Talk:Autism

The image

I’m autistic.

A baby stacking cans is not a good picture. It has little to do with autism and suggests no internal complexity on the part of autistic people. It makes it look… basic. Boring. Like the kind of thing that only leads to annoying and pointless habits. Meaningless.

What would be better? In my opinion, an artistic representation of some sort of creative activity or of something that’s really relevant to autism would be much better. The sheer depth and complexity and difficulty and beauty of being autistic is not portrayed by the cans baby.

Note: I don’t want to try to send any specific message about autism through the image. It should portray autism in a neutral way. I just want something that is a little more dignified than the baby. Thoughts? Language Boi (talk) 05:18, 12 May 2024 (UTC)

It’s also the case that there have been very few times in my life when I have had absolutely no friends. This is true of most autistic people. The image might be able to hint at the fact that social interactions are not always difficult for autistic people. Language Boi (talk) 05:30, 12 May 2024 (UTC)

Same, @Language Boi! 206.57.152.111 (talk) 14:58, 6 November 2024 (UTC)

Autism is a very large diagnosis - every autistic person has a different experience with it and no two autistic people have the exact same characteristics/symptoms of the disorder. It is true that repetitive lining up and stacking of objects is a behavior associated with autism, even if you're autistic and you didn't do that as a child. Also, very few pictures actual suggest internal complexity - that is the job of the article. I would actually argue that some kind of diagram trying to show complexity in autistic people would be counterproductive, and having the photo of a human being is a lot more fitting. With Love from Cassie Schebel (talk) 19:40, 12 May 2024 (UTC)

I'm not suggesting a diagram-that would be a bad idea. I just think that if we find a better image we should use it. The cans baby doesn't show the whole picture. I did lots of goofy things as a kid-but autism gives me serious feelings and ideas. It's more than just something that causes weird habits.

Note: I'm using "goofy" and "weird" here as shorthand for "things that don't have a direct purpose and arguably lack deep meaning". There's nothing wrong with such behaviors (I have several myself), but the picture should show autism from a more big-picture perspective. Language Boi (talk) 20:57, 12 May 2024 (UTC)

The child is a toddler, the cans are stacked very precisely, the photo is showing a child with unusual skill levels for his or her age. It seems to me to be a relatively positive image of autism. Urselius (talk) 17:34, 13 May 2024 (UTC)

I agree - but I can see @Language Boi's point. Perhaps a similar but more impressive behavior, something that shows both intelligence and autistic behavioral patterns, would be better.

However - and this is something that can be difficult to cope with - we have to remember that not all autistic people are as fortunate as we are. Autism is a condition that can cause severe developmental disability. There are people who, due to autism, lack either that internal complexity or the ability to utilize and express it.

With the scope and variability of Autism, I don't think there will ever actually be a particularly good well-representative lead picture. With Love from Cassie Schebel (talk) 22:09, 16 May 2024 (UTC)

What about an image from some sort of autistic-related movement or protest? I think that some pages related to the LGBTQ community have that. Lots of those pages also have a symbol of some sort. Maybe we could use that rainbow infinity sign thing? It just seems really weird to have autism represented by a young child doing something nonproductive or antisocial. I’m not completely opposed to it but we can do better. Language Boi (talk) 23:19, 21 May 2024 (UTC)

I agree with using an image that doesn't have a singular person in it. What about this image? https://commons.wikimedia.org/wiki/File:Autistic_Pride_Flag.png. It's used on other articles about Autism and its community Tonkarooson (talk) *new editor* 01:09, 22 May 2024 (UTC)

Autism is a medical diagnosis. Images about social movements do not represent medical topics. Autism rights movement (a social movement) already have that. --WikiLinuz (talk) 16:46, 22 May 2024 (UTC)

If I remember correctly, that image I suggested has been added to one of the Autism articles one time before the merging. Tonkarooson (talk) *new editor* 03:45, 23 May 2024 (UTC)

"There are people who, due to autism, lack either that internal complexity or the ability to utilize and express it."

That's not actually true. If any autistic person lacks either internal complexity or the inability to use it, that is due to a co-occurring intellectual disability, not their autism. 80.193.98.150 (talk) 11:26, 28 September 2024 (UTC)

you sure? I'm pretty sure autism can be higher support needs like an intellectual disability Anthony2106 (talk) 12:40, 28 September 2024 (UTC)

Read again: "...co-occurring intellectual disability..." Basically, I never said that intellectual disability never occurs alongside autism, as you seem to be implying I claimed, I only stated that two characteristics of intellectual disability specifically are not characteristics of autism generally. 80.193.98.150 (talk) 13:42, 3 October 2024 (UTC)

@80.193.98.150 yeah but autistic people can "lack either that internal complexity or the ability to utilize and express it." even if they don't have a interlectal disability Anthony2106 (talk) 06:58, 6 October 2024 (UTC)

Yes, a person can lack the ability to communicate certain things due to autism, but that is not at all the same thing as lacking internal complexity or the ability to use it, which is what I originally asserted. You need to stop moving the goalposts because arguing that way indicates disingenuousness. 80.193.98.150 (talk) 10:34, 15 October 2024 (UTC)

Here's the thing: most of the people commenting and who likely wrote this page and "protected" it from correction by calling it "protection for vandalism..." You denounce, people who are called high support needs, which isn't even a term used, by many people who are autistic. We do not like it. It let's you call me high supports need, while thinking no support needs. And, excuses your ignorance of the higher amount of needs that I do have. Nevermind that I can't afford to even get a diagnosis because it's such a racket. No doctor will diagnose it in adult and the few that do charge you thousands of dollars. And, insurance does not pay for it. Most who need the diagnosis don't have the financial freedom or capabilities to afford that. I'm sure, as you read this, you're reminding yourself "But, you're high support needs..." ignoring you are insinuating to yourself this means no support needs. Those who have needed support all their life, but have not gotten it. They have struggled along, are still struggling along, and can't afford it. I was diagnosed with savant syndrome as a child because my parent fought to keep the doctor from diagnosing me with autism. At the time, autism was still consider childhood schizophrenia. So, for that I am glad she did it. But, it does not help now. Getting a diagnosis now will be almost impossible, and convincing people that I struggle as much as I do is less so. It doesn't matter that even people who knew me that remember the entire family teasing me because they considered me speaking, walking, and hitting other early childhood developmental milestones late. I REMEMBER them calling me retarded, slow, and saying I was going to need lots of help or be put in a care facility; saying I was very "retarded" and not all there. Not knowing that I had a very rich inner dialogue, one that I used to help me teach myself to talk, and then I just one day started talking. Because I went from completely nonverbal to speaking like a little adult just before turning 3 yrs old; I was actually first classified as being a prodigy in the neuropsych evaluation before the start of school. It wasn't just the speaking, it was what else I was able to comprehend and had already learned, or taught myself by the time I had begun speaking. And, because I spoke so well, people tended to forget the earlier issues. When clear social issues and other issues that most people associate with autism (then and now) became apparent I would be reevaluated, and I would be reclassified as a savant. My parent would use that diagnosis to stave off and help people forget how they conditioned me to not present autistic in other ways long before any of that! While it was conditioning, I will not let people continue to be blind to the fact that most of that conditioning is a result of sheer trauma from abuse. You get to disavow yourself of damage done by telling yourself that if a person masks, that if they're able to not be autistic, or able to stop being autistic, then they must not be or must not be too much; NONE OF THIS IS WHAT IS HAPPENING THOUGH. You have the children who were truly just conditioned through things like ABA; and if you have tried to convince yourself that ABA is anything other than that, then you are the worst kind of abuser. But, there are the children who were truly abused, terrorize, and traumatized into masking. Not that most will care anyway, as that would mess up their narrative. For many, it is to acknowledge that they have done something possibly horrific to someone they care about; and many people will not allow themselves to acknowledge that. For others, it is to acknowledge something that they see as a severe flaw that they can draw correlations or similarities to themselves. Once again, most humans will not allow themselves to do that! Trauma! That is how an overwhelming majority of us were "conditioned" into what I've had people call not "appearing to be autistic..." All because they are too ignorant to know, and too lazy to do actual research and find out what autism is, that you can have something comorbid with autism, and that can differentiate how a person presents (as with any condition). 96.234.220.222 (talk) 06:43, 6 October 2024 (UTC)

I don't really see the issue with the autism baby? it shows an autistic person engaging in an activity that's typical for autism, in a natural and neutral way. boring isn't necessarily bad either—especially for an encyclopedia. it neither dramatizes nor glamorizes the subject.

you're never gonna show "the whole picture" of autism in a single pic because autism is too heterogeneous. and you're never gonna show the internal experience of autism in a single pic because by their very nature, pictures only capture what's outwardly observable (you can't capture what a person feels when sorting objects, but you can show that sorting objects is a common activity in autistics). a single picture is inherently reductive, there's no way around it. but an autistic person doing a typically autistic thing is still appropriately illustrative, in my opinion. as a comparison, the page for Intellectual disability shows children participating in the special olympics, Developmental coordination disorder shows a picture of shoes to illustrate the fact that tying laces is difficult for people with DCD, Obsessive–compulsive disorder illustrates hand-washing, Schizophrenia a piece of art by a person with schizophrenia, and Dysgraphia shows handwriting by an adult with dysgraphia. None of these pictures show the full depth and complexity of the subject matter, or the internal complexity of the people with the disability—and they don't have to.

if you have a better picture, by all means bring it forward (especially if there can be improvement of the demographic diversity of the images on this page—e.g. most pics now are of kids, so an adult would be nice), but I don't think the autism baby is so bad that we should urgently look for replacement or flat-out remove it. TheZoodles (talk) 15:51, 19 May 2024 (UTC)

I propose Greta Thunberg as the photo. She is a notable person with autism, and many other wikipedia articles don't use a photo to represent the entire subject, but to give a notable example. Here are some: Arch, Murder, Lesbian, Car. What these articles have in common is that their subject has a wide diversity in appearance - no one picture is going to represent all arches, all murders, all lesbians, or all cars. The same is true for autistic people, so perhaps a notable example of an autistic person is the best choice. With Love from Cassie Schebel (talk) 21:29, 20 May 2024 (UTC)

I don't mind what the picture is changed to but I feel like a picture of Elon Musk when he was a guest appearance on SNL, him saying he was diagnosed with Asperger's syndrome. I suggest Elon as a picture because he is a very well known person, and how smart he is. Tonkarooson (talk) *new editor* 03:31, 21 May 2024 (UTC)

He’s also, arguably, an ass. This doesn’t mean that we should silence him, but Greta Thunberg is much less controversial when it comes to spreading misinformation. I would suggest someone like Einstein but he was never diagnosed with autism or anything. Language Boi (talk) 23:12, 21 May 2024 (UTC)

Greta Thunberg is also controversial - I do think that certain things that make both of these people controversial are actually autistic traits. People don't tend to be receptive to different communication styles - so when someone in the public eye has these autistic traits, they're disliked. I would support Elon Musk being the preview image for this article. With Love from Cassie Schebel (talk) 23:22, 21 May 2024 (UTC)

I don't really think content about Elon being autistic should be written in this article. We can put that in Asperger's syndrome article. I don't think he ever mentioned that he himself is autistic (he only mentioned Asperger's) so I think it'd be WP:SYNTH to deduce him this way (fwiw, he did mention his son being autistic though). Also, it doesn't matter if he's an ass or not - we don't add/remove content based on our personal opinions, see WP:NPOV. --WikiLinuz (talk) 16:42, 22 May 2024 (UTC)

Asperger's is a form of autism, actually, so Elon does indeed count as officially autistic (not so sure about his being actually autistic, though, given his complete lack of emotional empathy). 80.193.98.150 (talk) 16:04, 17 October 2024 (UTC)

I think that if your idea here is to avoid offensive comparisons or stereotypes -- if we're assuming that someone will look at the lead image and have that be the only piece of information they retain about people with autism -- I would aver that "a kid having fun minding their own business" is infinitely better than "annoying celebrity who mouths off on Twitter about politics 24/7". I mean, imagine this conversation:

• "ah, I heard about that, that's the syndrome that makes you be a kid who stacks up cans of vegetables?"
• "ah, I heard about that, that's the syndrome that makes you be Elon Musk?"
• "ah, I heard about that, that's the syndrome that makes you be Greta Thunberg?"

jp×g🗯️ 13:21, 28 May 2024 (UTC)

I mean, if it absolutely needs to be a hot relevant celeb pic, at least have it be John Elder Robison or Temple Grandin or something, for Christ's sake -- we don't have a picture of Donald Trump at bone spurs or Rachel Maddow at depression etc. jp×g🗯️ 13:40, 28 May 2024 (UTC)

People are going to be idiots and make irrational comparisons, this is not something we can change, therefore not something we need to concern ourselves over.

Furthermore, I didn't choose Greta because I like her, or I think she represents autism well; but because she is a notable and influential and has autism.

