Evidence map›Paper›PMID 39762643›Full record

ArticleJournal of autism and developmental disorders2026

Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts.

Heather E Volk, Diogo Fortes, Rashelle Musci, Amanda Kim, Theresa M Bastain, Carlos A Camargo, Lisa A Croen, Dana Dabelea, Cristiane S Duarte, Anne L Dunlop and 23 more

Abstract read
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In one paragraph

Article in Journal of autism and developmental disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Review
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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

33 authors.

Heather E VolkDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, HH811, Baltimore, MD, 20215, USA. Hvolk1@jhu.edu.ORCID http://orcid.org/0000-0002-5415-2494
Diogo FortesDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, HH811, Baltimore, MD, 20215, USA.
Rashelle MusciDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, HH811, Baltimore, MD, 20215, USA.
Amanda KimDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, HH811, Baltimore, MD, 20215, USA.
Theresa M BastainDepartment of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
Carlos A CamargoDepartment of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Lisa A CroenDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Dana DabeleaLifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Cristiane S DuarteDivision of Child and Adolescent Psychiatry, Columbia University, New York, NY, USA.
Anne L DunlopDepartment of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.
Kennedy GachigiDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, HH811, Baltimore, MD, 20215, USA.
Akhgar GhassabianDepartments of Pediatrics and Population Health, NYU Grossman School of Medicine, New York, NY, USA.
Irva Hertz-PicciottoDepartment of Public Health Sciences and the MIND Institute, University of California Davis, Davis, CA, USA.
Kathi C HuddlestonGeorge Mason University, Fairfax, VA, USA.
Robert M JosephDepartment of Anatomy and Neurobiology, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA.
Daniel KeatingDepartment of Psychology and Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
Rachel S KellyChanning Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Young Shin KimDept. of Psychiatry and Behavioral Sciences, UCSF, San Francisco, CA, USA.
Rebecca J LandaKennedy Krieger Institute, Baltimore, MD, USA.
Leslie D LevePrevention Science Institute, University of Oregon, Eugene, OR, USA.
Kristen LyallAJ Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
Jessie B NorthrupUniversity of Pittsburgh, Pittsburg, PA, USA.
Thomas O'ConnorDepartments of Psychiatry, Neuroscience, Obstetrics and Gynecology, University of Rochester, , Rochester, NY, USA.
Sally OzonoffDepartment of Psychiatry and Behavioral Sciences and the MIND Institute, University of California, Davis, Sacramento, CA, USA.
Anna RossDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, HH811, Baltimore, MD, 20215, USA.
Rebecca J SchmidtDepartment of Public Health Sciences and the MIND Institute, University of California Davis, Davis, CA, USA.
Julie B SchweitzerDepartment of Psychiatry and Behavioral Sciences and the MIND Institute, University of California, Davis, Sacramento, CA, USA.
Lauren C ShuffreyDepartment of Child and Adolescent Psychiatry, Child Study Center, Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA.
Coral ShusterWomen and Infants Hospital of Rhode Island, Providence, RI, USA.
Emily VanceDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, HH811, Baltimore, MD, 20215, USA.
Scott T WeissChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Greta WilkeningIchan School of Medicine at Mount Sinai, New York, NY, USA.
Robert O WrightIchan School of Medicine at Mount Sinai, New York, NY, USA.

