Distinct Neurodevelopmental Trajectories in Groups of Very Preterm Children Screening Positively for Autism Spectrum Conditions.
Laila Hadaya, Lucy Vanes, Vyacheslav Karolis and 7 others
PMID 36273367WHAT IT FOUND
Very preterm toddlers who failed two or more critical M-CHAT items had smaller brainstem and cerebellar volumes at term-equivalent age and more autism traits at age 4-7 than those who screened negative.
The critical positive group also showed the most severe developmental delay.
Key findings
01Critical positive M-CHAT scorers had reduced regional brain volume in the bilateral deep cerebellar nuclei, middle cerebellar peduncles and brainstem compared to negative scorers.
02Both critical and non-critical positive groups had higher social communication and repetitive behaviour scores at age 4-7 than the negative group, with no significant difference between the two positive groups.
03The critical positive group showed the greatest developmental delay at age 2, and this delay partially mediated later social communication deficits and exacerbated repetitive behaviours.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study did not systematically evaluate for autism diagnoses at the 4-7 year follow-up, relying only on symptom scores. The sample size was too small to perform formal predictive validity analyses for the M-CHAT in this population. Children with major brain lesions were excluded, so results do not apply to the most severely impaired preterm infants. The three screening groups may represent a continuum rather than distinct categories, as the non-critical positive group had intermediate outcomes.
Declared interests
Funded by the Medical Research Council, UK, National Institute for Health Research, and Action Medical Research and Dangoor Education. No conflicts of interest declared by authors.
The easy way to misread this
Do not assume that a non-critical positive M-CHAT screen is less serious than a critical positive one. While the critical positive group had more brain volume reductions and developmental delay, both positive groups showed similar levels of autism traits at age 4-7. A positive screen of any kind in a very preterm child warrants follow-up for social communication difficulties.