Also, the two examples you gave are much easier to represent with an image than autism, which is why this discussion began in the first place. Nobody is going to say that an X-ray of bone spurs is misrepresenting the condition. ~Puella Mortua~ Signed from the grave. (séance me!) 15:11, 28 May 2024 (UTC)

I strongly oppose using Greta Thunberg (or any specific notable individual) as the image. I think similar reasoning to MOS:PEOPLEGALLERY should apply here. It takes a judgement call to choose a specific person to represent a large group. (I think the "Lesbian" article is a different case as it's an artwork that clearly depicts the topic.) — Vigilant Cosmic Penguin 🐧 (talk | contribs) 20:48, 28 May 2024 (UTC)

There's a similar image on the Simple English version.

The URL: https://simple.wikipedia.org/wiki/Autism_spectrum Tonkarooson (talk) *new editor* 03:53, 23 May 2024 (UTC)

I have learned of this and am strongly opposed to changing the image. Nothing was wrong with the initial one. Me and all of my autismal buddies loved the kid stacking the cans, which was not only a neat pic but one that clearly demonstrated the traits of being an autist. I never heard anybody say a bad word about it. The kid was beloved. Now it is some random photo of a celebrity -- awful. jp×g🗯️ 13:09, 28 May 2024 (UTC)

I think Thunberg is only controversial in right wing political/petroleum industry circles, and who cares about them? The problem with trying to illustrate autistic traits is that no single trait will be universal. I am a diagnosed autist and I never stacked objects or arranged them in lines as a child. Having a the image of a celebrity in the infobox is an ideal way to prominently indicate that autism is not only a childhood condition, but is lifelong. Urselius (talk) 15:04, 28 May 2024 (UTC)

If this comment isn't a troll, it is wildly inappropriate -- are you really making the explicit argument that we should choose a politically contentious illustration for the pupose of annoying/demoralizing/etc people we disagree with? jp×g🗯️ 23:55, 29 May 2024 (UTC)

I am saying that political and industry viewpoints should have zero influence on an image in an encyclopaedic treatment of autism. Urselius (talk) 08:12, 1 June 2024 (UTC)

I have posted a link to this discussion on reddit along with a snippet from the discussion.I am posting this notice to avoid accusations of unintentional stealth canvassing or meat-puppetry. This is a simple disclosure, you may respond or disregard at your leisure. (talk) 01:36, 24 July 2024 (UTC)

Thank you, @Language Boi. I agree with you and have agreed for years. I believe a 22-year-old home photograph of a toddler stacking cans is an infantilizing and outdated view of an entire human condition.

While I believe it can stay in the article (no pun intended), it should not be the primary/representative image.

For example, note how the woman and man primary images are those of adults, not children.

An autistic adult engaging in autistic behavior would be far more representative of autism as a whole. Either that, or a strictly medical representation.

Here are my proposals for the primary/representative image:

"An autistic author, 2020."' This shows an autistic adult who is not a celebrity (Siena Castellon) achieving something related to autism (publishing The Spectrum Girl's Survival Guide). It is a high-quality modern photograph, not of a child or toddler, and not in a home, childcare, or medical setting.

"A nonverbal autistic child (left) and a caretaker (right), 2020." This is closer to our time period and shows an older, happy child. It is a more high-quality photograph, though still suffers some infantilization and medical association.

"An autistic public speaker in Oxford, 2012." Another autistic adult, who is not a celebrity (Paul Isaacs), engaging in behavior directly related to autism (speaking about autism at a sensory issues event). A high-quality, closer-to-modern photograph. Not a childcare or medical setting. Would be best cropped, however.

"The first winner of Mr. Autism Kenya, 2023." A slightly more historically significant event. Shows an autistic adult, who is not a celebrity, engaging in behavior directly related to autism (winning an award relating to being autistic).

"An image of an autistic mind versus a typical mind." Lastly, we can evade an photograph at all. I think the medical image would be the most accurate image as a header for such an expansive topic.

Evedawn99 (talk) 20:54, 19 August 2024 (UTC)

1, 3, and 4 are bad illustrative examples. For the brain image there would need to be secondary coverage of the study supporting it's validity. Traumnovelle (talk) 22:14, 19 August 2024 (UTC)

I'm autistic and the picture is about the last thing to take issue with! If you could read that entire article and walk away with only issues about the picture they used; there's your trouble... 96.234.220.222 (talk) 06:55, 6 October 2024 (UTC)

I genuinely think you might be one of the only people who genuinely has an issue with this image.. I came here to look because I've seen autistic people, like myself, grieving the image online. Why don't we reinstate it until you find a "better" image? I'm not sure you're even gonna find anything as complex as you seem to deem fit for the page.. RubraDolorosa (talk) 15:53, 25 October 2024 (UTC)

According to MOS:IMAGERELEVANCE "Images should look like what they are meant to illustrate", but none of the images mentioned or used thus far look like autism. Perhaps we should consider just not having an image, because there is really nothing that looks like autism. (Take any of those images, show them separately - not in the article - to a sample of people and ask them what the image looks like. How many people would say "that's a picture of autism"?) Mitch Ames (talk) 00:16, 29 May 2024 (UTC)

Like any MOS guideline it is not applicable to every case and people who do not recognise this shortcoming have missed an important fact. Try finding an image that looks like disestablishmentarianism, for example. Having disposed of the MOS as not applicable and irrelevant, we are given a choice of having an image that has relevance to autism, or no image at all. Personally, I would prefer a related image to no image. Urselius (talk) 08:27, 29 May 2024 (UTC)

It is essentially impossible to highlight the diversity and complexity of the autism spectrum with one image. The picture of the toddler seemed okay to me. It shows a child on the autism spectrum engaging in a repetitive behavior, in this case stacking cans. It may not be very exciting, but it's an accurate depiction of a common symptom/trait of people on the autism spectrum. Besides, showing an image of a person with autism who also has extraordinary skills seems like it would perpetrate stereotypes, as the vast majority of people with autism do not have such abilities. FriendlyNeighborhoodAspie (talk) 19:40, 26 July 2024 (UTC)

you like person first language better? Anthony2106 (talk) 10:46, 30 July 2024 (UTC)

I'm sorry, I don't understand. Could you try to communicate your idea/opinion more clearly? FriendlyNeighborhoodAspie (talk) 16:45, 30 July 2024 (UTC)

Most autistic people like Identity-first language but if you like person-first lauguage I wont bother you about it. Anthony2106 (talk) 00:18, 31 July 2024 (UTC)

As my name suggests, I am on the autism spectrum. I prefer to be refered to as a person with autism rather then an autistic person, which I suppose would mean I prefer person first language, due to "autistic person" implying that autism is the defining trait of that person, and common usage of the word "autistic" as an insult or synonymous with intellectual disability. FriendlyNeighborhoodAspie (talk) 00:43, 31 July 2024 (UTC)

This editor (me) is an example of an autistic person who prefers identity-first language. :) Evedawn99 (talk) 21:00, 19 August 2024 (UTC)

Well, I suppose I can see why identity first language could be preferred. "Person with autism" could potentially imply autism is a disease. It is not. Autism is a part of my identity, and even if it causes significant difficulty and mental pain in my daily life, it is not something I would change about myself. And I, along with what appears to be the majority of people with Asperger's syndrome/High functioning autism, do not want to be cured. So, if "autistic person" implies it to be a part of one's identity, rather than a disease one suffers from, then I can certainly see why one would prefer to be referred to with identity first language. I still prefer person first language, as autism is, after all, not my ONLY characteristic. FriendlyNeighborhoodAspie (talk) 19:22, 17 September 2024 (UTC)

In my opinon telling people your autistic dosen't mean its your only characteristic. Say what you want Anthony2106 (talk) 13:48, 18 September 2024 (UTC)

Just to reinforce this point: I only ever see this argument made with respect to disabilities, I think. If I say 'I'm a British person' nobody says 'don't let your Britishness define you'; if I tell people I'm bisexual, nobody seems to assume that's my chief (let alone sole) defining characteristic.

A strong majority of English-speaking autistic people prefer identity-first language, according to a large number of polls. Common reasons include the impossibility of separating a person from their autism, and the fact that when someone says 'a person with X', X is most often (not always) a disease or something on those lines. Oolong (talk) 12:13, 23 October 2024 (UTC)

@Oolong good point I think this has something to do with the social model of disability. Anthony2106 (talk) 12:38, 23 October 2024 (UTC)

Poll proposal

Considering the discussion already taken place. I propose a purality poll on the topic, 2-3 weeks length on which image to use. Until then the popular long time used can stacking image stays in place. I don't forsee a enormously clear concensus taking place with the number of options increasing seemingly. I think this is fair considering this is a very subjective matter, so whatever is the most popular view on it will be expressed on the page. Everyone can state which image option they are for, state a brief argument or point to a longer one expressed elsewhere on the talk page --LachlanTheUmUlGiTurtle (talk) 12:05, 19 August 2024 (UTC)

See WP:RFC Traumnovelle (talk) 19:40, 19 August 2024 (UTC)

The disagreement about infobox image

The lengthy discussion about changing the infobox image turning into a big disagreement has sparked me to say that the image just should be of something not someone; discussions about having the image of something has less disagreements than an image of someone. But there, of course, needs to be a consensus on this. Tonkarooson (talk) *new editor* 01:23, 31 May 2024 (UTC)

Thank you for your idea. For "something" rather than someone I would propose File:Powell2004Fig1A.png which illustrates the mind differences. I have also included it in my gallery above. Evedawn99 (talk) 20:56, 19 August 2024 (UTC)

I would oppose a brain scan image, because they tend to be wildly misleading. I don't believe that this one represents anything approaching a set of generally established differences between autistic and other brains, for example. Oolong (talk) 12:16, 23 October 2024 (UTC)

The kid with the cans as folk hero

Seeing as one of the primary concerns here is that the pic of the kid with the cans is offensive or infantilizing, such that the choice of image here is strictly a policy issue, and more of an optics issue. I think this is completely false. I will offer here a few facts:

• I have autism and so do a lot of my friends.
• Inasmuch as I've heard people comment on this infobox image in a non-Wikipedia context (which isn't a very common subject of conversation to begin with), it has been of unequivocal support and positive regard for both the kid with the cans, as well as his use as an illustration. I have never heard somebody say that
• This specific infobox illustration is regularly commented on by the public, which is again somewhat rare for an infobox image -- and is quite well-received, viz. this tweet ("every few years i check wikipedia to see if the autism baby stacking cans is still the main image representing Our Beautiful Nation") with ten thousand retweets and eighty thousand likes. Beneath it is a litany of comments like:
  • "There's something so poetic about this pic actually being relatable to a lot of the Autistic community where other places try and fail".
  • "I love the stacking cans pic bc I used to stack cans as a toddler and then at 16 I was like “hm I wonder if I have autism, maybe I should read up on Wikipedia” and then I got hit with that image immediately. Great start on my journey."
  • "I feel like I've succeeded as an Autistic adult because my job is basically stacking cans"
  • "I feel so seen and represented"

Given that we don't really have a way of setting up a Gallup poll, I think this is about as close as we're going to get to a public consensus on the image -- and from this it seems notable to me that I cannot find anybody saying they feel marginalized or offended by the picture, versus a great number who say it represents them in a positive way. Moreover, it's been here for a solid several years, and while there are occasionally arguments about its inclusion (e.g. Talk:Autism/Archive_5#Header_Photo from Feb 2023 which also features Urselius), they rarely reach any sort of consensus that the image is bad, even with the same people in the discussion each time.

Compare this to the photo of the celebrity, which has on this talk page alone caused several people to object in the last couple days -- of course, a couple people here and there aren't the end of the world, but I think it warrants asking how the "less offensive" image is getting complaints at, what, a hundred, thousand times the rate as the "more offensive" one? jp×g🗯️ 00:14, 30 May 2024 (UTC)

The image has certainly become a meme, and I, too, have been following the repercussions of its removal on X, Reddit, and other platforms. However, this is an encyclopedia, and its main (only?) goal is to be informative. Some of the tweets you quoted actually illustrate how out of place that image is. The main tweet didn't go viral because it showed how appropriate the image was. The mere fact that the child became known as "autism baby" and that stacking cans became immediately associated with autism should be enough to show that the child's "folk hero" status stems from how out of place the image was.

Stacking objects (cans included) is important developmental milestone as well as a broadly recommended activity. Images are important, and as one of the replies you quoted shows, if you come to read about autism and see a baby stacking cans as the most prominent image, and if you (or your child) are among the large majority of people who enjoyed stacking things at some point—most of whom are perfectly neurotypical—it's very possible that the image could be misleading. In that regard, the other image of a child sleeping next to different objects lined up would be much more representative of ASD, because that particular trait isn't a developmental milestone (although I don't support using that image either).

Is Greta the ideal choice? I don't think so, but it is more informative than the previous image. Ideally, we should come up with a meaningful visual representation of autism that visually identifies the article while being informative. I like the previously proposed idea of having something like a 7-sided polygon with each side filled with different intensities as an illustration of the DSM-5 diagnostic criteria.

Rkieferbaum (talk) 03:18, 30 May 2024 (UTC)

Agreed, there is clearly no consensus to change the image, which has lasted on Wikipedia for a very long time. The replacement was immediately criticised by two IP editors.

