Child Mental Health Nursing Case Report on Autism Spectrum Disorder: A Clinical Assessment and Nursing Management Plan

Abstract

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by persistent differences in social communication and interaction and by restricted, repetitive patterns of behavior.

Design and Setting: This is a single-patient case report prepared according to the CARE reporting guideline, describing a child evaluated at the Central Institute of Psychiatry (CIP), Ranchi, a tertiary psychiatric institute.

Case Presentation: A 7-year-old boy presented with delayed developmental milestones, limited eye contact, marked difficulty with verbal communication, high activity levels, aggression toward peers and their mother, and self-injurious behavior (head banging, self-biting).

Assessment: The Developmental Screening Test (DST) gave a Developmental Age (DA) of 46 months (Developmental Quotient [DQ] 55) and the Vineland Social Maturity Scale (VSMS) gave a Social Age (SA) of 48 months (Social Quotient [SQ] 57), at a chronological age of about 84 months. The Indian Scale for Assessment of Autism (ISAA) total score was 112, within the range classified as moderate autism; the corresponding disability percentage is an indicative estimate, not a certified rating.

Intervention and Outcome: The child received speech and occupational therapy for about one year (2022–2023). Clinicians and parents reported gains in 2–3-word phrases, motor coordination and comfortable engagement, while social, sensory and behavioral difficulties persisted. Standardized assessments were not repeated, so change could not be quantified. A nine-problem, priority-based nursing care plan was formulated, addressing safety, behavioral support, sensory regulation, communication, and parental psychoeducation.

Limitation: As a single case without post-intervention standardized scores, the findings cannot be generalized and do not establish treatment effectiveness.

Conclusion: This case illustrates how standardized assessment can inform a structured, family-centred nursing care plan for a child with ASD. The implementation and effect of the plan were not evaluated, so no conclusion about effectiveness can be drawn; the report underlines the value of follow-up with repeated measurement.