Talk:Autism/Archive 2

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Facial characteristics

The section Facial characteristics is based on one recent primary study of 65 subjects. This is not enough support for the claim - or implication or speculation - that there is a reliable correlation between ASD and physiognomy. See this guideline: Wikipedia:Identifying reliable sources (medicine). I've deleted the section for now.

An image of a young person illustrating that section has been removed in the past by Yobol (talk · contribs) and now by me. Regardless of the eventual fate of the disputed section, please do not restore the image. Images of recognisable people claiming they have a disorder must be accompanied by proof that the person's or their legal guardian's permission has been given. We would also need evidence that the image has the putative autistic characteristics, beyond the simple assertion of the uploader. --Anthonyhcole (talk) 02:12, 13 November 2012 (UTC)

Bad picture + one primary study = not a good section. Dbrodbeck (talk) 04:57, 13 November 2012 (UTC)

Massive rewrite needed

This is an important article encompassing all autism spectrum disorders; it is not some secondary daughter article. It should be an accurate, broad overview based on reliable medical sources.

Here is the last good version just after Eubulides stopped editing. From that correct version, the article has grown to this as of today; there are entire sections now that are based on primary sources, little regard for WP:MEDRS (numerous secondary reviews are available), and WP:UNDUE and speculative text.

A rewrite to remove primary sources is needed. I plan to begin removing information to talk for discussion and MEDRS-compliant sourcing. Has no one been watching this article for addition of primary-sourced, UNDUE and speculative information? SandyGeorgia (Talk) 16:32, 13 December 2012 (UTC)

Language acquisition

Removed to talk for discussion, based on primary sources, undue, hypothetical, and in what section per WP:MEDMOS should this text belong? Can something sourced to secondary reviews be rewritten and fit into the MEDMOS scheme? SandyGeorgia (Talk) 16:55, 13 December 2012 (UTC)

Theory of mind tasks assess the ability of an individual to understand the capabilities of others with respect to cognitive abilities and perception. Theory of mind tasks assess attribution of epistemic mental states, intentions and motivations, and affective states. In the field of cognitive development, these tasks are usually pursued with children over the age of three, in coordination with language development for interaction with the researcher. These tasks are presented as behavioral tasks to the subject. Theory of mind difficulties seem to be universal among individuals that present on the autism spectrum. When asked to differentiate between mental and physical activities, children ages 3–4 had difficulty assessing which was which accurately. Additionally, they tend to have issues understanding figurative speech or appropriate speech with respect to the social context.

As adults, only half of autistic patients are capable of speech and their linguistic abilities are lower than normal subjects. Autistic children do not seem to acquire language by immersion. Mean length utterance, a measure of linguistic productivity, evolves rapidly in autistic children. A possible rationale is that they do not have enough referential vocabulary to trigger syntax. Referential words, the understanding of what a specific word refers to, is contrasted by relational vocabulary. Limited grammatical acquisition may be attributed to a decreased lexicon of referential words.

Linguistic and non linguistic elements evolve with isolated and specific social and cognitive elements, with autism there is mutual interference. Gestural means of communication is used by both non-verbal and verbal autistic children. The mother may also have an influence on development of communication.

There is a division of the Autism spectrum into three categories for patients. Individuals with Asperger who acquire language to a normal degree but with a slight delay in the process of acquisition. Verbal autistic children who show delay in language acquisition and individuals who are never capable of language acquisition, they are considered nonverbal. Difference in language acquisition may be linked to different levels of impairment at theory of mind tasks.

Atypical empathic response

Primary sources, UNDUE. SandyGeorgia (Talk) 16:55, 13 December 2012 (UTC)

Further information: Lack of empathy and the autism spectrum

People on the autism spectrum exhibit atypical empathic responses compared to neurotypicals, including a relative lack of empathy. The interaction between empathy and the autism spectrum is a complex and ongoing field of research, and several different factors are proposed to be involved, including alexithymia, impaired theory of mind, and reduced mirror neuron activity.

They look like reliable secondary sources to me. E.g. analysis and interpretation of data from studies (which would constitute secondary sources), published in Journal of Autism and Developmental Disorders (summary here), Nature Neuroscience journal (summary here), (which are reliable) etc. Which are primary?

