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We aimed to characterize stage\u2010specific phenotypes and temporal onset patterns of autism using longitudinal electronic health records (EHRs). We analyzed EHR data from Columbia University Irving Medical Center. Autism cases were stratified by age at diagnosis. Phenotype enrichment analyses were performed using chi\u2010square and Fisher's exact tests to identify phenotypes overrepresented in autism cases compared with matched controls, and temporal patterns of phenotype onset were subsequently evaluated to identify stage\u2010specific clinical signatures and provide insight into differences between early\u2010 and late\u2010diagnosed individuals. Among 4818 cases and 1433 phenotypes, 195 and 155 were enriched in toddlerhood and adolescence groups. Early diagnosed individuals exhibited a higher prevalence of sensory\u2010related conditions, greater exposure to maternal and perinatal complications than their matched controls (all ORs &gt;\u20091;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01), and earlier onset of neurologic features, including coordination abnormalities and convulsions, compared with later\u2010diagnosed individuals. The study provides a publicly accessible resource to enrich autism\u2010related phenotypic profiles, uncovering notable phenotypic differences and variations in timing of phenotype onset between early\u2010diagnosed and later\u2010diagnosed individuals. These findings underscore phenotypic heterogeneity and highlight the need for age\u2010sensitive screening strategies. To our knowledge, this is among the first studies to jointly characterize phenotypic profiles and their temporal onset patterns across developmental stages in autism using longitudinal EHR data. These findings offer novel insights into age\u2010dependent clinical signatures, informing earlier and more precise screening strategies.\n                  <\/jats:p>","DOI":"10.1002\/aur.70378","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T05:49:12Z","timestamp":1791784152000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characterizing Autism Phenotype Onset in the Electronic Health Records to Enable Age\u2010Specific Screening"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2926-1063","authenticated-orcid":false,"given":"Fangyi","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Biomedical Informatics Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8740-8409","authenticated-orcid":false,"given":"Jerard","family":"Kneifati\u2010Hayek","sequence":"additional","affiliation":[{"name":"Division of General Medicine Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7568-7132","authenticated-orcid":false,"given":"Charlotte","family":"Zelin","sequence":"additional","affiliation":[{"name":"The University of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da","family":"Wu","sequence":"additional","affiliation":[{"name":"Raymond G. Perelman Center for Cellular and Molecular Therapeutics Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4181-7943","authenticated-orcid":false,"given":"Quan M.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Raymond G. Perelman Center for Cellular and Molecular Therapeutics Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Bioengineering University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4679-805X","authenticated-orcid":false,"given":"Casey N.","family":"Ta","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5585-982X","authenticated-orcid":false,"given":"Kai","family":"Wang","sequence":"additional","affiliation":[{"name":"Raymond G. 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