Premature Babies and Autism – An Early Factor for Diagnosis

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There is a growing body of research and evidence that suggest premature babies may be at increased risk of symptoms associated with Autism Spectrum Disorders .  A premature baby is a baby born before 37 weeks of pregnancy. There are more problems when a baby doesn’t make it to its full-term birthdate. These problems include:

  • Pregnancy complications, such as preeclampsia, a pregnancy-related form of high blood pressure (this was our situation)
  • Premature newborn health problems, such as brain bleeds
  • Lasting disabilities; cerebral palsy, intellectual disabilities, and vision and hearing impairments

Modern neonatal intensive care unit – the NICU

According to the World Health Organization, in both developing and industrialized countries, more than one in 10 children are born prematurely, and the numbers are growing. Sadly the end results of this trend are heart breaking disabilities and autism is one of the brain disorder disabling conditions that have been associated with an early, premature or preterm birth.

What’s the Issue???

Diagnosing autism in a child shouldn’t be a challenge. After all the fact of the matter is that autism has grown to become more and more prevalent since the 1980s. In fact experts from the Centers for Disease Control Prevention in the United States stated in a report released March 30, 2012 that 1 out of 88 children age 8 will have an Autism Spectrum Disorder (ASD). Males are four times more likely to have an ASD than females and what some research is demonstrating is that the hormone estrogen, which is in higher concentrations in females, appears to be creating a protective barrier for girls where suffering from autism brain disorders are concerned.



Why Pay Attention to the Issue?

So here is something very important to keep in mind. And I have said it before in other pages or posts of my blog…having a well-trained Developmental Pediatric Physician is critically important to ensure that a correct diagnosis is made. Because the health care providers generally diagnose ASDs by observing a child’s behavior and evaluation of their characteristics.  There are no medical tests like blood work that can substantiate this condition and the varied characteristics of an autistic presentation require astute observation.  I have read that the clinic one goes to can sometimes influence and be a determining factor.  As caretakers we have to remember that professionals are people too, so you, as the child’s very important ‘advocate’ must be able to stand up for what you know will ensure your child receives the support necessary.  Receiving a correct diagnosis, that likely will overlap with other conditions like FASD (Fetal Alcohol Spectrum Disorder) will keep the correct supports in place.


Characteristic lining up of toys or items … so autistic.

When we saw our community’s physician, I was on pins and needles. I knew that my granddaughter was continuing to present with many of the characteristics of autism. But frankly, she had been doing so well with her three therapists I was afraid that her progress was going to mask what continued to underlie all of her struggles and hard won progress.  It would take her months and months to learn what would come fairly easy for kids whose brains were functioning normally; for instance, learning colors took over 9 months.


Autism Spectrum and Developmental Delays

An assessment has the inherent potential to overlook what was really going on.  She went from not sitting up on her own at 17 months to being able to walk and talk.  My observations were that she struggled with being able to socialize, to follow instructions and expectations in a classroom, and to carry on a conversation or engage in the give and take of play. Her style of play was and continues to be repetitive and she wants to be in control, which I believe just allows her to be more comfortable as interactions don’t happen easily for her. This continues down to this day and is an underlying reason for her discouragement (already) in kindergarten…she already doesn’t like school.

The definition for autism from National Institute Neurological Disorders and Stroke (NINDS) captures the essence of this condition when stating: “Autism spectrum disorder (ASD) is a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior.  Autistic disorder, sometimes called autism or classical ASD, is the most severe form of ASD, while other conditions along the spectrum include a milder form known as Asperger syndrome, and childhood disintegrative disorder and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS).”  I found this article from the NINDS full of excellent technical information and the concerns parents and caretakers want to better understand. I recommend reading it.

brain images

Brain images of regions before and after treatment protocols are used.


The science and medical fields that are studying brain disorders like autism continue to learn so very much. One resource that I have tapped into from time to time is the University of California San Diego and San Francisco. The research being done in these two institutions is amazing as they are using brain imaging technology to better understand the abnormal characteristics of children who present with a variety of developmental and behavioral disorders.


