You are a psychiatric/mental health nurse practitioner employed in a local community health center. Today you are seeing Melinda, a 4-year-old female who presents with her biological, single father. Melinda was referred by her pediatrician.  The reason for the referral is a possible autism spectrum disorder. She has limited verbal skills with sensory issues. SOLVED – NSG5905 Week 4 Discussion Board

1. What will be your initial approach to an evidence-based assessment of this child and her family?  

A comprehensive evaluation of autism spectrum disorder should incorporate information from various sources such as the caregiver, teacher, client and direct observation by a trained provider. An evidence-based assessment of a child with autism generally starts with a caregiver interview. It aim to gather information about the child’s development, behavior, and concerns. Moreover, interviews are not the only tools used. Some other tools include questionnaires, diagnostic tools such as the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R).

2. What are the parameters to consider for the ultimate diagnosis, based on the assessment findings and evaluation?  

The key parameters include prolonged deficits in social communication and interaction, restricted and repetitive patterns of behavior, interests, or activities. Other symptoms include developmental history, cognitive functioning, language skills, sensory sensitivities, and the presence of symptoms causing clinically significant impairment in daily life. Besides, this evaluated through a comprehensive assessment, including observations, interviews with caregivers, and standardized tests. Also, the American Psychiatric Association gives specific diagnostic criteria through the Diagnostic and Statistical Manual of Mental Disorders-5

3. What would be your approach to treatment, integrating both psychotherapy and psychopharmacologic approaches? 

The goal of treatment is to manage the core behaviors as that will improve the symptoms. Also, the use of intensive behavioral programs, parent training and participation, and educational interventions can make a great impact on the treatment of ASD. Psychotherapy should form a major part of treatment. Additionally, the 2^nd generation antipsychotics such as risperidone and aripiprazole have been approved by the FDA.

4. What types of support and long-term care and follow-up might be needed for this child and her family? 

The management of ASD includes the treatment of comorbidities which can be both psychiatric and medical. Therapy and access to resources can greatly help. With respect to therapy, we can encourage speech therapy, occupational therapy, physical therapy, behavioral therapy. APA