Parental Concerns About their Child’s Development During the First Year of Life and a Subsequent Autism Spectrum Disorder Diagnosis

Eliciting parents' concerns about their child's development is a key component of developmental surveillance. Here, we aimed to examine whether parental concern about the child's development during the first year of life is associated with a later diagnosis of autism spectrum disorder (ASD). We compared prospectively collected data from medical records on parental concerns and children's developmental milestones at ages 2, 4, 6, 9, and 12 months between 280 children later diagnosed with ASD and 560 children without ASD. Overall, 8.1% of parents in our study expressed concerns regarding their child's development during the first year of life, with a significantly higher portion of parents of children later diagnosed with ASD expressing concerns vs. parents of children without ASD (19.5% vs. 2.8%; p < 0.001). Notably, parental concerns were associated with the failure of children to master age-appropriate language, motor, and social developmental milestones (OR = 5.27, p < 0.001; OR = 2.46, p = 0.023; and OR = 2.27, p = 0.012, respectively). Nevertheless, even after adjustment for this association, parental concerns were found to be an independent risk factor for ASD (aOR = 7.76; 95%CI = 4.31-13.97). Thus, regular monitoring of parent-reported concerns may be invaluable in early screening programs for ASD.