Positive Autism Screening in Children Born Preterm
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Purpose
Autism is more common among children born preterm than term. This study determined the prevalence of positive autism screening among 18-30 month old preterm-born children and evaluated sociodemographic, clinical, and neurodevelopmental factors associated with positive screens.
Methods
Secondary analyses of Stanford data from California Perinatal Quality Care Collaborative. Infants born < 32 weeks gestation between 2016-2020, who attended High-Risk Infant Follow-Up 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
Prevalence of positive-screens was 12.2% (41/337). 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); gestational age was the primary factor associated with a positive screen (OR 0.75, 0.56-0.99). We found no group differences in sociodemographics or medical complications; children in the positive-screen group had lower language scores than children in the negative-screen group ( p < .001). All children in the positive-screen group and ~⅓ of children in the negative-screen group scored low in language.
Conclusion
The high prevalence of positive-screens reinforces the importance of early screening for autism in very preterm children. Gestational age at birth was the only 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.
