Comparing autism phenotypes in children born extremely preterm and born at term.
Extremely preterm young learners with autism show the same social-communication symptoms as term-born peers but milder parent-reported repetitive behaviors and lower language scores.
01Research in Context
What this study did
The team looked at young learners with autism. Some were born extremely early—before 28 weeks. Others were born on time.
Parents filled out the ADI-R. Kids took IQ and language tests. The goal: see if the two groups act differently.
What they found
Both groups scored the same on social and communication items. The preterm kids had lower language scores.
Parents also recalled fewer stereotyped phrases or repeated actions in the preterm group.
How this fits with other research
Eklöf et al. (2019) saw brain asymmetry in the same preterm babies years earlier. M et al. now show those infants grow into a milder repetitive-behavior profile.
Brayette et al. (2019) found lower IQ in early-term and moderate-late preterm kids with ASD. M et al. add that extremely preterm kids have extra language delay but equal social symptoms.
Tang et al. (2025) showed that even preterm kids without autism have anxiety and social slips. Together the papers hint that preterm birth nudges kids toward language and social issues, but full autism diagnosis still brings the classic social struggles.
Why it matters
When you assess a child with ASD who was born extremely preterm, expect speech to lag but do not assume more repetitive behaviors. Tailor goals to language growth and keep social targets the same as for term-born peers.
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02At a glance
03Original 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.
Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1016/0378-3782(87)90099-5