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watery contents which then spill around the hard stool causing abrupt diarrhea. The treatment of diarrhea depends on the cause therefore, to effectively treat diarrhea the cause must be investigated and addressed accordingly. For example, if diarrhea is found to be Pediatr Neonatal Nurs Open J. 2022; Eta VEA caused by food allergies, over consumption of juice, lactose intolerance or celiac disease, changes in diet may treat the diarrhea.23 Also, depending on the cause medications may be administered or a surgical intervention may be required. GASTROESOPHAGEAL REFLUX DISEASE Gastroesophageal reflux disease (GERD) occurs when the muscle between the esophagus and stomach is weakened allowing partially digested food and liquid mixed with stomach acid to move up out of the stomach. GERD may lead to ulceration of the esophagus and put the child at risk of developing esophageal cancer. Symptoms commonly include sensations of “heartburn”, pain and discomfort in the throat.7 It is important to note that pain and discomfort may be communicated by persons who are minimally verbal or nonverbal in atypical ways. These include an increased in repetitive behaviors and displaying self-injurious acts such as banging the head against the wall, as well as challenging behaviors. Sometimes, pushing out the jaw or tapping the throat, straining the neck and unusual body postures may be observed. Also, the individual may experience chronic sore throat, cough, hoarseness, dental erosions, inability to eat and disrupted sleep.28 In diagnosing GERD a thorough history taking and physical examination is conducted. This assist in eliciting information as to whether the manifestation of the unusual behaviors are initiated or worsened when the patient lies down since the lying position favors reflux of gastric contents. When GERD is severe and chronic specialized tests are ordered in order to identify acid levels and tissue damage in the esophagus. Tips for relieving the symptoms of GERD include behavioral modifications such as raising the head when sleeping, eating small quantities of food, identifying and avoiding foods that are likely to elicit symptoms, and avoid eating just before going to bed. Medications such as antacids, histamine-2 blockers and protein-pump inhibitors may be administered.29 For chronic and severe cases of GERD the patient is referred to a specialist. EPILEPSY Epilepsy also known as seizure disorder that affects just one to two percent of typically developing persons is common in about a third of individuals with autism. It is said that one in every four children with autism has seizures.21 Seizures occur due to lesions or cuts on the brain resulting in unusual electrical activity in the brain. Generally, it begins in either early childhood or adolescence. Occasionally, hyperpyrexia and difficulty sleeping contribute to the occurrence of seizures meanwhile if seizures are not managed or controlled sleep is disrupted. Its signs and symptoms most commonly include unexplained staring spells and confusion, severe headaches and involuntary or unusual movements. Also, the person may experience a brief loss of consciousness and or “blackout” and a body convulsion as well as stiffening of muscles and involuntary jerking of limbs. Less commonly the individual may experience unexplained changes in abilities or emotions as well as sleepiness or disrupted sleep which can in turn increase seizures.25 In addition, there may be regression in normal development as well as inexplicable irritability or aggressiveness. It is important to note that just like autism, epilepsy is equally a spectrum disorder as it varies broadly in severity. Epilepsy in children with autism may begin at any age; however, literature holds that seizures mostly start in the preschool years and also in adolescence. It is usually difficult to diagnose epilepsy because many individuals with autism have difficulty recognizing and reporting their symptoms, and the symptoms do not always manifest outwardly. Generally, the diagnosis of epilepsy is made using an electroencephalogram (EEG) in order for the individual to be treated properly and prevent brain damage. Several factors are taken into
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