School-age outcomes of infants at risk for autism spectrum disorder

Meghan Miller1, Ana-Maria Iosif2, Gregory S Young1

  • 1MIND Institute, University of California, Davis.

Insights

Children with a family history of autism spectrum disorder (ASD) show higher rates of clinical concerns, including ADHD and language difficulties, into school age. Continued monitoring is recommended for these high-risk children.

Area of Science:

  • Developmental Psychology
  • Clinical Psychology
  • Genetics

Background:

  • Autism spectrum disorder (ASD) research often focuses on affected individuals, with less attention to long-term outcomes in at-risk siblings.
  • Understanding the developmental trajectories of siblings of children with ASD is crucial for identifying non-ASD related clinical concerns.

Purpose of the Study:

  • To conduct a longer-term follow-up of high-risk siblings (younger siblings of children with ASD) and low-risk siblings.
  • To evaluate differences in clinical outcomes, psychopathology, autism symptoms, language, and cognitive abilities at school age (5.5-9 years).

Main Methods:

  • Follow-up study of infants initially recruited as high-risk (n=79) or low-risk (n=60) for ASD.
  • Utilized examiner ratings, parent reports, and standardized assessments to evaluate clinical concerns, psychopathology, autism symptoms, language, and nonverbal cognition.
  • Excluded children diagnosed with ASD to focus on non-ASD outcomes in high-risk siblings.

Main Results:

  • High-risk siblings showed significantly increased odds of clinically elevated/impaired scores across measures (43% vs. 12%) and examiner-rated Clinical Concerns (CC) (38% vs. 13%) compared to low-risk siblings.
  • High-risk siblings with CC outcomes had higher parent-reported psychopathology and autism symptoms, and lower language skills than low-risk and high-risk siblings without CC.
  • No differences in nonverbal cognitive skills were observed between groups.

Conclusions:

  • A significant subgroup of school-age children with a family history of ASD exhibits persistent or emerging clinical concerns beyond autism.
  • These findings highlight the continued vulnerability in high-risk siblings and underscore the need for ongoing screening and monitoring into the school-age years.
  • The study emphasizes the importance of assessing a broad range of developmental and behavioral outcomes in children with a familial risk for ASD.

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