Concern for Another's Distress in Toddlers at High and Low Genetic Risk for Autism Spectrum Disorder.

Researchers watched 22-month-old toddlers during short distress scenes. One scene had an adult bump her knee and cry. Another showed an adult pretending to hurt a finger.

Kids were already labeled high-risk or low-risk for autism based on having an older sibling with ASD. The team noted whether each child looked concerned, tried to comfort, or checked with their parent.

Toddlers later diagnosed with ASD rarely showed worry or offered comfort. They also looked at their parent less during the adult’s pain.

High-risk toddlers who did not receive an ASD diagnosis fell in the middle—some concern, but still less than low-risk peers.

Levinson et al. (2020) extends these results. They gave the ITSEA questionnaire at 18 months and also flagged later ASD, showing social-emotional red flags can be caught even earlier.

Bontinck et al. (2018) watched the same age group at home. High-risk toddlers played with their older ASD sibling and showed less imitation—another social gap that matches the low concern seen here.

Pilgrim et al. (2000) asked parents to look back. Parents of kids later diagnosed with ASD recalled the same early social disengagement. The new lab data confirm those parent memories with live coding.

If a toddler ignores an adult’s pain and rarely checks your face, note it. Add a brief empathic-concern probe to your early-screen toolkit alongside the M-CHAT. Pair the sign with parent questions about shared emotion at home. Early clarity speeds referral and intervention.