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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Positive Autism Screening in Children Born Preterm
Nuria Lisset Ontiveros Perez1, Pamela M Rios1, Stella Firth Wang2
1Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
Insights
Autism screening is crucial for preterm infants, with 12.2% showing positive results. Lower gestational age was the key factor, emphasizing early developmental assessments for this vulnerable population.
Area of Science:
- Neonatal Development
- Child Psychology
- Developmental Pediatrics
Background:
- Autism Spectrum Disorder (ASD) is more prevalent in preterm-born children compared to term-born infants.
- Early identification of ASD in high-risk populations is critical for timely intervention and improved outcomes.
Purpose of the Study:
- To determine the prevalence of positive autism screening results in preterm infants.
- To identify sociodemographic, clinical, and neurodevelopmental factors associated with positive autism screens in this cohort.
Main Methods:
- Secondary analysis of data from a high-risk infant follow-up clinic.
- Inclusion of infants born before 32 weeks gestation between 2016-2020, assessed at 18-30 months.
- Classification into positive (M-CHAT-R/F score > 2) and negative (≤ 2) screening groups for comparison of factors.
Main Results:
- The prevalence of positive autism screens was 12.2% among preterm infants.
- Lower gestational age was the sole significant factor associated with positive screens in multivariate analysis (p=0.04).
- The positive-screen group exhibited lower mean language scores, though language delays were also present in 36.6% of the negative-screen group.
Conclusions:
- The high prevalence underscores the necessity of early autism screening for all preterm children.
- Gestational age is a primary predictor of positive autism screens in preterm infants.
- Language difficulties are common in preterm infants regardless of autism screen status, necessitating comprehensive developmental monitoring.
Purpose:
Autism is more common among children born preterm than children born at term. This study determined the prevalence of positive autism screening among children born preterm and evaluated sociodemographic, clinical, and neurodevelopmental factors associated with positive screens.
Methods:
Secondary analyses of data from Lucile Packard Children's Hospital High Risk Infant Follow-up clinic. Infants born < 32 weeks gestation between 2016 and 2020, who attended the clinic at 18-30 months, were classified into two groups based on results of Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F): positive-screen (score > 2) and negative-screen (≤ 2). We compared sociodemographics, clinical factors, and language development across groups.
Results:
The prevalence of positive screens was 12.2%. Children in the positive-screen group had lower gestational age, birthweight, and longer hospital stays than children in the negative-screen group (all p <.05). However, in multivariate analysis, gestational age was the only factor significantly associated with positive screens (p =.04). We found no group differences in sociodemographics or medical complications. The positive-screen group had lower mean language scores than the negative-screen group (p <.001). However, 36.6% of children in the negative-screen group also had a language developmental quotient ≤ 85.
Conclusion:
The high prevalence of positive screens reinforces the importance of early screening for autism in preterm children. Gestational age at birth was the primary factor associated with positive screens. Language difficulties were not specific to children with positive screens, highlighting the need for autism screening and routine developmental assessments for preterm children.
