Comparison of three screening tests for autism in preterm children with birth weights less than 1,500 grams

Abstract

BackgroundPreterm children seem to be at increased risk for autism spectrum disorders (ASD).MethodsParents of 157 children with birth weights less than 1,500 g (age 2 years, corrected for prematurity; 88 boys, 69 girls) completed 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 assessed by clinical examination including the Autism Diagnostic Observation Schedule.ResultsFifty-six children (35.7%) screened positive on at least one of the parental screening questionnaires. Of the 56 children who tested positive, 33 participated in the detailed clinical follow-up assessment. A diagnosis of ASD was confirmed in 13 of the 33 children. The ASD prevalence was 9.7% of the sample. Analysis of children with and without an ASD diagnosis found significant differences relative to gestational age (26.9 weeks vs 28.3 weeks, P=0.033) and length of the stay in hospital (89.5 days vs 75.4 days, P=0.042). The screening tool with the most positive results was CSBS-DP-ITC (42 positive screens [PS]), followed by M-CHAT (28 PS), and ITSP (22 PS). Differences in the frequency of PS among the tests were significant (P=0.008). CSBS-DP-ITC had the highest sensitivity (0.846), followed by M-CHAT (0.692) and ITSP (0.462).ConclusionOur results indicate a higher prevalence of autism in children with birth weights <1,500 g at 2 years of age compared to the general population prevalence. The ASD diagnosis was associated with shorter gestation times and longer hospital stays. Our findings support the simultaneous use of more than one screening tests in order to increase screening sensitivity.

Autism in Toddlers Born Very Preterm

“…In toddlers born preterm, the use of multiple screens has yielded high but varied positive rates (20%-35.7% on any screen; 1%-9% on all screens). 7,37,38 Only 1 study, by Dudova et al, 38 used diagnostic validation for combinations of screens and demonstrated sensitivity and specificity >76% in all combinations except when all 3 screen tests had to be positive, which yielded a sensitivity of 23%.…”

Endosomal system genetics and autism spectrum disorders: A literature review

“…Over or under weight mothers are at increased risk for birthing a child with ASDs (Dudova et al, 2014a; Dudova et al, 2014b; Krakowiak et al, 2012; Rivera et al, 2015). This could be due to a gene-environment interaction in which leptin, or the mTOR-pathway, are dysregulated and producing increased risk for developing autism.…”

Critical region within 22q11.2 linked to higher rate of autism spectrum disorder

“…Nine participants were excluded from the ASD and psychiatric symptom analyses ( n = 34; see Fig. 2 ) for two types of reasons: (1) ASD classification could not be determined ( n = 2; see below) or (2) if they presented with another medical issue likely to affect brain development ( n = 2 extreme prematurity and/or birth weight < 5th centile, n = 2 with CEDNIK syndrome, n = 1 with 16p11.2 deletion which is independently associated with ASD, n = 2 history of hypoxic brain injury) [ 31 – 34 ]. Participant characteristics of the sample excluding these nine cases are described in Table 2 .…”