Comparison of Parent Questionnaires, Examiner-Led Assessment and Parents’ Concerns at 14 Months of Age as Indicators of Later Diagnosis of Autism

Abstract

Parents participating in a prospective longitudinal study of infants with older siblings with autism completed an autism screening questionnaire and were asked about any concerns relating to their child's development, and children were administered an interactive assessment conducted by a researcher at 14 months. Scores on the parent questionnaire were highest for children later diagnosed with autism. Parental concerns and scores from the examiner-led assessment distinguished children with later developmental difficulties (both autism and other developmental atypicalities) from those who were developing typically. Children about whom parents expressed concern scored higher on both the questionnaire and the interactive assessment than those without concerns. There were no significant associations between total or individual item scores from the questionnaire and interactive assessment.

Clinical, socio-demographic, and parental correlates of early autism traits in a community cohort

“…To date, one study has directly reported on the association between parental history of ASD and Q-CHAT score and found a large group difference, with the familial ASD history group having higher Q-CHAT scores at age 16-30 months (Ben-Sasson et al, 2018). One other study has specifically examined the difference between Q-CHAT scores in individuals with and without an older sibling with autism, and also found significant group differences (Pasco et al, 2021). It is not clear why we do not see the same effect here, although it is possible that the method in which we recorded family history (the mother was asked only if she or her partner had ever been diagnosed with autism) was too narrow a definition, or alternatively it may be the case that we lacked sufficient positive cases (28 parents reported an ASD or ADHD diagnosis compared to 506 with no diagnosis) to have determinative power.…”

A Combined Study on the Use of the Child Behavior Checklist 1½–5 for Identifying Autism Spectrum Disorders at 18 Months

“…Indeed, children who are recruited in prospective longitudinal studies are more likely to display fewer and less severe symptoms than those recruited on the basis of clinical referral or with a provisional diagnosis (Sacrey et al 2017 ). Thus, it is possible that with individuals of this kind, screening instruments whose properties include greater variance in the distribution of features are more informative (Pasco et al 2019 ).…”

“…Furthermore, although it has been shown that parents of children subsequently diagnosed with ASD are more likely to report concerns about their child’s development than parents of children with TD and children with other developmental difficulties, their concerns tend to be more about broad behavioral issues rather than about social communication and interaction (Pasco et al 2019 ). If, on the one hand, parents who have older children with ASD are inevitably better informed about the emerging signs of autism than most parents of young children, it is possible that when comparing their younger offspring with the older child with autism rather than to “typical development” they may tend to under-report autistic-like behavioral symptoms, especially when they differ from the older sibling’s behavioral profile.…”

Editorial S.I: Early Identification in Autism Spectrum Disorders: The Present and Future, and Advances in Early Identification

“…The majority of these papers described early detection strategies that relied on parent report, but varied in recruitment of participants (high-risk siblings of children with ASD, children receiving early intervention) and emphasis on standardized screening versus parent contributions. When parent concerns were elicited in addition to standardized screening (Pasco et al 2019), high-risk siblings who were later diagnosed with ASD had higher screening scores and also more concerns raised by parents at 14 months. A striking difference with prior literature was seen in the type of concerns parents reported; unlike studies both with high-risk siblings (Ozonoff et al 2009) and children identified from primary care screening (Richards et al 2016), disruptive behaviors were most commonly reported, rather than language concerns.…”