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Parent Prediction of Autism Spectrum Disorder in Infants at Risk: A Follow-up Study


Later-born siblings of children with autism spectrum disorder are considered at biological risk for autism spectrum disorder and the broader phenotype. Early screening may detect first signs of autism spectrum disorder and expedite diagnosis and early intervention. In this follow-up study, we re-examine a validated second-degree autism spectrum disorder screener for children at biological risk of autism spectrum disorder, the parent observation of early markers scale. Using available follow-up information up to age 13 years, 110 children (the original 108 infants plus 2 infants recruited after the completion of the original study) were divided into three groups: diagnosed group (n = 13), lost diagnosis group (n = 5), and undiagnosed group (n = 92). The parent observation of early markers scale continued to show acceptable predictive validity. The parent observation of early markers scale total scores and mean number of elevated items were significantly higher in the diagnosed group than the undiagnosed group. The lost-diagnosis group did not differ from the undiagnosed group on parent observation of early markers scale total scores and elevated items at any age, but the lost-diagnosis group had significantly lower total scores, and number of elevated items than the diagnosed group starting at 18 months. Both autism spectrum disorder core and subsidiary behaviors differentiated the diagnosed and undiagnosed groups from 9 to 36 months of age. We hereby provide further evidence that the parent observation of early markers scale may serve as a low-cost early screener for autism spectrum disorder in at-risk children and pinpoint specific developmental ,and behavioral problems that may be amenable to very early intervention.

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The first author was the principal student investigator of the follow-up study reported in this manuscript which is based on her MA thesis. The senior author is the director of the ASD Canadian-American Research Consortium (ASD-CARC) prospective study and was Ms. Wang’s thesis supervisor. The second author is the Research Coordinator of the Queen’s University Genomics Laboratory at Ongwanada and third author is director of the lab. The fourth author is the primary developer of the POEMS. This work was supported by CIHR Interdisciplinary Health Research Team grant (RT-43820) to ASD-CARC (www.autismresearch.ca) and funding from Ongwanada. We thank the families for their long-term commitment to this project.

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Correspondence to Maurice Feldman.

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The authors declare that they have no conflict of interests.

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All procedures performed with human participants were in accordance with the ethical standards of the Brock University Research Ethics Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all participants included in this study.

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Wang, C.Q., Hudson, M., Liu, X. et al. Parent Prediction of Autism Spectrum Disorder in Infants at Risk: A Follow-up Study. J Child Fam Stud 25, 3593–3606 (2016). https://doi.org/10.1007/s10826-016-0508-4

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  • Autism spectrum disorder
  • Infants at risk for ASD
  • ASD screener
  • Early identification
  • Follow-up study