Carnegie Mellon University
March 15, 2017

Grandma Knows Best: Research Explains How Family Members Can Impact Autism Diagnosis

By Shilo Rea

image of a grandmother and grandchild sitting together

Early detection is critical for improving treatment for those with autism spectrum disorder (ASD). And often, those closest to a child notice the first signs.

New research reveals that children who had frequent interaction with grandparents or older siblings were diagnosed earlier with ASD. Published in the journal Autism, the study was the first to ask not only parents, but also friends and family members who had contact with the child about their early observations.

In the study from Columbia Business School, Carnegie Mellon University and the Seaver Autism Center for Research and Treatment at Mt. Sinai, parents reported family members were integral catalysts in diagnosing children with ASD. Approximately 50 percent of friends and family reported they suspected a child had a serious condition before they were aware that either parent was concerned. Maternal grandmothers and teachers were most often the first to raise concerns.

"Many parents avoid seeking help to find a diagnosis for their child, even though they sense something might be wrong," said Nachum Sicherman, the Carson Family Professor of Business at Columbia Business School. "They often ignore signs of a larger problem and look the other way, making the role of close family members and friends vital to accelerating diagnosis and helping a child's condition."

The researchers found frequent interaction with a grandmother reduces the age of ASD diagnosis by 5.18 months, and frequent interaction with a grandfather reduces the age of diagnosis by 3.78 months.

While interactions with grandparents play an important role, family structure also impacts the age of diagnosis. Children with no siblings are diagnosed with ASD on average six to eight months sooner than others. Additionally, the presence of older siblings, especially when the youngest child is in question, reduces the age of diagnosis by 9.5 to 10 months, compared with children who only have younger siblings. Hence, it appears older children serve as a reference point, helping parents calibrate whether younger siblings are on-target developmentally.

"This study is unique because we asked multiple friends and family members about the factors that may contribute to age of diagnosis of autism. We were troubled that about half of the friends and family who were concerned about a child were reluctant to share their concerns. Importantly, frequent interaction with a grandparent, and particularly a grandmother, was associated with earlier diagnosis," said Joseph D. Buxbaum, professor of psychiatry, neuroscience and genetics and genomic sciences at the Seaver Autism Center for Research and Treatment at Mt. Sinai.

Carnegie Mellon's George Loewenstein said, "The study provides new evidence of the occurrence of information-avoidance, and of its consequences."

Prior research by Loewenstein, the Herbert A. Simon University Professor of Economics and Psychology, and Sicherman examined information avoidance and documented an "ostrich effect" among investors, who are more likely to avoid looking up the value of their portfolio when the market is down.

The findings in "Grandma Knows Best: Family Structure and Age Diagnosis of Autism Spectrum Disorder" suggest there are opportunities to achieve an earlier diagnosis by tapping into wisdom from friends and family. Accelerating the age of diagnosis can have long-term effects on a child's behavior and improve overall treatment, social behavior and IQ.

Teresa Tavassoli of the Seaver Autism Center for Research and Treatment at Mt. Sinai also participated in the research.

The Organization for Autism Research and the Seaver Foundation funded this study.

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