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Autism Screening Using Parent's Observations of Social Interactions (POSI) in High-Risk Infants

Lydia Vielmetti1, Aarabhi Rajagopal2, Robin Manus3

  • 1Department of Pediatrics, Division of Neonatology, Lurie Children's Hospital, 225 East Chicago Avenue, Chicago, IL, 60611, USA. lvielmetti@luriechildrens.org.

Journal of Autism and Developmental Disorders
|March 12, 2026
PubMed

Insights

The Parent's Observations of Social Interactions (POSI) effectively screens for autism spectrum disorder (ASD) in high-risk infants, correlating with developmental delays. Further research is needed to enhance its specificity for early ASD detection.

Area of Science:

  • Pediatric Neurology
  • Developmental Pediatrics
  • Autism Spectrum Disorder Research

Background:

  • The Parent's Observations of Social Interactions (POSI) is a screening tool for autism spectrum disorder (ASD).
  • Limited data exists on its utility in high-risk infants with potential developmental delays.
  • Evaluating POSI's effectiveness in this population is crucial for early identification.

Purpose of the Study:

  • To assess the Parent's Observations of Social Interactions (POSI) as a screening tool for autism spectrum disorder (ASD).
  • To evaluate POSI's association with developmental delays and later ASD diagnosis in high-risk infants.
  • To test the hypothesis that positive POSI scores predict developmental impairments and ASD.

Main Methods:

  • A retrospective cohort study analyzed toddlers (born 2016-2019) using POSI and Bayley Scales of Infant and Toddler Development (BSITD).
  • Evaluations occurred between 18-33 months corrected age.
  • Compared outcomes (developmental delays, cerebral palsy, ASD diagnosis) between positive and negative POSI screens.

Main Results:

  • 36.4% of infants had positive POSI scores; 8.6% were later diagnosed with ASD.
  • Positive POSI scores were linked to higher rates of developmental delays and cerebral palsy.
  • The POSI demonstrated 76% sensitivity and 66.7% specificity for detecting later ASD diagnoses.

Conclusions:

  • The POSI is a feasible screening method for ASD in high-risk infants when used alongside other developmental assessments.
  • Low specificity necessitates further research to improve early ASD screening accuracy in this population.
  • Long-term follow-up studies are recommended to refine screening protocols.
Abstract

Keywords:
Autism spectrum disorderDevelopmental delayHigh-risk infantsPOSIScreening

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