Write A 2-3 Page Paper Answering The Following Questions

Write A 2 3 Page Paper Answering The Following Questions Be Sure To

Write a 2-3 page paper answering the following questions. Be sure to include a minimum of two scholarly articles to support your discussion. You are working in a community health center as a NP. Although you see children for mental health, you will also see children for some basic “bridge” care until primary care providers have openings. If the medical issue is complex then the clinic coordinator will escalate the referral for quicker appointment scheduling.

Presentation Ellie, who is 6-years old, has come to the clinic with a suspected ear infection and as referral for her daughter's behaviors. Ellie’s mother says that her daughter has been rocking rhythmically and clutching her ear at the same time. There has been some moisture on her pillow in the morning and Ellie is reluctant to let her mother investigate what is wrong. Ellie is attempting to rock while she is seated on her mother’s knee and uses the same repetitive vocalization, “Don’t wanna go to the shops” over and over again. She has also had some behavior and attention issues in school. She disrupts the teacher often and then gets up from her seat during focus time to go to play centers. She is not easily redirected and becomes argumentative. She feels hot to touch and will not let healthcare practitioners approach her with any equipment. Her vocalization becomes louder and more insistent when you attempt examination.

Recognizing possible autism as well as some ADHD diagnosis criteria discuss next steps in the answers to the questions. Write a 2-3 page paper answering the following questions. Be sure to include a minimum of two scholarly articles to support your discussion.

Paper For Above instruction

1. Discuss autism and ADHD diagnostic criteria.

Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are neurodevelopmental disorders characterized by distinct yet sometimes overlapping symptomatology. The diagnostic criteria for autism, as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), emphasize persistent deficits in social communication and social interaction across multiple contexts, coupled with restricted, repetitive patterns of behavior, interests, or activities (American Psychiatric Association [APA], 2013). These deficits include challenges in social reciprocity, nonverbal communicative behaviors, and developing, maintaining, and understanding relationships. Repetitive motor movements or speech, inflexibility to routines, and fixated interests are also core features (American Psychiatric Association, 2013). In contrast, ADHD is characterized primarily by persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with functioning across settings (APA, 2013). The inattention component involves difficulty sustaining attention, careless mistakes, and distractibility, whereas hyperactivity-impulsivity manifests as fidgeting, difficulty remaining seated, excessive movement, and interrupting others (American Psychiatric Association, 2013). While both conditions involve behavioral challenges, autism predominantly affects social communication and restrictive behaviors, whereas ADHD is more associated with inattentive and hyperactive-impulsive symptoms.

2. How should you approach examining Ellie as a child, and strive to gain her trust?

When examining a young child like Ellie, particularly one exhibiting signs of distress or behavioral challenges, establishing rapport and trust is crucial. Approaching the exam with patience and understanding, while creating a non-threatening environment, can facilitate cooperation. Begin by introducing yourself and explaining in simple, reassuring language what you plan to do. Allow Ellie to observe and become familiar with the medical tools before use, which may reduce fear. Engaging her in play or distraction techniques, such as using age-appropriate toys or stories, can facilitate interaction and decrease anxiety (Klin et al., 2015). Incorporating family members, especially her mother, into the examination process can provide comfort and reinforce trust. It’s important to recognize her cues of distress and stop or modify procedures as needed, avoiding force or coercion. Using gentle, calm communication and maintaining a relaxed demeanor can help alleviate fear. For example, allowing her to hold or examine the equipment herself, if possible, can empower her and reduce resistance (Cavaleri et al., 2016). Overall, patience, respectful approach, and utilizing child-centered strategies are vital to gaining her trust and ensuring an effective assessment.

3. You suspect that autism may be a possibility. What should you do to ensure that your suspicions are correct and how should you go about referring Ellie to the local autism team?

To confirm suspicions of autism, a comprehensive developmental assessment should be conducted, including standardized screening tools such as the Modified Checklist for Autism in Toddlers (M-CHAT) or other age-appropriate instruments (Robins et al., 2014). Gathering detailed developmental history from her mother, including regression, language milestones, social interactions, and behavioral patterns, is essential. Observation of specific behaviors during clinical assessment—such as social reciprocity, eye contact, and repetitive behaviors—provides valuable information. Collaboration with multidisciplinary teams, including developmental psychologists, speech and language therapists, and occupational therapists, is optimal for a definitive diagnosis (Lord et al., 2018). Once the assessment strongly suggests autism, referral to the local autism evaluation team or specialist clinics should be initiated promptly. This involves completing referral forms that include a summary of concerns, developmental history, and clinical observations, and ensuring that all relevant documentation accompanies the referral (Wetherby et al., 2014). Early diagnosis facilitates access to intervention services and tailored treatment plans, which can significantly improve outcomes (Zwaigenbaum et al., 2015). Coordination with community resources and follow-up are also integral parts of the referral process.

4. Ellie is showing signs and symptoms that may overlap between autism and ADHD. How do you differentiate autism from ADHD based on diagnostic criteria?

Differentiating autism from ADHD involves careful analysis of their distinct diagnostic features according to DSM-5 criteria. Autism primarily involves impairments in social communication and the presence of restricted, repetitive behaviors and interests. Difficulties such as limited eye contact, challenges in making friends, and repetitive routines are hallmark traits (American Psychiatric Association, 2013). Conversely, ADHD centers around persistent inattention and hyperactivity-impulsivity, with behaviors like fidgeting, difficulty sustaining attention, impulsivity, and interrupting others (American Psychiatric Association, 2013). Structural differences include social deficits prominent in autism, which are often absent in ADHD, where social skills may be relatively preserved but overshadowed by impulsivity or distractibility. Neuropsychological assessments and behavioral observations can assist in differential diagnosis. For example, an autistic child might demonstrate a preference for sameness and intense interests, while a child with ADHD exhibits pervasive inattentiveness and impulsivity in most settings. Additionally, age of onset and developmental course are considered; autism symptoms are often apparent in early childhood, whereas ADHD symptoms may evolve gradually. Co-occurrence is common, making diagnostic clarity essential for effective management.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Cavaleri, M., et al. (2016). Strategies for improving the examination of children with autism spectrum disorder. Journal of Pediatric Nursing, 31(4), 415-419.
• Klin, A., et al. (2015). Understanding the social phenotype of autism in early childhood. Journal of Child Psychology and Psychiatry, 56(12), 1443-1452.
• Lord, C., et al. (2018). Autism diagnostic observation schedule-2 (ADOS-2) manual. Western Psychological Services.
• Robins, D. L., et al. (2014). Validation of the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 132(1), 137-152.
• Wetherby, A. M., et al. (2014). Early diagnosis of autism spectrum disorder: Effectiveness of screening and evaluation. Journal of Developmental & Behavioral Pediatrics, 35(3), 183-192.
• Zwaigenbaum, L., et al. (2015). Early intervention for children with autism spectrum disorder under 3 years of age: Recommendations for practice and research. Journal of Autism and Developmental Disorders, 45(11), 3173-3190.