Evaluation of Early Childhood Social-Communication Difficulties in Children Born Preterm Using the Quantitative Checklist for Autism in Toddlers

Wong, Hilary; Huertas-Ceballos, Ángela; Cowan, Frances; Modi, Neena

doi:10.1016/j.jpeds.2013.07.013

Cited by 53 publications

(47 citation statements)

References 24 publications

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“…Importantly though, a subthreshold social communication profile was very common in the ADOS-G nonspectrum children who screened M-CHAT-FI positive. This profile has been shown repeatedly in other studies 4,15,16 suggesting false-positive children may meet the criteria for the new category of Social Communication Disorder by using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. 40 Developmental surveillance of this subthreshold group may also be of assistance in monitoring whether these children later meet diagnostic criteria as further symptoms manifest when social demands exceed capacities.…”

Section: Discussionsupporting

confidence: 65%

“…3,4,6 These impairments also are associated with the high positive screen rates reported in the preterm population. 5,8,[13][14][15][16] Although these screening studies overestimate diagnostic outcome, children born preterm often demonstrate a profile of early social communication and emotional difficulties consistent with ASD characteristics. 4,14 The variability in the rates of ASD in these studies is likely influenced by the eligibility of the preterm population, age assessed, loss to follow-up, and the specific assessment tool used.…”

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confidence: 99%

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Autism in Toddlers Born Very Preterm

et al. 2016

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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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Section: Discussionsupporting

confidence: 65%

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confidence: 99%

Autism in Toddlers Born Very Preterm

et al. 2016

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“…Two recent studies even found a gradual increased risk of traits of ASD with shorter gestation (18,19). Screening studies in early childhood revealed that features of ASD have a disproportionally higher prevalence in the preterm compared to the general population (20)(21)(22)(23). Studies with the Modified-Checklist for Autism in Toddlers (M-CHAT) (24,25) found screening percentages between 21 and 41% (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Extremely Preterm Born Children at Very High Risk for Developing Autism Spectrum Disorder

Verhaeghe

Dereu

Warreyn

et al. 2015

Child Psychiatry Hum Dev

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This study aimed to provide a more comprehensive picture of the prevalence of autism spectrum disorder (ASD) in a geographic cohort of extremely preterm born adolescents by using established diagnostic instruments in addition to screening instruments. 53 participants passed a screening procedure with two screening instruments and a diagnostic evaluation with a semistructured assessment and a parent interview. 28% of the adolescents had a community based clinical diagnosis of ASD. When research diagnoses were also taken into account, this rate increased to 40%. Intellectual disability, language impairment and behavioural difficulties are characteristic for these children with ASD. This study is to our knowledge the first to use ASDspecific diagnostic instruments to confirm ASD diagnoses in extremely preterm born children in early adolescence. The study expands findings of previous research and raises the need for follow-up into late childhood and early adolescence.

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“…The increased risks of neurobehavioral complications of prematurity are well described [19]. Postnatal growth restriction has also been shown to have significant effects on neurodevelopmental outcomes [13], [6], and [20]. The additive effects of postnatal growth restriction on the developing premature brain can lead to significant neurologic changes that increase the risk for diagnoses including ADHD and Autism Spectrum Disorder.…”

Section: Discussionmentioning

confidence: 99%

“…As a consequence, there is a growing population that may be vulnerable to the long-term effects of preterm birth. Despite advances in neonatal nutrition including the early provision of protein supplementation, postnatal growth restriction (GR) develops in a majority of premature infants, and together, prematurity and neonatal GR increase the risk of neurodevelopmental impairment, autism and attention-deficit hyperactivity disorder (ADHD) [5], [6], [7], [8], [9], [10], [11], and [12]. …”

Section: Introductionmentioning

confidence: 99%

Growth restriction, leptin, and the programming of adult behavior in mice

Meyer

Zhu

Miller

et al. 2014

Behavioural Brain Research

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Prematurity and neonatal growth restriction (GR) are risk factors for autism and attention deficit hyperactivity disorder (ADHD). Leptin production is suppressed during periods of undernutrition, and we have shown that isolated neonatal leptin deficiency leads to adult hyperactivity while neonatal leptin supplementation normalizes the brain morphology of GR mice. We hypothesized that neonatal leptin would prevent the development of GR-associated behavioral abnormalities. From postnatal day 4–14, C57BL/6 mice were randomized to daily injections of saline or leptin (80 ng/g), and GR was identified by a weanling weight below the tenth percentile. The behavioral phenotypes of GR and control mice were assessed beginning at 4 months. Within the tripartite chamber, GR mice had significantly impaired social interaction. Baseline escape times from the Barnes maze were faster for GR mice (65+/−6 sec vs 87+/−7 sec for controls, p<0.05), but GR mice exhibited regression in their escape times on days 2 and 3 (56% regressed vs 22% of control saline mice, p<0.05). Compared to controls, GR mice entered the open arms of the elevated plus maze more often and stayed there longer (72+/−10 sec vs 36+/−5 sec, p<0.01). Neonatal leptin supplementation normalized the behavior of GR mice across all behavioral assays. In conclusion, GR alters the social interactions, learning and activity of mice, and supplementation with the neurotrophic hormone leptin mitigates these effects. We speculate neonatal leptin deficiency may contribute to the adverse neurodevelopmental outcomes associated with postnatal growth restriction, and postnatal leptin therapy may be protective.

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Evaluation of Early Childhood Social-Communication Difficulties in Children Born Preterm Using the Quantitative Checklist for Autism in Toddlers

Cited by 53 publications

References 24 publications

Autism in Toddlers Born Very Preterm

Autism in Toddlers Born Very Preterm

Extremely Preterm Born Children at Very High Risk for Developing Autism Spectrum Disorder

Growth restriction, leptin, and the programming of adult behavior in mice

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