How to write a nursing essay on Medical Therapies in Children with Autism

How to write a nursing essay on Medical Therapies in Children with Autism

Introduction: What is autism?

Autism, also known as autism spectrum disorder (ASD) is a developmental condition that affects one’s communication and behavior. Even though it can be diagnosed at any point in life, it is described as developmental since the symptoms normally appear within the first two years after birth. It is also called a ‘spectrum’ disorder since those diagnosed with it experience a wide variety of types and severity of symptoms. Autism affects people from all ethnic, racial, and economic groups, and is primarily characterized by impaired social interaction and communication. Also, the condition manifests with atypical behavioral patterns including difficulties in transitioning from one activity to another, too much focus on details, and, strange reactions to sensations (National Institute of Mental Health, 2018). Even though some people can live independently, most autistic people need significant care and support, which has a significant impact on the demands of the family providing care (WHO, 2021). Despite being a lifetime disorder, several evidence-based treatment options are available to improve the symptoms and one’s ability to function. In totality, people’s attitudes in society, and the amount of support provided by the authorities are essential in determining the quality of life of those diagnosed with autism. This paper describes the treatment options for children diagnosed with autism, and how their integration into clinical practice can impact nursing care.

Problem Area

According to CDC (2021), 1 in every 44 children from all ethnic, racial, and socioeconomic are diagnosed with autism annually. Boy s are affected at a rate of more than four times higher than girls. According to CDC (2021), “About 1 in 6 (17%) children aged 3–17 years were diagnosed with a developmental disability, as reported by parents, during a study period of 2009-2017.” Among the stated developmental disabilities was autism spectrum disorder. People with ASD are often stigmatized, discriminated against, and their human rights violated (WHO,2021). Additionally, raising a child with ASD is an overwhelming responsibility to caregivers, parents, and families. These children present with persistent and severe deficits in cognitive and motor abilities, which are associated with significant difficulties in care providers such as reduced parenting efficacy, elevated parenting stress, increased mental and physical health problems compared to their counterparts’ raisin typically developing children.

Notably, having a child with ASD can place a significant financial burden on families, resulting in impaired general family well-being and increased divorce rates. These effects in turn negatively affect the child with ASD, and according to Musetti et al. (2021), this reduces the positive effects of treatments and interventions. In a study by Blaxil, Rogers, and Nevison (2021), the future cost of ASD is estimated to increase significantly from $223 billion annually in 2020 to $589 billion annually in 2030, to $1.36 trillion annually in 2040, to $5.54 annually by 2060. In another study in Ireland, the average annual cost per child with autism was €28,464.89 for families, which was higher compared to the annual government expenditure per child which was €14,192 (Roddy & O’Neil, 2019). The study indicates that ASD is quite associated with increased out-of-pocket costs compared to state health expenditures. As such, Blaxil et al. (2021) recommend ASD prevention strategies as a significant way of cutting these costs. The transmission of costs from parents to government as children grow older, and the projected increase in total costs as the decades go by demand an urgent emphasis on prevention and timely intervention of evidence-based treatment strategies.

Target Population

CDC estimates that autism spectrum disorder affects 1 in every 44 children. Autism is also reported to affect people from all ethnic, racial, and socioeconomic backgrounds. However, it is four times more likely to affect boys than girls. According to CDC (2021), in a study conducted between 2009 and 2017, parents reported that 1 in every 6 children between 3 and 17 years old was diagnosed with a developmental disability. These disabilities included autism, cerebral palsy, blindness, and attention-deficit/hyperactivity disorder among others. Since it is a spectrum of disorders, some children experience more severe impairment of abilities than others. Cognitive or physical impairments may confound an already complicated situation. Just like other conditions, healthcare professionals should not make assumptions regarding a child’s ability based significantly on their diagnosis. According to WHO (2021), an autistic child is not necessarily cognitively impaired. Addressing ASD from earlier on in childhood is significant in establishing a population of healthy and productive individuals, which aligns with the sustainable development goal of health and wellbeing.