A lack of empathy being a trait of autism spectrum is neither unsupported nor an overwhelming minority view. Two very brief sentences on a notable facet of autism spectrum shouldn't warrant the UNDUE tag. If it helps to "neutralize" the viewpoints, we could also incorporate something about the study done on cognitive versus affective empathy in which autism spectrum participants were found to be impaired in the former type of empathy (relative to neurotypicals) but not the latter type of empathy. --Xagg (talk) 17:52, 14 December 2012 (UTC)

There are reviews on the topic. Of the two you highlight above,

• PMID 15162941 is not a review.
• PMID 16327784 is a clinical trial (and please see statements from reviews in our article on mirror neuron

Please use secondary reviews; we sometimes use primary sources when secondary reviews are not available. That is not the case here. SandyGeorgia (Talk) 17:45, 19 December 2012 (UTC)

Copyright infringement ??

Could someone who has this book please verify that this text is not infringing copyright? SandyGeorgia (Talk) 17:04, 13 December 2012 (UTC)

Table 1: Early Symptoms of Autism

Social behavior	Typically develops	Behavior in autistic children compared to typically developing children
Looking at faces	Birth	Less at 12 months
Following person's gaze	6–9 months	Less at 18 months
Turning when name called	6–9 months	Less at 9 and 12 months
Showing objects to others	9–12 months	Less at 12 months
Pointing at interesting objects	9–12 months	Less at 12 months and 18 months
Pointing to request	9–12 months	Delayed at 18 months
Symbolic play	14 months	Absent at 18 months

Genetic risk factors

Primary source, removed for sourcing to a secondary review. SandyGeorgia (Talk) 17:09, 13 December 2012 (UTC)

These studies suggest a strong genetic component in autism. It is estimated that autism involves 5-10 genes and possibly more. Possible susceptibility regions include chromosomes 1p, 2q, 7q, 13q, 16p, and 19q.

A better possible genetic explanation for Autism can be related to the papers below and the mGluR theory of fragile X mental retardation.

This is a pervasive and extremely important study going on to find a genetically caused molecular reason for autism among other mental retardations. The paper is online and should be brought up, as recovery of normal functioning has also been proven possible in mice. Therazzz (talk) 05:10, 22 April 2013 (UTC)

Environmental risk factors

The doi is a dead link, the source is from 2005; I'm sure that something can be said about environmental risk factors, but it surely can be sourced to an updated secondary review. SandyGeorgia (Talk) 17:35, 13 December 2012 (UTC)

A wide variety of environmental risk factors have been proposed as contributing to autism. These include gastrointestinal or immune system abnormalities, allergies, and exposure of children to drugs, vaccines, infection, certain foods, or heavy metals. The evidence for these risk factors is anecdotal and has not been confirmed by reliable studies. The subject remains controversial and extensive further searches for environmental factors are underway.

Pathophysiology

primary source. SandyGeorgia (Talk) 18:26, 13 December 2012 (UTC)

In neurotypical children, there is a bias of the left lateralized network that is essential for language development, as shown by magnetoencephalography. Specifically, there was a left dominance of parieto-temporal coherence in the theta band that was correlated with higher performance on language related tasks. This was not correlated with head circumference or chronological age.

Corpus callosum

Primary source and weasly (from pathophysiology). SandyGeorgia (Talk) 17:37, 13 December 2012 (UTC)

Studies have found evidence of reduced size of the corpus callosum in autistics. These findings suggest that there may be a link between autism and impaired communication between brain hemispheres.

Limbic system

Also from pathophysiology, primary sources; there is surely a recent secondary review that discusses pathophysiology in ASD, no need to cobble together this entire section from primary sources. SandyGeorgia (Talk) 17:39, 13 December 2012 (UTC)

Social skills impairments in autism have been theorized to reflect abnormal functioning in the limbic system. In animal models, it has been found that monkeys with lesions in the medial temporal lobe (e.g., the amygdala and hippocampus) demonstrate autistic-like behaviors, such as a failure to develop normal social relationships, stereotyped movements, and poor eye-contact. Notably, it was found that the most severe autistic symptoms resulted from lesions in the amygdala and hippocampus whereas less severe forms resulted from lesions to the amygdala alone. Human autopsy studies have also found evidence for limbic system abnormalities in individuals with ASDs. These studies revealed reduced neuronal cell size and increased cell-packing density in the hippocampus and amygdala. However, MRI studies have not found any evidence for abnormalities in the hippocampus.

