Objective: To study the relationship between parent concerns about development in the first year and a half of life and later autism diagnostic outcomes.

Method: Parent concerns about development were collected (via PEDS^®) for infants at high and low risk for autism, using a prospective, longitudinal design. Parents were asked about developmental concerns at study intake and when their infant was 6, 12, and 18 months. Infants were then followed up until 36 months, when diagnostic status was determined.

Results: By the time their child was 12 months, parents who have an older child with autism reported significantly more concerns in autism spectrum disorders-related areas than parents of children with typical outcomes. These concerns were significantly related to independent measures of developmental status and autism symptoms and helped predict which infants would later be diagnosed with autism or autism spectrum disorders. At 6 months, however, the concerns of parents who have an older child with autism do not predict outcome well.

Conclusion: Explicitly probing for parent concerns about development is useful for identifying children in need of closer monitoring and surveillance, as recommended by the American Academy of Pediatrics.

Comment: This invaluable study shows that parents may worry unnecessarily about their young children when an older child has an ASD diagnosis. That seems totally understandable and worth attending to with vigilant monitoring. Risk of ASD, just as with any developmental-behavioral problem increases as children age and the genetic correlates of ASD are high. Thus parents should be worried early on and it is our job as providers to address those worries, dispel when needed and watch carefully the development of all children at risk.