Autism Nursing Care - Assignment Example

Research Review and Appraisal Synopses Autism is a global health problem that constitutes about 0.3% of the global burden of disease according to the World Health Organization figures leading to the designation of 2 April as World Autism Awareness Day (World Health Organization, 2013). We can define autism as a popular disorder among children and adults that subjects victims to various complex neurodevelopment disorders that relate to communication challenges, social impairments, and repetitive and restricted behaviors that limit their cognitive development and learning (Autism Speaks Inc, 2013). This global health problem is important for nursing considering that it a lifetime challenge with no cure. Hence, nurse ought to have a clear understanding of the disorder and its prevalence with an aim of learning how to manage it through effective nursing care. Four nursing research studies define the known information about autism in the United States population and in U.K and South Korea. The paper will also include an Appraisal Synopsis for each of the research studies published in peer-reviewed journals and written by nurses. Research Review and Appraisal Synopses PART A Recent statistics confirm that cases of autism are increasing in developed and developing nations leading to adverse effects like stigma and discrimination on education, health, and opportunities in the society (World Health Organization, 2013). With one in 68 U.S. children having an autism, the U.S government seeks to improve the lives of autism victims and their families by supporting research, improving supports and services, and working closely with the entire community (U.S. Department of Health & Human Services, 2014). Furthermore, with more than 1.1% of the U.K population having autism, the National Autistic Society seeks to provide information, support and pioneering services, and campaign to improve the lives of the victims (The National Autistic Society, 2014). PART B Study #1 This study addresses the efficacy of MBCT for eliciting speech in nonverbal children with autism (Givona, Karen, & Noha, 2013). Obtaining the sample The researchers derived the sample from southern California (Givona, Karen, & Noha, 2013). Exclusion Criteria Researchers excluded participants if they were receiving other language or articulation treatments or therapy at the time of the study, were unable to attend four 45 min sessions of therapy weekly for 5 weeks, or had a history of severe hearing impairment (Givona, Karen & Noha, 2013). Participants with a history of severe visual impairment/blindness, diagnosis of an organic impairment of oral or laryngeal structures, or significant medical illness also faced exclusion from the study (Givona, Karen & Noha, 2013). Determining the sample size More than four speech pathologists analyzed each participant before entering the study. Participants in the study were autistic, nonverbal with no functional speech, and aged between 5 and 7 years (Givona, Karen, & Noha, 2013). Actual Sample Twelve participants from the Southern California that included five seven year olds, three six year olds, and four five year olds participated in the study (Givona, Karen & Noha, 2013). Data Collection Methods The participants received 5 weeks of intervention, with four 45 min individual sessions a week after which the researchers surveyed the participants’ response to twenty-five stimulus items using twenty-five target words and ADOS scores (Givona, Karen & Noha, 2013). Main Findings The study established no fundamental differences in the frequency of verbal attempts or frequency of correct words between groups after the MBCT intervention (Givona, Karen & Noha, 2013). The MBCT group (p = .04) registered a significant number of new words in their home environment and more imitative attempts (p = .03) (Givona, Karen & Noha, 2013). Credibility The study features in a peer-reviewed source, Journal of Autism and Developmental Disorders. The study adopts an appropriate research design that addresses the research question where the random control design defined the effectiveness of the experimental treatment and regulation for external factors (Givona, Karen & Noha, 2013). The Fisher’s exact test, Intraclass correlation coefficient, and ADOS are reliable and valid measuring instruments for this study. The Fisher’s exact test measures the gender proportions between the two groups while ADOS is a standard measure for autism (Givona, Karen & Noha, 2013). The researchers controlled variables and bias by defining inclusions such as age, diagnosis, and ability to complete the intervention/survey. The study findings are consistent with findings from previous research since they correlate and recognize the eminent merits of music-based interventions derived by various researchers in previous studies (Givona, Karen & Noha, 2013). The clarity about the target population and the faster rate of improvement for the MBCT group and the greater overall gains in verbal attempts and imitative depict clinical significance (Givona, Karen & Noha, 2013). In conclusion, the presence of no significant differences in number of verbal attempts between groups derives the need for more research. Further research on using new melodies and music-based interventions and the effectiveness of MBCT may be relevant for maximizing MBCT. Study #2 This study addresses the different costs of caring for young children with Autism in Britain (Barrett et al., 2012). Purpose of study This study investigates service and wider societal costs of very young children in UK, examines the range and scope of service use on different service providing sectors, families and the wider economy as well as comparing and contrasting actual levels of service use with UK national recommendations for the care of young children with autism (Barrett et al., 2012). Obtaining the sample The researchers obtained