Frontal lobe

More primary studies from pathophysiology. SandyGeorgia (Talk) 17:41, 13 December 2012 (UTC)

The frontal lobe is central to many functions that are associated with autism, such as language and executive functions. For instance, Broca's area, which is related to language production, is located in the inferior prefrontal lobe. Other important areas of the frontal lobe include: the prefrontal cortex (involved with aspects of executive function such as working memory, inhibition, planning, organizing, set-shifting and cognitive flexibility), the orbitofrontal cortex (involved in social cognition and theory of mind) and the inferior frontal gyrus (part of the mirror neuron system). Current research suggests that dysfunction in the frontal lobe may be associated with some of the deficits observed in individuals with ASD, including social cognition, imitation, face processing, language, attention, working memory, and problem-solving. For example, it has been found that autistics have decreased concentrations of N-acetyl-asparate (NAA) and reduced glutaminergic neurons in the frontal lobe, suggesting some dysfunction in this region. Another study found that boys with high-functioning autism had reduced activity in the pars opercularis when observing and imitating emotions. Orbitofrontal cortex deficits have also been implicated with autism, as individuals with high-functioning autism have shown decreased functioning in this area when participating in a task that involved the perception of fearful faces. Finally, individuals with ASD have shown decreased activation in the medial prefrontal cortex relative to a control group during a theory of mind task.

Temporal lobe

More primary studies from pathopysiology SandyGeorgia (Talk) 18:24, 13 December 2012 (UTC)

Other studies have suggested that the role of the STS may be more complex than simple face processing, as research has found that individuals with ASDs have shown reduced functioning when viewing fear-provoking faces; implying that the STS is involved in understanding the emotions of others. Other areas of the temporal lobe have also been implicated in ASDs. For instance, fMRI research suggests that individuals with ASDs have reduced activity in the right temporoparietal junction and other regions during imitation and observation tasks.

Management

probably true, but not from that primary source, needs better sourcing. SandyGeorgia (Talk) 17:44, 13 December 2012 (UTC)

Many popular therapies including auditory integration training, GFCF diets, and chelation are not considered evidence-based practices. Notably, research suggests that children with ASDs on GFCF diets do not differ from control groups in terms of their symptoms.

primary, undue. SandyGeorgia (Talk) 18:06, 13 December 2012 (UTC)

All successful early intervention programs should focus on the TRIAD of impairments in ASDs. This includes: a) Joint attention and communication, b) Social understanding and relationships, and c) Flexibility in thinking and behavior. It also includes a strong, positive partnership with parents, siblings, and co-therapists to keep consistency throughout the childs day. Research for more effective treatments should focus on the extent to which E.I Programs are adapting to the child's pattern of strengths and weaknesses and take into account all family circumstances. The importance and effectiveness of treatment (especially ABA formatted treatment) relies heavily on both child and family circumstances. At the child's level the age at entry into treatment and the severity of impairment on a cognitive, language, and behavioral level are crucial. At the family level, Socio-Economic status, level of income, presence of parents and proximity to outside family and resources, organization, extent of stress of the parents and ability to work alongside the therapist are most important for success.

Break for now

That's all I have time for; the article has been chunked up with primary sources and everybody's pet theory. There are ample secondary reviews available. I'm not even halfway done; I hope others will begin identifying and addressing the WP:UNDUE introduced here as the result of overreliance on primary sources when secondary reveiws are available. SandyGeorgia (Talk) 17:52, 13 December 2012 (UTC)

You have done a great job! I'll see what I can do during the holidays. Lova Falk talk 08:18, 19 December 2012 (UTC)

Responded regarding removal of 'atypical empathic response'. I did not see any primary sources used, just secondary sources. If anything not saying anything on the relationship between autism spectrum and lack of empathy would be non-neutral considering its significance. --Xagg (talk) 14:51, 19 December 2012 (UTC)

Xagg, could you rephrase your last sentence because I'm not sure I understand what you mean? Lova Falk talk 15:16, 19 December 2012 (UTC)

