Developmental Trajectories of Autistic Social Traits in Youth Born Extremely Preterm
Developmental Trajectories of Autistic Social Traits in Youth Born Extremely Preterm

Developmental Trajectories of Autistic Social Traits in Youth Born Extremely Preterm

J Am Acad Child Adolesc Psychiatry. 2025 Dec 2:S0890-8567(25)02203-8. doi: 10.1016/j.jaac.2025.11.016. Online ahead of print.

ABSTRACT

OBJECTIVE: 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 10-17 years in a well-characterized sample of EP youth, including sex differences and associations with health and quality of life.

METHOD: Participants included 527 EP youth (n=275 females, 67.8% White), assessed at 10- and 17-years, from the 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.

RESULTS: ASTs in EP youth increased an average of 19 raw points from ages 10-17 years, reflecting a change of eight standardized points and a change in qualitative description from the “normal” to “mild concern” range. Most 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.

CONCLUSION: 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.

PMID:41344423 | DOI:10.1016/j.jaac.2025.11.016