The National Institute of Mental Health (2018), recommends that every child should receive check-ups and be screened for developmental delays with a pediatrician or an early childhood healthcare provider. This is done at 9, 18, 24, and 30 months old in well-child clinics. For autism, it is recommended that the screenings are conducted during 18- and 24-month visits. Children with high risks of ASD need additional screening. Indicators of high risks include first-degree relatives with ASD or certain genetic conditions, and babies born with very low birth weight.

Significance of The Topic

The findings of this research article will be used to improve the quality of nursing care and health outcomes in the management of children with an autism spectrum disorder. The integration of evidence-based treatment strategies will ensure reduced, mental, physical, and socioeconomic burdens associated with ASD in children. Additionally, these findings will be used to improve nursing assessment during patient admission which has an impact on the efficacy of the patient’s treatment plan, while maintaining the safety and wellbeing of the patient and healthcare providers. Application of the evidence-based treatment practices in clinical and home settings will ensure minimum costs are incurred in the management of ASD patients as they transition into adulthood, where most expenditures are catered for by the government.  Blaxil et al. (2021), insists that the key to cutting the increasing expenditures on ASD even in the coming decades is timely prevention and intervention strategies. In totality, tackling ASD through effective preventive and treatment strategies in childhood is critical in sustaining development, through maintaining an individual’s productivity.

Evidence-based Treatment Protocols

An intricate nursing assessment upon admission is critical in establishing the right course of treatment during the hospital stay. Some of the factors to consider when assessing include determining the child’s developmental level by considering their grade level and performance, the level of somatosensory impairment, emotional disturbances such as being easily irritable, moody, or overly stimulated, successful past interventions, and effective communication techniques for the patient.

The first treatment approach focuses on modifying behaviors through understanding the events that precede and happen after the behavior. According to CDC (2021), behavioral approaches have demonstrated the most efficacy in treating the symptoms of autism. Therefore, they have been widely incorporated in healthcare and education settings. Applied behavior analysis (ABA), is one of the behavioral approaches effective in the treatment of ASD. It reinforces desired behaviors and discourages the undesired ones, thus improving certain skills in the process. When using this approach, it is necessary to track and measure progress. Two ABA styles are used to achieve the desired outcomes: Discrete Trial Training (DTT) and Pivotal Response Training (PRT). DTT incorporates step-by-step instructions the encourage desired behavior. Instructors or healthcare provider breaks down lessons into simple parts, and reward the desired behaviors and responses (CDC, 2021). Undesired responses or behaviors are ignored. On the other hand, PRT is conducted in a natural setting to improve “pivotal skills” that help the children learn other subsequent skills (CDC, 2021). For example, initiating communication with their peers, which is useful in establishing a conversation and sharpening social skills.

The second treatment approach is a developmental one that emphasizes improving specific developmental skills. These skills include language and physical skills which are associated with developmental abilities. In conjunction with behavioral approaches, development treatment approaches have demonstrated significant efficacy in alleviating ASD symptoms (National Institute of Mental Health, 2018). Speech and language therapy is the most common developmental approach and it helps autistic children improve their use of speech and language. Autistic children can have various ways of communication, such as through pictures, signs, gestures, or verbally. Whichever way, speech and language therapy should be useful in improving their communication. Additionally, occupational therapy is part of the developmental approach that equips learners with skills that ensure their independence. These skills include self-care activities.

The National Institute of Mental Health (2018) recommends an Early Start Denver Model (ESDM) that is a road developmental approach with borrowed principles from ABA. It incorporates play, social exchanges, and shared attention between children and their caregivers or parents to enhance language, social and pedagogical skills. Its efficacy is demonstrated in children between 12 and 48 months of age.

The third approach is the use of educational treatments, which are administered in a classroom setting. One such approach is the use of Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH). The principles in TEACCH are founded on the idea that autistic children thrive on repeated patterns and visual learning (WHO, 2021). It provides teachers with options for improving classroom structure to enhance academic outcomes for autistic children. For instance, daily routines can be displayed on a wall where everyone can see them, in drawings or written format (Musetti et al., 2021). Teachers can also accompany verbal instructions with visual ones or physical demonstrations.