I apologise, it does sound like a run-on sentence; will insert some commas: 'If anything, not saying anything about the relationship between autism spectrum and lack of empathy would be non-neutral, considering its significance.' I mean that atypical empathic response (most notably lack of empathy) is a notable, much-researched and significant aspect of autism spectrum, such that excluding anything about said relationship from the article seems to be depriving it from a fair, proportionate discussion of all significant views that have been published by reliable sources. See how much there is about the subject matter in the article on empathy and compare that to the current lack of anything about it in this article. --Xagg (talk) 16:28, 19 December 2012 (UTC)

I agree with you! Lova Falk talk 17:41, 19 December 2012 (UTC)

see the section above; reviews are available, no need to use primary sources, and specifically, see the reviews at our article on mirror neuron (WP:UNDUE here). SandyGeorgia (Talk) 17:47, 19 December 2012 (UTC)

I should stay out of this discussion until I have the time and energy to really dive into this matter. Which will probably be sometimes after christmas... Lova Falk talk 17:57, 19 December 2012 (UTC)

Picture or diagram

Hi, I don't know if this is a good suggestion, but I think this page would benefit from a diagram showing the spectrum it's talking about to get the concept across. Perhaps someone who understands the page could make one? Jamietwells (talk) 10:08, 3 August 2014 (UTC)

It's not a spectrum in the sense that the visible light spectrum is a spectrum. Frankly, spectrum is a bit of a misnomner. It's more of a continuum, a related set of correlated behaviors and experiences whose cause and manifestation are not well understood or even well defined. A diagram would most likely only add misinformation.

The autism community likes this symbol to represent the diversity of the spectrum:

Muffinator (talk) 12:14, 3 August 2014 (UTC)

I think it could be useful. Something similar to these:

• http://1.bp.blogspot.com/-BhgCjV7fhGQ/Uv0K4OVlBdI/AAAAAAAAKhY/mXJrrGhu8cY/s1600/Autism+Spectrum+Disorder.png
• http://www.scienceinschool.org/repository/images/issue24autism9_xl.jpg
• http://images.sussexpublishers.netdna-cdn.com/article-inline-full/blogs/43103/2010/06/44605-30115.jpg

May get across the range of symptoms of ASD better for interested readers. What the autism community represents themselves with isn't really relevant to an informational article, is it? -Iamozy (talk) 22:08, 5 August 2014 (UTC)

Those first two (venn diagram and triangle) are a possible graphical design, although those specific images are missing a lot of information. The graph doesn't work at all, especially since the various autism spectrum diagnoses are not distinguished by IQ (AFAIK autistic people are no more or less intelligent than any other neurotype). The rainbow infinity is relevant since it's a symbol for autism in general, not just of the community or organizations. Muffinator (talk) 22:40, 5 August 2014 (UTC)

Review article collection

Hi All, I have a PubMed Autism Review article collection, which may be useful. Been busy elsewhere and not much has been added from this year. dolfrog (talk) 13:17, 29 November 2013 (UTC)

Genetic risk factors

I don't understand why an article in Journal of Child Psychology and Psychiatry is an unreliable medical source. I found another source for the multiple genes involved: http://www.pediatricsdigest.mobi/content/113/5/e472.full.pdf but before I start rephrasing and referencing, I would like to know if this is a reliable source (and if not, why not), so I won't do it in vain... Lova Falk talk 11:06, 31 December 2012 (UTC)

Gender

I happened to respond to a query over at the Reference Desk, and noticed that this article doesn't mention the significant ASD gender differential. I found a good secondary sources, with reliable references; in case somebody^[who?] would like to add this.

• "Autism: why do more boys than girls develop it?". Gender and autism. The National Autistic Society. Retrieved 15 January 2013.
• Baron-Cohen S, Lombardo MV, Auyeung B, Ashwin E, Chakrabarti B, et al. (2011) "Why Are Autism Spectrum Conditions More Prevalent in Males?" PLoS Biol 9(6): e1001081. doi:10.1371/journal.pbio.1001081
  

~Eric F 74.60.29.141 (talk) 08:27, 15 January 2013 (UTC)

Hi Eric, why don't you add it? Lova Falk talk 10:49, 16 January 2013 (UTC)

