Social Script iPad Application Versus Usual Care Before Undergoing Medical Imaging: Two Case Studies of Children With Autism

Autism spectrum disorders (ASDs) are neurodevelopmental disorders of socialization, communication, and repetitive behaviors. Children with ASD have underlying anxiety leading to challenging behaviors in unfamiliar situations. The anxiety impacts timely completion of an imaging procedure. The purpose of the case study was to describe the process of the social script intervention delivered using the iPad application on parent and child anxiety, child behaviors, and imaging procedure length between two parent and child dyads. The case study of two parent-child dyads demonstrated the process for comparing the social script intervention iPad app for preparing for imaging versus usual care. Parent anxiety decreased more for the parent with the intervention. Computerized tomographic scan length of time to hold still decreased more for child with the intervention. There were fewer challenging child behaviors for child with the intervention. The results guide development of larger study, with the potential to mitigate the negative experiences for a child with ASD and the family during imaging

Translating Research to Practice for Children With Autism Spectrum Disorder: Part 2: Behavior Management in Home and Health Care Settings

Introduction Managing home and health care for children with autism spectrum disorder can be challenging because of the range of symptoms and behaviors exhibited. Method This article presents an overview of the emerging science related to the methods to foster family self-management of common concerns regarding activities of daily living and behaviors, as well as for the health care provider in primary and acute health care settings. Results Recommendations are provided to enhance the overall delivery of services, including understanding and managing a child\u27s challenging behaviors, and supporting family management of common activities of daily living and behaviors. Discussion Health care providers\u27 knowledge of evidence-based recommendations for providing care, supporting family self-management of common concerns, and referral heighten the likelihood of better outcomes for children with autism spectrum disorder

Genomics and Autism Spectrum Disorder (ASD)

Purpose: To understand the current state of the evidence regarding translation of genetics and genomics into nursing care of children with (ASD)

Evaluation of a Coping Kit of Items to Support Children with Developmental Disorders in the Hospital Setting

This study attempted to answer the question, Do nurses perceive coping kits to be effective at meeting the needs of hospitalized children with developmental disabilities who are at increased risk for challenging behaviors? A cross-sectional post-test survey study design was used, with a convenience sample of 24 registered nurses at a Midwestern free-standing children\u27s hospital. A coping kit with simple communication cards, social script book, and distraction items (toys) was developed to enhance communication and distract children with developmental disabilities (including autism spectrum disorder) undergoing procedures in the hospital. A modified version of Hudson\u27s (2006) intervention effectiveness survey was used to measure the nurse\u27s perception of the effectiveness of the coping kit. Nurses perceived the coping kits to be effective for decreasing their patient\u27s anxiety, calming the child\u27s behavior, and increasing cooperation during procedures. The nurse can develop a plan of care that includes a coping kit to help gain cooperation with the hospitalized child with challenging behaviors

Effects on Resilience of Caregivers of Persons With Autism Spectrum Disorder: The Role of Positive Cognitions

BACKGROUND: Approximately 2.8 million people in the United States are diagnosed with autism spectrum disorder (ASD). Family caregivers manage many aspects of their care, which is demanding, overwhelming, and can affect their mental health. OBJECTIVE: This study examined the effects of caregiver burden (risk factor) and positive cognitions (protective factors) on resourcefulness(resilience indicator) in 95 caregivers of persons with ASD. DESIGN: Descriptive, correlational, and cross-sectional. RESULTS: Positive cognitions explained 32% of the variance in resourcefulness, F(1, 93) = 44.49, p \u3c .001, and as positive cognitions increased, caregivers’ resourcefulness increased. A substantial drop in the beta weight of caregiver burden from B = −.36 to −.04 when positive cognitions was entered the equation suggested that positive cognitions mediated the effect of caregiver burden on resourcefulness. CONCLUSION: The results support resilience theory and suggest a need for developing interventions to strengthen positive thinking among caregivers of persons with ASD

