Title

Autism in toddlers born very preterm

Date of this Version

2-2016

Document Type

Journal Article

Publication Details

Citation only

Pritchard, M.A., De Dassel, T., Beller, E., Bogossian, F., Johnston, L., Paynter, J., Russo, S., Scott, J. (2016). Autism in toddlers born very preterm. Pediatrics, 137 (2), 1-8.

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© Copyright, The American Academy of Pediatrics, 2016

ISSN

0031-4005

Abstract

OBJECTIVE:

This study aimed to determine the prevalence of autism spectrum disorder (ASD) by using the Autism Diagnostic Observation Schedule-Generic (ADOS-G) classifications in children born very preterm during their toddler years.

METHODS:

Two birth cohorts of toddlers (2 and 4 years old) each recruited over 12 months and born at <29 weeks' gestation were administered the Modified Checklist of Autism in Toddlers-Follow-up Interview (M-CHAT-FI) screen, the ADOS-G, and developmental assessments. The ADOS-G was conducted on toddlers with M-CHAT-FI-positive screens.

RESULTS:

Data were available on 88% (169/192) of children. In total, 22 (13%) toddlers screened positive and 3 (1.8%) were confirmed diagnostically with ASD. These 3 cases reached the highest ADOS-G threshold classification of autism. All but 1 child who scored below the ADOS-G thresholds (11/12) demonstrated some difficulty with social communication. Risk was significantly increased for co-occurring neurodevelopmental problems in 21 of the 22 positive-screen ASD cases. Adaptive behavior (P < .001) was the only co-occurring factor independently predictive of ASD in toddlers.

CONCLUSIONS:

Children born very preterm are at increased risk of ASD. By using the ADOS-G, we found a lower incidence of ASD in children born at <29 weeks' gestation compared with previous studies. Children who screened positive for ASD on the M-CHAT-FI had developmental delays consistent with subthreshold communication impairment.

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This document has been peer reviewed.