Evidence map›Paper›PMID 40889145›Full record

ArticleJournal of child psychology and psychiatry, and allied disciplines2026

Initial diagnosis patterns of coexisting mental health and neurodevelopmental conditions in autistic children and youth: Evidence from a nationally representative sample in Canada.

Yun-Ju Chen, Meng-Chuan Lai, Stelios Georgiades, Eric Duku, Jordan Edwards, Emma Nolan, Peter Szatmari, Ryan Miller, Katherine Cost, Katholiki Georgiades

Abstract read
In one paragraph

Article in Journal of child psychology and psychiatry, and allied disciplines, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yun-Ju ChenOfford Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-0659-2110
Meng-Chuan LaiCampbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.ORCID 0000-0002-9593-5508
Stelios GeorgiadesOfford Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.
Eric DukuOfford Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.
Jordan EdwardsHamilton Health Sciences, Hamilton, Ontario, Canada.
Emma NolanOfford Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.
Peter SzatmariCampbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Ryan MillerOfford Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.
Katherine CostOfford Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.
Katholiki GeorgiadesOfford Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-1413-9332

Funding

Canadian Neurodevelopmental Research Training Platform
6 · The paper itself

Abstract

backgroundElevated prevalence of coexisting health conditions has been observed in autistic people, yet how the timing of their initial diagnoses varies by sex and age of autism diagnosis remains understudied. Using a person-centered approach, we examined the patterns of initial diagnosis for mental health and neurodevelopmental conditions among autistic children and youth identified from the general population.

methodsThe sample was drawn from the 2019 Canadian Health Survey on Children and Youth (CHSCY) cohort (N = 47,781), consisting of 776 5-17-year-olds (82% assigned-male-at-birth) with a caregiver-reported diagnosis of autism. Multigroup latent class analysis was used to identify subgroups based on ages of initial diagnoses of autism, anxiety, mood, learning, and attention-deficit/hyperactivity disorders stratified by sex assigned at birth. Functional difficulties and multimorbidity status, including the number and types of coexisting conditions, were compared across the subgroups.

resultsFour latent subgroups were identified for each sex group, primarily differentiated by the age of autism diagnosis. The most prevalent class (46%) was characterized by an initial autism diagnosis at ages 3-5 years. The remaining subgroups, with autism diagnosed primarily before age 3, at 6-8, and at 9-17 years, each comprised ~20% of the sample. Subgroups with autism diagnosed after age 6 tended to have more coexisting conditions, with females showing heightened probabilities of mental health diagnoses across age windows from birth to age 17 years. The temporal order of coexisting diagnoses relative to autism diagnosis varied across subgroups, with sex differences more evident for anxiety and attention-deficit/hyperactivity disorders.

conclusionsThere were nuanced variations in the timing of initial diagnoses of coexisting conditions based on the age of autism diagnosis. The sex-varying patterns highlight the importance of continuous monitoring and evaluation of the neurodevelopmental and mental health needs of autistic children and youth, with supports tailored to sex and the timing of autism diagnosis.

Indexed as

Attention Deficit Disorder with HyperactivityAutism Spectrum DisorderAutistic DisorderLearning DisabilitiesMood DisordersNeurodevelopmental DisordersAdolescentCanadaChildChild, PreschoolComorbidityFemaleHealth SurveysHumansMaleSex Factorsage of diagnosisAutismmental healthneurodevelopmental conditionssex differences

Identifiers

PMID40889145
PMCPMC12812786

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.