Researchers continue to search for the cause(s) of autism. Very low birthweight babies are known to have a much higher risk for a number of neurodevelopmental problems. A new study shows that kids born prematurely frequently show some of the early signs of autism when tested in the later part of their second year of life.
Researchers conducting this study gave developmental tests — including a screening test for autism — to 91 18- to 24-month-olds who'd been born prematurely (at 26 weeks' gestational age, on average) and weighed less than or equal to about 3.3 pounds at birth (these premature infants are sometimes called "extreme preemies").
Results of the studies showed a "high prevalence of early autistic features" (such as difficulties socializing and communicating) in children born extremely early. More than a quarter of the kids had positive results for the autism screening test.
The lower the birthweight and gestational age, the more likely the child had an abnormal autism screening score. The risk was higher for male ex-preemies, as well as for those who had abnormal brain MRI studies and severe illnesses while in the neonatal intensive care unit (NICU).
More on Autism
Often referred to collectively as "autism," autism spectrum disorders (or ASDs) are a group of developmental disorders that can affect the way a child behaves, thinks, communicates, and interacts with others — some kids have only mild symptoms, whereas others' are more severe.
Calling autism an "urgent public health issue," the Centers for Disease Control and Prevention (CDC) reported in early 2007 that about 1 in 150 children in the United States are diagnosed with the developmental disorder — a higher rate than health officials had previously thought.
Although it might seem like more kids have autism today, it's unclear whether the increased numbers mean that the disorder is actually on the rise. Why? For one, a broader definition of autism can be applied to more children who show varying degrees of symptoms. Plus, health professionals have become more aware of the condition, which has led to more diagnoses.
What This Means to You
Of course, if your child was born prematurely it doesn't automatically mean your little one has or will ever have autism. And the children in this study had not yet been followed long enough to find out whether the early autistic symptoms they showed on the screening test meant they would be diagnosed with autism later on. Although most children who develop autism are not ex-preemies, the results of this study emphasize the importance of keeping an eye out for early signs of the disorder, especially in children (like "extreme preemies") who may be at increased risk.
Subtle symptoms of autism are often present before a child's first birthday — sometimes even in early infancy — but often go unnoticed until the symptoms are more obvious to parents, usually when a child is between 15 and 36 months old.
But, in an effort to help detect autism as early as possible, the American Academy of Pediatrics (AAP) now urges doctors to routinely screen all children for red flags of autism at 18 and 24 months old. Although there's no cure for autism, getting help early on is crucial for helping kids cope with the condition, learn, and communicate.
Common warning signs that moms and dads — and their doctors — need to be aware of include:
- not showing big smiles or other expressions of joy by 6 months
- not sharing back-and-forth smiles, sounds, or other facial expressions by 9 months
- not babbling or using gestures (like pointing or waving bye-bye) by 12 months
- not using single words by 16 months
- not using two-word "spontaneous phrases" by 24 months (that is, not saying two-word phrases on their own without repeating or mimicking someone else)
- losing language or social skills at any age
In addition to the regular well-child visits and immunizations that all babies get, premature infants need periodic hearing and eye examinations, too. And doctors have to pay careful attention to the development of preemies' nervous systems, including their achievement of motor skills like smiling, sitting, and walking. Some also may require speech therapy or physical therapy as they grow up.
There's a wide range of normal, but looking out for developmental red flags is important for all children, whether they were born prematurely or not. Talk to your doctor if you're concerned about any aspect of your child's development.
Reviewed by: Steven Dowshen, MD
Date reviewed: April 2008
Source: "Positive Screening for Autism in Ex-preterm Infants: Prevalence and Risk Factors," Pediatrics, April 2008.