ChatGPT: Artificial Intelligence as a Potential Tool for Parents Seeking Information About Autism.

Autism Spectrum Disorder has seen a drastic increase in prevalence over the past two decades, along with discourse rife with debates and misinformation. This discourse has primarily taken place online, the main source of information for parents seeking information about autism. One potential tool for navigating information is ChatGPT-4, an artificial intelligence question and answer-style communication program. Although ChatGPT shows great promise, no empirical work has evaluated its viability as a tool for providing information about autism to caregivers. The current study evaluated answers provided by ChatGPT, including basic information about autism, myths/misconceptions, and resources. Our results suggested that ChatGPT was largely correct, concise, and clear, but did not provide much actionable advice, which was further limited by inaccurate references and hyperlinks. The authors conclude that ChatGPT-4 is a viable tool for parents seeking accurate information about autism, with opportunities for improvement in actionability and reference accuracy.

Autism Prevalence and the Intersectionality of Assigned Sex at Birth, Race, and Ethnicity on Age of Diagnosis.

PURPOSE: An official autism diagnosis is required to access timely intervention and is associated with better long-term wellbeing and mental health. Certain demographic characteristics, such as being female or a racially or ethnically minoritized youth, have been associated with significant diagnostic lag. However, it remains unclear how assigned sex, race, and ethnicity interact with each other in predicting the prevalence and age of autism diagnosis. METHODS: To examine the interactions between assigned sex, race, and ethnicity, we used data from the National Survey of Children's Health (NSCH; 2016 > 2021). RESULTS: One in 38 children had an autism diagnosis and 3.8 males were diagnosed per 1 female. Hierarchical linear regressions yielded diagnostic delays in some females, particularly those who were non-Hispanic white, Black, and Asian. Ethnic and racial minority children had significantly earlier diagnoses than white and non-Hispanic children when not accounting for sex. CONCLUSION: This study demonstrates slight increases in reported autism prevalence, a diagnostic lag in some autistic females that was strongly associated with ethnicity, and earlier diagnoses in racial and ethnic minority youth, a finding that may be explained by factors associated with phenotypic differences. This study has important implications for the diagnosis of minority autistic youth, particularly females and females who are non-Hispanic, who may experience a greater propensity for diagnostic delays.

Sensory Reactivity of Infants at Elevated Likelihood of Autism and Associations with Caregiver Responsiveness.

Infants at elevated likelihood of developing autism display differences in sensory reactivity, especially hyporeactivity, as early as 7 months of age, potentially contributing to a developmental cascade of autism symptoms. Caregiver responsiveness, which has been linked to positive social communication outcomes, has not been adequately examined with regard to infant sensory reactivity. This study examined the multiplicative impact of infant sensory hypo- and hyperreactivity on caregiver responsiveness to sensory reactivity and regulation cues in 43 infants at elevated likelihood of autism. Sensory hyperreactivity was found to moderate the association between sensory hyporeactivity and caregiver responsiveness, such that caregivers of infants with moderately high sensory hypo- and hyperreactivity demonstrated higher responsiveness.

Family history predicts stress fracture in active female adolescents.

OBJECTIVE: Increased physical activity and menstrual irregularity have been associated with increased risk for stress fracture among adult women active in athletics. The purposes of this study were to determine whether menstrual irregularity is also a risk factor for stress fracture in active female adolescents and to estimate the quantity of exercise associated with an increased risk for this injury. PATIENTS AND METHODS: A case-control study was conducted of 13- to 22-year-old females diagnosed with their first stress fracture, each matched prospectively on age and self-reported ethnicity with 2 controls. Patients with chronic illnesses or use of medications known to affect bone mineral density were excluded, including use of hormonal preparations that could alter menstrual cycles. The primary outcome, stress fracture in any extremity or the spine, was confirmed radiographically. Girls with stress fracture had bone mineral density measured at the lumbar spine by dual-energy x-ray absorptiometry. RESULTS: The mean +/- SD age of the 168 participants was 15.9 +/- 2.1 years; 91.7% were postmenarchal, with a mean age at menarche of 13.1 +/- 1.1 years. The prevalence of menstrual irregularity was similar among cases and controls. There was no significant difference in the mean hours per week of total physical activity between girls in this sample with stress fracture (8.2 hours/week) and those without (7.4 hours/week). In multivariate models, case subjects had nearly 3 times the odds of having a family member with osteoporosis or osteopenia. In secondary analyses, participants with stress fracture had a low mean spinal bone mineral density for their age. CONCLUSIONS: Among highly active female adolescents, only family history was independently associated with stress fracture. The magnitude of this association suggests that further investigations of inheritable skeletal factors are warranted in this population, along with evaluation of bone mineral density in girls with stress fracture.