The reasons to remove it are not policy or guideline based but instead complaining about it being 'basic' and 'boring', which are hardly issues with an image in an encyclopaedia. Traumnovelle (talk) 00:28, 31 May 2024 (UTC)

My reason to remove it as specified in #Why is there a picture of a person with autism at the top of the page at all? (not sure if that topic would have been better added here) was "guideline based", i.e. MOS:LEADIMAGE. Ybllaw (talk) 09:58, 31 May 2024 (UTC)

The image was a representation of the topic; it was a boy with autism engaging in a stereotypy. The guideline supports inclusion of said image. Traumnovelle (talk) 20:21, 31 May 2024 (UTC)

Autism, as a non material concept - a specialised concept as it is a neurodevelopmental condition - cannot be illustrated in a literal way. There are no images of autism. Therefore, it is either no image in the lead or an image at some remove from the subject of the article. Any image showing a behaviour, even a stereotype, will be unrepresentative of a considerable proportion of autistic people. However, an image of one well-known autistic person can, with some level of legitimacy, stand for all. Urselius (talk) 20:33, 31 May 2024 (UTC)

An image does not have to be representative of every single person, see Woman. As for the 'non material concept', see Attention deficit hyperactivity disorder, which is a WP:GOODARTICLE or look at Beauty, Greed, Philosophy (featured article), and Altruism. Just to name a few. Traumnovelle (talk) 20:39, 31 May 2024 (UTC)

There is a difference between a general image and an image illustrating a stereotypical behaviour. Using one particular behaviour to illustrate a neurodevelopmental condition may give it undue prominence. In an extreme case it might inhibit a potentially autistic person who does not show that behaviour from seeking a diagnosis. We need to be careful. Urselius (talk) 21:05, 31 May 2024 (UTC)

It is a general image.

>In an extreme case it might inhibit a potentially autistic person who does not show that behaviour from seeking a diagnosis

So we should also remove the ducks in a row and the cork images too? Traumnovelle (talk) 21:09, 31 May 2024 (UTC)

They are problematical, but the lead image has much more impact than others. The major problems in autism are communication-based and sensory (with resultant problems including anxiety, OCD etc.), stacking/lining up objects, rocking and hand flapping are irrelevant to the real impact of the condition, and not all autists do them. Urselius (talk) 08:02, 1 June 2024 (UTC)

To address Greta: it does nothing to illustrate or inform a reader about autism. Traumnovelle (talk) 20:40, 31 May 2024 (UTC)

Neither does an image of a child stacking cans. It says nothing about life-long communication problems, alienation or sensory difficulties that make life really difficult, or increased suicide rates and lower life expectancy in autists. Plus an image of a small child merely reinforces the common misapprehension that autism is a childhood condition. Urselius (talk) 08:02, 1 June 2024 (UTC)

It demonstrates an autistic behaviour. You can't exactly illustrate any of those other things via an image, text is for that. Traumnovelle (talk) 08:04, 1 June 2024 (UTC)

But these behaviours are trivial, not universal and pander to the childhood condition stereotype. These represent considerable downsides. Perhaps an image of a non-vocal autistic person using a communication device would be ideal? It would eloquently indicate the communication difficulties common to all autists. Urselius (talk) 08:20, 1 June 2024 (UTC)

I was able to easily find several articles discussing can stacking. https://doi.org/10.1007/s10802-019-00606-6 even uses videos of stacking then compares how autistic and non-autistic children react to it. Traumnovelle (talk) 08:35, 1 June 2024 (UTC)

I could not enumerate the number of books and papers on communication problems in autism I found on Google Scholar, even autistic non-verbalism had very many. But mere numbers is not really relevant to the marginality that the occurrence of the lining up and stacking of objects in small children has to autism as a condition and the centrality of communication problems. Urselius (talk) 11:18, 1 June 2024 (UTC)

As an autistic person, I agree with you on this. The can stacking baby does a great job at representing an autistic behavior in an image. 🎸✒️ ZoidChan23 🥁🍕 18:24, 1 June 2024 (UTC)

As an autistic person, I profoundly disagree. The image merely reinforces a widely-held and incorrect opinion that autism is a childhood condition. Urselius (talk) 09:21, 11 June 2024 (UTC)

Right. And that it’s “childish “. Language Boi (talk) 18:48, 5 August 2024 (UTC)

Admittedly I did decide to post about this after seeing that tweet Language Boi (talk) 20:47, 31 May 2024 (UTC)

Autistic here. I share with you the feeling for the change, but bear with me here;

The boy stacking cans is an extremely iconic figure for us all, and, like the meme version of the C&BT article, will remain in our memories for generations to come, but it is most important that we remain focus in our objective to portray an informed picture of what is Autism, and if sacrificing the presence of this legendary image in favor of concreteness is what it takes, then we must adapt.

May our beloved boy live a thousand years more, forever in our minds. ThaNook (talk) 21:17, 2 June 2024 (UTC)

I, as a person with autism, feel marginalized. You’re creating a false sense of consensus that doesn’t exist. Language Boi (talk) 18:50, 5 August 2024 (UTC)

Stacking objects (typically blocks) is a common behaviour of all children - in fact it is a developmental milestone (search "developmental milestones stacking blocks"). I don't think it's "iconic" of autism to have a picture of a child doing what all children normally do. Mitch Ames (talk) 04:05, 6 August 2024 (UTC)

Having more then one image

Making a new section so it's organized better.

I have somewhat changed my opinion on the disagreeing image. Since I'm seeing quite a few people (including anonymous users) wanting the image back, the picture somehow grew on me. But I still don't prefer the image; I'll be fine with whatever picture is used. Tonkarooson (talk) *new editor* 22:26, 2 June 2024 (UTC)

@Tonkarooson can we just put like 5 images of the most common autistic traits so everyones happy that one of the photos is one they they did? Anthony2106 (talk) 21:50, 3 June 2024 (UTC)

cats have more then one image Anthony2106 (talk) 21:54, 3 June 2024 (UTC)

Sounds like an excellent idea, but the images would have to be found. Tonkarooson (talk) *new editor* 00:52, 4 June 2024 (UTC)

I can make drawings, but they may not be that good as I almost never draw. Anthony2106 (talk) 01:58, 4 June 2024 (UTC)

Lunascape has 2 images and buttons to swap them, maybe we could do that. Anthony2106 (talk) 09:40, 8 June 2024 (UTC)

The autism symbole

fuck it lets just put the autism sybole by commons:user:MissLunaRose12 as that one is a different colour to the nurodiversity symbole and should be the new autism symbole.

This would make it consistent with AIDS and Diabetes. Anthony2106 (talk) 00:50, 10 July 2024 (UTC)

this Language Boi (talk) 20:37, 10 July 2024 (UTC)

@Language Boi its good isn't it? Anthony2106 (talk) 22:02, 10 July 2024 (UTC)

Yeah honestly that seems perfect Language Boi (talk) 18:47, 5 August 2024 (UTC)

so you support puting the autism symbole? Anthony2106 (talk) 02:04, 12 July 2024 (UTC)

@Notcharizard @user:Mitch Ames @user:Urselius @user:Tonkarooson @User:Puella mortua @user:Traumnovelle @user:Language Boi @User:LachlanTheUmUlGiTurtlepeople what do you think about puting the symbole on the page. I pingned you to get you to see this section cus no one was responding. seeing this edit reminded me of my edit so I felt like coming here to ask about it. I also don't know if there is a rule about not pinging everyone so sorry if I broke that rule.

also the person who made this edit made a new section #Poll proposal, maybe that should go under here Anthony2106 (talk) 12:17, 19 August 2024 (UTC)

Personally I don't like the symbol, I think it doesn't convey anything of much inherently.

And I don't believe the poll proposal should be here, a poll proposal needs discussion for itself in it's design.

The difference between your edit and mine is you only had the support of 1 other on this page to put it up. Whereas there's many several voices to keep the can stacking picture on this talk page along with widespread public support on other platforms LachlanTheUmUlGiTurtle (talk) 12:26, 19 August 2024 (UTC)

Really? I do not like the image much, myself. Urselius (talk) 20:19, 19 August 2024 (UTC)

No because the symbol is representative of a social movement relating to the condition and not of the medical condition itself. See homosexual which has no lead image versus LGBT which has a lead image of a symbol of the social movement. Traumnovelle (talk) 18:56, 19 August 2024 (UTC)

As this article covers the societal aspects of autism (the autism community, political lobbying etc.) as well as the medical aspects, arguments to exclude societal images purely because they are societal lack merit, on the grounds of logic, if nothing else. I dislike the child stacker image because it panders to the widespread and false idea that autism is purely or predominantly a childhood condition. As such I would much prefer the infobox to be free of images and 'the stacker' image to be placed somewhere in the body of the text, to satisfy those who have some apparent fondness for it. Urselius (talk) 19:17, 19 August 2024 (UTC)

I agree with Urselius. It's not just a societal thing; a medical condition is part of the person who has it, so you cannot separate the societal aspect. The can-stacking behavior is also very hardly representative of autistic people; I know many personally and obsessive stacking is not part of any of their childhood behaviors.--Jasper Deng (talk) 19:26, 19 August 2024 (UTC)

so HIV/AIDS and Diabetes (the examples I used before) use the symboles because they are medical conditions that can be seperated from the person, unlike being autistic, so thats why we shouldnt use the symbole, is that what you were saying? Anthony2106 (talk) 23:44, 19 August 2024 (UTC)

Nitpick: it's symbol, not "symbole" with an extra e, and "separated", not "seperated". Both of these can use symbols as well if there's a well-accepted one. There is also a community around being AIDS. In any case, what we do with those is a red herring; we are talking about autism, not AIDS or diabetes.--Jasper Deng (talk) 23:52, 19 August 2024 (UTC)

yes I know Im bad at spelling you don't need to remind me.

I wasnt trying to make a red herring I was trying to use an example of other pages with symbols, but these pages are too diffrent form this page and may not apply, autism is not a disease. In that case maybe it is a red herring.

Nitpick back: I think having AIDS or people with AIDS is the correct one for AIDS Anthony2106 (talk) 00:25, 20 August 2024 (UTC)

It has a brief overview but it links to a larger main article. The article is still about the medical condition and not the societal aspects, hence why it says 'Main article: Societal and cultural aspects of autism' Traumnovelle (talk) 19:43, 19 August 2024 (UTC)

No image is still a better option than an infantilising image to illustrate for a lifelong condition. Autism is a condition that primarily impacts communication, not dexterity. Plus there are plenty of autistic people, including children, with impaired dexterity who would find stacking cans at any age quite a challenge. The 'stacker' is not a good illustration of the condition and its effects or of autistic people in general. Urselius (talk) 20:18, 19 August 2024 (UTC)

I agree. Stacking is non-specific to autism. The fact that Twitter thinks it's representative of autistic people is a problem, not something to base our editorial decision off of.--Jasper Deng (talk) 22:27, 19 August 2024 (UTC)

I aggree that Twitter should not be involved with wikipedia editing, but there is one more thing we would try if we want a photo (but at this point I dont mind not having one I got used to it) we could try having more then one photo like I seid in #Having more then one image Anthony2106 (talk) 23:33, 19 August 2024 (UTC)

The other problem is that you cannot "see" autism. It's not like a bone fracture that's seen via x-ray or MRI imagery.--Jasper Deng (talk) 23:53, 19 August 2024 (UTC)

its common for autistic people to have developmental coordination disorder so technicly autism dose affect dexterity - in a bad way. so now there is another reason not to use the stacker image Anthony2106 (talk) 23:46, 19 August 2024 (UTC)

I would chose the baby stacking the cans over the infinity. The infinity symbol is used in the autistic community, the article is mostly written about the diagnosis more than the traits associated with the individual.

As to what Jasper said, even though you can't technically spot out autism until it's mentioned, you can describe it with the sentence including the word. Tonkarooson (discuss). 00:28, 20 August 2024 (UTC)

@Tonkarooson: Your comment is confusing. If this is not about traits, then an image illustrating a(n) (incorrectly) purported trait (the can stacking image) is not the way to go.--Jasper Deng (talk) 00:39, 20 August 2024 (UTC)

I think you can see some autistic traits if you know enough about autism (eg you can see stimming), but everyone is diffrent, not everyone stacked cans as a kid, and I aggree with user:Urselius it makes people think its a kid thing (disablility/disorder/condition) and autism has nothing to do with dexterity apart from what I seid about DCD before. but the photo was a sitmmy activity thats an autistic trait, but I don't think its a poplour stim. maybe more photos could help like I menitoned in #Having more then one image but at this point I don't mind not having an image and if we do add more then one photo I wouldnt pick the stacker image to be one of them Anthony2106 (talk) 00:47, 20 August 2024 (UTC)

@Jasper Deng, @Anthony2106. It seems the best option is to have no image, or use the infinity. Tonkarooson (discuss). 00:55, 20 August 2024 (UTC)

Yeah I see the reasoning behind using the infinity symbol, but I think the cans stacking image better represents the real-life experiences of autistic individuals, as made evident and obvious by the community support for it. It’s relatable and neutral, helping to visually connect readers to the topic. LachlanTheUmUlGiTurtle (talk) 08:13, 20 August 2024 (UTC)

@LachlanTheUmUlGiTurtle I agree user:Urselius it makes people think its a kids condition, and autism has nothing to do with dexterity apart from DCD being common amung autistics Anthony2106 (talk) 08:20, 20 August 2024 (UTC)

No it is certainly not neutral. It is a very prominent visual support of the widespread and pernicious viewpoint that autism only affects children. Given Wikipedia's prominence as an informational source for the general public we really need the lead of this article to be genuinely neutral, by not featuring any image. The 'stacker' can go into the body of the text to satisfy those who find the image endearing or relatable. Urselius (talk) 10:38, 20 August 2024 (UTC)

arguing for no image to avoid any kind of bias and be neutral? im sure you could make the case any image has a bias on every page on wikipedia.