Funny, I've found other ASD pages where sex difference data gets short shrift. It's apparently a pattern. Leadwind (talk) 15:57, 19 October 2013 (UTC)

Evolutionary Considerations

This section was added as part of the Evolutionary Medicine Wikipedia Network. Wikipedia is increasingly used as a medical reference resource by the general public and medical students. This assignment, designed for students in Evolutionary Medicine courses across the country, is designed to contribute to the goals of the Evolutionary Medicine Wikipedia Network (EvMedWikiNet), identified as a priority by the National Evolutionary Synthesis Center (NESCent) working group on evolutionary medicine education. The goal of the EvMedWikiNet is to add evolutionary considerations to existing Wikipedia articles and to develop new pages on key terms and concepts in evolutionary medicine. The EvMedWikiNet aims to make Wikipedia entries on Evolutionary Medicine topics up-to-date, reliable, cross-linked and accessible to the general public while integrating effectively with existing Wikipedia content. Please feel free to add/edit this section as you feel necessary. This article was edited by Sarmocid at Case Western Reserve University. — Preceding unsigned comment added by Sarmocid (talk • contribs) 19:42, 13 October 2013 (UTC)

I removed this text one for cut-and-paste copyvio. There is still some too close paraphrasing, text that does not accurately represent the source, text that is WP:UNDUE, and text does not belong in this article (speculative theories about causes, all based on one paper, might be better placed at causes of autism within context and given due weight). There are also WP:MSH issues. I will not revert a second time without further discussion, but I believe there is little of this edit that should be left here. SandyGeorgia (Talk) 21:01, 13 October 2013 (UTC)

Wow, Sarmocid provides a bunch of referenced material about evolutionary medicine and sees it all deleted. That's a bummer. The gene imprinting theory and the EMB theory get no treatment on this page? Sarmocid's material was lengthy, and as Sandy says it's better on the Causes page, but the reader deserves at least some treatment of this topic. Evolution is controversial when applied to human behavior (or at least it used to be), but it's still a notable point of view. Leadwind (talk) 16:05, 19 October 2013 (UTC)

Sure but editor must 1) paraphrase 2) use secondary sources per WP:MEDRS 3) write in an encyclopedic style. While other editors may be willing to help this bar must be reached before the content is added. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:38, 19 November 2013 (UTC)

Student encounters editor who has a case of IDHT and edits with a POV-- unfortunate. SandyGeorgia (Talk) 00:47, 19 November 2013 (UTC)

Causes--thimerosal

The claim that thimerosal is 50% ethylmercury is confusing. The name ethylmercury suggests it is a compound, maybe diethylmercury, but according to the ethylmercury page it is actually the (mono) ethyl mercury (II) ion, with a +1 charge. The thimerosal page shows a covalent structure for thimerosal, so it does not contain any ions or any ethylmercury in particular. We could speculate that it might dissociate into ethylmercury ions and another ion, but that does not mean it is 50% ethylmercury. I can't help wondering if there is confusion between compounds and mixtures or reactants and products here. There seems to be an unsubstantiated implication that thimerosal is 50% as toxic as ionic ethylmercury salts. — Preceding unsigned comment added by Straits (talk • contribs) 11:23, 29 October 2013 (UTC)

Is Autism caused by Birth Injuries?

Please take a look at this website www.cordclamp.org there are tons of articles here, written by certified doctors and containing tons of references. The contention of this site is that a widely used and recently (last 60 years) adopted delivery procedure is causing brain damage, with Autism being a common result. — Preceding unsigned comment added by 50.47.4.32 (talk) 00:46, 27 November 2013 (UTC)

I don't think those satisfy WP:MEDRS. Dbrodbeck (talk) 00:51, 27 November 2013 (UTC)

Sorry about the bad edit

But what was written citing [1] as source was not verifiable from the citation given. — Preceding unsigned comment added by 2600:E00F:4004:10:0:0:0:3B (talk) 04:30, 29 November 2013 (UTC)

Counter systemic bias CE overdue

This looks like a sandbox for a Autism spectrum in the United States article.

