III.

INTRODUCTION

Autism Spectrum Disorder (ASD) is a complex and lifelong developmental

disability that typically appears during early childhood, it involves persistent

challenges in social interaction, speech and nonverbal communication, and restricted

or repetitive behaviors. Since people with ASD may exhibit a wide variety of

symptoms, it is referred to as a "spectrum" condition. People with ASD may have

difficulty communicating with you or may not look you in the eyes when you speak to

them. They can also have a limited range of interests and engage in repetitive

behaviors. They might spend a long-time putting things in order, or they might repeat

the same sentence over and over. They may appear to be in their "own world" on a

regular basis.

The exact cause of ASD is still unknown, the most current research

demonstrates that there’s no single cause. However, studies have learned that there are

likely many causes for multiple types of ASD. There may be many different factors

that make an individual more likely to have an ASD, including environmental,

biologic and genetic factors. In 2021, it is reported that approximately 1 in 54 children

is diagnosed with an Autism Spectrum Disorder (ASD), according to 2019 data. Boys

are four times more likely to be diagnosed with autism than girls.

IV. OBJECTIVES:

a) Short-Term

The short-term purpose of this study is to observe, describe, analyze the

importance to know the life of a patient living with Autism Spectrum Disorder

(ASD).

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 b) Long-Term

The purpose of this study is to obtain necessary information about the

patient's condition, to identify the health care needs of the patient by reviewing

all the data collected, to support the patient during rehabilitation, and

improvement, to impart the patient's necessary health teachings, to perform

adequate nursing care in accordance with the patient's condition and, in

particular, to expand and improve the awareness and skills of the student nurse

through more study on the essence of the disability, its signs and symptoms,

its psychopathology, diagnosis and treatment.

V. PATIENT’S PROFILE

Name: Giana Scel A. Bagorio

Address: Brgy. VI, Pagpandayan, Vigan City, Ilocos Sur

Age: 24 years old

Gender: Female

Civil Status: Single

Nationality: Filipino

Religion: Roman Catholic

Chief Complaint: Self-injury and aggression

Reason for Admission: Constant moving (pacing) and “hyper” behavior

Admitting Diagnosis: Attention Deficit Hyperactivity Disorder (ADHD)

Date Admitted: January 21, 2007

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 Attending Physician: Dr. Elton Ong

Source of Information: Melbourne A. Bagorio (mother)

Date of Discharge: January 24, 2007

Final Diagnosis: Autism Spectrum Disorder

VI. MINI MENTAL STATUS EXAMINATION

1. General Observations

A. Appearance

Hygiene: Back then, while she was still young, she looks neat and clean, but now

that she’s grown up she looks filthy and haggard.

Dress: Before, she’s well-dressed, she has a taste of fashion. Right now, she’s into

wearing oversized shirts and men’s shorts and she chooses oddly and not so

presentable clothes and outfits.

Facial Expression: Her facial expressions that she manifests depends on her

mood, sometimes she’s happy, sad, mad, and irritable.

Alertness: Most of the time she’s active, but sometimes she lacks energy and pre-

occupied.

B. Speech

General: Maximal answers and most of the time she speaks slurred and throaty

words.

Rate: Slow speech with long pauses before answering.

Latency: There are increased delays in speaking.

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 Volume: She speaks loud and fast.

Intonations: Monotonous tone of voice.

C. Behavior

General: She is restless, has a high self-esteem, decreased activity of daily living,

loves to go out. She really loves to communicate with others.

Eye Contact: Every time she’s talking to a person, she doesn’t avoid making an

eye contact, especially if you’re talking to her face to face, she’ll surely look your

eyes straight.

Mannerism: When she encounters the people, she’s looking these certain persons

all the time. She touches the hair and the arm of the people she’s comfortable

with.

D. Cooperativeness

She really does love going out of their house, make friends with the other people,

she’s friendly that’s why she’s good in communicating others and jolly too.

2. Thinking

A. Thought Process: Analytical thinking, she thinks logically consistent way that

leads to quick decision making.

B. Thought Content: Her thought contents include being different from the other

people around her, either nobody wants to be friends with her.

C. Perceptions: She has episodes of tantrums.

3. Emotion

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 A. Mood: She has her moment of mood swings, when talking to other people she

knows how to take accountable towards herself, but of course when it comes to

her parents and other relatives her mood is not appropriate.

B. Affect: Energy level. A person's mood may fluctuate depending on what she feels,

from irritability to extreme sadness to an angry outburst.

4. Cognition

A. Orientation/Attention: She’s aware of how other people treat her, she also knows

regarding her condition, being bullied by the other people regarding her condition.

B. Memory: She has a good memory skill; she can also remember what happens

during our interview.

C. Insight: She was not aware of her thoughts, actions, and behavior. She has an

irrational thoughts and different capabilities because of her condition.

D. Judgment: Her judgment is limited since she barely understands a certain

situation.