And the infobox already says it is a lifelong duration, seems very clear to me LachlanTheUmUlGiTurtle (talk) 14:16, 20 August 2024 (UTC)

That would work if everyone read the infobox in detail, and if people were not more immediately impacted by images to a far greater extent than text, which they are! Using an image that is biased towards a particular, erroneous, viewpoint on a subject is not supported by arguing that every image might be perceived as biased. Which I am sure is mistaken. However, this argument is of no relevance because it carries no weight against the certainty that having no image at all is an entirely bias-free option.

Responding because I was tagged.

I like the kid stacking things - relatable content tbh. I don't make think it makes it look like a "childhood disorder" any more than it makes it look like a "people with short hair disorder" and I think it works better than the infinity symbol, which is great but doesn't feel as useful. It's more a community symbol, at least to me. I don't really have strong feelings on it either way, I think this article has a lot of huge issues and the image is not really one of them. -- NotCharizard ^🗨 10:54, 20 August 2024 (UTC)

I agree that the article has way bigger issues than the image, but I do think that using an image of a small child for an article about something which is still widely misunderstood as a childhood thing is unhelpful.

I think the symbol would be an improvement, and I don't find any of the arguments against it at all convincing, but like you, I don't have particularly strong feelings about this... Oolong (talk) 14:54, 3 November 2024 (UTC)

R.e., ASD Severity

I have noticed a concern @1Veertje expressed in an edit summary and lengthy talk discussion above that autism cannot be characterised as varying in severity, and that varying degrees of impairment are entirely the result of comorbid disorders such as ID. This contradicts the global scientific consensus. The ICD-11 and World Health Organization concluded that autism is characterised as: "Persistent deficits in initiating and sustaining social communication and reciprocal social interactions... Specific manifestations of these deficits vary according to chronological age, verbal and intellectual ability, and disorder severity.

Moreover, the DSM-5 has an entire dedicated section, as an example: "Table 2: Severity Levels for Autism Spectrum Disorder" and that severity is to be specified.

One can also look at some peer-reviewed papers, that I summarily found, for further evidence: https://link.springer.com/article/10.1007/s10803-016-2731-7, https://link.springer.com/article/10.1007/s10803-008-0674-3

Therefore, I suggest that their edit is retracted or at least partly undone to reflect the fact that varying severity levels are indeed part of the disorder itself, not merely because of comorbidities.Димитрий Улянов Иванов (talk) 16:38, 9 September 2024 (UTC)

There's no evidence that "Independent living is unlikely with more severe forms of the condition.". What's the point of saying something so definitive when, as I pointed out, there are autistic individuals like Temple Grandin who were thought of as "severe" who nonetheless grew up to live independent lives? functioning labels are very regrettable 1Veertje (talk) 18:17, 9 September 2024 (UTC)

Thanks for replying, Vera, but I doubt that my points have been adequately addressed.

Re. ASD Severity The citation you provided appears to be a blog post as opposed to a peer-reviewed, scientific article. It can also be said that it doesn't overturn results from controlled studies that the global scientific consensus is based upon. In my view, a failure to consider this perspective and instead choose to focus exclusively on the opinions expressed by advocacy groups risks becoming a theoretical exercise far removed from daily clinical practice, and whose output depends on ideological perspectives and the specific subjective choices made when assessing the evidence.

Re. outcomes associated with independent living I did not contest that people with ASD are probably unable to live independently, but rather, contrary to your statements, that it is a disorder established with varying levels of severity. Regarding rates of independence, though, research seems to suggest that:

"Autism and Severe ID seem to be at particular risk for poor community inclusion and living skills..." (Gray et al., June, 2014).

"Factors related to psychophysical stability and daily living, financial management, and integrated community living and housing were all found to influence the ability of adults with ASD to live independently"(

Ghanouni et al., Nov, 2021

).

Димитрий Улянов Иванов (talk) 19:06, 9 September 2024 (UTC)

Here's the thing: most of the people commenting and who likely wrote this page and "protected" it from correction by calling it "protection for vandalism..." You casually talk about the spectrum of autism, high support needs individuals, and whether comorbidity plays any part in presentation (hint: high supports needs doesn't mean no support needs)... I can't afford to even get a diagnosis because it's such a racket. Few doctor will diagnose it in adults and the ones that do charge thousands of dollars. And, insurance does not pay for it. Those who need the diagnosis most don't have the financial freedom or capabilities to afford that. I'm sure, as you read this, you're reminding yourself "But, you're high support needs..." ignoring you are insinuating to yourself this means no support needs. Those who have needed support all their life, but have not gotten it. They still need it, have struggled along, are still struggling still, and can't afford it. I was diagnosed with savant syndrome as a child because my parent fought to keep the doctor from diagnosing me with autism. At the time, autism was still consider childhood schizophrenia. So, for that I am glad she did it. But, it does not help now. Getting a diagnosis now will be almost impossible, and convincing people that I struggle as much as I do is less so. It doesn't matter that even people who knew me long enough to remember the entire family teasing me, or parent in front of me because they considered me speaking, walking, and hitting other early childhood developmental milestones late. I REMEMBER them calling me retarded, slow, and saying I was going to need lots of help or be put in a care facility; saying I was very "retarded" and not all there. Not knowing that I had a very rich inner dialogue, one that I used to help me teach myself to talk, and then I just one day started talking. Because I went from completely nonverbal to speaking like a little adult just before turning 3 yrs old; I was actually first classified as being a prodigy in the neuropsych evaluation before the start of school. It wasn't just the speaking, it was what else I was able to comprehend and had already learned, or taught myself by the time I had begun speaking. And, because I spoke so well, people tended to forget the earlier issues. When clear social issues and other issues that most people associate with autism (then and now) became apparent I would be reevaluated, and I would be reclassified as a savant. My parent would use that diagnosis to stave off and help people forget how they conditioned me to not present autistic in other ways long before any of that! While it was conditioning, I will not let people continue to be blind to the fact that most of that conditioning is a result of sheer trauma from abuse. You get to disavow yourself of damage done by telling yourself that if a person masks, that if they're able to not be autistic, or able to stop being autistic, then they must not be or must not be too much; NONE OF THIS IS WHAT IS HAPPENING THOUGH. You have the children who were truly just conditioned through things like ABA; and if you have tried to convince yourself that ABA is anything other than that, then you are the worst kind of abuser. But, there are the children who were truly abused, terrorize, and traumatized into masking. Not that most will care anyway, as that would mess up their narrative. For many, it is to acknowledge that they have done something possibly horrific to someone they care about; and many people will not allow themselves to acknowledge that. For others, it is to acknowledge something that they see as a severe flaw that they can draw correlations or similarities to themselves. Once again, most humans will not allow themselves to do that! Trauma! That is how an overwhelming majority of us were "conditioned" into what I've had people call not "appearing to be autistic..." All because they are too ignorant to know, and too lazy to do actual research and find out what autism is, that you can have something comorbid with autism, and that can differentiate how a person presents (AS WITH ANY CONDITION). Even Temple Grandin acknowledges that society has a flawed, ignorant, and biased view of what autism is. That view is often reasserted ignorantly by ignorance in the medical field. This causes society to create a self-fulfilling prophecy of what their autistic children will grow up to be?m. They know what autism is, they're told what autism is, and they will make sure their child is exactly what they KNOW autism is! But, if you have a parent like Temple's who was determined to show them that just is not true. Well, you never know what you'll get. 96.234.220.222 (talk) 07:23, 6 October 2024 (UTC)

You have twice indicated that you don't have doubts that vandalism prompted the page protection levels. Here's a few versions of the page when it was unprotected. [1][2][3][4][5][6][7][8][9]

Other versions had legal problems (e.g., libel), so they had to be deleted.

If you are interested in editing this article, you need to create a free account. No e-mail address or other information is required. WhatamIdoing (talk) 01:56, 2 November 2024 (UTC)

Vandalism is certainly a problem, as it is on any high-traffic page, but this one is on the watchlist of 2,307 people... do you know if any of the vandalisations lasted long? Oolong (talk) 15:01, 3 November 2024 (UTC)

References

Risk?

In the wiki article about risk- risk is defined as something “bad happening”. Is this article implying autism spectrum is a bad thing? Please explain why Autism is a “risk” (something bad), I’d like to know more about your bigotry. 2606:CE40:70:7F06:7D91:2B4:804E:2B0 (talk) 20:32, 13 September 2024 (UTC)

• Outside the term "risk factor", a phrase with a medical/technical meaning, the word here is used for instance in the phrase "risk of suicidality". Suicide is a pretty bad thing. You don't need to wikilink "bigotry", by the way. Drmies (talk) 20:35, 13 September 2024 (UTC)

  Hi Drmies, thank you for your clarification! However, I believe the OP's point is worth consideration.

  To be specific, the term "risk" comes up a 47 times in this article, not just regarding suicidality or video game addiction (which is appropriate usage, yes). Most of these usages are regarding ASD itself.

  For example, the infobox plus "higher risk of a child developing ASD"; "many risk factors identified in the research literature may contribute to ASD"; "autism risk"; and many more times.

  The infobox uses the term Risk Factor, which its article defines as "a variable associated with an increased risk of disease or infection". I do not believe autism is classified as a disease any longer. Neither disease nor infection comes up in the ICD definition. I more often hear the term "condition."

  A more suitable term than risk would be "Causes." In fact, this is the title of the article Causes of autism. It also is the heading and term the ADA uses in its description of ASD. Evedawn99 (talk) 18:49, 25 September 2024 (UTC)

  I agree "causes" is better but we might need more votes before a consensus is made Anthony2106 (talk) 03:41, 5 October 2024 (UTC)

  This is incorrect. The term "risk factor" is used widely for neurodevelopmental disorders, and the definition you are finding are superficial and not reflective of the scientific consensus. For instance, see the International Consensus Statement on ADHD (Faraone et al., 2021-2022) which concludes "Most cases of ADHD [another neurodevelopmental disorder] are caused by the combined effects of many genetic and environmental risks". And further one, the ICS states "For most people with ADHD, many genetic and environmental risk factors accumulate to cause the disorder". Clearly, the use of both "risk" and "risk factor" in the context of neurodevelopmental disorders is warranted. A talk page consensus should probably be used to guide edits exclusively in matters requiring subject determination, and not overturn objective facts like these. Note that this is not to say the term "causes" cannot be used but the term "risk/risk factors" are not invalidated.Димитрий Улянов Иванов (talk) 21:34, 5 October 2024 (UTC)

  I think this is the point that they're trying to make. This is what makes your point appear to be bigotry. I'm not saying that it is. But, you clearly missed the point that risk of developing autism versus environmental risks (i.e. risks as it pertains to chances of developmental differences manifesting in vitro versus risks as it pertains to outside source of stimuli as causes for the developmental differences. Correlation and causation are not the same thing, and I think that's what you're conflating here, and that does not look very good as the differences in the two appear obvious. Especially as the risk being discussed is the condition of autism itself, not the causes thereof. When the use of the word risk is stated 47 times in the article, many were specifically referring to autism itself, not its causes. HarmonyA8 (talk) 07:42, 6 October 2024 (UTC)

  Thanks your comment but I don’t quite understand your point. First, referencing the scientific consensus should not even imply bigotry so that makes little sense to me. But the term ‘risk’ and ‘risk factors’ are clearly used in reference to the causes of neurodevelopmental disorders, not just disease. That’s essentially all my point. I’m not implying cause from correlational evidence; the consensus statement itself contextualises risk as a causal factor. Thus, the reasoning that these terms cannot be used because they are exclusive for disease is wrong. Димитрий Улянов Иванов (talk) 07:53, 6 October 2024 (UTC)

  Hi, 'risk' is pretty much universally used to describe the chance of an undesirable thing - as the Wikipedia summary says, 'Possibility of something bad happening'.

  It is not a neutral term.