Funding

Project-005U2COD023375 · OD · DUKE UNIVERSITY · PI Linda S Adair, Phillip Brian Smith · 2016 to 2026
$215.9M
ECHODAC (Environmental Influences on Child Health Outcomes Data Analysis Center)U24OD023382 · OD · JOHNS HOPKINS UNIVERSITY · PI Diane J Catellier, LISA P JACOBSON · 2016 to 2026
$148.4M
The ECHO Measurement Core: A Framework and Resource for Assessing Environmental Exposure and Child HealthU24OD023319 · OD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Courtney K Blackwell, RICHARD GERSHON · 2016 to 2026
$43.7M
Prenatal and Early Childhood Pathways To Health:  An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory OutcomesUH3OD023271 · OD · UNIVERSITY OF WASHINGTON · PI BUSH, NICOLE RENEE, KARR, CATHERINE J · 2018 to 2022
$37.3M
ECHO Laboratory Core at Vanderbilt for Integrated Sample Biobanking and ProcessingU24OD035523 · OD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Suman Ranjan Das, NATASHA Bassam HALASA · 2023 to 2026
$32.8M
Lifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory Health (LA DREAMERs)UH3OD023287 · OD · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BASTAIN, THERESA M, BRETON, CARRIE VAN DOREN · 2018 to 2022
$28.4M
Statistical Services and Methods Development ResourceU2CES026555 · NIEHS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI GENNINGS, CHRIS · 2015 to 2025
$26.4M
Untargeted Analysis ResourceU2CES026561 · NIEHS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI WRIGHT, ROBERT O · 2015 to 2025
$24.5M
Environmental Influences on Child Health Outcomes in Puerto Rico (ECHO-PRO)UH3OD023251 · OD · NORTHEASTERN UNIVERSITY · PI Akram N Alshawabkeh · 2018 to 2026
$24.0M
Early Life Stress and the Environmental Origins of Disease: a Population-based Prospective Longitudinal Study of Children in Rural Poverty (ECHO)UH3OD023332 · OD · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI KOPP, LISA MICHELLE, SWINGLER, MARGARET M. · 2018 to 2022
$22.7M
ENVIRONMENTAL INFLUENCES ON NEURODEVELOPMENTAL OUTCOME IN INFANTS BORN VERY PRETERMUH3OD023347 · OD · WOMEN AND INFANTS HOSPITAL-RHODE ISLAND · PI LESTER, BARRY M., MARSIT, CARMEN JOSEPH · 2018 to 2022
$18.4M
BREAKING THE CYCLE OF INTERGENERATIONAL DISADVANTAGE: NEURODEVELOPMENT AMONG PUERTO RICAN CHILDREN.UH3OD023328 · OD · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI CANINO, GLORISA J, DUARTE, CRISTIANE S. · 2018 to 2022
$18.3M
Eunice Kennedy Shriver National Institute of Child Health and Human Development R01HD072267NHLBI NIH HHS K01 HL146980NHLBI NIH HHS R01 HL091528NHLBI NIH HHS R01HL091528NICHD NIH HHS P50 HD103538NICHD NIH HHS R01 HD072267NIEHS NIH HHS R24 ES028533NIEHS NIH HHS R24ES028533NIEHS NIH HHS U24 ES026539NIEHS NIH HHS U2C ES026533NIEHS NIH HHS U2C ES026542NIEHS NIH HHS U2C ES026555NIEHS NIH HHS U2C ES026561NIEHS NIH HHS U2C ES030851NIEHS NIH HHS U2C ES030857NIEHS NIH HHS U2C ES030859NIH HHS U24 OD023319NIH HHS U24 OD023382NIH HHS U24 OD035523NIH HHS U2C OD023375NIH HHS UG3 OD023251NIH HHS UG3 OD023342NIH HHS UG3 OD035508NIH HHS UG3 OD035509NIH HHS UG3 OD035513NIH HHS UG3 OD035516NIH HHS UG3 OD035517NIH HHS UG3 OD035518NIH HHS UG3 OD035519NIH HHS UG3 OD035521NIH HHS UG3 OD035526NIH HHS UG3 OD035527NIH HHS UG3 OD035528NIH HHS UG3 OD035529NIH HHS UG3 OD035532NIH HHS UG3 OD035533NIH HHS UG3 OD035536NIH HHS UG3 OD035537NIH HHS UG3 OD035540NIH HHS UG3 OD035542NIH HHS UG3 OD035543NIH HHS UG3 OD035544NIH HHS UG3 OD035546NIH HHS UG3 OD035550NIH HHS UH3 OD023251NIH HHS UH3 OD023253NIH HHS UH3 OD023268NIH HHS UH3 OD023271NIH HHS UH3 OD023286NIH HHS UH3 OD023287NIH HHS UH3 OD023318NIH HHS UH3 OD023320NIH HHS UH3 OD023328NIH HHS UH3 OD023332NIH HHS UH3 OD023347NIH HHS UH3 OD035543NIH Office of the Director ES0266542NIH Office of the Director U24ES026539NIH Office of the Director U24OD023319NIH Office of the Director U24OD023382NIH Office of the Director U24OD035523NIH Office of the Director U2CES026533NIH Office of the Director U2CES026542NIH Office of the Director U2CES026555NIH Office of the Director U2CES026561NIH Office of the Director U2CES030851NIH Office of the Director U2CES030857NIH Office of the Director U2CES030859NIH Office of the Director U2COD023375NIH Office of the Director UG3OD035508NIH Office of the Director UG3OD035509NIH Office of the Director UG3OD035513NIH Office of the Director UG3OD035516NIH Office of the Director UG3OD035517NIH Office of the Director UG3OD035518NIH Office of the Director UG3OD035519NIH Office of the Director UG3OD035521NIH Office of the Director UG3OD035526NIH Office of the Director UG3OD035527NIH Office of the Director UG3OD035528NIH Office of the Director UG3OD035529NIH Office of the Director UG3OD035532NIH Office of the Director UG3OD035533NIH Office of the Director UG3OD035536NIH Office of the Director UG3OD035537NIH Office of the Director UG3OD035540NIH Office of the Director UG3OD035542NIH Office of the Director UG3OD035543NIH Office of the Director UG3OD035544NIH Office of the Director UG3OD035546NIH Office of the Director UG3OD035550NIH Office of the Director UG3/UH3OD023244NIH Office of the Director UG3/UH3OD023248NIH Office of the Director UG3/UH3OD023249NIH Office of the Director UG3/UH3OD023251NIH Office of the Director UG3/UH3OD023253NIH Office of the Director UG3/UH3OD023272NIH Office of the Director UG3/UH3OD023275NIH Office of the Director UG3/UH3OD023279NIH Office of the Director UG3/UH3OD023282NIH Office of the Director UG3/UH3OD023285NIH Office of the Director UG3/UH3OD023288NIH Office of the Director UG3/UH3OD023289NIH Office of the Director UG3/UH3OD023290NIH Office of the Director UG3/UH3OD023305NIH Office of the Director UG3/UH3OD023313NIH Office of the Director UG3/UH3OD023337NIH Office of the Director UG3/UH3OD023342NIH Office of the Director UG3/UH3OD023344NIH Office of the Director UG3/UH3OD023348NIH Office of the Director UG3/UH3OD023349NIH Office of the Director UG3/UH3OD023365NIH Office of the Director UG3/UH3OD023389NIH Office of the Director UH3OD023268NIH Office of the Director UH3OD023271NIH Office of the Director UH3OD023286NIH Office of the Director UH3OD023287NIH Office of the Director UH3OD023318NIH Office of the Director UH3OD023320NIH Office of the Director UH3OD023328NIH Office of the Director UH3OD023332NIH Office of the Director UH3OD023347
6 · The paper itself

