking. They may find it difficult to interpret facial expressions and tone of voice. Speech content may be limited as language is not understood as a pleasure or a means of reaching others.
- Behaviour: lack of imaginative play and limited range of imaginative activities. A familiar routine is preferred. Tantrums, hyperactivity or self-injury can be a problem, particularly in more severely affected children. Some may possess a special talent, for example music, art, mechanics, mathematics and memory.
‘Features vary widely between individuals - the overall pattern of behaviour is most important as those affected can display flashes of ‘normality’.
- Comprehensive assessment of the child’s strengths, problems and requirements, and a detailed developmental history.
Referral to child psychiatrist or developmental paediatrician.
Education with speech and language therapy. The type of education required will be decided after assessment.
Severely affected people may need lifelong supervision and support.
The National Autistic Society website contains a list of ongoing research.
The story of learning disability nursing is one of survival against the odds. The profession, which celebrates its 100 th anniversary this year, has continued despite attempts to do away with the role altogether and a debate that has rumbled on over the decades as to whether or not it is “proper” nursing.
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