MDJ 3272 PAEDIATRIC NURSING

Abi, a 4 y/o boy has been diagnosed with autism. He came from a very poor family background. The family find it hard to take care of him because of his condition. You are required to provide his mother information to help her understand Abis condition regarding the etiology and child characteristics.

Discuss the existing resources/ support services locally to enable the family to facilitate and promote her childs potential for development.

Group 4 members: Nor Azia bt Othman Nur Attiqah bt Abdul Malek Nur Fadizlahastiana bt Dawid Nur Faridah bt Husni Nur Safira bt Asman Philumena Kueh Jing Feng

Outline
Definition Etiology Childs Characteristics
Existing resources/ support services in Malaysia # My Star International Academy # National Autism Society of Malaysia (NASOM) # Early Autism Project (EAP) Malaysia # Parents' Resource for Autism (PR4A) Malaysia # Mary Anne Joseph Special Needs # Hua Ming Autism Society # Sarawak Autistic Association (SAA) # Others: Newspaper & Website

DEFINITION

Etiology

Genetic

Non Genetic

Infectious disease

Heavy metal toxicity

Vaccines

Seizures/ Epilepsy

At least 10 genes were involved Eg: Chromosome 7 important role in development of mechanism for brain cells communication Autism is among the most heritable of all neurological conditions identical twins 82% chance, fraternal twins 10% chance other siblings 2-8 % chance
(Maino, Viola, & Donati, 2009)

Possible Non-Genetic Factor

Infectious disease One theory is that an intestinal virus disrupts the mucosa and allows neurotoxins to enter the bloodstream, triggering autism. Others: Borna virus Herpes virus Heavy metal toxicity Some parents and researchers have alleged that heavy metal poisoning results in symptoms similar to those of autism. Eg: Mercury

(Amarai & Courchesne, 2008)

 Vaccines for measles, rubella and mumps has been claimed as a cause for autism. This claimed is due to the autistic characteristics that often appear at around the same age vaccinations are carried out. Nevertheless, the link is inconclusive
(Amarai & Courchesne, 2008)

Increased the risk of developing autism These individuals had more motor difficulties, developmental delays & problematic behaviors.
(Maino, Viola, & Donati, 2009)

Characteristics
Speech, Language, and Communication

Social Interaction Unusual or no eye contact Show little body language or facial expressions when interacting difficulty in mixing with other children

Difficulty communicating with speech Indicate needs with gestures Difficulty understanding Have difficulty starting or continuing a conversation May repeat what others say (echolalia)

(Brown, 2012)

Behavior
Inappropriate attachment to objects Perform repetitive routines Resist changes in routines Perform repetitive movements (such as waving hands, rocking) Crying tantrums-extreme Stand-offish manner Inappropriate laughing No fear of real dangers. Apparent insensitivity to pain Acts deaf Enjoys spinning objects Hyperactivity/ Passitivity
(Brown, 2012)

Impaired ability to assign meaning to same objects and events that others find meaningful. (Potts & Mandleco, 2002)

(NASOM, 2012)

Existing resources/support services in Malaysia

School Organization/Centres

My Star International Academy

The National Autism Society of Malaysia (NASOM)

Early Autism Project (EAP)

Parents Resource for Autism (PR4A)

Mary Anne Joseph Special Needs

Hua Ming Autism Society

Sarawak Autistic Association (SAA)

My Star International Academy

Combines applied behavior analysis (ABA), Cambridge UK Curriculum and home schooling to provide an individualized program for each child.
For children with special needs such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Global Developmental Delay (GDD), Down Syndrome, Dyslexia, Cerebral Palsy (CP) and other learning difficulties. Each child starts from behavioral modification and moves towards an optimal goal of obtaining formal academic qualification Provides 6 extra activities to enrich the child's development on a daily basis. The activities include Computing, Music, Dance, Drama, Art and Mental Arithmetic.
(My Star International Academy ,2005)

The National Autism Society of Malaysia (NASOM)

Offering Life-Long Services to People with Autism Non-profit, non-governmental welfare

organisation since 3rd March 1987. Aim to provide education, help, care and protection for people with autism and their family. To date, NASOM provides 19 centres all over Malaysia.