  You might like to check out Avoiding Ableist Language: Suggestions for Autism Researchers, which suggests phrases like “At risk” for ASD⁷³ should be substituted for something like 'Increased likelihood/chance of autism'. No accuracy is sacrificed in such rephrasing! See also [10] on this specific point, and [11] and [12] for more general considerations on language use, accuracy and neutrality. Oolong (talk) 16:32, 2 November 2024 (UTC)

  Again - there is a global scientific consensus that "risk" is usable in the context of neurodevelopmental disorders. Sorry to be blunt, but quite frankly, I did cite the International Consensus Statement on ADHD [another neurodevelopmental disorder] and the scientific literature unanimously use the term for ASD as well (e.g., Dietert et al., 2010; Mojgan et al., 2017; Belmonte et al., 2022). Citation 11 you have given is a blog post, which is not peer-reviewed scientific literature. The other two are advocacy papers ,and they don't overturn the consensus. Димитрий Улянов Иванов (talk) 17:44, 2 November 2024 (UTC)

  The Open Notebook is a reputable source, and the other two are editorials/Perspective articles in scientific journals. I can provide many more citations if you really want.

  You are greatly exaggerating the degree of consensus on this. Oolong (talk) 15:04, 3 November 2024 (UTC)

  To take another example, the textbook 'Autism: A New Introduction to Psychological Theory and Current Debate', authored by two of the leading experts in this field, explains (on page 30):

  "The current diagnostic criteria, in both the 5th edition of the Diagnostic an Statistical Manual of Mental Disorders (DSM-5; APA, 2013 - see Table 3.1 and the forthcoming 11th edition of the International Classification Diseases (ICD-11; WHO, 2018) specify only one category for autism. This is termed "Autism Spectrum Disorder" (ASD) in recognition of the variability of presentation. The use of the word 'disorder' as part of the diagnostic ter minology is rejected by many autistic people, who emphasise that autism is a natural part of variation in the human population. For this reason, we refer to autism, rather than ASD, in this book." Oolong (talk) 15:12, 3 November 2024 (UTC)

  Notably, the 'Avoiding Ableist Language' paper, which only came out in 2021, has already been cited well over 1000 times.

  Do you have an argument in favour of using value-laden language like 'risk' instead of neutral terms like 'chance' which get across the message just as clearly? Oolong (talk) 15:28, 3 November 2024 (UTC)

  I am not "exaggerating the consensus on this". The examples given in the article currently are as follows:

  The ICD-11 and World Health Organization (WHO) conclude that autism is a neurodevelopmental disorder.

  The DSM-5 and American Psychological Association (APA) conclude that autism is a neurodevelopmental disorder.

  The UK National Institute for Clinical Excellence (NICE) Guidelines conclude that autism is a neurodevelopmental/developmental disorder.

  Because these are guidelines that are globally standardised for scientists and diagnosticians and are developed by a unification of thousands of researchers, they reflect the global scientific consensus on the matter. Even International Consensus Statements exist attesting to the fact that autism is a neurodevelopmental disorder (e.g. Cole et al., 2019).

  Blog posts are not peer-reviewed, scientific papers and thus are not "reputable" in comparison to the scientific literature. Regarding the other two citations, as I have already addressed, they are advocating for something that is not currently established. Thus, they are not sources that can overturn the statement that autism is a neurodevelopmental disorder as it's currently defined. In fact, several peer-reviewed papers cited in this Wikipedia article criticise such advocacy papers on their logic that ASD is not a disorder, concluding that it indeed is in accordance with guidelines worldwide. So even in the context of advocacy papers, your opinion has not been demonstrated to represent a large number of researchers by any means.

  Unfortunately, none of this was addressed in your comment. I am having to essentially reiterate myself here.

  The Wikipedia article does a good job of balancing the debate on whether the term should be changed in the future, so I don't see what your arguing for exactly to change.

  The text-book you cited appears to - again - be implicitly advocating for a change in terms. It is also based on faulty logic. ASD is not incompatible with the concept of neurodiversity. There is indeed an underlying dimensional spectrum to ASD (which is why it's called autism spectrum disorder) but the term disorder is defined by the presence of impairment, wherein we draw the line and make a categorical diagnosis. There really is no contradiction there. The claim that it's "ableist" is just a subjective proclamation. On the contrary, continuing to espouse that autism is not a neurodevelopmental spectrum disorder may be offensive to those who actually experience impairment and dislike being obfuscated with mere diversity. This is for at least two reasons. First, traits of autism is not autism; you must be significantly impaired by those symptoms to be diagnosable (which is why it’s a disorder). Second, ‘diversity’ typically implies positivity and thus may be offensive to those who do not view it as such. Димитрий Улянов Иванов (talk) 16:35, 3 November 2024 (UTC)

  As regarding risk, I'd like to reiterate that the term is used in International Consensus Statements for the context of neurodevelopmental disorders and is used consistently in systematic reviews for ASD as well that I cited above. Unfortunately, none of these were acknowledged in your reply. Димитрий Улянов Иванов (talk) 16:38, 3 November 2024 (UTC)

I suggest that we should defer to the relevant style guide from NIH (the USA's National Institutes of Health) on this point, although some aspects of its guidance elsewhere are a little confused and/or outdated:

"Use increased likelihood for autism instead of terms like risk of autism or at risk for autism. Likelihood is more specific and less stigmatizing."

I haven't seen anything resembling a counter-argument to this.

While we're at it, the same source recommends that we "Use the terms characteristics, or traits, instead of symptoms when referring to people with autism."

Notably, elsewhere the NIH recommends to "Check a variety of sources, including self-advocacy groups and organizations led by the communities you are writing about, to see what language they use and why."

This seems like eminently sensible advice to me, and I'm pleased to see it from such an authoritative source (specifically Shannon Wooldridge, Public Affairs Specialist, NIH Office of Communications and Public Liaison, writing for their 'Science, Health, and Public Trust' section - "a place for discussion of ways to improve the quality and usefulness of information for the public about science and health"). Oolong (talk) 18:31, 6 November 2024 (UTC)

Please actually address the rebuttals to your comments here before deflecting. I have cited International Consensus Statements, the global diagnostic criteria, international clinical guidelines, and systematic reviews which unanimously attest to (1) ASD is a disorder; (2) the term “risk” can be used in the context of neurodevelopmental disorders like ASD; (3) ASD is characterised by symptoms and the presence of significant impairment, not “traits”. You are objectively contradicting the global scientific consensus by denying this, and that is why such changes in terms should not be made in this article. Димитрий Улянов Иванов (talk) 19:01, 6 November 2024 (UTC)

Paradoxically, different NIMH guidelines conflict with the one you cited, as some explicitly use the terms symptoms, disorder and risk in accordance with the scientific consensus: https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd

So even the NIMH you are citing is not a valid source to overturn the scientific consensus. Димитрий Улянов Иванов (talk) 19:12, 6 November 2024 (UTC)

Remove "Disorder" and add "Coocuring Conditions "

Please reframe behavioral deficit-centric influence of the autism industrial complex to honor the lived experience of autistic people with many different manifestations. Do not assume that lack of speaking means lack of intelligence. Furthermore, consider root somatosensory causes of so-called social communication difficulties. Consider the eyes of the neurodominant beholders. 2600:1014:B131:5BCD:0:10:B10B:DA01 (talk) 19:23, 8 October 2024 (UTC)

Autism is a neurodevelopmental disorder. This is the global scientific consensus. See the ICD-11, the World Health Organisation and the DSM-5, as examples, all cited in the article to substantiate the classification. So it is to be kept.

Various approaches have been used to establish this fact. A very useful one stipulates that there must be scientifically established evidence that those suffering the condition have a significant deviation or deficit in or failure of a physical or psychological mechanism that is universal to humans. That is, all humans normally would be expected, regardless of culture, to have developed that neuropsychological trait or ability.

And there must be equally incontrovertible scientific evidence that this serious deficiency or deviation leads to harm to the individual. Harm is established through evidence of increased mortality, morbidity, or impairment in the major life activities required of one’s developmental stage in life. Major life activities are those domains of functioning such as education, social relationships, family functioning, independence and self-sufficiency, and occupational functioning that all humans of that developmental level are expected to perform.

As attested by the scientific consensus, autism candidly meets such criteria and thus is a neurodevelopmental disorder. Димитрий Улянов Иванов (talk) 22:13, 8 October 2024 (UTC)

It is incorrect to suggest that there is a general scientific consensus that autism is a disorder. The neurodiversity perspective is taken seriously by a large and growing number of researchers, and contradicts the assumption that differences like autism should be seen as disorders.

See for example this Annual Research Review: Shifting from ‘normal science’ to neurodiversity in autism science; the journal Neurodiversity; Wiley's 38-journal neurodiversity special issue; or indeed the 31,600 Google Scholar results for the term. Oolong (talk) 16:41, 2 November 2024 (UTC)

It is not taken seriously by a "large and growing number of researchers". Autism is classified as a neurodevelopmental disorder by the ICD-11, World Health Organization, DSM-5, NICE etc because it is defined by the presence of impairment, not merely symptoms. That is thereby citing the worldwide scientific consensus, and that of clinicians who unanimously use the above diagnostic criteria. In response to the article you cited, the lede of the article further states that:

"On the contrary, other scientists argue that ASD impairs functioning in many ways that are inherent to the disorder itself and unrelated to society.[17][18]"

The neurodiversity movement is a political, not a scientific, movement. Many people also subscribe to the anti-psychiatry movement, whose presence doesn't negate the scientific consensus on the validty of psychiatry as it's largely political in nature. Димитрий Улянов Иванов (talk) 17:28, 2 November 2024 (UTC)

The neurodiversity movement is absolutely a scientific (or perhaps more accurately, meta-scientific) movement as well as a political one. The choice of the term 'neurodiversity paradigm' is neither accidental, nor inaccurate.

You are simply incorrect to claim that neurodiversity is not taken taken seriously by a large and growing number of researchers, which should already have been clear from my comment above. Oolong (talk) 15:35, 3 November 2024 (UTC)

I have addressed the above reply in another page, but I will reprint it here so others don't miss it:

I am not "exaggerating the consensus on this". The examples given in the article currently are as follows:

The ICD-11 and World Health Organization (WHO) conclude that autism is a neurodevelopmental disorder.

The DSM-5 and American Psychological Association (APA) conclude that autism is a neurodevelopmental disorder.

The UK National Institute for Clinical Excellence (NICE) Guidelines conclude that autism is a neurodevelopmental/developmental disorder.

Because these are guidelines that are globally standardised for scientists and diagnosticians and are developed by a unification of thousands of researchers, they reflect the global scientific consensus on the matter. Even International Consensus Statements exist attesting to the fact that autism is a neurodevelopmental disorder (e.g. Cole et al., 2019).

Blog posts are not peer-reviewed, scientific papers and thus are not "reputable" in comparison to the scientific literature. Regarding the other two citations, as I have already addressed, they are advocating for something that is not currently established. Thus, they are not sources that can overturn the statement that autism is a neurodevelopmental disorder as it's currently defined. In fact, several peer-reviewed papers cited in this Wikipedia article criticise such advocacy papers on their logic that ASD is not a disorder, concluding that it indeed is in accordance with guidelines worldwide. So even in the context of advocacy papers, your opinion has not been demonstrated to represent a large number of researchers by any means.

Unfortunately, none of this was addressed in your comment. I am having to essentially reiterate myself here.

The Wikipedia article does a good job of balancing the debate on whether the term should be changed in the future, so I don't see what your arguing for exactly to change.

The text-book you cited appears to - again - be implicitly advocating for a change in terms. It is also based on faulty logic. ASD is not incompatible with the concept of neurodiversity. There is indeed an underlying dimensional spectrum to ASD (which is why it's called autism spectrum disorder) but the term disorder is defined by the presence of impairment, wherein we draw the line and make a categorical diagnosis. There really is no contradiction there. The claim that it's "ableist" is just a subjective proclamation. On the contrary, continuing to espouse that autism is not a neurodevelopmental spectrum disorder may be offensive to those who actually experience impairment and dislike being obfuscated with mere diversity. This is for at least two reasons. First, traits of autism is not autism; you must be significantly impaired by those symptoms to be diagnosable (which is why it’s a disorder). Second, ‘diversity’ typically implies positivity and thus may be offensive to those who do not view it as such. Димитрий Улянов Иванов (talk) 17:16, 3 November 2024 (UTC)

AGREED. It is not a disorder! (Coming from a autistic person) 206.57.152.111 (talk) 14:58, 6 November 2024 (UTC)

why delete Wentworth Miller's image?

