Journal of Autism and Developmental Disorders

, Volume 47, Issue 5, pp 1542–1550 | Cite as

Brief Report: Characteristics of preschool children with ASD vary by ascertainment

  • Lori-Ann R. SacreyEmail author
  • Lonnie Zwaigenbaum
  • Peter Szatmari
  • Susan Bryson
  • Stelios Georgiades
  • Jessica Brian
  • Isabel M. Smith
  • Tracy Vaillancourt
  • Nancy Garon
  • Caroline Roncadin
  • Mayada Elsabbagh
Brief Report


Prospective studies of infant siblings of children diagnosed with autism spectrum disorder (ASD) provide a unique opportunity to characterize ASD as it unfolds. A critical question that remains unanswered is whether and how these children with ASD resemble other children identified from the community, including those with no family history. The purpose of this study was to compare clinical characteristics of children with ASD identified by each method (n = 86 per group), drawn from two Canadian longitudinal research cohorts. Children ascertained from a prospective cohort were less severely affected and included a larger proportion of girls, compared to the clinically referred sample. These results may have important implications for conclusions drawn from studies of high-risk and clinically referred cohorts.


Autism spectrum disorder High-risk siblings Prospective Community referral Comparison 



The authors would like to thank the research assistants at each site for their help with data collection and the parents and children who participated in our study. The study was funded by Canadian Institutes of Health Research (CIHR) and NeuroDevNet.

Author Contributions

LRS made substantial contributions to conception and design of the paper, analyzed the data, and prepared the first draft of the paper, and approved the final draft. LZ, PS, SB, SG, JB, IMS, TV, NG, CR, ME contributed to the conception of the project, provided a critical review of the manuscript, and approved the final draft.


This study was funded by the Canadian Institutes of Health Research (CIHR) and NeuroDevNet.

Compliance with Ethical Standards

Conflict of interest

All of the authors declare that they have no conflicts of interest.

Ethical approval

All of the procedures involving our human participants were performed in accordance with the ethical standards of the institutional boards at each institution and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants (parents) prior to study onset.

Supplementary material

10803_2017_3062_MOESM1_ESM.docx (133 kb)
Supplementary material 1 (DOCX 134 KB)