participants from referrals received from South London, Greater Manchester, and North East England (Barrett et al., 2012). Exclusion Criteria The researchers excluded children with 12 months or less non-verbal age equivalent developmental level, those with a twin with autism, those with epilepsy requiring medication, those with a parent with current severe psychiatric disorder requiring treatment and those with severe hearing or visual impairment (parent or child) (Barrett et al., 2012). Determining the sample size Researchers included children aged 2–4 years 11 months (Barrett et al., 2012). The participants had to fulfill the diagnostic criteria for core autism that included Autism Diagnostic Observation Schedule (ADOS) and Autism Diagnostic Interview-Revised (ADI-R) (Barrett et al., 2012). The participants had to depict sufficient spoken English at home. Actual Sample 152 children with autism and aged between 24 and 60 months participated in the study (Barrett et al., 2012). Data Collection Methods The study relied on a modified version of the Child and Adolescent Service Use Schedule (CA-SUS) to collect Service use data (Barrett et al., 2012). Main Findings The study established that children and their families accessed a wide range of hospital and community services (Barrett et al., 2012). The study established that TOTAL service costs varied greatly (mean £430 per month; range £53 to £1,116) and over £5,000 per year with an average £2,581 per child (Barrett et al., 2012). Education and childcare costs accounted for 45% of the costs, community health and social services consumed 41% while hospital service accounted for 12% of the service costs (Barrett et al., 2012). Credibility The study features in a peer-reviewed source, Journal of Autism and Developmental Disorders. The research design is appropriate to the research question where it confirmed the diagnosis of autism, collected brief demographic information, and collected information on service use and clinical measures of outcome (Barrett et al., 2012). The measuring instruments for this study are reliable and valid since regression analysis allowed inferences on the arithmetic mean for the untransformed costs. The researchers controlled variables and bias by defining inclusions such as research center, sex, age at study entry, ethnicity, parental education, ADOS total algorithm score, number of functional domains of the ADI-R meeting criteria for (2 or 3) and time in months since diagnosis of autism (Barrett et al., 2012). The target population is clear since the exclusion/inclusion criteria define it. The study manifests clinical significance (Barrett et al., 2012). In conclusion, there is need for more research to identify more factors that predict service cost. The study derives that children experience varying levels of service use and that service use and cost influence individual children’s needs. There is need for further research on health services and costs between different health systems as well as cost-effectiveness of interventions for very young children with autism. Study #3 This is a global study examining the effects of cross-cultural variations on the social skills of autistic children in U.K and U.S (Sipes, Furniss, Matson, & Hattier, 2012). Purpose of study The study sought to examine the cross-cultural differences in social skills of children with autism by comparing Matson Evaluation of Social Skills with Youngsters-II (MESSY-II) for children from U.K and U.S (Sipes, Furniss, Matson & Hattier, 2012). Obtaining the sample The researchers used outpatient clinics, schools, parent advocacy and support groups to obtain the U.S sample (Sipes, Furniss, Matson & Hattier, 2012). They also relied on seven schools that specialized in either or both ASD and Intellectual Disability (ID) children to obtain the U.K sample (Sipes, Furniss, Matson & Hattier, 2012). Exclusion Criteria Researchers excluded children who did not meet the criteria for ASD based on the DSM-IV-TR/ICD-10 checklist, children with unrecorded ages, and children who were missing more than four items on the outcome measure, the MESSY-II (Sipes, Furniss, Matson & Hattier, 2012). Determining the sample size The researchers relied on the DSM-IV-TR/ICD-10 checklist in determining the sample size (Sipes, Furniss, Matson & Hattier, 2012). Actual Sample The actual sample included 160 children with ASD, 135 from the United States and 25 from the United Kingdom (Sipes, Furniss, Matson & Hattier, 2012). Data Collection Methods Researchers used MESSY-II and blank database to collect data. Main Findings The study established that MESSY-II had excellent internal reliability for both countries and that significant difference only occurred on the Adaptive/Appropriate subscale with the US children having greater adaptive social skills compared to the UK children (Sipes, Furniss, Matson & Hattier, 2012). Credibility The findings relate to previous studies that support continued use of MESSY-II for children in both the US and the UK (Sipes, Furniss, Matson & Hattier, 2012). The MESSY-II is a reliable measure for deriving social deficits in the core diagnostic features of ASDs in young children (Sipes, Furniss, Matson & Hattier, 2012). A peer-reviewed source, Journal of Developmental and Physical Disabilities hosts the study (Sipes, Furniss, Matson & Hattier, 2012). The research design is appropriate to the research question where the researchers sent MESSY-II along with a blank database to the researchers from the UK who ensured that the parents or caregivers of the recruited sample completed the measure (Sipes, Furniss, Matson & Hattier, 2012). The measuring instruments for this study are reliable and valid since the MESSY-II is a reliable measure for deriving social deficits for ASDs in young children (Sipes, Furniss, Matson & Hattier, 2012). The researchers controlled variables and bias by using DSM-IV-TR/ICD-10 checklist that gleaned