title: Comparison of three screening tests for autism in preterm children with birth weights less than 1,500 grams.
abstract: BACKGROUND
  Preterm children seem to be at increased risk for autism spectrum disorders (ASD).
  
  
  METHODS
  Parents of 157 children with birth weights less than 1,500 g (age 2 years, corrected for prematurity; 88 boys, 69 girls) completed screening questionnaires. The screening battery included the Modified Checklist for Autism in Toddlers (M-CHAT), Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC), and the Infant/Toddler Sensory Profile (ITSP). Children with disabilities were excluded. All children who screened positive on any of the screening tools were subsequently assessed by clinical examination including the Autism Diagnostic Observation Schedule.
  
  
  RESULTS
  Fifty-six children (35.7%) screened positive on at least one of the parental screening questionnaires. Of the 56 children who tested positive, 33 participated in the detailed clinical follow-up assessment. A diagnosis of ASD was confirmed in 13 of the 33 children. The ASD prevalence was 9.7% of the sample. Analysis of children with and without an ASD diagnosis found significant differences relative to gestational age (26.9 weeks vs 28.3 weeks, P=0.033) and length of the stay in hospital (89.5 days vs 75.4 days, P=0.042). The screening tool with the most positive results was CSBS-DP-ITC (42 positive screens [PS]), followed by M-CHAT (28 PS), and ITSP (22 PS). Differences in the frequency of PS among the tests were significant (P=0.008). CSBS-DP-ITC had the highest sensitivity (0.846), followed by M-CHAT (0.692) and ITSP (0.462).
  
  
  CONCLUSIONS
  Our results indicate a higher prevalence of autism in children with birth weights <1,500 g at 2 years of age compared to the general population prevalence. The ASD diagnosis was associated with shorter gestation times and longer hospital stays. Our findings support the simultaneous use of more than one screening tests in order to increase screening sensitivity.
authors.affiliation: Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic.
authors.forename: Iva
authors.initials: I
authors.lastname: Dudova
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Charles University First Faculty of Medicine and General University Hospital, Prague, Czech Republic.
authors.forename: Daniela
authors.initials: D
authors.lastname: Markova
authors.affiliation: Department of Pediatrics, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic.
authors.forename: Martina
authors.initials: M
authors.lastname: Kasparova
authors.affiliation: Department of Pediatrics, Charles University Faculty of Medicine and University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Zemankova
authors.affiliation: Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic.
authors.forename: Stepanka
authors.initials: S
authors.lastname: Beranova
authors.affiliation: Institute of Psychology, Academy of Sciences, Brno, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Urbanek
authors.affiliation: Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Hrdlicka
keywords: Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist; Infant/Toddler Sensory Profile; Modified Checklist for Autism in Toddlers; autism spectrum disorders; preterm children; screening