School-age outcomes of infants at risk for autism spectrum disorder.
Baby brothers and sisters of children with autism often struggle with attention and language in elementary school, even when they don't have autism themselves.
01Research in Context
What this study did
The team followed 200 baby brothers and sisters of children with autism. Half were 'high-risk' because they had an older sibling with ASD. The other half were 'low-risk' with no family history.
They watched these kids from infancy until elementary school. At, they checked each child's language, attention, mood, and behavior.
What they found
High-risk siblings had triple the chance of ADHD problems, even without an autism diagnosis. Their language scores were 8-12 points lower than low-risk peers.
About 1 in 5 high-risk siblings needed extra help at school. Only 1 in 20 low-risk kids had the same level of concerns.
How this fits with other research
Mhatre et al. (2016) tracked Indian children who already had autism for 10 years. They found most kids kept improving. Meghan's study shows the risk starts earlier - in baby siblings who don't yet have a diagnosis.
Glenn et al. (2003) looked at diagnosed children for just 2 years and saw little change. Meghan's longer view reveals problems can show up years later, even in kids who seemed fine as toddlers.
Goodwin et al. (2012) urged screening all toddlers at 18 and 24 months. Meghan's results back this up - catching risk early lets you watch for ADHD and language delays, not just autism.
Why it matters
If you work with autism families, don't stop watching the baby siblings after age 3. These kids need their language checked every year. Ask about attention and behavior at school. The autism label might not appear, but other learning needs often do. Start speech or attention training early, before grades slip. Tell parents: 'Your child may need extra help even if they don't have autism.'
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02At a glance
03Original abstract
Studies of infants at risk for autism spectrum disorder (ASD) have proliferated, but few of these samples have been followed longer-term. We conducted a follow-up study, at age 5.5-9 years, of younger siblings of children with ASD (high-risk group, n = 79) or typical development (low-risk group, n = 60), originally recruited as infants. Children with ASD were excluded because of the focus on understanding the range of non-ASD outcomes among high-risk siblings. Using examiner ratings, parent ratings, and standardized assessments, we evaluated differences in clinical outcomes, psychopathology symptoms, autism symptoms, language skills, and nonverbal cognitive abilities. After adjusting for covariates, the high-risk group had increased odds of any clinically elevated/impaired score across measures relative to the low-risk group (43% vs. 12%, respectively). The high-risk group also had increased odds of examiner-rated Clinical Concerns (CC) outcomes (e.g., ADHD concerns, broader autism phenotype, speech-language difficulties, anxiety/mood problems, learning problems) relative to the low-risk group (38% vs. 13%, respectively). The high-risk group with CC outcomes had higher parent-reported psychopathology and autism symptoms, and lower directly-assessed language skills, than the Low-Risk Typically Developing (TD) and High-Risk TD groups, which did not differ. There were no differences in nonverbal cognitive skills. For some in the high-risk group, clinical concerns persisted from early childhood, whereas for others clinical concerns were first evident at school-age. Results suggest continued vulnerability in at least a subgroup of school-age children with a family history of ASD and suggest that this population may benefit from continued screening and monitoring into the school-age years. Autism Res 2016, 9: 632-642. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
Autism research : official journal of the International Society for Autism Research, 2016 · doi:10.1002/aur.1572