Mid-childhood autism sibling recurrence in infants with a family history of autism.
Tessel Bazelmans, Rowan Arthur, Greg Pasco and 7 others
PMID 38973707WHAT IT FOUND
At mid-childhood, 37.1% of 159 siblings of autistic children were diagnosed by researchers, compared with 16.8% of 226 siblings assessed at 3 years.
Thirty-one of 59 mid-childhood diagnoses were first made later.
Key findings
01In 159 siblings seen in person at mid-childhood, 59 were diagnosed with autism by the research team, a recurrence rate of 37.1%.
02Of the 59 siblings diagnosed at mid-childhood, 31 had not received a research autism diagnosis at the 3-year assessment.
03A community clinical autism diagnosis was reported for 37 of 59 children with a research diagnosis, giving a community-based recurrence rate of 24.5%.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The mid-childhood sample was 159 siblings from one single-site cohort, and the authors say the recurrence rate cannot be generalised outside this group. Retention from recruitment to mid-childhood was 67.9%, and White children were more likely to be retained than Asian/Black/Mixed children. The mid-childhood diagnosis was not blind to the 3-year diagnosis, and the same research team was involved, so earlier information could influence later decisions. No independent reliability check of diagnostic decisions was done. Families had high income and education on average, and volunteer family-history studies may differ from routine populations. The study did not collect genetic data or systematically measure parent or researcher concerns in infancy, so some possible influences on recurrence and recognition were not assessed.
Declared interests
Funding came from the Medical Research Council, BASIS consortium led by Autistica, Autism Speaks, the Innovative Medicines Initiative, EU Horizon and UKRI, Maudsley Charity, Guy's and St Thomas' Charity, and NIHR. The paper states funders had no role in design, collection, analysis, interpretation, writing, or publication. One author declared paid consultancy to F. Hoffmann-La Roche and Servier, and several declared royalties from publishers; the remaining authors declared no competing conflicts.
The easy way to misread this
Do not conclude that a 3-year research assessment ruling out autism means the child will not later be diagnosed. Thirty-one of 59 siblings diagnosed at mid-childhood had not received a diagnosis at 3 years.