@Article{chd.12461,
AUTHOR = {Jessica L. Bean Jaworski, Thomas Flynn, Nancy Burnham, Jesse L. Chittams, Therese Sammarco, Marsha Gerdes, Judy C. Bernbaum, Robert R. Clancy, Cynthia B. Solot, Elaine H. Zackai, Donna M. McDonald-McGinn, J. William Gaynor},
TITLE = {Rates of autism and potential risk factors in children with congenital heart defects},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {12},
YEAR = {2017},
NUMBER = {4},
PAGES = {421--429},
URL = {http://www.techscience.com/schd/v12n4/39172},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Atypical development, behavioral difficulties, and academic underachievement are
common morbidities in children with a history of congenital heart defects and impact quality of
life. Language and social-cognitive deficits have been described, which are associated with autism
spectrum disorders. The current study aimed to assess the rates of autism spectrum disorders in a
large sample of children with a history of congenital heart defects and to assess medical, behavioral, and individual factors that may be associated with the risk of autism spectrum disorders.<br/>
<b>Design:</b> Participants included 195 children with a history of congenital heart defects, who are followed in a large-scale longitudinal study. Measures included behavioral data from 4-year-old
neurodevelopmental evaluations and parent-report data from a later annual follow-up.<br/>
<b>Results:</b> Using established cutoffs on an autism spectrum disorder screener, children with congenital heart defects showed higher rates of “possible” autism spectrum disorders than national rates,
(Chi-square Test of Equal Proportions), all Ps < .05. A stepwise variable selection method was used
to create a “best prediction model” and multivariable logistic regression was used to identify variables predicting diagnostic status. Factors associated with diagnostic risk included medical (delayed
sternal closure, prematurity, positive genetic findings), behavioral (cognitive, language, attention
issues), and individual (socioeconomic, cultural/racial) variables. ROC analyses identified a cutoff of
7 to maximize sensitivity/specificity based on parent-reported diagnosis.<br/>
<b>Conclusions:</b> Risk of autism spectrum disorder screening status in children with congenital heart
defects was higher than expected from population rates. Findings highlight the need for referral to a specialist to assess the presence and severity of social-communication issues and congenital heart defects
population-specific screening thresholds for children with concern for autism spectrum disorders.},
DOI = {10.1111/chd.12461}
}