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J Am Acad Child Adolesc Psychiatry. 2016 Mar;55(3):179-87. doi: 10.1016/j.jaac.2015.12.014. Epub 2016 Jan 8.

Prospective Longitudinal Studies of Infant Siblings of Children With Autism: Lessons Learned and Future Directions.

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Child and Youth Mental Health Collaborative, the Hospital for Sick Children and Centre for Addiction and Mental Health, and Division of Child and Youth Mental Health, University of Toronto. Electronic address:
Toddler Developmental Disabilities Clinic, Yale Child Study Center, New Haven, CT.
School of Medicine, Duke Institute for Brain Sciences, Duke University, Durham, NC.
Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore.
Weill Cornell Medical College, New York Presbyterian Hospital, New York and Teachers College, Columbia University, New York.
University of Miami, FL.
Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health (NIMH), Bethesda, MD.
Autism Science Foundation, New York and Rutgers University, New Brunswick, NJ.



The objectives of this review are to highlight the impact of the first decade of high-risk (HR) infant sibling work in autism spectrum disorder (ASD) and to identify potential areas of translational focus for the next decade of research.


A group of clinicians and researchers in ASD working both inside and outside of the HR design met on a regular basis to review the infant sibling research, and came to an agreement on areas that had changed clinical practice and areas that had the potential to change practice with further research. The group then outlined several methodological and translational challenges that must be addressed in the next decade of research if the field is to reach its potential.


The review concluded that the HR design has yielded an understanding that ASD often, but not always, begins to emerge between 6 and 18 months, with early signs affecting social communication. Research using the HR design has also allowed a better understanding of the sibling recurrence risk (between 10% and 20%). Emerging areas of interest include the developmental trajectories of social communications skills in the early years, the expression of a milder phenotype in siblings not affected with ASD, and the possibility that early intervention with infant siblings may improve outcomes for those with ASD. Important challenges for the future include linking screening to intervention, collecting large sample sizes while ensuring cross-site reliability, and building in capacity for replication.


Although there are significant methodological and translational challenges for high-risk infant sibling research, the potential of this design to improve long-term outcomes of all children with ASD is substantial.


autism; development; longitudinal; opportunities; sibling

[Available on 2017-03-01]
[Indexed for MEDLINE]
Free PMC Article

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