Positive Screening on the Modified Checklist for Autism in Toddlers (M-CHAT) in Extremely Low Gestational Age Newborns
Received 1 July 2008; received in revised form 22 August 2008; accepted 7 October 2008. published online 30 January 2009.
Refers to article:
Positive Screening Results on the Modified Checklist for Autism in Toddlers: Implications for Very Preterm Populations
, 30 January 2009
Samantha Johnson, Neil Marlow
The Journal of Pediatrics
April 2009 (Vol. 154, Issue 4, Pages 478-480) Full Text |
Full-Text PDF (135 KB)
Objective
To test the hypothesis that children born preterm are more likely to screen positive on the M-CHAT for an autism spectrum disorder.
Study design
We compared the M-CHAT positive rate of those with cerebral palsy, cognitive impairment, and vision and hearing impairments to those without such deficits.
Results
Relative to children who could walk, the odds for screening positive on the M-CHAT were increased 23-fold for those unable to sit or stand independently and more than 7-fold for those requiring assistance to walk. Compared with children without a diagnosis of cerebral palsy, those with quadriparesis were 13 times more likely to screen positive, and those with hemiparesis were 4 times more likely to screen positive. Children with major vision or hearing impairments were 8 times more likely to screen positive than those without such impairments. Relative to those with a Mental Development Index (MDI) of >70, the odds for screening positive were increased 13-fold for those with an MDI of <55 and more than 4-fold for those with an MDI of 55 to 69.
Conclusions
Major motor, cognitive, visual, and hearing impairments appear to account for more than half of the positive M-CHAT screens in extremely low gestational age newborns. Even after those with such impairments were eliminated, 10% of children—nearly double the expected rate—screened positive.
aDivision of Pediatric Neurology, Department of Pediatrics, Boston Medical Center, Boston University, Boston, MA
bDepartment of Pediatrics, Wake Forest University, Winston-Salem, NC
cNeuroepidemiology Unit, Department of Neurology, Children's Hospital Boston, Harvard University, Boston, MA
dDepartment of Biostatistics, Harvard School of Public Health, Harvard University, Boston, MA
eDepartment of Anatomy and Neurobiology & Pediatrics, Boston University School of Medicine, Boston, MA
Reprint requests: Karl Kuban, MD, SMEpi, One Boston Medical Center Place, Dowling 3 South, Boston, MA 02118
All of the authors are members of the ELGAN Study Group.
Supported by the National Institute of Neurological Disorders and Stroke (cooperative agreement 1 U01 NS 40069-01A2). The authors declare no conflicts of interest.
ABSTRACT