Screening for autism in preterm children with extremely low and very low birth weight

Abstract

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.

Keywords:

• autism spectrum disorder
• preterm children
• screening
• Autism Diagnostic Observation Schedule
• prevalence

Acknowledgments

This study was supported by the Ministry of Education, Youth and Sports, Czech Republic (research grant COST LD11028), the Ministry of Health, Czech Republic (conceptual development of research organization, University Hospital Motol, Prague, Czech Republic 00064203), and by the ESF (COST Action ESSEA BM1004). The authors would like to thank Thomas Secrest for his assistance with the English version of the manuscript.

Disclosure

The authors declare that they have no competing interests in this work.