Nursing Research Presentation

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Autism Spectrum

Disorders in Children

+Autism in the Pediatric Patient Problem: The diagnosis of Autism Spectrum Disorders in

children and how that affects the child’s level of function in the world.

Autism is a developmental disability that causes problems with behavior and communication.

Why is this significant? 1 in 68 children are diagnosed with autism. It is prevalent among all races and socioeconomic levels. On average, children aren’t diagnosed until the age of 4.

The need for research utilization: As healthcare providers, nurses must be educated on how to

provide the best care to the patient with autism and how to teach parents to care for their child. Providing evidenced based practice by using research helps us accomplish this goal.

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Autism InterventionsKatherine Borders

+Autism and Picture Schedules Title: Using picture schedules in medical settings for patients

with an Autism Spectrum Disorder Researchers: Amy Chebuhar RN, MSN; Ann Marie McCarthy

PhD, RN, PNP, FAAN; Joni Bosch PhD, ARNP; Sue Baker MA Purpose: Test the usefulness of picture schedules in the

medical clinic when used with children who have autism. Design: Quasi-Experimental Sample: Non-probability-Convenience Outcomes:

1. Do the picture schedules decrease maladaptive behaviors and alleviate distress in individuals with autism in the medical setting?

2. Do parents/caregivers feel less distress when picture schedules are available for their child’s use?

3. Is the use of picture schedules feasible within medical settings?

+Autism and Picture Schedules Goal: Alleviate stress in parents and autistic patients

during a medical clinic visit Setting: University of Iowa Hospitals and Clinics Participants: Staff-six nurses, one child-life specialist, one

medical assistant; Nine parents and care-givers Intervention: Picture schedules Measurement: Surveys Outcomes:

Staff: 87.5% felt anxious behaviors were decreased; 75% thought the schedules made it easier to complete the task; 100% of staff were willing to use the schedules

77.8% of parents felt anxious behaviors were decreased in the child and themselves; 50% felt less anxious about future appointment when utilizing the picture schedules

+Autism, Picture Schedules, and using Research Picture schedules have been shown to be feasible within the

medical setting according to this research. How are the picture schedules used to alleviate the stress in

autism? Showing the child what to expect Making them feel comfortable with their medical experience

Feasibility Issues: Resources must be available to create picture schedules Child and staff must be willing to use the picture schedules Pilot-study: small sample size

Future Research Larger scale Inpatient procedures Health education

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Families of Children with Autism: Behaviors of Children, Community

Support and CopingAuthor: Heather R. Hall, PhD, MSNReviewed by: Erika Burchett, EKU BSN student

+Research Purpose

To examine the association of severity of autistic behaviors, community support for the family, and family coping in the families of children with autism (Hall, 2012).

+Research Design

Hall’s (2012) quantitative study is supported by a descriptive correlational research design. This design facilitates identification of interrelationships

existing between the variables: (a) behaviors of children with autism(b) community support(c) family coping

The researcher made no attempt to control or manipulate the situation.

+Sampling Method

A purposive sampling method that included: 38 biological parents (28 mothers; 10 fathers) who met

specific inclusion criteria: (a) Parents of children aged 2-21 who were diagnosed with autism(b) Residents of Alabama or Mississippi(c) Able to speak English

Participants also must have consented to participate in a face-to-face meeting or telephone interview.

+Research Outcomes

1. Overall, parents report their children show severe autistic behaviors, that they need additional community support, and they need more coping strategies (Hall, 2012).

2. Although seven parents claimed their children did not have autistic behaviors, twenty-seven (71.1%) rated their children as demonstrating severe autistic behaviors (Hall, 2012).

3. Only four mothers (10.5%) in the study reported they had attended a community support group (Hall, 2012).

4. Family and friends serve as the most common coping strategy for families (Hall, 2012).

5. Increased community support is associated with increased family coping strategies (Hall, 2012).

+Research Utilization Goal in Clinical Nursing Practice As healthcare providers, nurses must be educated on

how to provide optimal care to the pediatric patient with autism and how to teach parents to care for their child. Applying evidence-based practice supported by research helps nurses accomplish this goal.

+Feasibility Issues of Research Utilization in Clinical Nursing Practice

Benefits Early diagnosis of autism for children in all races and socio-

economic areas leads to more therapeutic long-term outcomes for the child.

Immediate intervention helps improve cognitive, language, and behavioral skills in the child with autism.

Barriers to Implementation Lack of community support groups and leaders Hesitation by parents to communicate personal information

to individuals they do not know in open support groups.

+Feasibility Issues of Research Utilization in Clinical Nursing Practice (Continued)

Required Resources Community support groups and leaders assisting in the

care of families with autistic children. Family members and friends willing to aid in the support of

families with autistic children.

+Suggestions for Future Research & Utilization Nurses are responsible for:

Being a support system for these patients and their families

Referring families to supportive leaders in the community as soon as a diagnosis for autism has been confirmed.

