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Autism: Relevance to immunizations. Meghan Cole Brenda Curenton Ashley Donaldson Auburn University of Montgomery. What is Autism?. - PowerPoint PPT Presentation
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Autism:Relevance to immunizations
Meghan Cole
Brenda Curenton
Ashley Donaldson
Auburn University of Montgomery
What is Autism?
Autism, also known as Autism Spectrum Disorder, is a disorder of brain development categorized by difficulties in social interaction, verbal and nonverbal communication, and repetitive behaviors (Autism Speaks, Incorporated 2013).
Social Skills Communication Skills Behavioral Skills
Currently there are no known laboratory tests to diagnose autism.
How is Autism Diagnosed?
Treatment Methods No cure exists.Treatment involves:
level of function
by
autistic symptoms
Therapy involves: Educational Family Counseling Behavioral modification Communication Medications
Because many of the causes of autism remain unknown by the medical community and concerned parents, there is some question if immunizations in children can cause this disorder.
The case study involves an expectant mother already dealing with one child who has been diagnosed with autism. The mother has a strong belief that immunizations caused the first child’s autism. The mother requested a pediatric nurse to verbalize her opinion on the matter.
The information to be identified by this case study is whether or not vaccinations can be linked to the cause of autism
??? Causes of Autism ???
Patient or Situation Focused Question
Meta-analyses and systematic
reviews
Evidence-based reviews
Random control trials
Case-control studiesCase series
Case reports
Textbook, review articles, expert opinions, and laboratory research
The purpose and goal of this query are to determine the link between the development of autism and immunizations in children.
The focused question is:
“What is the highest level of evidence to determine if immunizations can cause autism in young children?”
Targeted ResourcesIn order to find the highest level of evidence based information related to
the focused question the EBP team explored in Cochrane Library, PubMed, and Google Scholar.
The word search within the databases is shown in the following (see Table 1).
SEARCH WORDS CORRESPONDING TO PPARRE
ALTERNATIVE WORDS OR SYNONYMS
Autism Development disorder, socially impaired, impaired communication, risk factors of autism
Immunizations Vaccines, vaccinations, childhood vaccines
Children Girls and boys ages birth to 6Mercury Thimerosal
Table 1 PPARRE Word Search
To be thorough in the research the EBP team used the PPAARE process in developing the focused question. The acronym mapped the course for the development.
Problem-autism linked to immunizations. Population-young children. Action-gaining knowledge to determine whether or not vaccines are
actually linked to autism. Alternative-in this case there is no alternative. Results-educate the mother on the link between vaccines and autism so that
the mother can make an informed decision about immunizing and decreasing the mother’s fear and anxiety.
Evidence- that will be gained with the completion of our research.
The following demonstrates this process (see table 2).
PPAARE
Table 2 PPAARE Question for Case Study Focused Query Question
Problem PPAARE Component Case Example
Patient Children
Action Gain knowledge whether autism is linked to vaccinations
Alternative
Patient Results Educate the mother with information about immunizations so she can make an informed decision and reduce mother’s anxiety and fear
Level of Evidence Highest level
Relevance of Evidence
In order to ensure the EBP team stays on track with the research, a “Relevance of Evidence” table was used.
This table is multifunctional
Keeps data/visited sites listed Reveals relevance of the articles found
Evidence Appraisal
To establish trustworthiness of two relevant studies:
A quantitative study was used from authors E. Fombonne, R. Zakarian, A. Bennett, L. Meng, and D. McLean-Heywood written in 2006.
A qualitative study was conducted from authors S. Hilton, K. Hunt, M. Petticrew written in 2007.
After conducting the analysis using this systematic process, both studies were found to be trustworthy. The qualitative study was the most beneficial for the EBP team to use to prove the trustworthiness of the project
Course of ActionThe course of action the Evidence Based Practice (EBP) team plans to implement includes:
Share with the mother the study conducted for the highest level of evidence found to determine if immunizations can cause autism in young children.
Educate the mother on the outcome of the study.
The outcome can be measured by following up with mother to see if her concerns have been relieved.
Allowing the child to be immunized would demonstrate a positive outcome from the knowledge gained and shared with the mother from this study that there is no link between immunizations and autism.
Conclusion
In conclusion, this study was an effective use of the EBP team’s efforts:
Searched for the highest level of evidence to determine if immunizations can cause autism in young children.
Found no evidence that immunizations can cause autism.
Shared this information with the concerned mother Put to rest mother’s fear of immunizing her younger
child. The team completed a post- education evaluation Determined that the mother’s anxieties were relieved Mother allow her child to receive the MMR vaccine.
ReferencesAutism Speaks Incorporated. (2013). What is Autism? Retrieved from http://www.autismspeaks.org/what-autism
Demicheli, V., Riveter, A., Deadline, M.G., & Di Pietrantonj, C. (2012). Vaccines for measles, mumps and rubella in
children. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004407.pub3/abstract
Fombonne, E., Zakarian, R., Bennett, A., Meng, L., & McLean-Heywood, D. (2006). Pervasive developmental disorders in
Montreal, Quebec, Canada: Prevalence and links with immunizations. Pediatrics, 118 (1), 139-150. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/16818529
Health Council of the Netherlands. (2007). MMR vaccination and autism: no indication for a
association. Retrieved from http://www.gezondheidsraad.nl/sites/default/files/200704EMMR.pdf
Hilton, S., Hunt, K., & Petticrew, M. (2007). MMR: Marginalized, misrepresented and reject? Autism: A focus group study.
Archives of Disease in Childhood, 92(4), 322-327. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17376937
Mayo Clinic. (2012). Autism. Retrieved from http://www.mayoclinic.com/health/autism/DS00348