Parent and clinician agreement regarding early behavioral signs in 12- and 18-month-old infants at-risk of autism spectrum disorder.
Parents spot early autism signs better than clinicians during short visits—use their answers.
01Research in Context
What this study did
The team watched 12- and 18-month-old babies who had an older sibling with autism.
Parents filled out a short survey about early signs. Clinicians also gave a quick rating after a brief visit.
They later checked which kids got an autism diagnosis at age three.
What they found
Parent answers picked out the later autism cases better than the clinic ratings.
Clinician scores during the short visit missed many babies who were later diagnosed.
How this fits with other research
Shu et al. (2022) found the same thing in 5,000 older kids: parent surveys alone predicted low IQ with 88 % accuracy.
Schroeder et al. (2014) saw the pattern in adults with Williams syndrome: parent report matched real-life social moves, self-report did not.
Messinger et al. (2010) looked extremely low-birth-weight toddlers and also showed that quick adult ratings at 18 months forecast later delays.
All four studies line up: brief adult questionnaires beat short expert looks.
Why it matters
You can trust a one-page parent screener more than a five-minute clinic peek.
Add a simple survey to every 12- and 18-month well-baby visit.
It costs nothing and catches kids who need early intervention sooner.
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02At a glance
03Original abstract
UNLABELLED: Parent and clinician agreement regarding early behavioral signs of Autism Spectrum Disorder (ASD) in children from a high-risk cohort (siblings of children diagnosed with ASD, n = 188) was examined. Infants were assessed prospectively at 12 and 18 months of age using the clinician administered Autism Observational Scale for Infants (AOSI) and the Autism Parent Screen for Infants (APSI) and underwent a blind independent diagnostic assessment for ASD at 36 months of age. Direct comparison of parent and clinician ratings showed poor agreement on all early behavioral signs, with parent-reported symptoms being better able to differentiate between children with and without ASD at both 12 and 18 months of age compared to clinician observations during a brief office visit. The results suggest that parents may detect some clinically informative behaviors based on their day-to-day observations more readily than do clinicians during brief clinical assessments, a result that needs to be replicated in a non-sibling cohort. Autism Res 2018, 11: 539-547. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Parents of children at high-risk of autism spectrum disorder (ASD; have an older sibling with ASD) and clinicians were compared on their reporting of 19 early signs of autism. Direct comparison of parent and clinician ratings showed poor agreement on all early behavioral signs, with parent-reported symptoms being better able to differentiate between children with and without ASD at both 12 and 18 months of age compared to clinician observations during a brief office visit. This suggests that parents may have important information regarding early development of their high-risk child.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1002/aur.1920