Future research may best be investigated by a qualitative research approach that allows parents to express: Concerns Views Reasons for not attending support groups

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Evaluation of a Coping Kit for Children With Challenging Behaviors In a Pediatric Hospital

By Jennifer Drake, Norah Johnson, Alive V. Stoneck, Deb M. Martinez, and Megan MasseyArticle Review By: Abby Tye

+Research Purpose

The researchers put together Coping Kits for Children with Disabilities and gave them to the nurses.

Evaluated the nurse’s perception of whether or not the coping kits were effective with the developmentally disabled patients

+Research Design

Posttest Design After using kits answered a questionnaire consisting of 9

demographic questions and 16 intervention effectiveness questions.

+Research Sample

Convenience Sample 3 inpatient units and the Emergency Room

Inclusion criteria Prior nursing experience caring for a child 2 to 18 years of

age with a developmental disability

Exclusion criteria Using kits on children without developmental disabilities

+Research Sample

24 Nurses Participated 17 Female, 7 male 2 or more years of nursing experience 21 Bachelor’s, 1 Associate’s, 2 Master’s Eleven nurses were between 21 to 30 years of age One-third worked in the emergency department

Age of Children Evenly distributed between preschool-aged, school-

aged, and teenage children.

+Research Outcomes

Nurses indicated that a change in the child’s behavior was noticeable after using the kit Most useful toys were the chewable toys and the light up

spinning fan

Nurses found the communication items (paper, pencil, communication cards) help to effectively communicate with the child

Children were calmer and more compliant with the use of the kits

+Research Utilization Plan

Nurses need to be aware of the increase in anxiety in autistic children when hospitalized and the need for a tool to relieve it

Effectiveness of Coping Kits Nurses indicated that a change in the child’s behavior was

noticeable after using the kit Children were calmer and more compliant with the use of

the kits

+Research Utilization Plan

Feasibility Buying Coping Kits Train nurses how to use them

Future Research Focus on the families of the hospitalized children Behavioral Observation Tool as an objective measure for

the child’s behaviors

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Autism in Pediatrics

Article Review By: Molly LewisNSC 390W

+Title/Authors

Lack of Father Involvement in Research on Children with Autism Spectrum Disorder: Maternal Parenting Stress and Family Functioning

By: Norah L. Johnson, PhD, RN,CPNP and Pippa M. Simpson, PhD

+Purpose

Understand the ramifications of a spouse’s lack of participation in the studies about having a child with an autistic spectrum disorder, when both parents were recruited to participate.

+Design

A comparative, cross-sectional design or comparative descriptive

Compare data to previous studies and across the groups, descriptive data from each group was collected

+Sample Method of convenience No exclusion but inclusion included

English speaking Child with a positive diagnosis of autistic spectrum disorder Internet access Reside in U.S.

Majority were white, college educated, married mothers. The mean age of mothers was 39.2 years

261 total participants 164-married, spouse not participating 61-married, spouse participating 36-non-married, no participating partner

+Outcomes Mothers married with participating spouses has lower stress

levels Non-married mothers with no participating partner had higher

stress levels Married mothers reported more discrepancy's in family

functioning Having to explain discipline, not the same expectations

Single mothers are vulnerable from lack of support but married mothers have the most stress from negotiating with their spouse on how to deal with the child.

Father’s participation would help fill in some gaps and give a better picture of day-to-day stressors and maybe identify why the do not participate.

+Research Utilization Plan

When caring for a pediatric patient, no matter their diagnosis, the nurse also needs to provide care for and assess the family. The care-takers effect the health and well-being of the child.

This plan is fairly feasible. On the nurses end, we can always assess for family stress levels. However, no one can force the spouses to participate in studies, even if it would better the care for our patients.

For future research I would suggest: More diverse population

+Summary of Research Outcomes Anxiety of children and parents were decreased when

using interventions such as picture schedules and coping kits.

Increased community support is associated with increased family coping strategies. The support groups are especially beneficial to vulnerable support groups such as non-married mothers.

+Reference Chebuhar, A., McCarthy, A. M., Bosch, J., & Baker, S.

(2013). Using Picture Schedules in Medical Settings for Patients With an Autism Spectrum Disorder. Journal of Pediatric Nursing, 28, 125-134. Retrieved January 15, 2014, from the Science Direct database.

Data & Statistics. (2014, March 24). Centers for Disease Control and Prevention. Retrieved April 11, 2014, from http://www.cdc.gov/ncbddd/autism/data.html

Hall, H. (2012). Families of children with autism: Behaviors of children, community support and coping. Issues In Comprehensive Pediatric Nursing, 35(2), 111-132. doi: 10.3109/01460862.2012.678263

+Reference

Drake, J., Johnson, N., Stoneck, A. V., Martinez, D. M., & Massey, M. (2012). Evaluation of a Coping Kit for Children with Challenging Behaviors in a Pediatric Hospital. Pediatric Nursing, 38(4), 215-221. http://

eds.b.ebscohost.com. Johnson, N. L., & Simpson, P. M. (2013). Lack of Father

Involvement in Research on Children with Autism Spectrum Disorder: Maternal Parenting Stress and Family Functioning. Issues In Mental Health Nursing, 34(4), 220-228. doi:10.3109/01612840.2012.745177