Finally, while there are no pharmacological treatments for the core symptoms of ASD, treating the co-occurring symptoms in ASD can significantly improve a patient’s abilities and help them live a quality life (WHO, 2021). For instance, depending on individual assessments, medications can be administered to manage high energy levels, inability to pay attention, self-harming actions such as banging head, pinching oneself, or hand biting. Common co-occurring psychological conditions such as anxiety and depression can also be treated. Additionally, medications can also be prescribed for comorbidities such as seizures, sleep disorders, or gastrointestinal disorders. Essentially, caution should be exercised when using medications. Close monitoring of progress and side effects should be considered during treatment.

Impact On Nursing Practice

Statistics of increasing ASD prevalence suggest an increasing likelihood of caring for autistic children. The findings of this research article suggest a significant positive impact on nursing care. Nurses particularly those in family practice, primary and acute care settings should be well-equipped to administer safe interventions which are developmentally appropriate. The discussion above on the evidence-based treatment approaches provide the basis for developing individualized care plans for autistic children so they can have quality nursing care. The application of a specific, focused, and developmentally appropriate treatment approach helps build a safe environment for nurses and patients, where quality healthcare can be delivered.

Essentially, a multidisciplinary approach in the treatment of ASD is critical to improved clinical outcomes. Regardless of the setting where care is provided, planning and coordinating patient care with other healthcare professionals is key in availing resources, effective treatment, and follow-up procedures. Inarguably, the best plan of care considers the unique spectrum of symptoms and involves the family and caregivers for a better quality of life.

The application of these findings in administering interventions to patients will ensure improved outcomes, which will consequently mitigate the associated financial burden in families and the government. This money will then be channeled to other areas such as improving accessibility and availability of occupational therapy centers, which are crucial part of treating autism spectrum disorders.

Conclusion

To conclude, Autism Spectrum Disorders are a group of conditions characterized by varying degrees of impaired social interaction and communication. Trends in statistics suggest an increasing prevalence over the past decades. Projections indicate that the prevalence will increase and by 2060, the government expenditure on ASD will be over $5 trillion. The abilities of children with autism vary significantly. Living with autism can be challenging financially, physically, mentally and emotionally, particularly to those diagnosed with it and their close family members. This is worsened by the negative societal attitudes in some areas, and stigmatization in social spaces. The burden presented by those who entirely depend on their families and caregivers demands a supportive environment, free of stigma and discrimination. Those who cannot live independently can significantly benefit from the following treatment approaches which have demonstrated high levels of efficacy. They are behavioral, developmental, and educational approaches. Pharmacological approaches are only available for treating co-occurring symptoms and comorbidities. Initial nursing assessment upon admission that considers the unique developmental delays, and family situation is key in the subsequent coordinated patient care. The application of these approaches in various healthcare settings through collaboration with different relevant healthcare professionals is critical in establishing good outcomes and improving the quality of life.

References

Blaxill, M., Rogers, T., & Nevison, C. (2021). Autism Tsunami: The Impact of Rising Prevalence on the Societal Cost of Autism in the United States. Journal of Autism and Developmental Disorders, 1-17.

Musetti, A., Manari, T., Dioni, B., Raffin, C., Bravo, G., Mariani, R., … & Corsano, P. (2021). Parental Quality of Life and Involvement in Intervention for Children or Adolescents with Autism Spectrum Disorders: A Systematic Review. Journal of personalized medicine, 11(9), 894.

Roddy, A., & O’Neill, C. (2019). The economic costs and its predictors for childhood autism spectrum disorders in Ireland: How is the burden distributed?. Autism, 23(5), 1106-1118.

U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health. (Updated 2018). Autism Spectrum Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd

World Health Organization (WHO). (2021). AutismSpectrum Disorders. Retrieved from https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders

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