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Autism spectrum disorders in extremely preterm children

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Johnson, Samantha J., Hollis, Chris, Kochhar, Puja, Hennessy, Enid M., Wolke, Dieter and Marlow, Neil (2010) Autism spectrum disorders in extremely preterm children. Journal of Pediatrics, Vol.156 (No.4). pp. 525-531. ISSN 0022-3476

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Official URL: http://dx.doi.org/10.1016/j.jpeds.2009.10.041

Abstract

Objectives

To investigate the prevalence, correlates, and antecedents of autism spectrum disorders (ASD) in extremely preterm children.
Study design

We conducted a prospective study of all births <26 weeks gestation in the United Kingdom and Ireland in 1995. Of 307 survivors at 11 years, 219 (71%) were assessed and compared with 153 term-born classmates. Parents completed the Social Communication Questionnaire (SCQ) to assess autism spectrum symptoms, and ASD were diagnosed by using a psychiatric evaluation. An IQ test and clinical evaluation were also administered. Longitudinal outcome data were available for extremely preterm children.
Results

Extremely preterm children had significantly higher SCQ scores than classmates (mean difference, 4.6 points; 95% CI, 3.4-5.8). Sixteen extremely preterm children (8%) were assigned an ASD diagnosis, compared with none of the classmates. By hospital discharge, male sex, lower gestation, vaginal breech delivery, abnormal cerebral ultrasound scanning results, and not having had breast milk were independently associated with autism spectrum symptoms. By 6 years, independent associates were cognitive impairment, inattention and peer problems, withdrawn behavior at 2.5 years, and not having had breast milk.
Conclusions

Extremely preterm children are at increased risk for autism spectrum symptoms and ASD in middle childhood. These symptoms and disorders were associated with neurocognitive outcomes, suggesting that ASD may result from abnormal brain development in this population.

Item Type:

Submitted Journal Article

Subjects:

R Medicine > RJ Pediatrics

Divisions:

Faculty of Science > Psychology
Faculty of Medicine > Warwick Medical School

Library of Congress Subject Headings (LCSH):

Autism spectrum disorders -- Great Britain -- Research, Premature infants -- Development, Developmental psychobiology -- Research, Developmental psychology

Journal or Publication Title:

Journal of Pediatrics

Publisher:

Elsevier

ISSN:

0022-3476

Official Date:

2010

Dates:

Date	Event
2010	["eprint_fieldopt_dates_date_type_available" not defined]

Volume:

Vol.156

Number:

No.4

Page Range:

pp. 525-531

Identification Number:

10.1016/j.jpeds.2009.10.041

Status:

Peer Reviewed

Access rights to Published version:

Open Access

References:

