Early symptoms of autism spectrum disorders and association with Brazilian children's development and behavior.
Rafaela Silva Moreira, Marina Aguiar Pires Guimarães, Lívia de Castro Magalhães and 2 others
PMID 40638491WHAT IT FOUND
In 221 Brazilian toddlers, 33% screened positive for autism risk.
These children showed lower communication and social scores and higher behavioral problems. Screening should trigger holistic developmental assessment, not just an autism referral.
Key findings
0133% of the children screened positive for ASD risk, with no difference by age or gender.
02Children with positive screening had lower scores in Developmental Milestones, communication, fine motor, and personal-social domains, and higher scores for behavioral problems.
03Communication delays were the earliest and most consistent finding, present even in the youngest group (18-23 months), while broader developmental and behavioral differences became significant only after 24 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was a convenience sample, so the 33% positive screening rate may not represent the general population. The POSI is a pre-screening tool with known low specificity, meaning many children flagged as 'at risk' may not have ASD. Most families had low or very low socioeconomic status, which is an independent risk factor for developmental delay and may confound the association between 'ASD risk' and poor developmental scores. There were no normative data for the POSI in Brazilian children at the time of the study, requiring caution in interpreting cutoffs.
Declared interests
The study was funded by Grand Challenges Canada-Saving Brains, CNPQ, FAPESC, UFMG, and CAPES. No commercial conflicts of interest were declared.
The easy way to misread this
Do not interpret the 33% positive screening rate as the prevalence of autism. The POSI is a low-specificity pre-screen, and this study did not confirm diagnoses. Many of these children may have other developmental or behavioral conditions, or no condition at all, requiring further evaluation rather than an immediate ASD label.