1

I. INTRODUCTION

Autism and Autism Spectrum Disorder (ASD) is a
neurodevelopmental disorder characterized by impaired social interaction,
verbal and non0verbal communication, and by restricted and repetitive
behavior. According to the Diagnostic and Statistical Manual for Mental
Disorders (DSM IV), one of the diagnostic criteria for children with autism
is that the symptoms must already be apparent before they reach the age
of 3. It is one of the recognized disorders under the Autism Spectrum
Disorders (also known as Pervasive Developmental Disorders) along with
the other two disorders which are Retts disorder, a pervasive
developmental disorder which is characterized by the development of
multiple deficits after a period of normal functioning; and Aspergers
disorder, which is characterized by the same impairments of social
interaction and restricted stereotyped behaviors as seen in autistic
disorder, but there are no language or cognitive delays in development.
Children with autism display little eye contact with and make few
facial expressions towards others; they use limited gestures to
communicate. They also have a limited capacity to relate to their parents
and as well as towards their peers. They also lack spontaneous
enjoyment, express no moods or emotional affect, and they cannot
engage in play or make-believe with toys. These children engage in
stereotyped behaviors such as hand flapping, body twisting, or head
banging.
Research has showed that 80% cases of autism are early onset,
with developmental delays starting in infancy. The other 20% of children
with autism have seemingly normal growth and development until 2 or 3
years old, and then they start to have a developmental regression or loss
of abilities. They stop talking and relating to parents and peers and begin
to demonstrate the behaviors described previously.
Autism is linked with genetics; many children with autism have a
relative with autism or autistic traits. Controversy continues about whether
measles, mumps, and rubella (MMR) vaccinations contribute to the
development of late-onset autism.
Autism tends to improve, in some cases substantially, as children
start to acquire and use language to communicate with others. In
adolescence, if the behavior starts to deteriorate, it may reflect the effects
of hormonal changes or difficulty meeting increasingly complex social
demands. Autistic traits persist into adulthood, and most people with
autism remain dependent on some degree to others.

2
This case analysis is focused on the diagnosis of patient P. Patient
P is a patient diagnosed with Autism Spectrum Disorder. When he was
around 1 year old, his parents discovered that he hasnt spoken a word.
His parents wondered if there was something wrong with their child
because they know a child who is the same age as their son and that child
can already speak a few words but their son has always been silent. They
decided to bring their child to a pediatrician. The pediatrician informed
them that it is wrong to compare their childs development to another child
because each childs development varies. The pediatrician told them to
come back after 6 months if the child has still not spoken a word by then.
After 6 months, they returned and the pediatrician referred them to a
speech therapist. After 6 months of therapy, patient P showed no signs of
improvement and they were referred to a psychiatrist in Cebu. Patient P
was then diagnosed with autism. The parents were advised to bring
patient P for regular check-up every 6 months.
At the age of 4 years the specialist Dr. VD diagnosed patient P with
Autism Spectrum Disorder. This case analysis shall discuss the progress
of patient P, specifically his growth and development and as well as the
different theories that can be associated with Autism Spectrum Disorder.
The theories that are going to be used in this case analysis are, Florence
Nightingales Environmental Theory, Abraham Maslows Hierarchy of
Needs, Sister Callista Roys Role Adaptation Model and Dorothea Orems
Self-care Deficit Theory.
3
II. CLIENTS PROFILE

A. DEMOGRAPHIC DATA
NAME: Patient P
AGE: 8 years old
SEX: Male
DATE OF BIRTH: November 6, 2006
HOME ADDRESS: Brgy. Carangan , Ozamis City
RELIGION: Roman Catholic
CURRENT EDUCATIONAL LEVEL: Elementary Level
DIAGNOSIS: Autism Spectrum Disorder

B. HISTORY
When patient P was around one year old and a few months,
his parents noticed that he had not spoken a word and they found it
odd. The parents decided to bring patient P to a pediatrician. The
pediatrician informed the parents that there are times when children
have delayed language development, the pediatrician told them to
observe patient P for a few more months and return for follow-up
check-up after 6 months.
After 6 months of observation, the parents brought patient
P back for follow-up check-up and the pediatrician referred them to
a speech therapist to help patient P cope with his communication
problem. After month of therapy, the therapist observed that patient
P was not getting any better and the therapist asked them to visit a
specialist in Cebu.
At 4 years old, patient P was diagnosed with Autism
Spectrum Disorder by the specialist Dr. VD.

4
III. RELATED THEORIES

A. ABRAHAM MASLOWS HIERARCHY OF NEEDS

Abraham Maslow made a theory regarding the general
needs of humans. He derived a hierarchy of these needs.
Basically, in order to ascend in the hierarchy, one must have met
the needs of stage before that. There are 5 stages in the
hierarchy; the physiological needs, safety and security needs,
love and belongingness needs, self-esteem, and self-
actualization.

In the case of patient P, his needs are mostly met by his
family, specially by his parents. The parents have established a
daily routine for him, in order to let him participate in meeting his
needs. Patient P has difficulty in communication; therefore, he
cannot inform his parents when he is feeling hungry. The
established routine helps his parents feed him on time and it also
helps Patient P meet his physiological needs. With the love and
support provided by his family, he has achieved his safety and
security needs, as well as his love and belongingness needs.
Since patient P has difficulty in communication and social
interaction, I am not quite sure if he has already achieved the
other 2 stages of the hierarchy of needs.

5

B. FLORENCE NIGHTINGALES ENVIRONMENTAL THEORY

Florence Nightingales environmental theory emphasizes on
the manipulation of the environment in order to help patients
recover fully. Back in the day, Nightingale observed that patients
who were treated in a clean environment were most likely to
recover faster than the ones who were treated in a dirty
environment. She established the fact that the environment can
greatly affect a patients health.
In the case of patient P, his primary physician Dr. VD
advised his parents to manipulate his environment in order for
him to maximize his potentials. The parents have established a
routine for patient P to follow, in order to meet his basic needs.
Certain activities were also encouraged for patient P, in order to
help with his development; such as the beading therapy- which
involves making patient P use beads and insert it into a thread,
this activitys goal was to improve or to increase his attention
span and improve his control over his hands. The manipulation of
patient Ps environment has made him docile unlike other
patients with the same disorder. People with ASD (Autism
Spectrum Disorder) lack the ability to recognize danger and their
response to pain is not normal; these people are also very
hyperactive and they are very susceptible to falls and other
accident-related injuries. That is why it is very important to
control the childs environment to keep him safe.