Early concerns in parents of infants at risk for autism.
Amanda T Tran, Mithi Del Rosario, Erin Nosco and 6 others
PMID 34109620WHAT IT FOUND
Parents of infants with older autistic siblings reported significantly more developmental concerns than low-risk parents starting at 6 months.
By 12 months, high-risk parents whose infants were later classified as atypically developing reported more speech, social, and repetitive behavior concerns than those whose infants developed typically. This suggests parent reports at 12 months may flag risk earlier than standard screening ages.
Key findings
01Beginning at 6 months, parents of high-risk infants reported more ASD-related and general concerns than parents of low-risk infants, a difference that persisted at 18 months.
02At 12 months, parents of high-risk infants who were later classified as atypically developing reported more ASD-related concerns than parents of high-risk infants who were typically developing.
03In the high-risk atypically developing group at 12 months, the most frequently reported ASD-related concerns were speech/language (37%), restricted and repetitive behaviors (32%), and social (26%) categories.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was small (76 infants), predominantly white, and from highly educated families, which limits generalizability to more diverse populations. Parents were directly asked about concerns at every visit, which may have prompted them to report worries they would not have spontaneously raised. The high-risk parents were enrolled because they had an older child with ASD, so they were likely more vigilant or anxious about development than the general population. Subgroup analyses within the high-risk group had low power, particularly for distinguishing specific types of atypical development beyond the combined 'atypically developing' category. Six participants were siblings, which can inflate statistical significance; however, sensitivity analyses excluding siblings yielded similar results.
Declared interests
The study was supported by NIH grant P50HD055784-11. No other conflicts of interest are declared in the provided text.
The easy way to misread this
Do not assume parent concerns are specific to autism. High-risk parents reported more general concerns (motor, health, behavior) as well as ASD-related concerns starting at 6 months. A parent reporting concerns at 12 months does not confirm an ASD diagnosis; it indicates a need for closer follow-up, as many high-risk infants with early concerns were ultimately classified as typically developing.