  1. Begeer, S., Mandell, D., Wijnker-Holmes, B., Venderbosch, S., Rem, D., Stekelenburg, F., et al. (2013). Sex differences in the timing of identification among children and adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(5), 1151–1156. doi: 10.1007/s10803-012-1656-z.CrossRefPubMedGoogle Scholar
  2. Carter, A. S., Volkmar, F. R., Sparrow, S. S., Wang, J. J., Lord, C., Dawson, G., et al. (1998). The vineland adaptive behavior scales: Supplementary norms for individuals with autism. Journal of Autism and Developmental Disorders, 28(4), 287–302.CrossRefPubMedGoogle Scholar
  3. Daniels, A. M., & Mandell, D. S. (2013). Explaining differences in age at autism spectrum disorder diagnosis: A critical review. Autism, 18(5), 583–597.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Estes, A., Zwaigenbaum, L., Gu, H., St John, T., Paterson, S., Elison, J.T., et al (2015). Behavioral, cognitive, and adaptive development in infants with autism spectrum disorder in the first 2 years of life. Journal of Neurodevelopmental Disorders, 7(1), 24. doi: 10.1186/s11689-015-9117-6.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Giarelli, E., Wiggins, L. D., Rice, C. E., Levy, S. E., Kirby, R. S., Pinto-Martin, J., et al. (2010). Sex differences in the evaluation and diagnosis of autism spectrum disorders among children. Disability Health Journal, 3, 107–116.CrossRefPubMedGoogle Scholar
  6. Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorder, 39(5), 693–705.CrossRefGoogle Scholar
  7. Gotham, K., Risi, S., Pickles, A., & Lord, C. (2007). The autism diagnostic observational schedule: Revised algorithms for improved diagnostic validity. Journal of Autism and Developmental Disability, 37(4), 613–627.CrossRefGoogle Scholar
  8. Jones, E.J., Gliga, T., Bedford, R., Charman, T., & Johnson, M.H. (2014). Developmental pathways to autism: A review of prospective studies of infants at risk. Neuroscience and Biobehavioral Reviews 39, 1–33.CrossRefGoogle Scholar
  9. Jones, M. B., Szatmari, P., & Piven, J. (1996). Non-familiality of the sex ratio in autism. American Journal of Medical Genetics, 67, 499–500.CrossRefPubMedGoogle Scholar
  10. Kim, S. H., & Lord, C. (2010). Restricted and repetitive behaviors in toddlers and preschoolers with autism spectrum disorders based on the Autism Diagnostic Observation Schedule (ADOS). Autism Research, 3(4), 162–173. doi: 10.1002/aur.142.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Kim, S. H., & Lord, C. (2012). New Autism Diagnostic Interview-Revised algorithms for toddlers and young preschoolers from 12 to 47 months of age. Journal of Autism and Developmental Disorders, 42, 82–93.CrossRefPubMedGoogle Scholar
  12. Lord, C., Risi, S., Lambrecht, L., Cook, E. H. Jr., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.CrossRefPubMedGoogle Scholar
  13. Lord, C., Rutter, M., & Le Couteur, A. J. (1994). Autism diagnostic interview—revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.CrossRefPubMedGoogle Scholar
  14. Oerlemans, A. M., Burmanje, M. J., Franke, B., Buitelaar, J. K., Hartman, C. A., Rommelse, N. N., et al. (2015). Identifying unique versus shared pre- and perinatal risk factors for ASD and ADHD using a simplex-multiplex stratification. Journal of Abnormal Child Psychology, 44(5), 923–935.CrossRefPubMedCentralGoogle Scholar
  15. Oerlemans, A. M., Hartman, C. A., Franke, B., Buitelaar, J. K., & Rommelse, N. N. (2016). Does the cognitive architecture of simplex and multiplex ASD families differ? Journal of Autism and Developmental Disorders, 46(2), 489–501.CrossRefPubMedGoogle Scholar
  16. Russel, G., Steer, C., & Golding, J. (2011). Social and demographic factors that influence the diagnosis of autism spectrum disorders. Social Psychology and Psychiatric Epidemiology, 45(12), 1283–1293.CrossRefGoogle Scholar
  17. Rutter, M., Bailey, A., Lord, C., et al. (2003). Social Communication Questionnaire. Los Angeles: Western Psychological Services.Google Scholar
  18. Salomone, E., Charman, T., McConachie, H., Warreyn, P. (2016). Child’s verbal ability and gender are associated with age at diagnosis in a sample of young children with ASD in Europe. Child: Care, Health and Development, 42(1), 141–145. doi: 10.1111/cch.12261.
  19. Sparrow, S. S., Balla, D., & Cicchetti, D. (1984). Vineland Adaptive Behavior Scales (Survey Form). Circle Pines: American Guidance Service.Google Scholar
  20. Sparrow, S. S., Cicchetti, D. V., & Balla, D. A. (2005). Vineland Adaptive Behavior Scales: Second Edition (Vineland II). Survey Interview Form/Caregiver Rating Form: Pearson Assessments.Google Scholar
  21. Szatmari, P., Georgiades, S., Duku, E., Bennett, T. A., Bryson, S., Fombonne, E., et al. (2015). Developmental trajectories of symptom severity and adaptive functioning in an inception cohort of preschool children with autism spectrum disorders. JAMA Psychiatry, 72(3), 276–283.CrossRefPubMedGoogle Scholar
  22. Volkmar, F. R., Carter, A., Sparrow, S. S., & Cicchetti, D. V. (1993). Quantifying social development in autism. Journal of the American Academy of Child and Adolescent Psychiatry, 32(3), 627–632.CrossRefPubMedGoogle Scholar
  23. Zwaigenbaum, L., Bryson, S., Lord, C., Rogers, S., Carter, A., Carver, L., et al. (2009). Clinical assessment and management of toddlers with suspected autism spectrum disorder: Insights from studies of high-risk infants. Pediatrics, 123(5), 1383–1391.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Zwaigenbaum, L., Bryson, S., Rogers, T., Roberts, W., Brian, J., & Szatmari, P. (2005). Behavioral manifestations of autism in the first year of life. International Journal of Developmental Neuroscience, 23, 143–152.CrossRefPubMedGoogle Scholar
  25. Zwaigenbaum, L., Bryson, S.E., Brian, J., Smith, I.M., Roberts, W., Szatmari, P., et al. (2015). Stability of diagnostic assessment for autism spectrum disorder between 18 and 36 months in a high-risk cohort. Autism Research, 9, 790–800. doi: 10.1002/aur.1585.Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Lori-Ann R. Sacrey
    • 1
    • 2
    Email author
  • Lonnie Zwaigenbaum
    • 1
    • 2
  • Peter Szatmari
    • 3
    • 4
    • 5
  • Susan Bryson
    • 6
  • Stelios Georgiades
    • 7
  • Jessica Brian
    • 3
    • 8
  • Isabel M. Smith
    • 6
  • Tracy Vaillancourt
    • 9
  • Nancy Garon
    • 10
  • Caroline Roncadin
    • 3
    • 11
  • Mayada Elsabbagh
    • 12
  1. 1.Department of PediatricsUniversity of AlbertaEdmontonCanada
  2. 2.Autism Research Centre—E209Glenrose Rehabilitation HospitalEdmontonCanada
  3. 3.University of TorontoTorontoCanada
  4. 4.The Hospital for Sick ChildrenTorontoCanada
  5. 5.Centre for Addiction and Mental HealthTorontoCanada
  6. 6.Dalhousie University/IWK Health CentreHalifaxCanada
  7. 7.McMaster UniveristyHamiltonCanada
  8. 8.Bloorview Research InstituteTorontoCanada
  9. 9.University of OttawaOttawaCanada
  10. 10.Mount Allison UniversitySackvilleCanada
  11. 11.McMaster Children’s Hospital/Hamilton Health SciencesHamiltonCanada
  12. 12.McGill UniversityMontrealCanada

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