@Dashing24 why did you delete Wentworth Miller's image in this edit? you didn't leave behind an edit summery so now I'm curious. Anthony2106 (talk) 08:00, 10 October 2024 (UTC)

because all it does is reinforce how autistic people are so weird and whacky bro 82.168.236.78 (talk) 03:14, 9 November 2024 (UTC)

@82.168.236.78 highly doubt it Anthony2106 (talk) 03:17, 9 November 2024 (UTC)

Opening

I am writing because I fear that the opening to the article is difficult for the layperson to understand. Forgive me if there is something I have missed, but to me, "symptoms of deficient reciprocal social communication" sounds verbose and overly complicated. I feel that the previous "difficulties in social interaction and communication" is superior to this wording. I would edit this myself, but I would like to seek a consensus first. Please share your thoughts below if you have the inclination. FriendlyNeighborhoodAspie (talk) 12:37, 15 October 2024 (UTC)

I disagree. Terminology should not be dumbed down per se merely so the lay person can understand it as this is is the main English page, and not Simple English, which is available for this reason on Wikipedia. The definition given conforms to the ICD-11, World Health Organization, DSM-5 cited in the article and the other one you have given here is more ambiguous and less accurate. But thank you for checking on this issue and hopefully a consensus can be formed. Димитрий Улянов Иванов (talk) 16:28, 15 October 2024 (UTC)

According to Wikipedia's guidelines, the lead should be written in simpler language than the rest of the article. If that means that you have to "dumb down" a couple of sentences, then that's okay. You can keep the medicalese if you want; the guidelines only say not to put it at the top of the article (or as the first few sentences in a long section). See WP:MTAA for a good explanation. WhatamIdoing (talk) 01:40, 2 November 2024 (UTC)

Thanks for clarifying that. I think that’s fine as long as the underlying concepts are kept and consistent with the global scientific consensus (I.e., WHO, ICD-11, DSM-5, NICE, APA guidelines) so important information is not redacted. Basically, rather than shortening the first lede sentence, it can just be reworded differently. Димитрий Улянов Иванов (talk) 17:09, 3 November 2024 (UTC)

Yes, it's very badly written. Oolong (talk) 15:35, 3 November 2024 (UTC)

Do you have any suggestions as to how to improve the wording? FriendlyNeighborhoodAspie (talk) 16:59, 3 November 2024 (UTC)

It’s not ‘badly written’. It’s precisely how ASD is defined by the World Health Organisation (WHO), ICD-11, DSM-5, NICE guidelines etc. Димитрий Улянов Иванов (talk) 17:07, 3 November 2024 (UTC)

I'm now very satisfied with the wording. If nobody has any problems with it, I suggest we keep this wording until further notice. FriendlyNeighborhoodAspie (talk) 18:36, 3 November 2024 (UTC)

It definitely was badly written, I'm afraid. Sorry to be blunt. The phrasing was different from any of those sources, as far as I can see? I'm not sure which specific sources you had in mind?

Wikipedia is an encyclopaedia for a general audience, and leads in particular need to be written with that in mind. Oolong (talk) 18:38, 6 November 2024 (UTC)

I think the editor had the ICD in mind. Perhaps it wasn't written verbatim, but I can see significant sampling from the ICD text. FriendlyNeighborhoodAspie (talk) 22:06, 6 November 2024 (UTC)

Semi-protected edit request on 14 October 2024

The statement in the introduction of the Autism entry, "There are many theories about the causes of autism; it is highly heritable and mainly genetic, but many genes are involved, and environmental factors may also be relevant," may be seen as misleading and ethically concerning to vulnerable individuals with Autism Spectrum Disorder (ASD) and their families. The most current description of autism’s aetiology is as follows: "Autism does not have a single known cause and is considered a multifactorial condition arising from a complex interaction between genetic predispositions and environmental factors." Alternatively, Wikipedia's entry for 'Causes of Autism' offers a similarly comprehensive statement: "Many causes of autism, including environmental and genetic factors, have been recognized or proposed, but understanding of the theory of causation of autism is incomplete. Attempts have been made to incorporate the known genetic and environmental causes into a comprehensive causative framework."

Within the 'Autism' entry, it would also be sensible to remove the suggested reading of the 'Refrigerator Mother Theory' from the start of the aetiology section on 'Early Life', as it risks conflating outdated concepts. Otherwise, it would appear equally appropriate to suggest a reading on 'Eugenics' under the 'Genetics' section to offer a more balanced perspective of the criticisms of each view. Furthermore, it may further mislead that the 'Early Life' section is considerably shorter than the 'Genetics' section, with little discussion on environmental influences on neurodevelopment, like prenatal stress and its effects on neural inflammation and maladaptation. The 'Causes of Autism' entry already acknowledges these adjustments.

Evidence indicates that autism’s aetiology is multifactorial, with recent research suggesting that at least 50% of causes are environmental (Yenkoyan, Mkhitaryan1, & Bjørklund, 2024). In this sense, the environment plays a crucial role in triggering neurodevelopmental maladaptations in individuals with a biological predisposition. While genetic predispositions may exist, they may remain unexpressed unless activated by environmental factors. In relation to inheritance, epigenetic changes—modifications in gene expression due to external influences—are not yet fully understood (Boyce & Kobor, 2015; Lickliter & Witherington, 2017; Speybroeck, 2002; Masterpasqua, 2009; Goldsmith, et al., 1997). The fact that gene studies dominate autism research (Sweileh, et al., 2016) shows not only that no universally consistent genetic markers are definitive contributors to autism (Havdahl et al., 2021; Rylaarsdam et al., 2019) but also that other crucial factors are being under-researched. However, it is well understood that stressors, toxins, chemicals, advanced parental age, and other factors significantly impact fetal neurodevelopment (Yenkoyan, Mkhitaryan1, & Bjørklund, 2024; Hsiao et al., 2013; Jiang et al., 2023; Yin & Schaaf, 2017; Grove et al., 2019; Peretti et al., 2019; Gentile et al., 2013; Dawson, 2008; Liew, et al., 2016; Singletary, 2015). Therefore, framing environmental influences as potentially relevant understates their importance.

It is central to highlight that, while genetic research may assist with early screening, it offers little practical help for most individuals with ASD, especially given that genetic or MRI screenings remain largely inaccessible due to the heterogeneity of ASD biological presentations. Thus, they are unlikely to become widely available. The focus on genetics may also detract from the tangible benefits of early interventions and environmental adjustments, which can alleviate ASD symptoms and provide preventive strategies. Furthermore, it is sometimes understood as reinforcing eugenic ideas and parental stigma as well as limiting reproductive expectations for families with ASD children.

Moreover, genetic testing may encourage pharmacological interventions. This aligns with the medical model, including institutions like the WHO and the National Health Service (NHS), which has historically emphasised pharmacological treatments for psychiatric conditions such as depression and schizophrenia, often misleading the public to believe that these disorders are primarily organic, devoid of significant environmental influences. For the past few decades, this approach has contributed to medication misuse while downplaying or neglecting non-pharmacological interventions that address and enrich environmental factors (Torres et al., 2023; Moncrieff et al., 2023; Os, et al., 2008; Deacon, 2013). It would raise ethical concerns to extend this model to neurodevelopmental conditions like ASD, especially when there is substantial evidence demonstrating the strong environmental component of autism. This may be concerning if physicians are inadequately trained in pharmacological interventions for ASD (Austriaco et al., 2019; Unigwe et al., 2017; Mason, 2018), and there is limited evidence regarding the long-term efficacy of pharmacological treatments in ASD due to highly individualised ASD presentations (Brandford, et al., 2019; Deb et al., 2023; Persico, et al., 2021). Although this is noted in this entry, it is not directly linked to the genetic research on ASD.

Thus, the notion that autism is "mainly genetic" not only raises ethical concerns but also oversimplifies the complexity of the disorder, limiting the potential for understanding and addressing the significant environmental contributions critical to early intervention, including during pregnancy.

Austriaco, K., Aban, I., Willig, J., Kong, M. (2019). Contemporary Trainee Knowledge of Autism: How Prepared Are Our Future Providers? Front Pediatr. Apr 26;7:165. doi: 10.3389/fped.2019.00165.

Branford, D., Gerrard, D., Saleem, N., Shaw, C., & Webster, A. (2019). Stopping over-medication of people with intellectual disability, Autism or both (STOMP) in England part 1 – history and background of STOMP. Advances in Mental Health and Intellectual Disabilities, 13, 31–40. https://doi.org/10.1108/AMHID-02-2018-0004

Boyce, W., & Kobor, M. (2015). Development and the epigenome: The 'synapse' of gene-environment interplay. Developmental Science, 18(1), 1-23.

Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20(3), 775-803. https://doi.org/10.1017/S0954579408000370

Deacon, B. J. (2013). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy research. Clinical Psychology Review, 33, 846–861.

Deb, S., Limbu, B., Unwin, G. L., & Weaver, T. (2023). The Use of Medication for Challenging Behaviors in People with Intellectual Disabilities: The Direct Care Providers’ Perspective. Journal of Mental Health Research in Intellectual Disabilities, 16(3), 253–274. https://doi.org/10.1080/19315864.2023.2192691

Gentile, I., Zappulo, E., Militerni, R., Pascotto, A., Borgia, G., & Bravaccio, C. (2013). Etiopathogenesis of autism spectrum disorders: Fitting the pieces of the puzzle together. Medical Hypotheses, 81(1), 26-35. https://doi.org/10.1016/j.mehy.2013.04.002.

Goldsmith, H., Gottesman, I., & Lemery, K. (1997). Epigenetic approaches to developmental psychopathology. Development and Psychopathology, 9, 365-387. https://doi.org/10.1017/S0954579497002095.

Grove, J., et al. (2019). Identification of common genetic risk variants for autism spectrum disorder. Nature Genetics, 51, 431-444. https://doi.org/10.1038/s41588-019-0344-8.

Havdahl, A., Niarchou, M., Starnawska, A., Uddin, M., van der Merwe, C., & Warrier, V. (2021). Genetic contributions to autism spectrum disorder. Psychological Medicine, 51(13), 2260-2273. https://doi.org/10.1017/S0033291721000192

Hsiao, E. Y., McBride, S. W., Hsien, S., Sharon, G., Hyde, E. R., McCue, T., et al. (2013). Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders. Cell, 155(7), 1451-1463. https://doi.org/10.1016/j.cell.2013.11.024.

Jiang, M., Lu, T., Yang, K., Li, X., Zhao, L., Zhang, D., et al. (2023). Autism spectrum disorder research: Knowledge mapping of progress and focus between 2011 and 2022. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1096769.

Kim, S., & Kim, K. (2023). Effect of media exposure on social development in children. Global Pediatric Health, 10.

Lickliter, R., & Witherington, D. C. (2017). Towards a truly developmental epigenetics. Human Development, 60(2/3), 124-138.

Liew, Z., Ritz, B., Virk, J., & Olsen, J. (2016). Maternal use of acetaminophen during pregnancy and risk of autism spectrum disorders in childhood: A Danish national birth cohort study. Autism Research, 9. https://doi.org/10.1002/aur.1591.

Mason, D., McConachie, H., Garland, D., Petrou, A., Rodgers, J., & Parr, J. R. (2018). Predictors of quality of life for autistic adults. Autism Research, 11, 1138-1147.

Masterpasqua, F. (2009). Psychology and Epigenetics. Review of General Psychology, 13(3), 194-201. https://doi.org/10.1037/a0016301

Moncrieff, J., Cooper, R. E., Stockmann, T., et al. (2023). The serotonin theory of depression: A systematic umbrella review of the evidence. Molecular Psychiatry, 28, 3243-3256. https://doi.org/10.1038/s41380-022-01661-0.

Os, J., Rutten, B., & Poulton, R. (2008). Gene-environment interactions in schizophrenia: review of epidemiological findings and future directions. Schizophrenia bulletin, 34 6, 1066-82 . https://doi.org/10.1093/schbul/sbn117.

Peretti, S., Mariano, M., Mazzocchetti, C., Mazza, M., Mc, P., Pianella, A., & Valenti, M. (2019). Diet: The keystone of autism spectrum disorder? Nutritional Neuroscience, 22, 825-839. https://doi.org/10.1080/1028415X.2018.1464819.

Persico, A., Ricciardello, A., Lamberti, M., Turriziani, L., Cucinotta, F., Brogna, C., Vitiello, B., & Arango, C. (2021). The pediatric psychopharmacology of autism spectrum disorder: A systematic review - Part I: The past and the present. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 110. https://doi.org/10.1016/j.pnpbp.2021.110326.

Rylaarsdam, L., & Guemez-Gamboa, A. (2019). Genetic causes and modifiers of autism spectrum disorder. Frontiers in Cellular Neuroscience, 13. https://doi.org/10.3389/fncel.2019.00385.

Singletary, W. M. (2015). An integrative model of autism spectrum disorder: ASD as a neurobiological disorder of experienced environmental deprivation, early life stress, and allostatic overload. Neuropsychoanalysis, 17(2), 81-119. https://doi.org/10.1080/15294145.2015.1092334

Speybroeck, L. (2002). From epigenesis to epigenetics: The case of C. H. Waddington. Annals of the New York Academy of Sciences, 981, 61-81.

Sweileh, W.M., Al-Jabi, S.W., Sawalha, A.F. et al. (2016). Bibliometric profile of the global scientific research on autism spectrum disorders. SpringerPlus 5, 1480. https://doi.org/10.1186/s40064-016-3165-6

Torres, G., Mourad, M., Iqbal, S., Moses-Fynn, E., Pandita, A., Siddhartha, S., et al. (2023). Conceptualizing epigenetics and the environmental landscape of autism spectrum disorders. Genes, 14, 1734. https://doi.org/10.3390/genes14091734.

Unigwe, S., et al. (2017). GPs’ confidence in caring for their patients on the autism spectrum: An online self-report study. British Journal of General Practice, 67, e445-e452.

Yenkoyan, Konstantin & Mkhitaryan, Meri & Bjorklund, Geir. (2024). Environmental Risk Factors in Autism Spectrum Disorder: A Narrative Review. Current medicinal chemistry. 31. 10.2174/0109298673252471231121045529.

