- by Dr Gowher Yusuf
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- Jul 04 2017
Autistic-Like Traits Emerge Early in High-Risk Siblings
Source: Arch Gen Psychiatry. 2012. Published online September 3, 2012)
New research confirms that younger siblings of children with autism spectrum disorder (ASD) are at risk for subtle difficulties in social communication, cognitive skills, and anxiety regulation very early in life — even if they do not go on to develop an ASD.
In the study of infant siblings of children with ASD, researchers found autistic-like traits by 12 months of age in roughly 19% of these high-risk siblings who did not meet criteria for ASD at age 3. "This study supports previous recommendations of continuous monitoring of all HR [high-risk] siblings of probands with ASD," the authors say in report published in Archives of General Psychiatry.
"Siblings of children with ASD need to be followed from birth to assess the emergence not only of autism but these other more subtle difficulties," Peter Szatmari, MD, of the Centre for Child Studies and McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada, told Medscape Medical News.
These milder manifestations of ASD have been termed the broader autism phenotype (BAP) and include social, communication, and cognitive problems; restricted, rigid behavior patterns; and certain personality characteristics and psychiatric difficulties.
Using prospective data, Dr. Szatmari, with first author Stelios Georgiades from McMaster University and colleagues, examined the presence of autistic-like traits at age 12 months in 170 high-risk siblings of probands with ASD and 90 low-risk control infants with no family history of ASD. None of them had been diagnosed with ASD at age 3 years.
The researchers used the Autism Observation Scale for Infants (AOSI) to measure autistic-like traits and derive clusters at age 12 months. These clusters were then compared with respect to ASD symptoms, cognitive abilities, and social-emotional difficulties at age 3 years.
"This study reported that nearly 1 in 5 of the high-risk siblings who did not receive a diagnosis of ASD showed some subclinical features of the disorder at age 3. These data, combined with those reported in a recent study from the Baby Siblings Research Consortium, suggest that almost 40% of younger siblings of children with ASD either develop ASD or show autistic-like traits," Dr. Stone told Medscape Medical News. "These numbers," she added, "have tremendous implications for our service delivery systems. They highlight the critical needs for (1) careful developmental monitoring of later-born siblings of children with ASD, and (2) the availability of early intervention resources that can optimize the outcomes of children experiencing early difficulties."
In their article, Dr. Szatmari and colleagues say the study findings may imply that genetic liability in ASD families is "more normally distributed than restricted only to those with the disorder. Even children who do not go on to develop ASD could potentially benefit from surveillance and early intervention should there be impairment," the say.
The researchers also point out that it remains to be seen whether some of the siblings in the study will eventually be diagnosed with ASD, which is the subject of a follow-up study they are doing. "We need to know how these difficulties present at 5 years of age and older," Dr. Szatmari told Medscape Medical News.
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