Translating Research to Practice for Children With Autism Spectrum Disorder: Part I: Definition, Associated Behaviors, Prevalence, Diagnostic Process, and Interventions

Introduction The number of children with autism spectrum disorder (ASD) is rising, along with the potential for challenging behaviors during health care encounters. Method We present an overview of the emerging science related to ASD diagnosis and interventions for children with ASD. Results Emerging science on ASD reveals common associated challenging behaviors, increasing prevalence, emphasis on early diagnosis at 18 to 24 months of age, changes in the diagnostic process with criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, and interventions with medication, education, and behavior management. Discussion Family and health care provider preparation strategies facilitate care of children with ASD and their families. Early diagnosis at 18 to 24 months of age and evidence-based interventions contribute to best outcomes for children and families. Health care providers must be aware of the state of the science for diagnosis and best practices to provide family-centered care for this growing population

Children With Developmental Disabilities at a Pediatric Hospital: Staff Education to Prevent and Manage Challenging Behaviors

Children with developmental disabilities may get frustrated in unpredictable hospital environments. Frustration may escalate to challenging behaviors, which are a safety concern and may contribute to staff and patient injuries, use of restraints, and procedure delay or cancelations. The purpose of this article was to describe a pilot staff education program on preventing and managing challenging behaviors of children with developmental disabilities at a pediatric hospital. The 2-hour-long education (1 hour on-line and 1 hour instructor led) content focused on family-centered care and communication skills, including verbal judo™ modified for use in the health care setting. Participants in the instructor-led sessions reported improved knowledge and decreased fear about caring for children with developmental disabilities. Relationships of the education and fewer staff injuries, fewer canceled procedures, and decreased use of restraints merit further study

Attributed Meanings and Strategies to Prevent Challenging Behaviors of Hospitalized Children with Autism: Two Perspectives

Introduction Understanding is limited of the meaning attributed to behaviors of children with autism spectrum disorder and strategies used to prevent challenging behaviors in the context of hospitalization. Methods This qualitative study consisted of two focus groups (n = 10; five mothers and five health care providers [HCPs]). Transcripts were analyzed using the qualitative method of narrative inquiry. Results The meaning attributed to behaviors by the mothers and the HCPs differed. The mothers attributed behaviors to the child\u27s communication of frustration, hyperactivity, and self-calming. The HCPs attributed challenging behaviors to self-stimulation and child aggression. Strategies to prevent behaviors also differed. Mothers focused on preparation prior to hospitalization and attempts to partner with HCPs. HCPs identified fewer strategies and consulted mothers for strategies to manage challenging behaviors. Discussion HCP and parent collaboration could lead to strategies to increase supports for children with autism spectrum disorder in the hospital to decrease their frustration and challenging behaviors

Nurses\u27 Experiences Implementing ePED :An iPad Application to Guide Quality Discharge Teaching

Quality discharge teaching prepares patients and families to transition safely from hospital to home. Technology can enhance and support quality discharge teaching by promoting patient family engagement during the transition. The purpose of this mixed methods study was to explore clinical nurses\u27 experience with using Engaging Parents in Education for Discharge, an iPad application to guide quality discharge teaching. Twelve nurses at a large Midwestern Children\u27s Hospital participated in small focus groups after use of the Engaging Parents in Education for Discharge application and completed a questionnaire on their perception of the acceptability and feasibility of the app. Findings revealed three themes: (1) development and deployment issues focused on the importance of training and support by the study team during implementation; (2) workflow integration centered on the importance of incorporating use of the app into current workflows and to preserve effective communication strategies with parents to optimize use in the healthcare setting; and (3) nurses perceived value in the use of the Engaging Parents in Education for Discharge app for beneficial scripting, questions on discharge topics often forgotten, and guidance for complex patients. Results of this study offer insight into key components for consideration when implementing and integrating technology to aid nursing practice