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Autism risk in preemies

Babies born prematurely are at an increased risk for autism spectrum disorders, so researchers at Washington University School of Medicine and St. Louis Children’s Hospital have been trying to determine whether it’s possible to identify which babies may go on to develop those problems. They assessed babies in the Neonatal Intensive Care Unit, looking for early signs that a child born prematurely might be at risk, but they found that the warning signs they would have expected — such as an avoidance of eye contact — didn’t actually predict autism spectrum disorders but instead were more prominent in babies who did not develop an autism spectrum disorder.

RATES OF AUTISM ARE INCREASING AND DIAGNOSIS IS OCCURING EARLIER THAN IN PREVIOUS YEARS, BUT HOW EARLY CAN THE SIGNS OF AUTISM BE DETECTED? BABIES WHO ARE BORN PREMATURELY ARE AT AN INCREASED RISK FOR AUTISM SPECTRUM DISORDERS. AND LOOKING FOR WARNING SIGNS IN PREMATURE BABIES , RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE AND ST. LOUIS CHILDREN’S HOSPITAL HAVE FOUND THAT IF THERE ARE ANY EARLY SIGNS IN THE NEONATAL PERIOD INDICATING A CHILD BORN PREMATURELY IS AT RISK FOR AN AUTISM SPECTRUM DISORDER, THEY AREN’T THE ONES MOST PEOPLE EXPECTED. JIM DRYDEN HAS MORE…

EARLY DETECTION OF PROBLEMS IS ONE OF THE KEYS TO ACTIVATING EARLY THERAPY TO ENABLE THE BEST POSSIBLE OUTCOMES, AND RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE AND ST. LOUIS CHILDREN’S HOSPITAL HAVE DONE NUMEROUS STUDIES IN RECENT YEARS LOOKING FOR WAYS TO IDENTIFY EARLY DEVELOPMENTAL PROBLEMS IN PREMATURE INFANTS. IN THIS STUDY, RESEARCHER BOBBI PINEDA AND HER COLLEAGUES EVALUATED INFANTS WHO WERE BORN EARLY TO SEE IF THEY COULD IDENTIFY EARLY WARNING SIGNS FOR AUTISM SPECTRUM DISORDER.

(act) :21 o/c disorder characteristic

Knowing that children that have autism characteristics later on

have social problems, we chose to specifically look at the

relationships between social interaction and later autism

spectrum disorder characteristic.

ONE CHARACTERISTIC RELATED TO SOCIAL INTERACTIONS IS AVERTING ONE’S GAZE. OLDER CHILDREN WITH AUTISM SPECTRUM DISORDER MAY AVOID MAKING EYE CONTACT, AND AS PART OF AN EVALUATION OF PREMATURE BABIES — AT AROUND THE TIME OF THEIR ACTUAL DUE DATE — THE RESEARCHERS FOCUSED ON WHETHER BABIES WHO LATER SCREENED POSITIVE FOR AUTISM TENDED TO AVERT THEIR GAZE, RATHER THAN MAKE EYE CONTACT. AT AGE 2, THE SAME BABIES EVALUATED AT BIRTH UNDERWENT AUTISM SCREENING USING THE MODIFIED CHECKLIST FOR AUTISM IN TODDLERS, A SCREENING TOOL THAT INDICATES THE NEED FOR DIAGNOSTIC TESTING.

(act) :14 o/c their gaze

So we specifically looked at how much the child averted

their gaze when prompted to interact socially. And instead,

we found the opposite, that they were actually more likely

to remain fixated and not avert their gaze.

THE RESEARCHERS ALSO FOCUSED ON A TYPE OF EYE MOVEMENT IN THE BABIES CALLED NYSTAGMUS. THAT’S WHEN THE EYES MOVE REPETITIVELY FROM SIDE-TO-SIDE.

(act) :11 o/c later on

Typically, we consider that to be a sign of immaturity or

a problem, but in fact, we found that babies that demonstrated

that actually had a better developmental outcome later on.

IN FACT, PINEDA SAYS THAT BOTH GAZE AVERSION AND HORIZONTAL MOVEMENT OF THE EYES WERE RELATED TO BETTER OUTCOMES IN THE BABIES THAT HER TEAM STUDIED.

(act) :15 o/c in life

It’s definitely opposite to what we had expected. And I think

if we’re really going to try and better understand autism, and

how it changes function throughout the lifespan, that we really

need to understand how it presents itself early in life.

PINEDA SAYS HER TEAM PLANS TO CONTINUE LOOKING AT OTHER BEHAVIORS IN NEWBORNS TO SEE WHETHER THERE MAY BE SOMETHING ELSE THAT WILL POINT TO PROBLEMS LATER IN CHILDHOOD. EARLY IDENTIFICATION CAN LEAD TO EARLY THERAPY, SUCH AS OCCUPATIONAL THERAPY, TO IMPROVE ADAPTIVE SKILLS AND OUTCOMES.

(act) :21 o/c protecting yourself

It’s possible that in babies that gaze aversion — and specifically

preterm infants — it may be a normal phenomenon because preterm

infants, specifically in the NICU, are exposed to a lot of stressors

within their environment. When a stimulus is too intense, or poorly

timed, averting your gaze is a way of sort of protecting yourself.

PINEDA AND HER COLLEAGUES REPORT THEIR FINDINGS IN THE AMERICAN JOURNAL OF OCCUPATIONAL THERAPY. I’M JIM DRYDEN…

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