Skeletal measurements by quantitative ultrasound in adolescents and young women with anorexia nervosa.

OBJECTIVE: To compare quantitative ultrasound (QUS) measurements in adolescents with anorexia nervosa (AN) with that in healthy control subjects and to determine the utility of QUS as a tool to evaluate skeletal status in these patients. STUDY DESIGN: Female adolescents with AN (n = 41) and healthy control subjects (n = 105) were recruited. Speed of sound (SOS) was measured at the radius and tibia. Participants with AN also had hip and spinal areal bone mineral density measurements by dual-energy x-ray absorptiometry (DXA); bone mineral apparent density (BMAD) was calculated. RESULTS: Subjects with AN had higher mean radial SOS (4044 +/- 99 m/s) than did control subjects (3947 +/- 116 m/s; P < .0001). These results were replicated at the tibia (AN, 3918 +/- 85 m/s vs control subjects, 3827 +/- 106 m/s; P < .0001). Neither DXA measures of areal bone mineral density nor BMAD were correlated with SOS. Weight and body mass index were negative predictors of tibial but not radial SOS. AN status remained a significant predictor of SOS after controlling for body mass index, age, and race. CONCLUSIONS: Subjects with AN had higher mean tibial and radial SOS than did control subjects. QUS variables did not correlate with DXA measures, calculated BMAD, or anthropometric variables. QUS measurements of SOS do not appear to be appropriate for bone density screening in patients with AN.

Effects of nutrition, puberty, and gender on bone ultrasound measurements in adolescents and young adults.

PURPOSE: Quantitative ultrasound (QUS) evaluation of bone is attractive for evaluating skeletal status in adolescents, but its use is limited in the United States due to sparse pediatric reference data. This study evaluated associations between radial and tibial speed of sound (SOS) measurements via QUS and demographic, anthropometric and nutritional variables. METHODS: We enrolled 151 healthy participants, aged 11-26 years, during routine visits to an urban adolescent clinic. SOS measurements were obtained using the Omnisense 7000P (Sunlight Medical Ltd., Tel-Aviv, Israel) and correlated with weight, height, gender, race, sexual maturity rating (SMR), and reported nutritional intake. RESULTS: The sample was 53% female; aged 17+/- 2.8 years (mean +/- SD); and 48% African-American, 21% Hispanic, and 21% Caucasian. Seventy percent of males and 91% of females had achieved SMR 5; 96% of females were postmenarchal. Males met the recommended daily allowance for calcium intake, on average; the females did not. Both the girls and boys reported consumption of inadequate vitamin D. Intake of neither calcium nor vitamin D was correlated with SOS. Radial and tibial SOS were significantly higher in those with SMR 5 (p < .001) and were moderately correlated with age in both genders (r = .42-.64, p < .001). In multivariate analyses, age was associated with SOS at both sites (p < .0001). CONCLUSIONS: This study provides QUS measurements of the peripheral skeleton among healthy adolescents. QUS measurements followed similar age and pubertal distributions to dual-energy X-ray absorptiometry (DXA) bone density measurements; other variables did not follow expected trends. Further research is needed to clarify what skeletal properties are assessed by this technique. This study adds to accumulating evidence that many adolescents do not consume adequate vitamin D or calcium.