Professor and Head, Pediatric Nursing Department, College of Nursing, CMC Vellore, India

*Corresponding author: Dr. Mary Anbarasi Johnson, Professor and Head, Pediatric Nursing Department, College of Nursing, CMC Vellore, India, Tel: 8903461145; Email: [email protected].

Received Date: December 08, 2023

Published Date: December 30, 2023

Citation: Johnson MA. (2023). Nursing Management of a Child with Autism. Mathews J Nurs. 5(7):35.

Copyrights: Johnson MA. © (2023).

ABSTRACT

Nursing management of a child with autism which a developmental compromise involves a holistic approach to address the physical, emotional, and social needs of the child and their family. Developmental compromise can result from various factors, such as congenital conditions, neurological disorders, or environmental influences. Here are some key aspects of nursing management for a developmentally compromised child some of the issues most commonly labeled as developmental disabilities include intellectual disabilities (low IQ), autism, and cerebral palsy. Nurses need to be empowered taking care of the developmentally challenged children as they have much more challenges than a normal child and the family as well face issues in different domains. Nurses playing a key role in the health care team can make the hospitalization experiences pleasant to the children and families and also provide continued support through adequate follow up care.

Keywords: Developmental Delay, Autism, Disabilities.

INTRODUCTION

The nursing management of a developmentally compromised child involves a holistic and multidisciplinary approach to address the unique needs of the child and support their optimal development. Here are some key aspects of nursing management for developmentally compromised children, along with references for further reading:

What are the 5 developmental disabilities?

The main types of developmental disabilities include autism spectrum disorder, cerebral palsy, fetal alcohol spectrum disorders, Down syndrome, and attention deficit hyperactivity disorder, Autism.

Who are children with developmental difficulties?

It is common for children with developmental delays to have difficulty with social and emotional skills. For example, they may have trouble understanding social cues, initiating communication with others, or carrying on two-way conversations. They may also have difficulty dealing with frustration or coping with change (ADHD).

What are symptoms of developmental disabilities?

A person with developmental disabilities such as autism or intellectual disabilities may show some or all of the following symptoms:

Delayed or no speech.

Delays in meeting milestones.

Poor eye contact.

Limited facial expressions.

Odd hand and body movements.

Unusual reactions to noise, textures and smells [1].

Nursing Management of a child with Autism

Autism affects information processing in the brain by altering how nerve cells and their synapses connect and organize; how this occurs is not well understood. Overt symptoms gradually begin after the age of six months, become established by age two or three years, and tend to continue through adulthood, although often in more muted form.

 A person with autism may seem socially awkward, makes very little eye contact, has an aversion for physical contacts such as cuddling, incapable of empathizing with others, finds loud noises, some smell and lights unpleasant and quite shocking, and may often repeat words or phrases they hear – an event called echolalia. Moreover, they tend to be predictable and obsessive. The severity of the symptoms depends on the autism of the child [2].

 Main features of Autism

1. Impaired social interaction and verbal and non-verbal communication
2. Repetitive or stereotyped behaviour e.g. echolalia

Goal of Treatment of a child with Autism

To provide remedy from specific symptoms and improve quality of life.

Autism Nursing Management

1. The nurse must be able to familiarize the combination of symptoms associated with autism of the patient.
2. The nurse is the coordinator of therapies and interventions that meet the specific needs of individual children.
3. During the treatment session, the nurse’s main goal is to provide safety. The nurse must ensure that unnecessary things that may harm the child are removed from the area. It is also important to let the other staff members know of the child’s special needs.
4. Apply appropriate behavioral strategies are implemented. One example is the applied behavioral analysis (ABA). This program uses a one-on-one teaching approach that reinforces the practice of various skills. The goal is to get the child close to normal developmental functioning.
5. Listen to the child, his parents and the caregivers. As a nurse, you have to be an effective channel of communication among these people [2].

Medical Management of a child with Autism

1. Prescription of antipsychotic drugs, anxiolytics, and anticonvulsant drugs.
2. The medical management mostly involves the management of the symptoms as well as repetitive behavior that may harm the child.
3. Diet modification must also be stressed since these children must have some kind of special diet that will fit their lifestyle. Changing the diet or adding vitamin supplements may improve digestion and eliminate food intolerances or allergies, which may contribute to behavioral problems in autistic patients.
4. The physician must provide ample information about the special needs of the child and the available resources for the family to get in the community [2].
5. Proper follow-up on psychiatrists and child developmental specialists must be done routinely in order to prevent untoward physical and mental disabilities. Children with autism may have medical problems, mostly cardiac problems that must also be addressed equally during the course of care.

With early intervention and appropriate treatment, some autistic patients can function productively and attain some degree of independence. Most patients require lifelong assistance. There are various centers and support group can be found here in the Philippines which will cater to the kind of care children with autism needs. The nurses have an important role in spreading this information and provide quality care for this spectrum of autism [2].

Assessment and Diagnosis

Conduct a comprehensive developmental assessment to identify the child's strengths and challenges. Collaborate with other healthcare professionals, such as pediatricians, neurologists, and developmental specialists, for accurate diagnosis [3].

Family-Centered Care

 Involve the family in the care planning process and provide support and education.

Encourage open communication and collaboration between healthcare providers and the family [4].

Developmental Stimulation

Implement age-appropriate activities and interventions to promote optimal development. Collaborate with physical therapists, occupational therapists, and speech therapists to address specific developmental needs [5].

Nutritional Support

Collaborate with dietitians to ensure the child receives appropriate nutrition for growth and development.Monitor and address any feeding difficulties or nutritional challenges [6].

Medication Management

Administer medications as prescribed to manage underlying medical conditions.

Monitor for potential side effects and collaborate with the healthcare team to adjust medications as needed [7].

Psychosocial Support

Assess and address the emotional and psychosocial needs of the child and their family.

Provide counselling and resources to support coping and resilience [8].

Advocacy and Education

 Advocate for the rights and inclusion of developmentally compromised children in educational and community settings. Educate caregivers, teachers, and other healthcare providers about the unique needs of these children [9].

CONCLUSION

Developmental disabilities are a group of conditions due to an impairment in physical, learning, language, or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person's lifetime.

REFERENCES

1. https://www.google.com/search?client=opera&q=developmentally+challenged+child&sourceid=opera&ie=UTF-8&oe=UTF-8
2. https://rnspeak.com/autism-nursing-management/s
3. Council on Children with Disabilities; Section on Developmental Behavioral Pediatrics; Bright Futures Steering Committee; Medical Home Initiatives for Children with Special Needs Project Advisory Committee. (2006). Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics. 118(1):405-420.
4. McAllister JW, Sherrieb K. (2019). Family-centered care in pediatrics. Pediatric Clinics. 66(6):1185-1195.
5. Case-Smith J, O'Brien JC. (2015). Occupational therapy for children and adolescents. 7^th edn. Netherlands: Elsevier.
6. Sullivan PB, Lambert B, Rose M. (2018). Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford Feeding Study. Dev Med Child Neurol. 60(2):190-197.
7. Wong DL, Hockenberry MJ. (2019). Nursing care of infants and children. 11^th  edn. Netherlands: Elsevier.
8. Knafl K, Deatrick J, Havill N. (2012). Transition of care for families of children with chronic conditions: A literature review. Journal of Pediatric Nursing. 27(2):152-170.
9. Shogren KA, Wehmeyer ML, Palmer SB. (2018). Knowing, caring, and doing: Promoting the rights of persons with intellectual and developmental disabilities. Inclusion. 6(2):86-97.