(The National Autism Society of Malaysia, 2012)

NASOMs provided services

1. Assessment & Diagnosis Runs One-Stop Service Centres where they offers services such as psychological screening & assessment for children at risk or with developmental delay, speech therapy, social classes & others. 2. Early Intervention Program Teach self help skills, elementary academic & learning skills & given educational therapy to help them cope their inherent deficits & disorders. 3. Transition Program To prepare children with autism for formal school. 4. Mainstreaming Program Provides full support for the children in and after school. 5. Pre-Vocational Program Children above 14 years old who are not in enrolled in formal school will be placed in a vocational training program. 6. Vocational Program Taught on self-care skills, social skills, recreation activities & work experience. 7. Residential Program Users are taught the skills of living in a community. (The National Autism Society of Malaysia, 2012)

 Program and clinic for the

treatment of children with autism. Provide the highest quality intensive behavioral treatment. Treatment philosophy is that every child is able to learn.
(Early Autism Project, 2011)

Services being offered:1. Applied Behavior Analysis (ABA) Program

Home-based program 1. Parents find / hire therapists 2. Parents supply toys / materials / data book forms 3. Consultation travels to home fortnightly 4. Consultation includes fortnightly phone consultations Centre-based program 1. EAP Malaysia finds / hires therapists / materials / data book forms 2. EAP Malaysia supplies toys / materials / data book forms 3. Consultation takes place at centre weekly 4. No phone consultations

2. Parent training program 3. Community program 4. Workshops

(Early Autism Project, 2011)

Parents Resource for Autism in Malaysia

About PR4A
They are parents who have children with autism and related learning disorders. Objective: To source for the latest and most successful methods for the treatment of autism in order to help their children realizes their full potential.

(Lim, 2011)

What Do They Want

To provide mutual support and information to affected families. To raise awareness that with effective intervention, autism is treatable. To encourage parents make informed choices and adopt proven therapies. To get parents pool resources to bring in trained and qualified professionals. To encourage networking with professionals.
(Lim, 2011)

How Do They Do It
They meet on a regular/monthly basis to share information, draw on each others experiences and lend support to each other. They organize workshops and seminars on methods and topics that would help parents intervene effectively. They network online to share opinions, alert fellow parents of relevant events organized by other support groups and touch base with members. They work with other organizations that advance the causes and the rights of the learning disabled community.
(Lim, 2011)

Physical development
Physical therapy Occupational therapy Speech, Language & Communication Development Play therapy PECS (Picture exchange communication system) Music therapy Behavior Development Intensive behavioral intervention Emotional Development Holding therapy Art therapy Social Development Social stories
(Lim, 2011)

A private organization in Wangsa Maju providing training and respite care for special needs children with Autism, ADD, ADHD and other Learning & Behaviour Issues.

(MA Joseph Special Needs, 2012)

 Conduct a one to one therapy basis. Provides hands on training to parents Enhance the child's growth by using educational tools according to the various children's needs.
(MA Joseph Special Needs, 2012)

This is the area for children to develop good co-ordination of mind and body. Colorful and quality equipments were chosen to attract the children to use the tools with a sense of joy.
(MA Joseph Special Needs, 2012)

 Provide education and training to autistic children and counseling to their parents Conduct training programs, seminars, workshop rlt act for children with autism and their parents Parents are trained to work with their children to manage behavior problem and improve learning, social and language skills.

