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In population and clinical cohorts autism is not recognized in some children until school\u2010age or later. One hundred and fifty\u2010nine infants with an older sibling with autism underwent research diagnostic assessments at 3\u2009years and mid\u2010childhood (6 to 12\u2009years (mean 9)). We report the autism sibling recurrence rate in mid\u2010childhood and compare developmental and behavioral profiles at mid\u2010childhood and 3\u2009years in those with earlier versus later recognized autism, and those who had, or had not, received a community autism diagnosis. The autism recurrence rate in this sample in mid\u2010childhood was 37.1%, 95% CI [29.9%, 44.9%] and higher in boys than girls. Around half of those diagnosed with autism in mid\u2010childhood had not received a diagnosis at 3\u2009years. Later, diagnosis was more common in girls than boys. While some had sub\u2010threshold symptoms at 3, in others late diagnosis followed a largely typical early presentation. Sibling recurrence based on community clinical diagnosis was 24.5%, 95% CI [18.4%, 31.9%]. Those who also had a community diagnosis tended to be older, have lower adaptive function and higher autism and inattention symptoms. Notwithstanding limitations of a single site study, modest sample size and limits to generalisability, autism sibling recurrence in family history infants may be higher in mid\u2010childhood than in studies reporting diagnostic outcome at 3\u2009years. Findings have implications for families and clinical services, and for prospective family history studies.<\/jats:p>","DOI":"10.1002\/aur.3182","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T10:59:56Z","timestamp":1720436396000},"page":"1501-1514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Mid\u2010childhood autism sibling recurrence in infants with a family history of autism"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9623-0473","authenticated-orcid":false,"given":"Tessel","family":"Bazelmans","sequence":"first","affiliation":[{"name":"Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowan","family":"Arthur","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Pasco","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Shephard","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bosiljka","family":"Milosavljevic","sequence":"additional","affiliation":[{"name":"School of Biological and Behavioural Sciences Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannath Begum","family":"Ali","sequence":"additional","affiliation":[{"name":"Centre for Brain and Cognitive Development, Birkbeck University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Pickles","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology &amp; Neuroscience, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark H.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Centre for Brain and Cognitive Development, Birkbeck University of London  London UK"},{"name":"Department of Psychology University of Cambridge  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily J. 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