Autism Screening Using Parent's Observations of Social Interactions (POSI) in High-Risk Infants.
A five-question parent checklist spots most toddler autism cases but needs backup testing to avoid false alarms.
01Research in Context
What this study did
Vielmetti et al. (2026) asked parents of high-risk toddlers five quick questions. The questions cover how the child looks at faces, shares smiles, and reacts to name.
Doctors then checked which kids later got an autism diagnosis. They wanted to see if the short parent list could flag autism without long tests.
What they found
The five-item POSI caught three out of every four toddlers who truly had autism. It also flagged one in three toddlers who did not have autism.
That means the screener is good at catching cases but gives some false alarms.
How this fits with other research
Rojahn et al. (2012) saw the same trade-off with the SRS questionnaire. Both tools catch many kids with autism yet also over-flag typical kids.
Aikat et al. (2025) took a different path. Their iPad app records gaze and smiles. Both studies want fast screens, but one uses tech and the other uses parent eyes.
Vrancic et al. (2002) also used parent input, yet by phone. POSI shortens the job to five items, showing parent reports can stay brief and still help.
Why it matters
You can use the POSI as a first red flag in busy clinics or home visits. Pair it with a longer tool before you tell families yes or no. The five questions take two minutes and cost nothing, so they fit early-intervention intake or pediatric check-ups.
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02At a glance
03Original abstract
PURPOSE: The Parent's Observations of Social Interactions (POSI) is a brief, targeted screening measure for autism spectrum disorder (ASD). There is minimal data on its use in infants at high risk for developmental delays. The objective was to evaluate the use of the POSI as an ASD screener in a cohort of infants at high risk for neurodevelopmental impairments. Our hypothesis was that positive POSI scores would be associated with developmental delays and the later diagnosis of ASD. METHODS: This retrospective cohort study included toddlers born between 2016 and 2019 assessed using the POSI and Bayley Scales of Infant and Toddler Development (BSITD) at 18-33 months corrected age. Children with positive and negative POSI screens were compared for developmental delays, cerebral palsy, and later diagnoses of ASD by a developmental pediatrician as noted in the electronic health record. RESULTS: Positive POSI scores were noted in 106/291 (36.4%) children, with 25/291 (8.6%) subsequently diagnosed with ASD. Toddlers with a positive score were more likely to have developmental delays and cerebral palsy compared with those with negative scores. The sensitivity of a positive POSI score for a later diagnosis of autism was 76% with a specificity of 66.7%. CONCLUSIONS: The POSI was a feasible method of ASD screening for high-risk children, in conjunction with other developmental evaluations. Due to low specificity, future research is warranted to improve the accuracy of early ASD screening in high-risk infants and long-term follow up.
Journal of autism and developmental disorders, 2026 · doi:10.1001/jamapediatrics.2022.5975