(Hua Ming Autism Society, 2012)

Classes Preschool group : Preparing preschooler (aged 2-6) to go into mainstream kindergarten, primary school or special class. ( Monday to Thursday, 9.30am ~ 12.00pm or 2:00pm ~ 4:30pm with once a week half hour 1-to-1 session ) For children (aged 7-12) who are unable to attend mainstream school or need extra support after school. ( Monday to Thursday, 9.30am ~ 12.00pm or 2:00pm ~ 4:30pm with once a week half hour 1-to-1 session )

Primary group :

English Class :

For high function autistic children (aged 7-15) who unable to adapt to mainstream school. (Monday to Thursday 9.30pm~12.00pm)
(Hua Ming Autism Society, 2012)

Daily routine classes/ activities:

Speech and communication Self-help skill Cognitive Sensory integration Physical education (gross motor activities) Art and craft (fine motor activities) Music and movement Group play Social skill (going out to buy lunch or grocery) Computer

Others:
organize seminars for parents once in every month, fostering communication between parents and teachers, and occasionally outdoor activities for family day provide free telephone and face to face consultations. provide free talks for kindergarten & primary school on the topic What is autism. invite other professionals to hold seminars or workshops.
(Hua Ming Autism Society, 2012)

(Moh, 2012)

(Lum, 2012)

(Nettleton, 2008)

http://eDirect3.com.my/SarawakAutis ticAssociation(SAA)

Budget 2013 TASKA OKU

Currently, there are many disabled children from low-income families who do not receive early education due to lack of pre-schools for disabled children (TASKA OKU). For this, the Government will implement a pilot project for TASKA OKU in six categories of disabled children, namely down syndrome, autism, blind or partially sighted, hearing and speaking disabilities, physical disability and learning difficulties.
(Abdul Razak, 2012)

Although there is no cure for autism, intensive early intervention services for children diagnosed with autism before the age of 5 years may lead to a better overall outcomes
(Hurth, Shaw, Izeman, Whaley & Rogers as cited in Potts & Mandleco, 2002)

CONCLUSION
Work to view AUTISM as a different ability rather than a disability. An autistic child may not be good at eye contact or conversation, but with their attention to fine detail and capacity for extraordinary focus, they could be the next Einstein or Mozart, for they too had autism.

 Abdul Razak, M. N. (2012, September 28). Full text of the 2013 budget speech. New Straits Times. Retrieved from http://www.nst.com.my/2013budget/full-text-of-the-2013-budgetspeech-1.149226##ixzz2896j5iGI Amarai, D. & Courchesne, E. ( 2008) Causes of autism. Retrieved September 13, 2012 from http://www.autism-help.org/autismcauses.htm Brown, F. (2012). Characteristics of children with autism. Retrieved September 12, 2012 from http://www.pbs.org/parents/inclusivecommunities/autism2.html Early Autism Project. (2011). ABA programmes. Retrieved from http://autismmalaysia.com/services/aba-programmes/ Hua Ming Autism Society (2012). Retrieved from http://www.autism.org.my/index.php?option=com_content&vie w=article&id=222&Itemid=1 Lim, K. C. (2011). About PR4A. Retrieved from http://www.pr4a.org.my

 Lum, M. (2012). Autism in our lives. Retrieved from http://thestar.com.my/health/story.asp?file=/2012/1/1 /health/10163830&sec=health MA Joseph Special Needs (2012). What do we do?. Retrieved from www.myautisticmalaysia.com Maino, D. M., Viola, S.G., & Donati, R. (2009). The etiology of autism [Electronic version]. Optometry & Vision Development, 40(3), 150 156. My Star International Academy (2005). About us. Retrieved from http://www.mystarinternational.com/index.html Moh, J. (2012). 13 year old autistic lad has big dreams. Retrieved from http://www.theborneopost.com/2012/09/11/13-yearold-autistic-lad-has-big-dreams/

 Nettleton, S. (2008). Pilot effort provides an early warning system for autistic children in Malaysia. Retrieved from
http://www.unicef.org/malaysia/education_4190.html

Potts, N. L. & Mandleco, B.L. (2002). Paediatric Nursing: Caring for children and their families. United States of America: Delmar. The National Autism Society of Malaysia. (2012). About NASOM. Retrieved from http://www.nasom.com.my/index.php?option=com_conte nt&view=article&id=58&Itemid=54&lang=en The National Autism Society of Malaysia (NASOM) [2012]. What is autism. Retrieved September 12, 2012 from http://www.nasom.com.my/index.php?option=com_conte nt&view=article&id=52&Itemid=53&lang=en