Diagnosing Autism Spectrum Disorder in Toddlers Born Very Preterm: Estimated Prevalence and Usefulness of Screeners and the Autism Diagnostic Observation Schedule (ADOS)

Abstract

This study estimated ASD prevalence in a cohort of 3-year-old very preterm children (N=55) and investigated the usefulness of parent-reported ASD screeners and the ADOS-2. 12.7% received an ASD diagnosis by clinical judgment based on DSM-5 criteria. An additional 14.5% were classified as having a broader-autism-phenotype outcome. Sensitivity values for the screeners were poor, whereas specificity values ranged from poor to excellent. The ADOS-2 identified all children with ASD and had a fair specificity. These findings confirm the elevated ASD prevalence made by previous studies with preterm children but also highlight the challenges of successfully identifying ASD in this at-risk group. Caution is warranted when interpreting results of ASD instruments with the currently available cut-off scores and algorithms, especially when developmental challenges are present.

Predictors of autism spectrum disorder diagnosis in a spanish sample of preterm children with very low birthweight: A cross‐sectional study

“…The main aim of this research was to study the preliminary results of ASD prevalence in preterm and VLBW children from the northwest of Spain. The estimated ASD prevalence for this sample was 7.02% (95% CI = 2.27%–17.83%), which, although the CI is quite large, is similar to the data shown in Agrawal et al 15 Other European studies reported a higher prevalence of 12.7% in a sample of very preterm children ( N = 55) at the age of 3 years old 23 ; or 11.9% in a cohort of extremely preterm children ( N = 84) at 6.5 years old 24 . Likewise, another study with preterm children showed a higher prevalence of 15.3% in a VLBW sample ( N = 59) with an average age of diagnosis of approximately 4 years old 25 …”

“…The sample was stratified based on the GA subcategories recommended by the World Health Organization (WHO). 21 GP at birth were calculated with the GP calculator from the WHO 22…”

The prevalence and profile of autism in individuals born preterm: a systematic review and meta-analysis

“…The results of this meta-analysis are of significant clinical importance. Following the publication of the WHO recommendations for improving outcomes of those born preterm, neurodevelopmental outcomes of preterm infants are considered to be of particular importance [ 69 ]. Services offered to preterm individuals are lacking, with further support deemed necessary in areas such as infant neurodevelopment as well as more specific domains such as feeding and sleeping.…”

Well-being does not predict change in parenting behaviours among mothers of young children at elevated likelihood of autism

“…TIARA is a collaboration between KU Leuven, Ghent University, and societal partners, that is conducted in Flanders, Belgium (www.tiara-onderzoek.be). Children participating in TIARA belong to one of two groups, each with an elevated likelihood of developing autism, namely (a) infant siblings of children with an established autism diagnosis (Messinger et al, 2015;Ozonoff et al, 2011), (b) infants born prematurely, at a gestational age of less than 30 weeks (Agrawal et al, 2018;Laverty et al, 2021, Vermeirsch et al, 2021. Siblings were recruited through centres for developmental disorders, rehabilitation centres, well-baby clinics, home guidance centres, centres for child and adolescent psychiatry, and paediatricians in Flanders, Belgium.…”

“…Given the heritability of autism, siblings have a 7-19.5% chance of developing autism themselves (Messinger et al, 2015;Szatmari et al, 2016), compared to a 0.62-1.7% chance in the general population (Elsabbagh et al, 2012;Maenner et al, 2021). More recently, a second group of prematurely born infants (i.e., infants born at a gestational age of less than 32 weeks; 'pre-terms'), has been identified as being at EL of autism, having a chance of 7-13% to develop autism (Agrawal et al, 2018;Laverty et al, 2021;Vermeirsch et al, 2021). Their EL is thought to be the result of interactions between a biological vulnerability and exposure to environmental stressors that would initiate a foetal immune response, leading to both pre-term birth and altered neurodevelopment (Erdei & Dammann, 2014;Limperopoulos, 2009).…”