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Social Cognitive Atypicalities Associated with Preterm Birth: A Challenge to the Early Diagnosis of Autism
Objectives: We tested the hypothesis that the early social cognitive phenotype associated with preterm birth differs from that of term controls. Our goal is to consider whether instead of being autism-specific, some early social cognitive atypicalities are generic markers of delayed development or associated with intellectual disability rather than autism.
Methods: We have recruited a large sample (n=92) of infants born preterm (less than 32 weeks gestational age, and weighing less than 1500g at birth). Of these, 38 have been assessed at approximately 9 months corrected age along with 37 typically-developing infants matched on age and gender.
Tasks were eye-tracker based assessments of social cognition previously used in comparative studies of populations with and without autism. The tasks increased in the complexity of the stimulus presented, but were all free-viewing tasks. Stimuli in order of complexity were: neutral, static faces; faces presented alongside other objects in a grid-like array; people depicted in naturalistic photographs alongside another photograph without people.
Results: We calculated looking time scores to social and non-social areas of interest. The preterm group fixated the eyes of a neutral face significantly less than the control group (mean difference = 0.62s, p=.036). They also looked less at a face in a grid-like array (mean difference = 0.45s, p=.05) and looked less at naturalistic photos with social content (mean difference = 0.34s, p=.048). There were no differences in latency to fixate social areas of interest. In addition, preterm children showed a normal sized attentional disengagement effect in the gap-overlap task, indicating that generalised attention deficits were not contributing to differences in social attention. Final results will be presented from a predicted sample of approximately n=60 in each group.
Conclusions: In each task preterm infants showed atypical fixation on social content, a pattern previously thought to be specific to children who later receive an autism diagnosis, but perhaps instead associated with general cognitive delay. Final results will be considered in light of their impact on our understanding of early autism and specifically consequences for attempts to create early diagnostic assessments.