1. Fombonne E. Epidemiology of Pervasive Developmental Disorders. Pediatric Research 2009;65(6):591-598.
2. Williams JG, Brayne CEG, Higgins JPT. Systematic review of prevalence studies of autism spectrum disorders. . Archives of Disease in Childhood 2006;91:8-15.
3. Marlow N, Wolke D, Bracewell MA, Samara M. Neurologic and developmental disability at six years of age after extremely preterm birth. New England Journal Of Medicine 2005;352(1):9-19.
4. Samara M, Marlow N, Wolke D. Pervasive behavior problems at 6 years of age in a total-population sample of children born at <25 weeks of gestation. Pediatrics 2008;122:562-573.
5. Anderson P, Doyle L. Executive functioning in school-aged children who were born very preterm or with extremely low birth weight in the 1990s. Pediatrics 2004;114(1):50-57.
6. Limperoloulos C, Bassan H, Sullivan NR, Soul JS, Robertson RL, Moore M, et al. Positive screening for autism in ex-preterm infants: Prevalence and risk factors. Pediatrics 2008;121:758-765.
7. Kuban KCK, O'Shea TM, Allred EN, Tager-Flusberg H, Goldstein DJ, Leviton A. Positive Screening on the Modified Checklist for Autism in Toddlers (M-CHAT) in Extremely Low Gestational Age Newborns The Journal of Pediatrics 2009;154(4):535-540.
8. Johnson S, Marlow N. Positive Screening Results on the Modified Checklist for Autism in Toddlers: Implications for Very Preterm Populations The Journal of Pediatrics 2009;154:478-480.
9. Hack M, Taylor HG, Schlichter M, Andreias L, Drotar D, Klein N. Behavioral outcomes of extremely low birth weight children at age 8 years. Journal of Developmental and Behavioral Pediatrics 2009;30(2):122-130.
10. Indredavik MS, Vik T, Heyerdahl S, Kulseng S, Fayers P, Brubakk AM. Psychiatric symptoms and disorders in adolescents with low birth weight. Archives of Disease in Childhood Fetal and Neonatal Edition 2004;89:F445-F450.
11. 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. Archives of Disease in Childhood Fetal Neonatal Edition 2002;87:F128-F132.
12. Happe F, Ronald A, Plomin R. Time to give up on a single explanation for autism. Nature Neuroscience 2006;9(10):1218-1220.
13. Rutter M, Bailey A, Lord C. The Social Communication Questionnaire. Los Angeles, CA: Western Psychological Services; 2003.
14. Goodman R, Ford T, Richards H, Gatward R, Meltzer H. The Development and Well-Being Assessment: Description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology, Psychiatry and Allied Disciplines 2000;41(5):645-655.
15. Fombonne E, Simmons H, Ford T, Meltzer H, Goodman R. Prevalence of pervasive developmental disorders in the British nationwide survery of child mental health. Journal of the American Academy of Child and Adolescent Psychiatry 2001;40(7):820-827.
16. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. 4th ed. Washington DC: American Psychiatric Association; 2000.
17. Kaufman AS, Kaufman NL. Kaufman Assessment Battery for Children. Circle Pines, MN: American Guidance Service, Inc; 1983.
18. Wolke D, Ratschinski G, Ohrt B, Riegel K. The cognitive outcome of very preterm infants may be poorer than often reported: an empirical investigation of how methodological issues make a big difference. European Journal of Pediatrics 1994;153:906-915.
19. Bayley N. Bayley Scales of Infant Development, 2nd Edition: Psychological Corporation; 1993.
20. Johnson S, Hennessy E, Smith R, Trikic R, Wolke D, Marlow N. Academic attainment and special educational needs in extremely preterm children at 11 years. The EPICure Study. Archives of Disease in Childhood Fetal and Neonatal Edition 2009;94:F283-F289.
21. Johnson S, Fawke J, Hennessy E, Rowell V, Thomas S, Wolke D, et al. Neurodevelopmental disability through 11 years in children born before 26 weeks of gestation: The EPICure Study. Pediatrics In press.
22. Achenbach TM. The Manual for the Child Behaviour Checklist/4-18 and 1991 Profile. Burlington, VT: University of Vermont, Department of Psychiatry; 1991.
23. Goodman R. Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry 2001;40(11):1337-1345.
24. Green H, McGinnity A, Meltzer H, Ford T, Goodman R. Mental health of children and young people in Great Britain; 2005.
25. Johnson S. Cognitive and behavioural outcomes following very preterm birth. Seminars In Fetal & Neonatal Medicine 2007;12(5):363-373.
26. Moster D, Terje R, Markestad T. Long-term medical and social consequences of preterm birth. New England Journal of Medicine 2008;359:262-273.
27. Chandler S, Charman T, Baird G, Simonoff E, Loucas T, Meldrum D, et al. Validation of the Social Communication Questionnaire in a population cohort of children with autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry 2007;46(10):1324-1332.
28. Wood N, Costeloe K, Gibson A, Hennessy E, Marlow N, Wilkinson A. The EPICure Study: associations and antecedents of neurological and developmental disability at 30 months of age following extremely preterm birth. Archives of Disease in Childhood Fetal Neonatal Edition 2005;90:F134-F140.
29. Gardener H, Spiegelman D, Buka SL. Prenatal risk factors for autism: comprehensive meta-analysis. The British Journal of Psychiatry 2009;195:7-14.
30. Rutter M, Bailey A, Bolton P, Le Couter A. Autism and known medical conditions: Myth and substance. Journal of Child Psychology and Psychiatry 1994;35:311-322.
31. Indredavik MS, vik T, Heyerdahl S, Kulseng S, Brubakk AM. Psychiatric symptoms in low birth weight adolescents, assessed by screening questionnaires. European Journal of Child and Adolescent Psychiatry 2005;14:226-236.
32. Rutter M, Anderson-Wood L, Beckett C, Bredenkamp D, Castle J, Groothues C, et al. Quasi-autistic patterns following severe earlly global privation. Journal of Child Psychology and Psychiatry 1998;40(4):537-549.
33. Berument SK, Rutter M, Lord C, Pickles A, Bailey A. Autism screening questionnaire: Diagnostic validity. British Journal of Psychiatry 1999;175:444-451.