Prevalence and associated features of autism spectrum disorder in extremely low gestational age newborns at age 10 years.
Robert M Joseph, Thomas M O'Shea, Elizabeth N Allred and 5 others
PMID 27220677WHAT IT FOUND
Autism was found in 7.1% of children born at 23 to 27 weeks who were assessed at age 10, higher than the 1.5% estimate for the general U.S. population.
Frequency was higher at lower gestational ages, and many children with autism spoke fluently.
Key findings
01The assessed sample had 857 children, and 61 children met ADOS-2 criteria for ASD, resulting in a prevalence of 7.1% (95% CI=5.5-9.0), higher than the 1.5% general estimate.
02ASD frequency was 15.0% among children born at 23 to 24 weeks, 6.5% among children born at 25 to 26 weeks, and 3.4% among children born at 27 weeks.
03Among children with ASD, 40% had verbal and nonverbal IQ below 70, and 42 of the 61 children were assessed with ADOS-2 Module 3 for complex sentence speech.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Families of 309 children who survived to age 10 did not take part, and those children differed from participants in maternal education and insurance status. 26 children were excluded from ASD assessment because of severe motor impairment, severe intellectual disability, or functional blindness, so the findings do not describe children with those impairments. Six children who had screened positive did not return to complete the ASD assessment, and 13 children assessed for ASD did not have an IQ assessment. This was an observational cohort, not a treatment study, so it reports prevalence and association, not that extreme prematurity caused autism.
The easy way to misread this
Do not read the 7.1% prevalence as evidence that extreme prematurity causes autism. The study observed children born at 23 to 27 weeks and compared them with a general population estimate; it did not assign children to different gestational ages.