From Toddlers to Late Childhood: Age-Related Patterns in Parental Concerns About Autism

Purpose: Concerns raised by parents regarding their child’s social-communication development often align closely with an eventual autism diagnosis. However, most studies have focused on toddlers and less is known about how the content and salience of these concerns shift across childhood. This study compared parental concerns related to DSM-5 criteria for ASD across different age groups and examined age-related patterns. Methods: The sample included 171 children aged 12 to 151 months, divided into four age groups: toddlerhood, preschool age, middle childhood, and late childhood. Parental concerns were extracted from the open-ended section of the Autism Diagnostic Interview-Revised (ADI-R) and coded according to the seven DSM-5 criteria for ASD. Results: Analyses revealed three distinct developmental patterns in concern frequency. First, concerns related to social-emotional reciprocity (Criterion A1) and sensory reactivity (Criterion B4) remained relatively stable across age groups. Second, concerns about restricted and fixated interests (Criterion B3) gradually increased with age. Third, several concerns showed stepwise shifts: reports of nonverbal communication deficits (Criterion A2) declined sharply over time, whereas concerns about peer relationships (Criterion A3), repetitive behaviors (Criterion B1), and insistence on sameness (Criterion B2) became more frequent in older children. Conclusion: These findings suggest that parental perceptions of ASD-related behaviors are influenced by both child age and contextual demands, with different symptom domains becoming more or less salient at various points in development. The study underscores the dynamic nature of parental reporting and highlights the importance of incorporating developmental considerations into screening and diagnostic practices.