Abstract

purposeOur goals were to: 1) examine the occurrence of behavioral and emotional symptoms in children on the autism spectrum in a large national sample, stratifying by sex, and 2) evaluate whether children with increased autism-related social communication deficits also experience more behavioral and emotional problems.

methodsParticipants (n = 7,998) were from 37 cohorts from the Environmental influences on Child Health Outcomes (ECHO) Program. Cross-sectional information on demographic factors, parent-report of an ASD diagnosis by clinician, Social Responsiveness Scale (SRS) scores, and Child Behavior Checklist (CBCL) scores were obtained for children aged 2.5-18 years by surveys. We examined mean differences in CBCL Total Problems and DSM-oriented subscale scores by autism diagnosis and by child sex. Analyses using logistic regression were conducted to examine whether autism was associated with higher CBCL scores. We further examined if these relationships differed by child age category (< 6 years, 6-11 years, 12 + years). The relationships between SRS score and CBCL total and subscale scores were examined using quantile regression models, with analyses adjusted for child sex and age.

resultsIn ECHO, 553 youth were reported by a parent to have a clinician diagnosis of autism spectrum disorder (ASD) (432 [78%] boys and 121 [22%] girls). Youth on the spectrum had higher mean CBCL raw scores on Total Problems and all DSM-oriented subscales compared to those not on the spectrum (all p < 0.0001). Analyses adjusted for sex and stratified by age group indicated that higher odds of autism diagnosis were associated with total, depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD) scales in the top 30% of the CBCL score distribution. Autistic girls were more likely to have parent-reported depression and anxiety compared to autistic boys. In quantile regression analyses, we observed evidence of stronger associations between SRS and CBCL for those in higher quantiles of CBCL total problems scale score (beta representing 1-unit change in SRS associated with 1-unit increase in CBCL total problems scale score), among children in the 70-90th percentile (β = 1.60, p < 0.01), or top 10th percentile (β = 2.43, p < 0.01) of the CBCL total problems scale score distribution. Similar findings were seen for the DSM-oriented depression, anxiety, and ADHD subscales.

conclusionResults from this large national sample suggest increased behavioral and emotional problems among autistic children compared to non-autistic children throughout early life. Among children on the spectrum this may warrant increased monitoring for co-occurring behavioral and emotional problems.

Indexed as

Autism Spectrum DisorderAdolescentChildChild, PreschoolCohort StudiesComorbidityCross-Sectional StudiesFemaleHumansMaleSex FactorsAnxietyAutism spectrum disorderDepressionPsychopathology

Identifiers

PMID39762643
PMCPMC12409737

What Socratic holds

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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 Socratic graph.