The following is a short list of some of the doctors and research programs that are making great strides in fine tuning a diagnosis on more than behavioral observations.  This is going to further improve treatment plans that may include medications as well as the time proven therapies.

Pediatric Neuroradiology Research
Doctor A. James Barkovich and his team are studying what is seen in MRs (Magnetic Resonance) of infant patients to better understand normal brain development in comparison to abnormalities. What has become an intensified research avenue is the study of the ‘myelin sheaths’ that surround the nerve fibers of the central nervous system. This is fascinating because the sheath’s integrity determines the brain’s processing speed. In other words the messages and neuron signals are better transmitted when the sheath has developed correctly and is intact, not damaged by various diseases or environmental /chemical exposures which result in the brain’s dysfunction.

Abnormal brain development using MRI and diffusion tensor MR imaging (DTI) as the tools to investigate brain anatomy.
Neonatal brain injury where standard MRIs MR spectroscopy (MRS) and DTI are used with babies less than a month old who are not breathing correctly, have poor reflexes and tone, and seizures that help in determining better developmental support.
Prematurely born neonates may have all three imaging methods (MRI, MRS, DTI) in their assessment of what are often times very subtle brain abnormalities. Knowing what these are can help the neonatal specialists and ultimately the parents in providing the best care for the precious and often tiny premie. (My granddaughter was only a tiny 2 pounds 5 ounces., she could have fit onto the palm of my hand.)

intracranial image_ molecular

brain image at molecular level


Another really intriguing area of research involves the work of Dr. David M. Wilson, MD, PhD. He is heading a team that is looking closely at the molecule activity of the brain through the Molecular Imaging Research group.  Their research assesses how cells within the brain, using simple molecules, will communicate with each other and maintain normal functioning by the accumulation of large quantities of antioxidants like Vitamin C.

One of the goals of this research is to detect brain chemistry of normal and abnormal brains with the goal of improving treatments and determining if certain therapeutic interventions are being effective or not.  THAT is very valuable feedback!


No – You Don’t Need to Feel Overwhelmed

Does all of this seem a bit mind boggling to you?  It did on first blush for me.  The fact that premature babies are statistically at increased risk for developing autism is an important consideration when one is considering becoming pregnant.  The child one conceives deserves to have the best start in life that is possible.  Take at least six months to be free of alcohol and cigarettes, having a clean slate for your health that includes a reasonable exercise regimen and clean healthy foods.  There is also some fascinating research on the effects of low thyroid hormone in the ability to conceive so have an endocrine panel done and make sure your thyroid is functioning well.

Remember that there are more than enough chemical exposures to cause harm.  And while there is a body of research on genetic factors which could be contributing, I tend to not embrace the genetic side of this story so much because of the increase over the last two decades of autism diagnosis and the recent 2012 CDC report.   If you are like me, confronted with the perplexing conduct of your little one, be assured that the sooner you engage ‘early intervention’ services the better it will be for you and your precious “special” person.  My baby grandaughter was a mere 2 and half pounds when she was born so we have come a very long way in creating a solid foundation for life.  Your precious and dear premie son or daughter can do well too!

If you have any concerns or wish to discuss something further, please do email me:

2 Responses to “Premature Babies and Autism – An Early Factor for Diagnosis

  • Linda, I’m having a hard time finding the words to express how amazing your website is! It’s informative, well written, researched, enhanced with relevant media and an absolute storehouse of useful information. Our son has Asperger’s, and had to learn how to communicate verbally and socially. I swear, reading your content, I can tell just how hard you’re working to help struggling parents and families. Keep up the GREAT work Linda!

    • admin

      My goodness, Bryan, we never know, do we, where we might touch someone’s life in a positive way. I have friends who either deal with Asperger’s or are the parent of a young person who has this diagnosis. I am grateful to meet another parent who cared so profoundly for their son that resources were made available for him to manage in life. To have learned to communicate verbally and socially was probably one of the most time consuming things you did as a family. I hope your son has a good foundation for getting along in our world that is often too impatient and sometimes even cruel. I hate seeing special needs folks hurt.

      I really appreciate your kindness in responding and your heart in sharing some about your family. Most generous.


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