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Year : 2013  |  Volume : 29  |  Issue : 1  |  Page : 38-45

Screening for autism in low-birth-weight Egyptian toddlers

1 Unit of Phoniatrics, Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Unit of Phoniatrics, Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Egypt
3 Unit of Pediatrics, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Egypt

Correspondence Address:
Fatma-Alzahraa A. Kaddah
MD, Doctor Soliman Fakeeh Hospital, P.O. Box 2537, 21461 Jeddah, Saudi Arabia

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Source of Support: None, Conflict of Interest: None

DOI: 10.7123/01.EJO.0000423017.91800.92

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In recent times major advances have been made in the field of early detection of autism in infants, and validated screening tools now exist to facilitate the early and accurate screening of infants before further referral for specialized autism diagnostic testing.


The aim of this study was to screen low-birth-weight (LBW) toddlers for early autistic features compared with normal controls and identify the associated risk factors.

Materials and methods

This cross-sectional study included 100 toddlers (24–30 months old) with a history of LBW. They were screened for autism using the Modified Checklist for Autism in Toddlers (M-CHAT). Further assessment was made using the Childhood Autism Rating Scale (CARS), Vineland Social Maturity Scale, and Arabic Language Test. One hundred age-matched and sex-matched full-term toddlers with a history of average birth weight and uneventful natal, perinatal, and postnatal history were included as the control group.


The toddlers with LBW had a significantly higher frequency of positive M-CHAT screening than did the controls (11% of LBW children vs. 2% of controls). Positively screened LBW toddlers had significantly higher parental age at conception, lower birth weight, higher frequency of small-for-gestational-age preterms as well as higher incidence of gestational bleeding when compared with negatively screened LBW. They also had lower language and social ages than the negatively screened LBW. M-CHAT scores of positively screened LBW children correlated positively with maternal age at conception and negatively with birth weight, social age, and language age. Five of the 11 positively screened LBW children and one of the two positively screened controls were confirmed to have autism on the basis of CARS.


LBW is probably an independent risk factor associated with the development of autism. Early screening for autism is recommended for the LBW population especially if associated with risk factor(s) or if showing early impairment of social and language abilities, to be followed by definitive autism testing in those with positive screening results.

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