Yin, J., and Schaaf, C. P. (2017). Autism genetics – an overview. Prenat Diagn, 37: 14–30. doi: 10.1002/pd.4942. Joliverat (talk) 13:16, 15 October 2024 (UTC)

Thanks for your comment but I'm sorry to say it does not stand up to serious inspection. It is advisable to take the opportunity to review the available aetiological evidence once again. You have given a long list of references - I have had a look at some - and they do not appear to support if not contradicting your claims. To give a couple examples, you cited a meta-analytic review published in the peer-reviewed journal Nature, which concluded: "Autism spectrum disorder (ASD) is a highly heritable and heterogeneous group of neurodevelopmental phenotypes diagnosed in more than 1% of children".

As indicated by professional associations and the Nature journal itself:

"Heritability is a concept that summarizes how much of the variation in a trait is due to variation in genetic factors"" (1)

"Heritability is a measure of how well differences in people’s genes account for differences in their traits" (2)

The abstract of Singletary (2015) states: "Converging evidence suggests that ASD is a potentially reversible neurodevelopmental disorder in which neurobiological factors – not poor parenting – interfere with the child–caregiver interaction". Indeed, the global scientific consensus classifies the disorder as neurodevelopmental and not psychosocial (e.g., the ICD-11, World Health Organization, DSM-5 cited in the article).

None of the sources you cite contribute any evidence of any kind regarding causality for environmental factors like actaminophen. You appear to be struggling with the distinction between simple correlative research and the much deeper ontologic questions of how diagnoses should be framed.

• The Liew et al. (2015) meta-analysis note a correlation between exposure and ASD diagnosis. This is zero evidence of any kind on causation, and does not establish that the subsequent diagnosis is correct.

Neurodevelopmental disorders do not arise from any such unsupportable environmental perspectives as claimed by critics. Indeed, studies of twins are an excellent means of testing such environmental hyotheses about disorders. Modern statistics can be applied to such data sets that can discern the extent to which variation in the population in certain traits or disorders can be attributed to common, shared, or rearing environment, to unique events that occur only to the affected family member, or to genetics. The hypotheses of our critics clearly fall within the common or shared environmental variation tested in such twin studies. To date, twin studies consistently have found no significant contribution of shared, social and familial environments to the symptom expression of ASD and other NDDs. They do find a small but significant contribution of unique environmental events (some or all of which can be due to biohazards experienced by the child as well as brain injury events). But they consistently find a substantial genetic contribution to neurodevelopmental disorders within the population.

These numerous studies, and many other lines of evidence, directly refute the nonexpert folk wisdom offered by here as to the origins of these disorders. To publish comments that ASD is a fictitious neurodevelopmental disorder or merely a conflict between today's Huckleberry Finns and their caregivers is tantamount to declaring the earth flat, the laws of gravity debatable, and the periodic table in chemistry a fraud.

Potential Conflicts of Interest: I have been involved in network meta-analyses conducted by the UK National Institute of Care Excellence (NICE), a guideline group the applicant contests, and have served periodically in NICE panels discussing pharmacological and psychosocial treatment solutions for ADHD. Димитрий Улянов Иванов (talk) 16:20, 15 October 2024 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. Bowler the Carmine | talk 17:07, 15 October 2024 (UTC)

The entry on 'Causes of Autism' already reflects the change I have advocated for, despite the doubts you raise regarding the scientific evidence and literature I have provided (which I acknowledge). Your response implies that the current statement in the 'Causes of Autism' entry—"Many causes of autism, including environmental and genetic factors, have been recognized or proposed, but understanding of the theory of causation of autism is incomplete. Attempts have been made to incorporate the known genetic and environmental causes into a comprehensive causative framework"—is not supported by evidence and is misleading. This appears contradictory to your own response, indicating a possible misunderstanding.

Thus, I suggest to change "There are many theories about the causes of autism; it is highly heritable and mainly genetic, but many genes are involved, and environmental factors may also be relevant," to "Many causes of autism, including environmental and genetic factors, have been recognized or proposed, but understanding of the theory of causation of autism is incomplete. Attempts have been made to incorporate the known genetic and environmental causes into a comprehensive causative framework."

I am not suggesting that autism is caused by psychosocial factors; I have consistently emphasised the complex interaction between biological predispositions and environmental risks. However, your response appears to emphasise a purely organic perspective of autism's aetiology, whereas my stance aligns with the prevailing scientific literature, which acknowledges the multifactorial nature of the disorder while still recognising it as a neurodevelopmental condition. This is clearly supported in the existing Wikipedia entry on the 'Causes of Autism', and I encourage you to review it. Your understanding of my suggestion and the ethical concerns you raise show you have completely misinterpreted it.

Environmental risk factors, as you may know, are challenging to test and may often be underreported. This difficulty is a central issue in the philosophy of science, and it is essential for any scientist, if any, to acknowledge this complexity when making definitive statements, especially about vulnerable groups of individuals.

Furthermore, the literature on pharmacological treatments for ASD indicates that ASD cannot be directly compared to ADHD in terms of treatment. ASD requires a far more nuanced approach due to the highly individualised nature of the condition, a point acknowledged in the 'Autism' entry itself, which raises concerns about the efficacy of generalised pharmacological treatments for ASD. Therefore, there seems to be a disconnect between your specialisation and this area of discussion. Joliverat (talk) 18:44, 15 October 2024 (UTC)

You haven't addressed the main points of my rebuttal. In your application, you claim that environmental causes appear to account for as high as 50% of variation in ASD symptoms and that genetic factors may not be relevant, thus implying a significant possibility that it is down entirely to environmental factors. This is not only inconsistent with the scientific consensus but the very references you gave to substantiate it in fact support that the disorder is highly genetic. You were also implying cause from correlational evidence about prenatal exposure to toxins. This is exactly why the article is correct in stating they are "potentially" relevant, so it is not misleading.

My contention is not that environmental factors are irrelevant. But to portray the evidence as uncertain as you do and remove statements that it is highly genetic has little support in the literature.

The disorder is classified as neurodevelopmental, differentiating it from psychosocial ones, as its aetiology is related to brain development and not the social/familial environment. Yes, non-shared environmental brain injuries might still be relevant but just something to keep in mind. Claims on other Wikipedia articles are not de facto evidence of something reprehensible taking place on this article; at best this is a form of scientific buck-passing for it can generate no useful understanding of the evidence and its context. The evidence is contained within the citations, and references you have provided contradict your claims in ways aligning with the conclusions on this article.

ADHD is in fact a highly individualised disorder due to the dimensionality of the underlying executive functions, justr as ASD is. Autism is indeed not my speciality but the fields substantially overlap as both being neurodevelopmental disorders, so the literature is understandable to me, and I was mainly trying to clarify how you are mispresenting the literature. Personally, I don't think my involvement with NICE reaches the degree to a conflict with regards to your contention with the institution, but that's not for me to say.

To conclude I don’t think it’s an argument worth pursuing any further as it will just take valuable time away from other projects and is unlikely to be convincing. The debate here could go on for quite awhile. And One could write an extensive review on these issues and I certainly dont have the time or interest in doing so. So I will just leave it at the comments I have provided already. Димитрий Улянов Иванов (talk) 21:16, 15 October 2024 (UTC)

Thank you for your valuable time and review. Genes will do. Joliverat (talk) 22:36, 15 October 2024 (UTC)

Being born with Asperger Syndrome and editing this article

Dear wikipedia community,

My name's Noam, 32 from Israel. I was born with Autism. Back in my childhood, they used the name Asperger Syndrome, which is still a name used today, but officially the name was changed to a mild type of autism, or high functioning. Its very important to me to be able to help edit this article and improve it. Being born with Autism, has made me a weird, different, special, emotional, and very disciplined person. Can you explain if the article is 100% complete or requires further ediiting? if so what needs to be edited? Noam Atadgy (talk) 23:50, 28 October 2024 (UTC)

Hi Noam, welcome to (English) Wikipedia! I don't know that anyone's going to be likely to respond to you telling you what they feel needs to be edited. I'd suggest being bold, and reviewing the article for yourself and making any changes that you feel will improve the article. That said, I'd also recommend being careful, making small numbers of relatively incremental edits (say, five at a time at most), and leaving edit summaries so other editors know what your intentions are. If you're adding information, you absolutely should provide reliable sources in the form of citations. It's reasonably likely that with an article of this nature your edits may be reverted; if and when that happens, please don't take it personally, but rather consider it a teachable moment, and above all, if that happens, please don't simply reinstate your edit(s), but rather initiate a discussion here or with the reverting editor, as suggested at WP:BRD. That way, other editors can review the situation as well and provide their counsel. I'm happy to try to answer any general questions you may have. Happy editing! DonIago (talk) 12:42, 29 October 2024 (UTC)

My brain works a bit differently. It affects how I see the world, how I communicate, and how I interact with people. It’s just a part of who I am, not something that needs to be fixed. It comes with its own strengths and challenges, but it's always been a part of my life. In essence, that is, I have autism as well. 206.57.152.111 (talk) 14:56, 6 November 2024 (UTC)

Autism, Wikipedia and epistemic injustice

Over the last few years I've occasionally tried to improve Wikipedia's autism coverage, working to bring it up to date with modern understandings and so on. For example, in 2022 I put in a lot of work to ensure the 'Autism' entry was merged with 'Autism Spectrum' (rather than the entry under that title focusing mainly on 'classic' or 'Kanner' autism). I also started work on a substantial rewrite of the page with a couple of other editors, but I think we all got kind of burned out on arguing with people every step of the way.

Obviously this page - in common with other autism-related pages - has been a bit of a battle-ground at times. No surprise there, when you look at how controversial practically everything about autism is in the wider world! Still, I think the result is a page (a set of pages, actually) that badly needs bringing up to date, and where all attempts to do so tend to be exhausting, especially for any newcomers. Effectively, some of the material here is so out of date and/or one-sided as to constitute misinformation, while we completely miss out some absolutely key things about autistic experience that anyone living, working with or being an autistic person really ought to know about.

In the hopes of helping people to understand these issues and how they come about, I ended up writing a long article for Thinking Person's Guide to Autism about 'Autism, Wikipedia and epistemic injustice', which should be published in the next few days (the link is to a draft copy - I'll edit when it comes out). This may also help motivate some more people to work on bringing Wikipedia up to date on all this.

I'm posting this here because I thought existing Wikipedians should know about it: it could potentially be considered 'canvasing'; and I figured that anyone looking at this Talk page might find it an interesting read, which could help inform how they think about this and related articles. There are also some questions in there which I'd be interested in other editors' answers to. It's packed with references to further reading - I tried to ensure that anything vaguely contentious (or little-known) was backed up with high-quality citations.

I'm happy to answer any questions here, or by email. Thanks!

Oolong (talk) 17:16, 2 November 2024 (UTC)

Should autism continue to be described as a neurodevelopmental disorder characterised by symptoms, impairment and severity?

In recent weeks, some commenters have been contesting the article's referral to autism as a neurodevelopmental disorder and that it's characterised by symptoms and impairments, varying severity levels, and risks or causes. A series of diplomatic discussions have occurred across various sections of talk pages with no clear conclusion. In this post, I provide a systematic review of the scientific evidence and Wikipedia Guidelines, leading to a robust conclusion on the continuity of this article.

Methods

I systematically gathered peer-reviewed reports, consensus statements and international or national guidelines through browsing journals, the National Library of Medicine (PubMed) and Google Scholar as well as by referring to citations in existing discussions. From this literature, I extracted a strong evidence base.

The terms "globally" refers to countries around the world while "internationally" refers to at least several countries or a particular continent.

Key terms are marked in bold.

Citations are marked and linked numerically (e.g., [1]).

The review is not intended to be absolutely comprehensive but sufficiently searched to reveal a clear scientific consensus and the indications from Wikipedia Guidelines.

The Evidence

The ICD-11 and World Health Organization (WHO), guidelines used globally, conclude that autism is a neurodevelopmental spectrum disorder and that "The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning". [1

The DSM-5 criteria, used internationally, concludes that autism is a neurodevelopmental spectrum disorder; per diagnosis that "Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning" and that "Severity is based on social communication impairments and restricted, repetitive patterns of behavior". 2

Guidelines from the UK National Institute of Health & Care Excellence (NICE) conclude that autism is a neurodevelopmental spectrum disorder. They write "The clinical picture of autism is variable because of differences in the severity of autism itself". 3 NICE guidelines also refer to "symptoms of possible autism..." 4

National Institute of Mental Health (NIMH) Guidelines conclude that "Autism spectrum disorder (ASD) is a neurological and developmental disorder" and acknowledge the existence of "signs and symptoms of ASD". 5 Paradoxically, a different NIMH publication advocates against some of the above [6].

