{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:57:32Z","timestamp":1790837852333,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["P50HD093074"],"award-info":[{"award-number":["P50HD093074"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Autism Research"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Autism commonly co\u2010occurs with other neurodevelopmental conditions (NDCs), although diagnostic trajectories of an autism diagnosis relative to other NDCs are not well understood. We sought to examine the prevalence of NDCs within autistic children and how co\u2010occurrence is associated with the timing of autism diagnoses. All children born between January 1, 2014 and December 31, 2015, and who had continuous enrollment in North Carolina Medicaid between less than 1\u2009month old through autism diagnosis were included. This time period was chosen because follow\u2010up data is available through December 31, 2022, which allowed inclusion of children to at least 8\u2009years of age. From a cohort of 91,907 children, we identified 2694 children (77% boys) diagnosed with autism spectrum disorder. We found language (82%) and global developmental (52%) delays the most prevalent co\u2010occurring NDCs. Within the most common combinations of co\u2010occurring NDCs, over half (55%) of autistic children were diagnosed with three combinations of NDCs (24% with motor, language, and global developmental delays; 16% with language delay only; 16% with language and global developmental delays). Diagnoses of NDCs are associated with earlier autism diagnoses, with autism diagnoses occurring 10.8\u2009months earlier for developmental, 8.4\u2009months for language, and 7.2\u2009months earlier for motor delays than children without these co\u2010occurring diagnoses. Earlier autism diagnoses were especially evident in children who received neurodevelopmental delay diagnoses between 1.5 and 2\u2009years of age. These findings are clinically relevant for developmental screening in children with neurodevelopmental disorders and intervention recommendations for autistic children.<\/jats:p>","DOI":"10.1002\/aur.70365","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:21:22Z","timestamp":1790835682000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterizing the Prevalence of Co\u2010Occurring Neurodevelopmental Conditions and Associations With the Timing of Diagnosis in Autism in Medicaid\u00a0Claims Data"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6715-7016","authenticated-orcid":false,"given":"Marika Cerie","family":"Coffman","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"Scheer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4112-9639","authenticated-orcid":false,"given":"Matthew","family":"Engelhard","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4434-7500","authenticated-orcid":false,"given":"Lauren","family":"Franz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-0335","authenticated-orcid":false,"given":"Gary","family":"Maslow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham North Carolina USA"},{"name":"Department of Pediatrics Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1410-2764","authenticated-orcid":false,"given":"Geraldine","family":"Dawson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham North Carolina USA"},{"name":"Department of Pediatrics Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5261-3632","authenticated-orcid":false,"given":"Benjamin Alan","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University School of Medicine  Durham North Carolina USA"},{"name":"Department of Pediatrics Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0054-7148","authenticated-orcid":false,"given":"Wei Angel","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association.2013.Diagnostic and Statistical Manual of Mental Disorders.5th ed.https:\/\/doi.org\/10.1176\/appi.books.9780890425596.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1007\/s10803-009-0755-y","article-title":"Brief Report: Parental Age and the Sex Ratio in Autism","volume":"39","author":"Anello A.","year":"2009","journal-title":"Journal of Autism and Developmental Disorders"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"3367","DOI":"10.1007\/s10803-018-3598-6","article-title":"Parental First Concerns and Timing of Autism Spectrum Disorder Diagnosis","volume":"48","author":"Becerra\u2010Culqui T. A.","year":"2018","journal-title":"Journal of Autism and Developmental Disorders"},{"issue":"8","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","DOI":"10.3390\/children10081414","article-title":"Comorbidities Affecting Children With Autism Spectrum Disorder: A Retrospective Chart Review","volume":"10","author":"Burns J.","year":"2023","journal-title":"Children"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2023.104390"},{"issue":"2","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"e2254303","DOI":"10.1001\/jamanetworkopen.2022.54303","article-title":"Predictive Value of Early Autism Detection Models Based on Electronic Health Record Data Collected Before Age 1 Year","volume":"6","author":"Engelhard M. M.","year":"2023","journal-title":"JAMA Network Open"},{"issue":"1","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13034-022-00462-1","article-title":"Current State of Knowledge on the Prevalence of Neurodevelopmental Disorders in Childhood According to the DSM\u20105: A Systematic Review in Accordance With the PRISMA Criteria","volume":"16","author":"Franc\u00e9s L.","year":"2022","journal-title":"Child and Adolescent Psychiatry and Mental Health"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ridd.2020.103702","article-title":"Motor Delay\u2010An Early and More Common \u201cRed Flag\u201d in Girls Rather Than Boys With Autism Spectrum Disorder","volume":"104","author":"Gabis L. V.","year":"2020","journal-title":"Research in Developmental Disabilities"},{"issue":"12","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1002\/aur.3043","article-title":"Sex Differences in the Age of Childhood Autism Diagnosis and the Impact of Co\u2010Occurring Conditions","volume":"16","author":"Gu Z.","year":"2023","journal-title":"Autism Research"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018\u20103963"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1007\/s10803-009-0810-8","article-title":"Sex Differences in Autism Spectrum Disorder: An Examination of Developmental Functioning, Autistic Symptoms, and Coexisting Behavior Problems in Toddlers","volume":"39","author":"Hartley S. L.","year":"2009","journal-title":"Journal of Autism and Developmental Disorders"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.pediatrneurol.2015.09.008","article-title":"Infant Motor Delay and Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations in Japan","volume":"54","author":"Hatakenaka Y.","year":"2016","journal-title":"Pediatric Neurology"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jbi.2024.104711","article-title":"A Conditional Multi\u2010Label Model to Improve Prediction of a Rare Outcome: An Illustration Predicting Autism Diagnosis","volume":"157","author":"Huang W. 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E.","year":"2010","journal-title":"Journal of Developmental and Behavioral Pediatrics"},{"issue":"2","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1002\/aur.2230","article-title":"Prevalence of Motor Difficulties in Autism Spectrum Disorder: Analysis of a Population\u2010Based Cohort","volume":"13","author":"Licari M. K.","year":"2020","journal-title":"Autism Research"},{"issue":"11","key":"e_1_2_10_19_1","first-page":"1","article-title":"Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8\u2009Years\u2014Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018","volume":"70","author":"Maenner M. J.","year":"2021","journal-title":"Morbidity and Mortality Weekly Report. Surveillance Summaries"},{"issue":"2","key":"e_1_2_10_20_1","first-page":"1","article-title":"Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8\u2009Years\u2014Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020","volume":"72","author":"Maenner M. J.","year":"2023","journal-title":"Morbidity and Mortality Weekly Report. Surveillance Summaries"},{"issue":"3","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1002\/aur.2261","article-title":"Autism Heterogeneity in a Densely Sampled US Population: Results From the First 1,000 Participants in the RI\u2010CART Study","volume":"13","author":"McCormick C. 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Types of Controls","volume":"135","author":"Wacholder S.","year":"1992","journal-title":"American Journal of Epidemiology"}],"container-title":["Autism Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/aur.70365","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/aur.70365","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/aur.70365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:21:29Z","timestamp":1790835689000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/aur.70365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":34,"alternative-id":["10.1002\/aur.70365"],"URL":"https:\/\/doi.org\/10.1002\/aur.70365","archive":["Portico"],"relation":{},"ISSN":["1939-3792","1939-3806"],"issn-type":[{"value":"1939-3792","type":"print"},{"value":"1939-3806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"2025-10-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70365"}}