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A model of individualised, family focused antenatal care: Findings from the Continuity of Care (CoCo) study

Margo Pritchard, Therese de Dassel, Elaine Beller, Fiona Bogossian, Linda Johnston, Jessica Paynter, Santo Russo, James Scott Australian Catholic University, the Royal Brisbane Women’s Hospital, the Bond University, the University of Queensland, the University of Toronto, the Griffith University, the Better Life Psychology, the University of Quensland Background: Although children born very preterm are at increased risk of autism, the diagnostic stability in these children is unknown. Objective: This study aimed to determine the diagnostic stability of Autism using the Autism Diagnostic Observation ScheduleGeneric (ADOS-G) classifications in children born very-preterm from age 2 to 4 years’ corrected age (CA). Methods: Child-survivors born < 29 weeks’ gestation were enrolled at age 2 years in a hospital-based prospective longitudinal Autism study. Measures included the Modified Checklist of Autism in Toddlers-Follow-up Interview (M-CHAT-FITM), ADOS-G and developmental assessments. The ADOS-G was conducted on toddlers who screened positive on the M-CHAT-FITM. Outcomes were assessed at ages 2 and 4 years. Results: Data were available on 85% (74/87) of VPT children aged 4 years. Two children were diagnosed with ASD at age 2 years and five children at age 4 years. Of these, both children diagnosed at age 2 years as well as three new cases were assessed as having autism at age 4 years. Of the three new cases identified at age 4 years one was subthreshold at age 2 years whilst two had lower developmental scores at age 4 years. Conclusion: In this first longitudinal study of autism in very preterm children, autism identified at 2 years persisted however, incident cases emerged between 2 and 4 years. This demonstrates the need for ongoing diagnostic vigilance for autism in young children born very preterm.