Comparing autism phenotypes in children born extremely preterm and born at term.

Researchers compared children with autism who were born extremely early (before 28 weeks) to those born at full term. They found that children born very early had very similar autism symptoms overall. The main differences were that extremely preterm children had slightly less repetitive speech patterns, were more likely to have delayed speech development, and were smaller in size. This suggests that being born very early doesn't dramatically change how autism appears in children.

This comparative study examined autism phenotypes in 59 extremely preterm (EP) children with ASD matched to term-born children on age, sex, language level, and nonverbal IQ. Using standardized diagnostic tools (ADI-R, ADOS), researchers found largely similar behavioral presentations between groups. EP children showed less severe parent-reported stereotyped language and repetitive behaviors on the ADI-R, but no differences in nonverbal communication, social interaction, or direct observation measures. EP children were more likely to have delayed speech milestones and lower physical growth parameters.

Female-only analyses yielded similar results, suggesting preterm birth may influence specific aspects of autism presentation while core social communication features remain comparable.

Clinicians should expect similar core autism presentations in extremely preterm children, but monitor more closely for speech delays and growth concerns. Diagnostic approaches can remain consistent across birth gestational ages, though additional developmental considerations may be warranted for preterm-born children.

Study relies partly on retrospective parent reports which may be subject to recall bias. Sample limited to extremely preterm children, so findings may not generalize to moderate or late preterm births. Cross-sectional design prevents understanding of developmental trajectories over time.

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.