Amber Blake and Dr. Lora Jean Campbell, Nursing
Autism spectrum disorders (ASD) have increased tenfold over the past fifty years. These disorders include: autistic disorder, Asperger disorder, and pervasive developmental disorder-not otherwise specified (PDD-NOS) (Johnson & Myers, 1184). Symptoms of ASD are language delay, severe deficits in social skills, and repetitive behavioral patterns. These symptoms make it hard for children with ASD to form peer relationships, communicate effectively, and develop appropriately (Johnson, 1191-1194).
Many theories have arisen to explain the rise in ASD: fetal hormone levels, genetics, vaccinations, and varying conditions during the birth process. One theory is that hyperbilirubinemia (jaundice) after birth may lead to or contribute to the development of ASD. Bilirubin is a product of the breakdown of hemoglobin from red blood cells, and an increase in bilirubin (hyperbilirubinemia) is toxic to the central nervous system and causes brain damage. Less aggressive hyperbilirubinemia treatment correlates with the time period that ASD disorders have increased.
It is possible that there is a correlation between hyperbilirubinemia and ASD, and there have been few research studies conducted to investigate this. Currently, the studies in the literature report conflicting data, as some researchers have found an association between hyperbilirubinemia and ASD, and others have not. Hyperbilirubinemia is easy to test and treat. If there is a correlation, hospital policies could be changed so neonates would receive more aggressive treatment for hyperbilirubinemia, thus decreasing the incidence of ASD.
My hypothesis was that there is an association between hyperbilirubinemia and ASD. I formulated my research to test this hypothesis. The subjects for the study were from a Special Education Preschool. They were ages four to six years old and had a diagnosis of one of the Autism spectrum disorders. I got permission from their parents to view their child’s intake chart from the preschool, and also to interview the parents by phone. The information I obtained about each child was their age, gender, diagnosis, gestational age, whether or not they had jaundice at birth, what treatment they received, if any, and if there were any other complications associated with their pregnancy or birth.
The most difficult part of my research so far has been obtaining parental consent for enough subjects. I hoped to be able to have at least twenty subjects for the study, and so far have only been able to get four subjects that meet all of the criteria. The study is ongoing as I am involving another preschool and continuing to find more subjects.
So far, of the four subjects that have participated in the study, two children had hyperbilirubinemia at birth, and two did not. Both children with hyperbilirubinemia were treated at home with phototherapy (special lights that help break down the bilirubin). One child that did not have hyperbilirubinemia had significant pregnancy and birth complications.
Because I have only obtained information from four subjects, it is impossible to analyze results at this stage in the research. I am continuing the research and will be able to analyze the results when I have gotten information from at least twenty subjects. I have not been able to get parental consent for any more subjects at the preschool where I have currently been doing research. I am going to try to get consent from parents at another preschool so that I am able to obtain more subjects.
As I was doing my research, I realized the importance of having a control group. I did not realize that this would be necessary when I was planning my research. In order to show there is a correlation between hyperbilirubinemia and autism, I will need to know the incidence rate of hyperbilirubinemia in children without a diagnosis of ASD. The second part of my research will be to get at least twenty subjects that are preschool-aged children without a diagnosis of ASD. I can then compare the two groups and more accurately show if a correlation exists.
So far, this research project has been a wonderful learning experience for me. I feel I have gotten about halfway through my project, and still need to get about sixteen more subjects before my research is complete. Doing this study has helped me to develop research skills and has given me the desire to do future research in nursing.
I have recently graduated with my Bachelor of Science degree in nursing, and am a new nurse working in a pediatrics hospital. This study has helped me see the importance of research and the ways that it affects current medical practice. I will use my research skills in my nursing practice to continue to learn and ensure my practice is evidence-based to help my patients have the best possible outcomes.