Abstract
Background/Objectives: Increasing scientific evidence supports the importance of early diagnosis of autism spectrum disorder (ASD), followed by timely intervention, in optimizing developmental trajectories. Despite these advances, achieving an early diagnosis remains challenging, and substantial delays in the diagnostic process continue to be reported worldwide. This study aimed to describe the clinical and sociodemographic characteristics associated with early referral to a telehealth parent-mediated intervention program for infants at high likelihood for ASD, under 18 months of age, with the broader goal of informing clinical services in the field of neurodevelopmental disorders. Methods: Infants were evaluated by a multidisciplinary team using standardized measures to assess autism risk, developmental functioning, adaptive behavior, and parental stress. Potential differences in age at access to the program were examined by comparing families who were referred before versus after 12 months of age. Results: Of the 78 families who expressed interest in the program, 69 consented and 60 met eligibility criteria (male/female ratio = 40/20; mean age = 10.0 months). Families were evenly distributed across Italy, and 66% of parents held a university degree. Self-referral accounted for 62% of cases. Higher parental concern was associated with earlier referral and children referred after 12 months of age showed significantly lower developmental and adaptive functioning scores. Conclusions: These findings support the feasibility of identifying prodromes of autism within the first year of life and highlight gaps in specialized services for infants at elevated likelihood in Italy. Maternal concern and self-referral drove early consultation, underscoring the need for improved pediatric training. Future studies should assess longitudinal population-based screening and the feasibility and long-term impact of timely interventions in routine care.