Highest positive predictive value seen for children born extremely preterm and those born at term
By Elana Gotkine HealthDay Reporter
TUESDAY, Aug. 27, 2024 (HealthDay News) — For children born preterm, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) has acceptable sensitivity and specificity, according to a study published online Aug. 21 in Developmental Medicine & Child Neurology.
Taralee Hamner, Ph.D., from the Children’s Hospital of Philadelphia, and colleagues used a cross-sectional design to examine screening measure performance and diagnostic outcomes according to preterm classification. To inform clinical practice, diagnostic evaluation attendance after screening was examined. A total of 9,725 toddlers whose gestational age was reported were screened at 15-, 18-, and 24-month well-child visits.
The researchers found that screen-positive rates were highest and lowest for children born extremely preterm and born at term (51.35 and 6.95 percent, respectively). There was no difference in evaluation attendance for screen-positive cases according to preterm classification. The rates of autism diagnoses differed according to preterm birth status and were 16.05, 2.00, 2.89, and 1.49 percent for children born extremely preterm, very preterm, moderately preterm, and at term, respectively. With increasing gestational age, M-CHAT-R/F sensitivity decreased and specificity increased. The highest positive predictive value was seen for children born extremely preterm and those born at term; across all groups, negative predictive value was consistently strong. There was an increase in the likelihood ratio for positive screening with gestational age.
“With this research, we are hoping to help dissipate doubts that clinicians might have about the utility of screening for autism in toddlers born preterm,” coauthor Georgina Perez Liz, M.D., from Drexel University in Philadelphia, said in a statement.
Several authors disclosed ties to relevant organizations.
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