Social Responsiveness Scale Assessment of the Preterm Behavioral Phenotype in 10-Year-Olds Born Extremely Preterm

Objective: To evaluate the correlates of a clinically significant high score on the Social Responsiveness Scale (SRS) in 10-year-old children who were born extremely preterm and who did not meet criteria for autism spectrum disorder (ASD). Methods: After excluding 61 participants diagnosed with ASD, we grouped children by IQ = 85 and then compared the prevalence of neurocognitive and other deficits between those who had SRS total and component scores >= 65 and their peers who had lower scores. Results: Among children who had IQ >= 85, the prevalence of SRS total scores >= 65 was 16% (n = 103/628), and among children who had IQ < 85, it was 27% (n = 40/148), higher than the 4% prevalence expected based on normative population data. Among children who had IQ >= 85, those who had high SRS scores more often than their peers had deficits in attention and executive function, and language and communication, and they were more often rated by their parents and teachers as having behavioral (e.g., attention-deficit hyperactivity disorder [ADHD]) and emotional (e.g., anxiety and depression) problems. Conclusion: Social Responsiveness Scale-defined social impairment was much more common in our cohort of 10-year-old children born extremely preterm than was expected based on general population norms. High SRS scores were characteristic of children who had intellectual, neurocognitive, language, and communication limitations, as well as deficits in behavior and emotion regulation.