Autism Spectrum Disorder: A Critical Role for Nurses in Screening and Interventions

“‘What’s the scoop with our autism screening?’ a concerned mother asked the nurse upon realizing that the autism spectrum disorder screening questionnaire she had completed wasn’t addressed during her daughter’s well-child visit. The nurse brought the mother’s concern to the primary care provider, who replied, ‘Don’t worry, I only look at screenings if I think there’s a problem. I can spot autism during a patient visit.’”

Is this provider’s confident claim a realistic one? Almost certainly not, as will become clear to anyone who reads the CE articles on autism spectrum disorder (ASD) in the October (“From the CDC: Understanding Autism Spectrum Disorder“) and November (“Autism Spectrum Disorder: The Nurse’s Role“) issues of AJN. As a result of such casual attitudes toward screening, many autistic children are almost certainly not receiving the early treatment and monitoring that can make a big difference in their quality of life.

Delayed diagnosis reduces the window for effective interventions.

ASD is the most common developmental disability in the United States, yet according to the November CE article, screening rates across the U.S. range from a low of 17.2% in Mississippi to a high of less than 60% in […]

2020-11-12T10:16:12-05:00November 12th, 2020|Nursing|0 Comments
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When They Can’t Tell You About the Hurt: Assessing Pain in People with Intellectual or Developmental Disabilities

By Sylvia Foley, AJN senior editor

When S.M., a 47-year-old resident at a facility for people with intellectual or developmental disabilities, started hitting himself in the left eye, his caregivers weren’t sure why. S.M., whose developmental quotient is equivalent to that of a two- or three-year-old, couldn’t tell them. Some thought he was frustrated at not being allowed to drink as much coffee as he wanted; others thought a recent decrease in his medication—quetiapine (Seroquel)—might be a factor. But a chart review revealed that both his father and brother had a history of cluster headaches. Was S.M.’s behavior an indicator of headache pain? How could clinicians best assess him?

In this month’s CE feature, authors Kathy Baldridge and Frank Andrasik provide an overview of pain assessment in people with intellectual or developmental disabilities, summarize the relevant research, and discuss the applicability of the American Society for Pain Management Nursing practice guidelines for assessing pain in nonverbal patients. The guidelines describe various behavioral pain assessment tools, some of which might be useful with S.M. and others like him. Other assessment methods include

a search for pathologic conditions or other problems or procedures known to cause pain; the observation of behaviors that might indicate pain; and the use of proxy reports (also called surrogate reports) by people who know the person best, whether family caregivers or professionals.

S.M. was encouraged to draw himself and what the “hurt” felt like; two […]

2016-11-21T13:14:41-05:00December 14th, 2010|Ethics, nursing perspective, pain management|3 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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