information on the three major impairment areas in ASD (Sipes, Furniss, Matson & Hattier, 2012). The study does not have a clear target population since it offers limited information on the informants. The main findings as well as the reliable and valid measures confirm the clinical significance of the study. In conclusion, this study is an extension of previous research since it depicts excellent internal consistency with respect to the three subscales for autistic children in America and U.K. The MESSY-II is a reliable measure for deriving social deficits in the core diagnostic features of ASDs in young children. The study confirms that cultural influences do not affect the challenges encountered by children with ASDs. Further research on the cultural differences, social skills, and similarities for children with ASDs would reinforce this study. Study #4 This study addresses the prevalence of autism spectrum disorders in a total population sample (Kim et al., 2011). Purpose of study The study aimed at estimating the prevalence and defining the clinical characteristics of autism in school-age children (Kim et al., 2011). Obtaining the sample The study relied on a high-probability group from special education schools and a disability registry as well as a low-probability and general-population samples from local schools in South Korea (Kim et al., 2011). Exclusion Criteria The study excluded children whose parents were not available to fill the questionnaires and standardized diagnostic tools (Kim et al., 2011). Determining the sample size The study used the general elementary school population in South Korea and a high probability autism group (Kim et al., 2011). They also relied on confirmatory diagnostic evaluations (Kim et al., 2011). Actual Sample The actual sample included parents of 23,337 children (Kim et al., 2011). Data Collection Methods Researchers used comprehensive assessments and the Autism Spectrum Screening Questionnaire for systematic, multi-informant screening (Kim et al., 2011). They also used a 27-item questionnaire (Kim et al., 2011). Main Findings In the high-probability group and general-population sample, males had greater ASD characteristics compared to females but in different levels (Kim et al., 2011). The general-population sample depicted greater IQs than the high-probability group (Kim et al., 2011). In both groups, the ratio of autistic disorders is greater than the ration of other ASD subtypes (Kim et al., 2011). Credibility The study features in a peer-reviewed source, The American Journal of Psychiatry. The research design is appropriate to the research question since it derives the prevalence of autism spectrum disorders in a total population sample by considering the general-population sample and the high-probability group. We cannot ascertain the reliability and validity of measuring instruments for this study. In conclusion, about 67 % of the ASD cases in the actual sample formed the general school population that is unaware of autism and receives no treatment. This derives the need for more and frequent screening and comprehensive screening for ASD. Part C: There were no significant differences in number of verbal attempts or number of correct words between groups following intervention. There is need for further research on using new melodies and music-based interventions to maximize MBCT. Children experience varying levels of service use and service use and cost influence individual children’s needs. This fosters the need for further research on health services and costs between different health systems and cost-effectiveness of interventions for very young children with autism. MESSY-II is good measure for deriving social deficits in young children suffering from ASD. US children manifested greater adaptive social skills compared to the UK children. Cultural influences do not affect the challenges encountered by children with ASDs. Moreover, males have greater ASD characteristics compared to females in both the high-probability group and the general-population. Ultimately, there is need for more and frequent screening and comprehensive screening for ASD with an aim of producing accurate figures for ASD prevalence. References Autism Speaks Inc. (2013). What Is Autism? Retrieved from: http://www.autismspeaks.org/what-autism Barrett, B., Byford, S., Sharac, J., Hudry, K., Leadbitter, K., Temple, K.,…Green, J. (2012). Service and Wider Societal Costs of Very Young Children with Autism in the UK. Journal of Autism and Developmental Disorders, 42, 797–804. Givona, S. A., Karen J. M., & Noha, S. D. (2013). A pilot study on the efficacy of melodic based communication therapy for eliciting speech in nonverbal children with autism. Journal of Autism and Developmental Disorders, 43 (6), 1298- 1307. Kim, Y. S., Leventhal, B. L., Koh,Y. J., Fombonne, E., Laska, E., Lim, E. C.,….Grinker, R. R. (2011). Prevalence of autism spectrum disorders in a total population sample. The American Journal of Psychiatry, 168 (9), 904-12. Sipes, M., Furniss, F., Matson, J., & Hattier, M. (2012). A Multinational Study Examining the Cross Cultural Differences in Social Skills of Children with Autism Spectrum Disorders: A Comparison between the United Kingdom and the United States of America. Journal of Developmental and Physical Disabilities, 24, 145–154. The National Autistic Society. (2014). Statistics: how many people have autism spectrum disorders? Retrieved from: http://www.autism.org.uk/about-autism/myths-facts-and-statistics/statistics-how-many-people-have-autism-spectrum-disorders.aspx U.S. Department of Health & Human Services. (2014). Our Commitment to Supporting Individuals on the Autism Spectrum and their Families. Retrieved from: http://www.hhs.gov/autism/factsheet_autism_support.html World Health Organization. (2013). Autism spectrum disorders & other developmental disorders. 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