The European Society for Child and Adolescent Psychiatry (ESCAP) and Autism Europe (AE) guidelines, used internationally, conclude that "autism spectrum disorder (ASD), which is now recognised not only as a childhood disorder but as a heterogeneous, neurodevelopmental condition that persists throughout life". They also state that "Earlier recognition of autism symptoms could also be improved...". 7

German AWMF guidelines conclude that autism is a neurodevelopmental disorder in accordance with the above guidelines. 8

National Guidelines in France conclude that autism is a neurodevelopmental disorder, with varying severity levels, characterised by the presence of significant impairment per the DSM-5 and ICD-11 (9).

A scientific consensus statement on the evaluation of ASD conclude that it's a neurodevelopmental disorder, with varying severity levels and is characterised by symptoms and the presence of impairments (National Consultation Meeting for Developing IAP Guidelines on Neuro Developmental Disorders under the aegis of IAP Childhood Disability Group and the Committee on Child Development and Neurodevelopmental Disorders et al., 2018)).

Consensus Guidelines on ASD concluded that "Autism spectrum disorder (ASD) is a neurodevelopmental disorder with an estimated lifetime prevalence of at least 1% (Baird et al., 2006; Brugha et al., 2011). Core symptoms include..." (Howes et al., 2018).

Canada's national diagnostic guidelines from the Canadian Paediatric Society (CPS) conclude autism is a neurodevelopmental disorder; that "[children with ASD] can present with a wide range and severity of symptoms"; that "This statement proposes three ASD diagnostic approaches, the choice of which depends upon the paediatric care provider’s clinical experience and judgment, and the complexity of symptom presentation" (CPS, updated: 2024).

The International Consensus Statement on ADHD, authored by 80 scientists, coendorsed by 403 experts and numerous associations, across 27 countries and 6 continents (Faraone et al., 2022) conclude that ADHD [another neurodevelopmental disorder] "is rarely caused by a single genetic or environmental risk factor but most cases of ADHD are caused by the combined effects of many genetic and environmental risks". Systematic reviews and meta-analyses unanimously use the term "risks" in the context of Autism as well, not just that specific neurodevelopmental disorder (Dietert et al., 2010; Mojgan et al., 2017; Belmonte et al., 2022).

It appears that some blog posts, advocacy papers and a textbook advocate for a change in terms deviating from calling ASD a neurodevelopmental disorder but simply a neurodiversity with "likelihoods" rather than "risks" and mere "traits" rather than symptoms and impairments.10,11,12. Note that these are advocating for something that is not currently established. Thus, they are not sources that can overturn the global scientific consensus that autism is a neurodevelopmental disorder as it's currently defined. Notably, other textbooks do not share such views (e.g., Volkmar, 2021). As cited in this WP article, other peer-reviewed reviews disagree with these advocations (Neison et al., 2021; Shields et al., 2021). Note that blog posts are not peer-reviewed, scientific papers and thus are not reputable in comparison to this literature. This Wikipedia article at the time of writing does a well-balanced view of the ongoing debate about whether an alteration in terms should take place in the future.

As shown by this extensive evidence, traits of autism are in fact not autism; you must be significantly impaired by those symptoms to be diagnosable, which arise from neurobiological factors. This is why it's a neurodevelopmental disorder with the requirement of present impairment in addition to symptoms.

Wikipedia Guidelines

"It is important to note that in forming its consensus it is the members of a particular scientific discipline who determine what is scientific and what is questionable science or pseudoscience. Public opinion or promoters of what is considered pseudoscience by the scientific consensus hold no sway in that determination." (Wikipedia:Scientific consensus).

Conclusion

There is a clear global scientific consensus across guideline developers, international consensus statements, systematic reviews, meta-analyses and other peer-reviewed reports that autism is a neurodevelopmental disorder characterised by symptoms, impairments and varying severity levels. The consensus appears to be less evident for the appropriateness of the terms "risks" and "causes", but there is no evidence to suggest these two terms are specifically inaccurate as opposed to interchangeable with other terms like "likelihood". According to Wikipedia guidelines, scientific consensus is one of, if not, the the most robust source to rely on in substantiating content and facts; that public opinion or promoters of contrary statements in no way influence that determination. Thus, autism must continue to be described as a neurodevelopmental disorder defined with symptoms and impairments. However, the terms "risks", "causes", "contributions/contributing factors" and "likelihood" may be used interchangeably in some contexts without invalidating the other. I hope these findings help inform decisions on the status of this article. Димитрий Улянов Иванов (talk) 23:24, 6 November 2024 (UTC)

It should be noted, however, that in medical contexts, such as psychiatric services providers, there is an increasing substitution of the term 'condition' for the term 'disorder'. This will most probably increase in the future, though it does not amount to a consensus at present. Urselius (talk) 08:30, 7 November 2024 (UTC)

Actually, the scientific consensus above consistently uses the term disorder in the medical context. Condition can be interchangeable with the term, in some contexts, but it’s not a replacement of it by any means. Димитрий Улянов Иванов (talk) 08:33, 7 November 2024 (UTC)

Scientific papers, presumably used to create a 'scientific consensus', will inevitably lag behind the usage of active clinicians. This is because at any one time the sum of all papers will have a bias towards those written in the past, a proportion of which may have been written many years in the past. This effect is exacerbated by the time lag between writing a paper and it appearing as a published work, which is often considerable. I merely suggest that changes in clinical usage need to be kept under watch. I am an author of many biomedical papers, so I know whereof I speak. Urselius (talk) 14:25, 7 November 2024 (UTC)

The references are published in reputable journals or the sites of national guidelines to be viewed by clinicians, so their findings are not in some pending pre-published state as you imply here. Yes, scientific findings and their dissemination take time to influence clinical practice. However, those guidelines and consensus statements are standardised internationally and are used by healthcare providers at this time until they are succeeded with a new revision, something I know also as a clinical researcher. Secondary literature published throughout this year unanimously use the term, which indicates it remains relevant ,as it has for decades. Individuals indeedm ay be idiosyncratic in their usage of termds but that provides no evidence against the standardisation/scientific consensus. The literature should be checked periodically for any novel changes but that can apply to other topics as well. Thanks for writing. Димитрий Улянов Иванов (talk) 19:01, 7 November 2024 (UTC)

You seem to read whatever I write as though I have some form of agenda that I do not possess. Faced with your seeming inability to comprehend what I mean, which in essence is that all things are mutable, including biomedical usage, further conversation is pointless. Urselius (talk) 15:26, 8 November 2024 (UTC)

I have comprehended and addressed your reasoning. For example, you state "This effect is exacerbated by the time lag between writing a paper and it appearing as a published work, which is often considerable" and I replied "The references are published in reputable journals or the sites of national guidelines to be viewed by clinicians, so their findings are not in some pending pre-published state as you imply here." and importantly that "Secondary literature published throughout this year unanimously use the term, which indicates it remains relevant ,as it has for decades". This indicates the term remains relevant irrespective of the publication of the guidelines. Another point I made, that I'd like to emphasise is that the DSM-5 and ICD-11 require the term "ASD" is used in diagnoses until a subsequent revision may change it. The date of their publication doesn't change that until any such new versions release. That said, one shouldn't rely exclusively on standardisations like the DSM-5/ICD-11 but they are highly relevant in this context.

And I certainly didn't believe you had an agenda nor implied one. I don't mind if you want to stop conversing here but if you can't understand that I've addressed your points explictly, it's not my problem. Димитрий Улянов Иванов (talk) 17:15, 8 November 2024 (UTC)

What are the diffs showing where this is contested? I cannot find them in the edit history. Thanks. Sirfurboy🏄 (talk) 08:34, 7 November 2024 (UTC)

Most of it took place in the section “Risk?” I think Димитрий Улянов Иванов (talk) 08:39, 7 November 2024 (UTC)

A diff is the edit in the edit history that shows someone has contested the term. This is a diff [13] where you added a very strong invisible comment for editors. Are there any diffs showing anyone actually tried to change that text? Also, we don't actually have a Risk section. What am I missing? Sirfurboy🏄 (talk) 08:45, 7 November 2024 (UTC)

Sorry, I meant the section “Risk?” in the talk page; no editing took place in regards to that recently, from my knowledge Димитрий Улянов Иванов (talk) 09:03, 7 November 2024 (UTC)

Ah, yes. I should have realised you meant the talk page. Okay. I am going to soften that invisible note though. We are getting a lot of notes in this article, and where they represent a consensus and an area of long term conflict (like the stacking cans image), they are helpful. They are helpful for pointing editors to the discussion and consensus, but are not binding over normal policy and guidance. The place for discussion is here (as you have it). I'll just change the note to ask editors to notice the discussion. Sirfurboy🏄 (talk) 09:12, 7 November 2024 (UTC)

I'm not so sure that I'd agree, unless there is a strict guideline indicating so. The purpose of those notes were to preempt alterations that are based on extensively disproven reasoning, as there is a tendency for that to happen in this sort of article. So I still think it's useful to refer to a specific talk page and summate the reasoning in the note itself as well rather than merely suggest one initiate a new section when one has already taken place substantiating the terms. The supporting evidence is too lengthy and contextual to be cited in the article,really. Thanks for your reply. Димитрий Улянов Иванов (talk) 19:07, 7 November 2024 (UTC)

Thanks. I am not sure if there is a specific guideline about such notes, but the point is that the place for detailed rationale is the talk page. Editors are under no obligation to respect or even retain comments in the article text (all of which are delivered to reader, albeit not obviously). On the other hand, editors are obliged to leave discussion on a talk page. They can reply to it but not remove it. I have only seen notes like these used in the past on matters where there has been extensive edit warring, and where new editors are inclined to make bold changes without checking the talk page. In such cases they are a useful flag to editors that they should discuss and not be bold - that their edit is controversial. I think that is what you want here, if pre-emptively. But I think it best to point editors to the page rather than assert a position that is (to my mind) right. Right but not yet fully discussed. Still, if others think the long form of the note is better, I'll not fight it. Sirfurboy🏄 (talk) 20:52, 7 November 2024 (UTC)

That's understandable. Perhaps we can use such notes if edit warring does occur in the future, but my main worry is that the article might be changed to frame ASD as a mere "neurodiversity" and noone will contest the decision in the first place. It's a quite popular viewpoint amongst some advocates, but certainly not in the scientific and medical literature. Nonetheless, I will try to keep an eye on the page as much as I can and voice my opinion if something like that happens, hopefully others will as well. Димитрий Улянов Иванов (talk) 17:30, 8 November 2024 (UTC)

Acronyms

Mitch Ames did you see my edit summary here? [14]. You have removed the acronym again as "unused" but it is used. Thus we should expand it on first use per web content accessibility guidelines. Sirfurboy🏄 (talk) 13:08, 7 November 2024 (UTC)

I did see your edit summary, but the use of the term in the reference title is irrelevant. It is not the article's responsibility to expand an acronym used in the title of a reference. We are not using the acronym as a replacement for a term (in the article) - we are merely quoting the article title verbatim. Mitch Ames (talk) 13:22, 7 November 2024 (UTC)

MOS:ACRO1STUSE, in line with the Web Content Accessibility Guidelines, says an acronym should be written out in full for the first time, followed by the abbreviation in parentheses, e.g. maximum transmission unit (MTU) if it is used again in the article. There are no exceptions for acronyms used in quotations or titles. It is the responsibility of the creator of a web page to ensure that the page complies with web content accessibility guidelines and Wikipedia policies. The acronym is on the page, so it should be expanded. Sirfurboy🏄 (talk) 14:21, 7 November 2024 (UTC)

I agree with the above ^. That is how I typically see this on the site, per WCAG Димитрий Улянов Иванов (talk) 14:22, 7 November 2024 (UTC)

MOS:ACRO1STUSE says (emphasis mine) "... the abbreviation in parentheses ... if it is used again in the article". Although "the article" includes the references, I suggest that that intent of that guideline is "used again in the article content (lead, table of contents, body)".

In any case...

• In the first reference, the term "NICE" is not "used", it is "mentioned", as part of the web page title (and the website address).
• In the second reference the publisher is listed as "NICE" - the name that their website repeatedly and almost exclusively uses to identify itself, including when describing themselves at https://www.nice.org.uk/about. Although we are using (rather than mentioning) "NICE" in this reference, I argue that we are not using the term as abbreviation of the full name, instead we are using the name that the organisation itself uses, so we do not need to define it.
• Given that NICE's own website almost exclusively uses "NICE", not "National Institute for Health and Care Excellence", I suggest that it is "most commonly known by its acronym, in which case the expansion can be omitted".
• With regard to Web Content Accessibility Guidelines, in both references (and in particular the second) the reader may click on the term to find out what it means, which satisfies Success Criterion 3.1.4 Abbrevations by way of Technique G55 Linking to definitions.

Mitch Ames (talk) 09:52, 9 November 2024 (UTC)

References

Semi-protected edit request on 8 November 2024

Add a citation for the percentage of fraternal twins both having autism spectrum disorder: Rosenberg RE, Law JK, Yenokyan G, McGready J, Kaufmann WE, Law PA. Characteristics and concordance of autism spectrum disorders among 277 twin pairs. Arch Pediatr Adolesc Med. 2009 Oct;163(10):907-14. doi: 10.1001/archpediatrics.2009.98. PMID: 19805709. Sunnyjw (talk) 20:20, 8 November 2024 (UTC)