Developmental Trajectories of Autistic Social Traits in Youth Born Extremely Preterm.
The study found that autistic social traits increased significantly in youth born extremely preterm from ages 10 to 17, with most showing a worsening of social performance that correlated with lower self-esteem and health issues.
Where it sits
this study against the rest of the setmelanotide corpusSummary and findings
This study measured changes in autistic social traits (ASTs) in 527 youth born extremely preterm (EP) from ages 10 to 17 years. The average AST increase was 19 raw points, reflecting a shift from the 'normal' to 'mild concern' range. The majority of participants exhibited an increasing trajectory of ASTs, which correlated with poorer health and self-esteem outcomes.
Abstract
<h4>Objective</h4>Autistic social traits (ASTs), evident in the general population, are associated with mental health challenges. ASTs have not been evaluated in youth born extremely preterm (EP), despite their increased prevalence of autism. The current research evaluates AST change from 10 to 17 years in a well-characterized sample of EP youth, including sex differences and associations with health and quality of life.<h4>Method</h4>Participants included 527 EP youth (n = 275 female, 67.8% White), assessed at 10 and 17 years, from the Extremely Low Gestational Age Newborn (ELGAN) Study. Adolescents were born at an average of 26 weeks gestation. ASTs were parent-reported via the Social Responsiveness Scale at 10 and 17 years. Adolescents self-reported quality of life, health, and psychopathology at 17 years. AST change scores were calculated to evaluate change over time. AST change scores and increasing, decreasing, and stable trajectories were analyzed in relation to sex and quality-of-life scores.<h4>Results</h4>ASTs in EP youth increased an average of 19 raw points from age 10 to 17 years, reflecting a change of 8 standardized points and a change in qualitative description from the "normal" to "mild concern" range. The majority of youth (70%) exhibited an "Increasing" trajectory, reflecting increasing AST as a preterm phenotype. No sex differences emerged in AST change score or trajectory group. Higher AST change scores were associated with worse adolescent-reported health, self-esteem, and externalizing psychopathology.<h4>Conclusion</h4>Increasing ASTs were consistent in this sample of EP youth. Increases in ASTs were not associated with child's sex or demographics, suggesting a unique preterm phenotype of social trajectories. These findings have implications for quality of life as adolescents enter young adulthood.<h4>Plain language summary</h4>Extremely preterm (EP) infants, born before 27 weeks' gestation, are considered a high-risk group for receiving an autism diagnosis, though no prior research has assessed autistic social traits (ASTs). The current study examined the changes in ASTs of 527 participants from ages 10 to 17 years as part of the Extremely Low Gestational Age Newborn (ELGAN) Study. Results showed a significant increase in ASTs in both males and females for the majority of participants (n = 368), suggesting a worsening of social performance, which was significantly associated with many child-reported quality of life measures at age 17, including lower self-esteem and more externalizing problems. These results underscore the social vulnerability of EP youth through adolescence.
Background
This paper addresses the developmental trajectories of autistic social traits (ASTs) in youth born extremely preterm (EP), a population known to have a higher prevalence of autism. Prior research has not focused on ASTs in this demographic, making this study significant for understanding their social development. The study aims to evaluate how ASTs change from ages 10 to 17, considering factors such as sex differences and associations with health and quality of life.
Methods
The study utilized a longitudinal design involving 527 EP youth (n = 275 female, 67.8% White) from the Extremely Low Gestational Age Newborn (ELGAN) Study. Participants were assessed at ages 10 and 17 years, with ASTs measured via the Social Responsiveness Scale. The average gestational age at birth was 26 weeks. The primary outcome was AST change scores, while secondary outcomes included self-reported health and quality of life measures.
Results
The primary finding indicated that ASTs in EP youth increased an average of 19 raw points from age 10 to 17 years, which corresponds to a change of 8 standardized points. This change reflects a qualitative shift from the 'normal' to 'mild concern' range. The majority of participants (70%) showed an 'Increasing' trajectory in ASTs, and higher AST change scores correlated with worse health and self-esteem outcomes.
Interpretation
The observed increase in ASTs aligns with existing literature that suggests social vulnerabilities in EP youth. While the statistical significance of the findings is clear, the clinical significance may be limited, as the change represents a shift in qualitative description rather than a dramatic clinical outcome. Confounding factors include reliance on parent-reported measures and a lack of diversity in the sample, which may restrict the applicability of the results to broader populations.
Key findings
- ASTs in EP youth increased an average of 19 raw points from age 10 to 17 years.
- Change of 8 standardized points in ASTs from age 10 to 17 years.
- 70% of youth exhibited an 'Increasing' trajectory of ASTs.
- Higher AST change scores were associated with worse adolescent-reported health, self-esteem, and externalizing psychopathology.
Limitations
- Reliance on parent-reported measures for ASTs.
- Sample limited to a specific demographic (67.8% White).
- No assessment of the long-term implications beyond age 17.
- Potential biases in self-reported health and quality of life measures.