A disorder characterized by impairment in social interaction skills and interpersonal
communication and a restricted repertoire of activities &
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Broad spectrum of D/Os including: autistic, Rett’s, childhood disintegrative, pervasive
developmental D/O not otherwise specified, & Asperger’s D/O
Presents in early childhood and is more common in boys than girls
Manifestations include:
a. Sensory integration dysfunction
b. Little to no interest in people & often don’t respond to others’ attempts at interaction
c. As infants- aversion to affection/physical contact
d. As toddlers- attachment to significant adult may be absent or exaggerated
e. As children- failure to develop cooperative play, imaginative play, or friendships
f. Non verbal communication absent or socially inappropriate
g. Language may be absent or impaired
h. Routine may become an obsession
i. Stereotypical body movements: hand clapping, rocking, whole-body swaying
j. Self-injurious behavior: head banging, biting
k. Sleep disorders
l. Digestive disorders, feeding disorders, &/or allergies
m. Epilepsy
n. Withdrawal of the child into the self & into fantasy world of his/her own creations
o. Wide variability in functioning abilities:
i. Poor (inability to perform self-care, inability to communicate and relate to others)
ii. High (ability to function at near normal levels)
Nursing interventions
Initiate a referral for early intervention
Provide a structured environment
Consult with parents to provide consistent and individualized care
Encourage parents to participate in the child’s care and treatment plan as much as possible
Use short, concise, and developmentally appropriate communication
Identify desired behaviors and reward them
Role model social skills
Role play situations that involve conflict and conflict resolution strategies
Encourage verbal communication
Limit self-stimulating and ritualistic behaviors by providing alternative play activities
Determine emotional and situational triggers
Give plenty of notice before changing routines
Carefully monitor the child’s behavior to ensure safety
NANDAs
Risk for self or other directed violence
Impaired Social Interaction
MEDS: Treat the symptoms
risperidone (Risperdal) or aripiprazole (Abilify): For irritability
olanzapine (Zyprexa): For aggression
fluoxetine (Prozac) or sertraline (Zoloft): For depression & anxiety. Also can reduce
repetitive behaviors. [Show Less]