Screening for Behavioral Signs of Autism Spectrum Disorder in 9-Month-Old Infant Siblings

  • Lori-Ann R. SacreyEmail author
  • Lonnie Zwaigenbaum
  • Susan Bryson
  • Jessica Brian
  • Isabel M. Smith
  • Wendy Roberts
  • Peter Szatmari
  • Tracy Vaillancourt
  • Caroline Roncadin
  • Nancy Garon
Original Paper


Despite considerable progress in characterizing the early signs of autism spectrum disorder (ASD), more remains to be learned about how symptoms emerge in the first year of life. Parents with a new baby who already had at least one biological child diagnosed with ASD (high-risk) or no family history of ASD (low-risk) completed two measures when their baby was 9 months of age, the Autism Parent Screen for Infants (APSI) questionnaire and the interview-based Parent Concerns Form. Children underwent a blinded independent diagnostic assessment for ASD at age 3 years. Total scores on the APSI and the Parent Concerns Form were both able to independently differentiate high-risk children who were later diagnosed with ASD from other high-risk and low-risk children who were not. Using logistic regression, we found that the total score on the APSI predicted ASD outcomes at age 3 with 70% accuracy, but the Parent Concerns Form did not contribute any unique variance when the APSI was already in the model. The results suggest that the APSI identifies early features predictive of ASD in high-risk infants and can be used to flag them for targeted follow-up and screening.


Autism spectrum disorder Parent report High-risk siblings Prospective Screening Early detection 



The authors would like to thank the research assistants at each site for their help with data collection and the parents and children who participated in our study. The study was funded by Canadian Institutes of Health Research (CIHR) and Kids Brain Health Network.

Author Contributions

LRS made substantial contributions to conception and design, collected and analyzed the data and prepared the first draft of the paper, and approved the final draft. LZ, SB, JB, IMS, WR, PS, TV, CR, and NG contributed to the conception of the project, provided a critical review of the manuscript, and approved the final draft.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Lori-Ann R. Sacrey
    • 1
    • 2
    Email author
  • Lonnie Zwaigenbaum
    • 1
    • 2
  • Susan Bryson
    • 3
  • Jessica Brian
    • 4
    • 5
  • Isabel M. Smith
    • 3
  • Wendy Roberts
    • 6
  • Peter Szatmari
    • 5
    • 7
    • 8
  • Tracy Vaillancourt
    • 9
  • Caroline Roncadin
    • 5
    • 10
  • Nancy Garon
    • 11
  1. 1.Department of PediatricsUniversity of AlbertaEdmontonCanada
  2. 2.Department of Pediatrics, Autism Research Centre – E209Glenrose Rehabilitation HospitalEdmontonCanada
  3. 3.Dalhousie University/IWK Health CentreHalifaxCanada
  4. 4.Bloorview Research InstituteTorontoCanada
  5. 5.University of TorontoTorontoCanada
  6. 6.ISANDTorontoCanada
  7. 7.The Hospital for Sick ChildrenTorontoCanada
  8. 8.Centre for Addiction and Mental HealthTorontoCanada
  9. 9.University of OttawaOttawaCanada
  10. 10.McMaster Children’s HospitalHamilton Health SciencesHamiltonCanada
  11. 11.Mount Allison UniversitySackvilleCanada

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