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A comparison of children born preterm and full-term on the autism spectrum in a prospective community sample

Introduction: Previous research suggests children diagnosed with autism spectrum disorder (ASD or "autism") born extremely and very preterm face substantially delayed development than their peers born full-term. Further, children born preterm are proposed to show a unique behavioral phenotype, which may overlap with characteristics of autism, making it difficult to disentangle their clinical presentation. To clarify the presentation of autism in children born preterm, this study examined differences in key indicators of child development (expressive language, receptive language, fine motor, and visual reception) and characteristics of autism (social affect and repetitive, restricted behaviors). Materials and Methods: One fifty-eight children (136 full-term, twenty-two preterm) diagnosed with autism, aged 22-34 months, were identified prospectively using the Social Attention and Communication Surveillance tools during community-based, developmental surveillance checks in the second year of life. Those identified at "high likelihood" of an autism diagnosis were administered the Mullen Scales of Early Learning and the Autism Diagnostic Observation Schedule. Results: The children born preterm and full-term did not differ significantly in their fine motor, visual reception, expressive language, or receptive language skills. No significant differences in social affect and repetitive and restrictive behavior traits were found. Discussion: The findings of this study differs from previous research where children diagnosed with autism born very or extremely preterm were developmentally delayed and had greater autistic traits than their term-born peers. These null findings may relate to the large proportion of children born moderate to late preterm in this sample. This study was unique in its use of a community-based, prospectively identified sample of children diagnosed with autism at an early age. It may be that children in these groups differ from clinic- and hospital-based samples, that potential differences emerge later in development, or that within the autism spectrum, children born preterm and full-term develop similarly. It was concluded that within the current sample, at 2 years of age, children diagnosed with autism born preterm are similar to their peers born full-term. Thus, when clinicians identify characteristics of autism in children born preterm, it is important to refer the child for a diagnostic assessment for autism.

Funding

Funding from the Telstra Foundation Community Development Fund (for the SACS), the Menzies Foundation (for the SACS and SACS-R), and the Cooperative Research Centre for Living with Autism (Autism CRC; Project 1.005RC), established and supported under the Australian Government's Cooperative Research Centres Program (for the SACS-R), to support the training of MCH nurses who participated in this study is gratefully acknowledged.

History

Publication Date

03/12/2020

Journal

Frontiers in Neurology

Volume

11

Article Number

597505

Pagination

12p. (p. 1-12)

Publisher

Frontiers Media S.A.

ISSN

1664-2295

Rights Statement

The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.