Pediatric emergency medicine trisk 4212 4212
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (70.42 KB, 1 trang )
carries a diagnosis of ASD. Thirty-one percent have associated intellectual
disability.
Clinical Considerations
Predictable patterns of comorbid medical conditions have been described in
those with ASD. Investigators identify significantly higher rates of
healthcare utilization among children with ASD for psychiatric,
gastrointestinal, neurologic, and sleep disorders. Eighty percent of children
with ASD report at least one psychiatric diagnosis, including inattention and
hyperactivity in 30% to 61%, anxiety in 11% to 40%, and depression in 7%
to 26%. Thirteen percent of emergency care visits among this population
relates to psychiatric-related concerns as compared to 2% in children without
ASD. Families seek care most often for management of externalizing
behaviors, such as physical aggression and disruptive conduct. Similarly,
many children with ASD require care for gastrointestinal and neurologic
complaints. Although 9% to 70% of individuals with ASD report concerning
abdominal pain, constipation, chronic diarrhea, and symptoms of
gastroesophageal reflux disease, there is no evidence for pathogenic
mechanisms related to these conditions specific to ASD. Notably, children
with ASD and common gastrointestinal disorders may present atypically
with behavior changes, irritability, disordered sleep, or new noncompliance
with previously mastered demands. Many individuals with ASD have
restricted or selective diets and may be at risk for nutritional deficiencies
causing illness. Children with ASD frequently pursue neurologic
intervention for impaired motor development and seizure management.
Epilepsy occurs in 25% to 46% of individuals with ASD.
Children with ASD in general have significantly higher rates of
poisonings, self-injury, traumatic brain injuries, injuries to the face and neck,
contusions, fractures, open wounds, and burns with lower rates of sprains
and strains compared to peers without ASD. Crucially, nearly half of
children with autism are known to wander from caregivers with an
associated risk for drowning being the most common cause of mortality in
such circumstances. Remarkably, two-thirds of children ages 6 to 15 years
report being bullied.
Self-injury is most common in patients with associated intellectual
disability or limited functional communication abilities. Such behavior may
