Pediatrics · Topic 15 of 32
Autism Spectrum Disorder
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Autism Spectrum Disorder
Lasting differences in social communication plus restricted, repetitive behaviors, starting in early childhood. Screen early, refer fast, and adapt care to keep the child calm and safe.
What it is
Two core features, starting in early childhood
A Danish cohort of over 650,000 children found MMR vaccination does not raise autism risk.
Risk factors
A sibling with ASD raises the risk
What you'll see
Social, repetitive and sensory signs
Common co-occurring conditions: seizures, constipation and other GI problems, sleep problems, ADHD-like behavior and anxiety.
Screening red flags
A red flag means refer now — never wait and see
Red flags
About half of children with autism try to wander or bolt from supervision. Electronic tracking devices are linked to less frequent elopement.
Treatment
Start intensive behavioral therapy early, such as ABA
Refer before a formal diagnosis if neededSpeech and occupational therapy
Monitor weight, glucose and lipids
Sedation; risperidone raises prolactinMedication details
Nursing priorities
Teach the family
Assess caregiver stress and siblings' needs, and include parents in every care plan.
Lower the input and keep the routine — a quiet room, the home schedule, one step at a time. Ask the parents what works. Any loss of skills at any age: refer now.
Sources · Autism Spectrum Disorder (StatPearls) · Psychiatric-Mental Health Nursing 23.3 Autism Spectrum Disorder (OpenStax) · Identification and Evaluation of Children With ASD (AAP) · Identification, Evaluation, and Management of Children With ASD (AAP) · Clinical Screening for ASD (CDC) · Signs and Symptoms of ASD (CDC) · Best Practices for Hospitalized Pediatric Patients with ASD (CHOC Children's) · Elopement in Children With ASD (Pediatrics) · Electronic Tracking Devices and Elopement (J Dev Behav Pediatr) · MMR Vaccination and Autism (Annals of Internal Medicine) · Risperdal label (DailyMed) · Abilify label (DailyMed) · Follow your facility's protocol for elopement prevention.
Autism Spectrum Disorder
Autism spectrum disorder is a neurodevelopmental disorder marked by persistent differences in social communication and interaction plus restricted, repetitive behaviors or interests, starting in early childhood. Every child gets an autism-specific screen, the M-CHAT-R/F, at 18 and 24 months. Certain signs call for evaluation right away: no babbling or gestures by 12 months, no single words by 16 months, no two-word phrases by 24 months, or any loss of language or social skills at any age. A positive screen means referral, not a diagnosis, and early intensive intervention should start without waiting. Look for poor eye contact, lining up toys, distress at small changes, echolalia, hand flapping, and unusual reactions to sound, light or touch. In the hospital, keep the home routine, lower the noise and light, use the same caregivers, prepare the child with pictures and concrete words, and ask the parents what works. Watch closely for wandering and self-injury. Risperidone and aripiprazole treat irritability and need weight and metabolic checks. Vaccines do not cause autism.
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