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Kaiser Permanente Study Finds Risk for Autism in Younger Children Increases Significantly If They Have Older Sibling with Disorder

August 5, 2016



mother walking with children

PASADENA, Calif., — A new Kaiser Permanente study found that the risk of younger siblings developing an autism spectrum disorder is 14 times higher if an older sibling has ASD. The study, which was published today in Journal of Developmental & Behavioral Pediatrics, also found the risk level was consistent across gestational age at birth.

Autism is a neurodevelopmental disorder defined by impairments in social interaction and communication, as well as restricted and repetitive patterns of behavior. It occurs in 1 in 68 children, according to the most recent data from the Centers for Disease Control and Prevention.

The cause of autism is unknown, but research has identified a number of different genetic and environmental factors that may play a role in its development. Previous research from Kaiser Permanente has found that second-born children who are conceived sooner than two years or later than six years after the arrival of their older sibling have a significantly increased risk of ASD.

“Our study provides additional insights into how autism affects siblings,” explained Darios Getahun, MD, PhD, study senior author, Kaiser Permanente Southern California, Department of Research & Evaluation. “These findings also contribute to a better understanding of the influence of factors such as gender on autism risk.”

The study included Kaiser Permanente members in Southern California and focused on at least two siblings born to the same mother between 28 and 42 weeks of gestation from 2001 through 2010. Researchers examined the medical records of the 53,336 children born during this time, of which 592 were diagnosed with ASD, and found:

  • Children with older siblings who had ASD had an ASD rate of 11.3 percent compared to 0.92 percent for those with unaffected older siblings.
  • Compared with gestational age-matched younger siblings without ASD diagnosis, those born at term (37-42 gestational weeks) who had an older sibling diagnosed with ASD had more than 15 times the increased risk for ASD diagnosis. Younger siblings who were born at preterm (28-36 gestational weeks) and had an older sibling diagnosed with ASD had an almost 10 times increased risk for ASD.
  • Younger boys with ASD who had older brothers were much more likely to be affected by the disorder than younger girls with older sisters (15 percent vs. 7 percent, respectively.)

“It’s possible that parents who have an older child with an autism diagnosis are more likely to have their younger siblings tested, too, resulting in a higher rate of diagnoses among younger siblings, compared with parents who do not have children diagnosed with an autism spectrum disorder,” noted Dr. Getahun.

The researchers also noted that the gender difference observed in this study could be due to biases in diagnosis and reporting. “Previous research has indicated that girls may be less likely to be referred for a diagnostic assessment or, if referred, they may be more likely to be misdiagnosed than boys,” added Dr. Getahun.

Other authors of the study include Fagen Xie, PhD, from the Kaiser Permanente Southern California, Department of Research & Evaluation, and Morgan Peltier, PhD, from the Department of Obstetrics-Gynecology, Winthrop University, New York.

This study was supported by funding from the Kaiser Permanente Community Benefit Fund.

About the Kaiser Permanente Southern California Department of Research & Evaluation
The Department of Research & Evaluation conducts high-quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiologic research, health services research, biostatistics research, and behavioral research as well as clinical trials. Major areas of study include chronic disease, infectious disease, cancer, drug safety and effectiveness, and maternal and child health. Headquartered in Pasadena, California, the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general public. Visit kp.org/research.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 10.6 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.