Comparing autism phenotypes in children born extremely preterm and born at term. Issue 3 (3rd January 2023)

• Record Type: Journal Article
• Authors: Joseph, Robert M.; Lai, Emily R.; Bishop, Somer; Yi, Joe; Bauman, Margaret L.; Frazier, Jean A.; Santos, Hudson P.; Douglas, Laurie M.; Kuban, Karl K. C.; Fry, Rebecca C.; O'Shea, T. Michael
• Is Part Of: Autism research. Volume 16:Issue 3(2023)
• Page Start: 653
• Page End: 666
• Publication Date: 2023-01-03
• Subjects: autism diagnostic interview‐revised -- autism diagnostic observation schedule -- autism spectrum disorder -- phenotypes -- preterm birth -- sex; Autism -- Periodicals; Autism -- Research -- Periodicals; 616.85882005
• DOI: 10.1002/aur.2885
• Languages: English
• ISSNs: 1939-3792

Abstract

Abstract: Children born preterm are at increased risk for autism spectrum disorder (ASD). There is limited knowledge about whether ASD phenotypes in children born preterm differ from children born at term. The objective of this study was to compare ASD core symptoms and associated characteristics among extremely preterm (EP) and term‐born children with ASD. EP participants ( n = 59) from the Extremely Low Gestational Age Newborn Study who met diagnostic criteria for ASD at approximately 10 years of age were matched with term‐born participants from the Simons Simplex Collection on age, sex, spoken language level, and nonverbal IQ. Core ASD symptomatology was evaluated with the Autism Diagnostic Interview‐Revised (ADI‐R) and the Autism Diagnostic Observation Schedule (ADOS). Developmental milestones, anthropometrics, seizure disorder, and psychiatric symptoms were also investigated. The EP group had lower parent‐reported symptom scores on ADI‐R verbal communication, specifically stereotyped language, and restricted, repetitive behaviors. There were no between‐group differences on ADI‐R nonverbal communication and ADI‐R reciprocal social interaction or with direct observation on the ADOS‐2. The EP group was more likely to have delayed speech milestones and lower physical growth parameters. Results from female‐only analyses were similar to those from whole‐group analyses. In sum, behavioral presentation was similar between EP and IQ‐ and sex‐matched term‐born children assessed at age 10 years, with the exception of less severe retrospectively reported stereotyped behaviors, lower physical growth parameters, and increased delays in language milestones among EP‐born children with ASD. Lay Summary: Children born extremely preterm (EP) are at high risk for autism spectrum disorder (ASD), but there is lack of information on behavioral and other characteristics in this population. We examined symptom profiles and other characteristics of EP‐born compared to term‐born children and found that symptoms and associated characteristics were generally similar, with some exceptions. Increased knowledge of the characteristics of EP‐born children may advance earlier detection and remediation of ASD in this population.