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.

Department of Child Psychiatry Charles University 2nd Faculty of Medicine and University Hospital Motol Prague Czech Republic

Department of Pediatrics and Adolescent Medicine Charles University 1st Faculty of Medicine and General University Hospital Prague Czech Republic

Department of Pediatrics Charles University 2nd Faculty of Medicine and University Hospital Motol Prague Czech Republic

Department of Pediatrics Charles University Faculty of Medicine and University Hospital Hradec Kralove Czech Republic

Institute of Psychology Academy of Sciences Brno Czech Republic

Zobrazit více v PubMed

Elgen I, Sommerfelt K, Markestad T. Population based, controlled study of behavioural problems and psychiatric disorders in low birthweight children at 11 years of age. Arch Dis Child Fetal Neonatal Ed. 2002;87:F128–F132. PubMed PMC

Robins DL, Fein D, Barton ML, Green A. The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Disord. 2001;31:131–144. PubMed

Limperopoulos C, Bassan H, Sullivan NR, et al. Positive screening for autism in ex-preterm infants: prevalence and risk factors. Pediatrics. 2008;121:758–765. PubMed PMC

Kuban KC, O’Shea M, Allred EN, Tager-Flusberg H, Goldstein DJ, Leviton A. Positive screening of the Modified Checklist for Autism in Toddlers (M-CHAT) in extremely low gestational age newborns. J Pediatr. 2009;154:535–540. PubMed PMC

Moore T, Johnson S, Hennessy E, Marlow N. Screening for autism in extremely preterm infants: problems in interpretation. Dev Med Child Neurol. 2012;54:514–520. PubMed

Indredavik MS, Vik T, Heyerdahl S, Kulseng S, Fayers P, Brubakk AM. Psychiatric symptoms and disorders in adolescents with low birth weight. Arch Dis Child Fetal Neonatal Ed. 2004;89:F445–F450. PubMed PMC

Hack M, Taylor HG, Schluchter M, Andreias L, Drotar D, Klein N. Behavioral outcomes of extremely low birth weight children at age 8 years. J Dev Behav Pediatr. 2009;30:122–130. PubMed PMC

Johnson S, Hollis C, Kochhar P, Hennessy E, Wolke D, Marlow N. Autism spectrum disorders in extremely preterm children. J Pediatr. 2010;156:525–531. PubMed

Lord C, Rutter M, LeCouteur A. Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord. 1994;24:659–685. PubMed

Lord C, Risi S, Lambrecht L, et al. The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord. 2000;30:205–223. PubMed

Pinto-Martin JA, Levy SE, Feldman JF, Lorenz JM, Paneth N, Whitaker AH. Prevalence of autism spectrum disorders in adolescents born weighing <2000 grams. Pediatrics. 2011;128:883–891. PubMed PMC

Stephens BE, Bann CM, Watson VE, et al. Screening for autism spectrum disorders in extremely preterm infants. J Dev Behav Pediatr. 2012;33:535–541. PubMed PMC

Kleinman JM, Robins DL, Ventola PE, et al. The Modified Checklist for Autism in Toddlers: a follow-up study investigating the early detection of autism spectrum disorders. J Autism Dev Disord. 2008;38:827–839. PubMed PMC

Wetherby AM, Brosnan-Maddox S, Peace V, Newton L. Validation of the Infant-Toddler Checklist as a broadband screener for autism spectrum disorders from 9 to 24 months of age. Autism. 2008;12:487–511. PubMed PMC

Pierce K, Carter C, Weinfeld M, et al. Detecting, studying, and treating autism early: the one-year well-baby check-up approach. J Pediatr. 2011;159:458–465. PubMed PMC

Dunn W. Infant/Toddler Sensory Profile User’s Manual. San Antonio, TX, USA: The Psychological Corporation; 2002.

Ben-Sasson A, Cermak SA, Orsmond GI, et al. Extreme sensory modulation behaviors in toddlers with autism spectrum disorders. Am J Occup Ther. 2007;61:584–592. PubMed

Ben-Sasson A, Cermak SA, Orsmond GI, Tager-Flusberg H, Kadlec MB, Carter AS. Sensory clusters of toddlers with autism spectrum disorders: differences in affective symptoms. J Child Psychol Psychiatry. 2008;49:817–825. PubMed

Eeles AL, Spittle AJ, Anderson PJ, et al. Assessment of sensory processing in infants: a systematic review. Dev Med Child Neurol. 2013;55:314–326. PubMed

Kim SH, Lord C. Combining information from multiple sources for the diagnosis of autism spectrum disorders for toddlers and young preschoolers from 12 to 47 months of age. J Child Psychol Psychiatry. 2012;53:143–151. PubMed PMC

World Health Organization . International Classification of Diseases. 10th. Geneva, Switzerland: World Health Organization; 1992.

Baron-Cohen S, Scott FJ, Allison C, et al. Prevalence of autism-spectrum conditions: UK school-based population study. Br J Psychiatry. 2009;194:500–509. PubMed

Abrahams BS, Geschwind DH. Advances in autism genetics: on the threshold of a new neurobiology. Nat Rev Genet. 2008;9:341–355. PubMed PMC

Losh M, Esserman D, Anckarsater H, Sullivan PF, Lichtenstein P. Lower birth weight indicates higher risk of autistic traits in discordant twin pairs. Psychol Med. 2012;42:1091–1102. PubMed PMC

Smith GC, Gutovich J, Smyser C, et al. Neonatal intensive care unit stress is associated with brain development in preterm infants. Ann Neurol. 2011;70:541–549. PubMed PMC

Guzzetta A, D’Acunto MG, Carotenuto M, et al. The effects of preterm infant massage on brain electrical activity. Dev Med Child Neurol. 2011;53(Suppl 4):46–51. PubMed

Guzzetta A, Pizzardi A, Belmonti V, et al. Hand movements at 3 months predict later hemiplegia in term infants with neonatal cerebral infarction. Dev Med Child Neurol. 2010;52:767–772. PubMed

Yirmiya N, Charman T. The prodrome of autism: early behavioral and biological signs, regression, peri- and post-natal development and genetics. J Child Psychol Psychiatry. 2010;51:432–458. PubMed

Helt M, Kelley E, Kinsbourne M, et al. Can children with autism recover? If so, how? Neuropsychol Rev. 2008;18:339–366. PubMed

Hrdlicka M, Dudova I. Controversies in autism: is a broader model of social disorders needed? Child Adolesc Psychiatry Ment Health. 2013;7:9. PubMed PMC

Eeles AL, Anderson PJ, Brown N, et al. Sensory profiles of children born <30 weeks’ gestation at 2 years of age and their environmental and biological predictors. Early Hum Dev. 2013;89:727–732. PubMed

A possible role of the Infant/Toddler Sensory Profile in screening for autism: a proof-of-concept study in the specific sample of prematurely born children with birth weights <1,500 g

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