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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Screening for autism in preterm children with extremely low and very low birth weight
Iva Dudova1, Martina Kasparova2, Daniela Markova3
1Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic.
Insights
Children with very low birth weight (VLBW) and extremely low birth weight (ELBW) show a higher prevalence of autism spectrum disorder (ASD). This study confirms an increased risk in VLBW/ELBW infants, highlighting the need for early screening and intervention.
Area of Science:
- Neonatal research
- Developmental pediatrics
- Autism spectrum disorder research
Background:
- Infants with very low birth weight (VLBW, 1,000-1,500 g) and extremely low birth weight (ELBW, <1,000 g) are considered at higher risk for autism spectrum disorder (ASD).
- Previous studies suggest a potential link between low birth weight and increased ASD prevalence.
Purpose of the Study:
- To investigate the prevalence of autism spectrum disorder (ASD) in a cohort of children born with very low birth weight (VLBW) or extremely low birth weight (ELBW).
- To evaluate the effectiveness of different screening tools in identifying potential ASD cases in this high-risk population.
Main Methods:
- A cohort of 75 VLBW and ELBW children (corrected age 2 years) underwent screening using the Modified Checklist for Autism in Toddlers (M-CHAT), Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC), and Infant/Toddler Sensory Profile (ITSP).
- Children with pre-existing disabilities were excluded.
- Children screening positive on any tool were invited for a comprehensive diagnostic assessment.
Main Results:
- Out of 75 children, 32 (42.7%) screened positive on at least one tool. The CSBS-DP-ITC identified the most positive screens (26), followed by M-CHAT (19) and ITSP (11).
- Nineteen children completed the detailed assessment, with eight (42.1% of those assessed) receiving an ASD diagnosis.
- The overall ASD prevalence in the sample was calculated at 12.9%.
Conclusions:
- The findings support the hypothesis that children born with a birth weight below 1,500 g have an elevated prevalence of autism spectrum disorder.
- The study underscores the importance of targeted screening for ASD in VLBW and ELBW populations.
Background:
Studies of children with very low birth weight (VLBW, 1,000-1,500 g) and extremely low birth weight (ELBW, less than 1,000 g) indicate that this population seems to be at increased risk of autism spectrum disorder (ASD).
Methods:
Parents of 101 VLBW and ELBW children (age 2 years, corrected for prematurity) agreed to participate in the study and signed informed consents; however, parents of only 75 children (44 boys, 31 girls) completed the screening questionnaires. The screening battery included the Modified Checklist for Autism in Toddlers (M-CHAT), Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC), and the Infant/Toddler Sensory Profile (ITSP). Children with disabilities were excluded. All children who screened positive on any of the screening tools were subsequently invited for a detailed assessment.
Results:
Thirty-two children (42.7%) screened positive on at least one of the screening questionnaires. The screening tool with the most positive results was the CSBS-DP-ITC (26 positive screens), followed by the M-CHAT (19 positive screens) and the ITSP (11 positive screens). Of the 32 children who tested positive, 19 participated in the detailed follow-up assessment. A diagnosis of ASD was confirmed in eight of the 19 children. ASD prevalence, calculated from those 19 children and those with negative screening results (43 children), yielded a prevalence of 12.9% in the sample. The difference in frequency of positive screens between the tests was significant (P=0.011). In pair comparisons, ITSP was found to be significantly less positive than CSBS-DP-ITC (P=0.032). No significant differences were found between the M-CHAT and CSBS-DP-ITC or between the M-CHAT and ITSP.
Conclusion:
The results strongly support the hypothesis of an increased prevalence of autism in children with a birth weight less than 1,500 g.
