Behavioral development and sociodemographics of infants and young children at higher and lower risk for autism spectrum disorders.
A parent checklist spots autism markers in 12-month-old high-risk siblings, giving BCBAs an easy early warning system.
01Research in Context
What this study did
The team asked parents to fill out the POEMS checklist every few months. POEMS stands for Parent Observation of Early Markers Scale. It lists simple behaviors like eye contact, name response, and toy play.
They compared two groups: babies who had an older sibling with autism (high-risk) and babies with no family history (low-risk). They started when the babies were 6 months old and kept tracking until age three.
What they found
High-risk babies scored higher on POEMS at every age. Higher scores mean more early autism markers. The gap showed up as early as 12 months.
Family income and parent age did not change the results. The checklist still flagged the same babies.
How this fits with other research
Zhang et al. (2026) found the same pattern using ADOS scores and adaptive tests. One in three high-risk toddlers without an ASD label still showed elevated symptoms. Together the studies say the broader autism phenotype is real and measurable.
Ben-Itzchak et al. (2021) tested a different parent form, the First Year Inventory, at the same 12-month visit. It also spotted later ASD. The message: parent report works, no matter which short form you pick.
Schwichtenberg et al. (2013) looked at the same high-risk preschoolers and found more anxiety, aggression, and sleep issues. POEMS catches the social side early; the CBCL catches the emotional side later. Use both windows.
Why it matters
You can hand parents the 10-item POEMS today. It takes five minutes and costs nothing. If the score is high, start monitoring and refer for early intervention even before a full diagnosis. The tool is free online in English and Spanish.
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02At a glance
03Original abstract
Identification of early signs of Autism Spectrum Disorder (ASD) could lead to earlier diagnosis and intervention. This cross-sectional study used the Parent Observation of Early Markers Scale (POEMS, Feldman et al. in J Autism Dev Disord 42:13-12, 2012) to identify early signs of ASD in 69 ASD high-risk (older sibling diagnosed with ASD) and 69 sex and aged-matched ASD low-risk second-born or later infants (no family history of ASD) between 6 and 36 months of age. Family sociodemographic comparisons were also made between the risk groups. The high-risk children had significantly more elevated POEMS items than the low-risk children at 12, 18, 24, 30 and 36 months of age, even when the children subsequently diagnosed with ASD were removed from the analyses. Families of the high-risk group had older parents, lower family income and fewer mothers working out of the home than the low-risk group. These sociodemographic variables were not significantly correlated with POEMS scores. The results suggest that high-risk infants may show signs of the broader ASD phenotype as early as 12 months of age that may be unrelated to observed sociodemographic family differences.
Journal of autism and developmental disorders, 2015 · doi:10.1007/s10803-014-2277-5