Heterogeneity of autism symptoms in community-referred infants and toddlers at elevated or low familial likelihood of autism.
Torrey L Cohenour, Amanda Gulsrud, Connie Kasari
PMID 37408377WHAT IT FOUND
Infants and toddlers with autism symptoms who had an autistic sibling showed milder social-communication symptoms and stronger cognitive scores than children with no family history, and less expressive language delay than children with no family history but non-autistic older siblings.
Key findings
01Children with an autistic sibling had lower social-communication and overall autism symptom severity scores than low familial likelihood children, while restricted/repetitive behavior scores did not differ.
02Children with an autistic sibling had higher nonverbal and verbal developmental quotient scores than both low familial likelihood groups.
03Low familial likelihood children with non-autistic older siblings were 3.5 times more likely to have expressive language delay than children with an autistic sibling.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The children were not required to have a formal autism diagnosis at enrollment, so some may not later meet diagnostic criteria. The study used baseline comparisons, not follow-up or intervention outcomes, so it cannot show that having an autistic sibling causes milder symptoms or stronger cognitive scores. The elevated familial likelihood group was small, and the groups differed in age and racial composition, which may affect interpretation. Referral and selection bias may have occurred because families with an autistic sibling may seek services differently, and children with more subtle or more severe symptoms may be unevenly represented. Some children classified as low familial likelihood may still have inherited autism risk that had not appeared in the family.
Declared interests
The article is listed as NIH extramural research support. Torrey Cohenour, Amanda Gulsrud, and Connie Kasari declared no conflicts of interest.
The easy way to misread this
Do not conclude that having an autistic sibling causes milder autism symptoms or better language. The children were not required to have a formal autism diagnosis, and this was a baseline comparison, not a treatment or follow-up study.