VII. PSYCHOPATHOLOGY

A. Algorithm

AUTISM SPECTRUM
DISORDER
• Behaviorally
based treatments
(Core and
• ASD complicates associated
differential symptoms; social
diagnosis. skills)
Developmental
• Baseline should be Screening and Management and
Diagnosis • Developmental
normal Effects
for the Rehabilitation
Therapies
individual. (Communication,
•Consider the sensory motor,
patient’s unique gross motor, fine
profile of motor)
neurocognitive
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features to Biologic Treatments
determine what is a • Support system
symptom.
 • Motor and
Communication
Difficulties
• Sensitivity to
change and
Stimulation
• Repetitive
Behavior
• Social
Impediments

B. Explanation

Individuals with Autism Spectrum Disorder (ASD) are reported to

have high rates of co-occurring psychopathology. Little is known about risk

factors that might contribute to this psychopathology. On the developmental

effects, ASD often co-occurs with other disorders, making diagnosis difficult.

Almost all individuals with a diagnosis of ASD establish a normal baseline for

the individual to go further. Neuropsychological assessment provides a

profound analysis of cognitive functioning in people with autism spectrum

disorder (ASD). Individuals on the autistic spectrum often show a high level

of anxiety and are frequently affected by comorbidities that influence their

quality of life. Yet, they also have cognitive strengths that should be identified

in order to develop effective support strategies. It explores the underlying

causes of behavioral problems in persons with ASD. Furthermore, it stresses

the importance of meticulous neuropsychological testing with regard to

cognitive remediation, a method that can help to enhance single cognitive

processes in a targeted manner.

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 On the part of screening and diagnosis, most autistic people, 87 %,

according to the latest estimate, have some sort of motor difficulty, ranging

from an atypical gait to problems with handwriting. These issues are distinct

from the repetitive behaviors considered to be a hallmark of autism. They may

have gross-motor problems, such as a clumsy, uncoordinated gait; and

difficulties with fine-motor control, such as manipulating objects and writing.

Some may have trouble coordinating movements between the left and right

side of the body among different limbs, making it difficult to do actions like

pumping their legs on a swing, jumping, skipping or hopping. Others may

have low muscle tone and problems maintaining their posture or balance. Still

others seem to have trouble with actions requiring hand-eye coordination, such

as catching a ball or imitating the movements of others, and with planning a

series of movements or gestures, known as praxis. These difficulties can range

from mild to severe and can impact any motor system of the body. Although

motor issues tend to be most severe in autistic people who have intellectual

disability, they can affect anyone on the spectrum. Sensory issues often

accompany autism. Autism’s sensory issues can involve both hyper-

sensitivities (over-responsiveness) and hypo-sensitivities (under-

responsiveness) to a wide range of stimuli. Autistic people with pronounced

social problems tend to have a larger gap between their IQ and adaptive

behavior score than do those with better social skills.

On the management and rehabilitation, there is no cure for autism, but

various interventions diminish the symptoms, sometimes profoundly. Since

both social and communication challenges are part of the autism diagnosis,

behavioral and speech language therapy typically comprise the basis of a

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 treatment plan. The most generally successful approach for individuals with

ASD is behavioral therapy. Many people think that behavioral intervention is

meant only for overly rambunctious children who act out. Developmental

therapies are widely considered to be plausible intervention approaches. It is

intended to promote social communication and other social interactions.

Complementary and alternative medical treatments are commonly used for

individuals with Autism Spectrum Disorders. Therefore, with pharmacological

therapies added to help patients function in their daily activities.

VIII. TREATMENT

Many people with ASD benefit from treatment, no matter how old they are

when they are diagnosed. People of all ages, at all levels of ability, can often improve

after well-designed interventions.

There is currently no standard treatment for Autism Spectrum Disorder

(ASD). But there are many ways to help minimize the symptoms and maximize

abilities. People who have ASD have the best chance of using all of their abilities and

skills if they receive appropriate therapies and interventions.

The most effective therapies and interventions are often different for each

person. However, most people with ASD respond best to highly structured and

specialized programs. In some cases, treatment can greatly reduce symptoms and help

people with autism with daily activities.

There are list of therapies and treatments available for ASD, and these are the

following: Behavioral management therapy, Cognitive behavior therapy, Educational

and school-based therapies, Joint attention therapy, Medication treatment, Nutritional

therapy, Occupational therapy, Parent-mediated therapy, Physical therapy, Social

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 skills training, and Speech-language therapy. The most important therapy for ASD

patients is Intensive Behavioural Intervention (IBI).

Research shows that early diagnosis and interventions, such as during

preschool or before, are more likely to have major positive effects on symptoms and

later skills. Because there can be overlap in symptoms between ASD and other

disorders, such as attention deficit hyperactivity disorder (ADHD), it's important that

treatment focus on a person's specific needs, rather than the diagnostic label.

IX. PSYCHOPHARMACOLOGY

DRUG MECHANISM USE AGONIST/ANTAGONIST

Risperidon To decrease Used to treat Antagonist for D2 and 5-
dopaminergic and schizophrenia,
(Risperdal) serotonergic bipolar disorder, HT2A.
pathway activity in or irritability
the brain, therefore associated with
decreasing autistic disorder.
symptoms of This medicine
schizophrenia and should not be used
mood disorders. to treat behavioral
problems in older
adults who have
dementia.
Levetiracetam Modulation of Used to treat Agonist for GABA
synaptic certain types of
(Keppra) neurotransmitter seizures in adults
release through and children with
binding to the epilepsy.
synaptic vesicle
protein sv2a in the
brain.

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