Meanwhile, we also want a Autism spectrum article. I think, copy-editing with the specific aim of countering systemic bias should be encouraged.   – Ian, DjScrawl (talk) 12:21, 29 November 2013 (UTC)

Could you point out where you see a problem? I think that would help greatly. Dbrodbeck (talk) 12:28, 29 November 2013 (UTC)

Thanks for asking. Anywhere US jargon is used, without being couched as such. The first two Lead sentences seem to have about three examples of that.   – Ian, DjScrawl (talk) 12:38, 29 November 2013 (UTC)

OK, so here are those first two sentences: 'The autism spectrum or autistic spectrum describes a range of conditions classified as neurodevelopmental disorders in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5). The DSM-5, published in 2013, redefined the autism spectrum to encompass the previous (DSM-IV-TR) diagnoses of autism, Asperger syndrome, pervasive developmental disorder not otherwise specified (PDD-NOS), childhood disintegrative disorder, and Rett syndrome.[1] '.

Is the issue the referencing the DSM? The DSM is used all over the world, not just in the US. Dbrodbeck (talk) 14:38, 29 November 2013 (UTC)

Nope. It's the lead - grounding the topic in more than three authoritative definitions would be excessive and, if only one's to be used, I'm sure this is amongst the best. However, I don't think that contraction should leave the suggestion it is the authoritative definition. I'm sure it's known to highly engaged Wikipedia readers in most countries and that most of those would regard it as a leading document (often informing future diagnosis/practice in their country). Meanwhile, I'm sure most Wikipedia readers who visit are not so pre-informed and most of those are not from the U.S. Thus, in this case I think, a well placed "In the USA, ..." would be in order.

I hope that illustrates a more general WP:CSB perspective. <aside> Further to that, here in the UK I've heard from multiple sources that the content of DSM-5 is considered to be politically motivated, by many in the Autism carers community - in which case, perhaps Wikipedia should be more reserved about relying upon it. </aside>   – Ian, DjScrawl (talk) 17:24, 29 November 2013 (UTC)

No, the DSM is used worldwide; adding "in the USA" is incorrect. The more correct solution to the problem is to include WHO's ICD crit. in the lead. That has not been done because the entire suite of autism articles has not been updated to reflect DSM5 v WHO ICD. SandyGeorgia (Talk) 17:28, 29 November 2013 (UTC)

Yes adding the ICD thing would be fine. To say the DSM is US centric is just incorrect. Dbrodbeck (talk) 17:54, 29 November 2013 (UTC)

Sweden calling. For good and for bad we are strongly influenced by DSM... Lova Falk talk 10:36, 14 December 2013 (UTC)

"Opposite of autism" revert

I've removed Williams syndrome from See also for the second time. It was added (twice) by an editor claiming that Williams is the "opposite of autism";[2] that editor then added same to the Williams syndrome article, which I have corrected. We don't add every neurodevelopmental disorder here that has some similarities to autism (eg Fragile X), for that we have, for example, Category:Neurogenetic disorders and Category:Neurological disorders. There's no reason to think that Williams deserves a special mention. SandyGeorgia (Talk) 15:47, 17 December 2013 (UTC)

Rett syndrome

I thought Rett syndrome was going to be pulled out of the autism spectrum in this edition of the DSM. (I don't have a copy.) --Anthonyhcole (talk · contribs · email) 17:37, 4 January 2014 (UTC)

All of the Wikipedia articles relating to the DSM IV definitions of autistic issues remain completely out of touch with the recent DSM 5 revisions of last year. Have a look at DSM-5: The New Diagnostic Criteria For Autism Spectrum Disorders dolfrog (talk) 16:23, 8 January 2014 (UTC)

References?

This paragraph was present at the end of the article, below the navigation templates. As the place is inappropriate, I paste it here:

Reference Page:
*"Autism-Home Treatment." WebMD. WebMD, 12 Apr. 2010. Web. 25 Feb. 2014.
*"Autism-Other Places To Get Help." WebMD. WebMD, 12 Apr. 21010. Web. 25 Feb. 2014.
*"Autism Symptoms in Children & Adults - WebMD." WebMD. WebMD, 12 Apr. 2010. Web. 25 Feb. 2014.
*"Autism Treatments -- Therapies, Medications, and Alternatives." WebMD. WebMD, 12 Apr. 2010. Web. 25 Feb. 2014.
*"Autism Types, Signs, Therapies, Causes, and More." WebMD. WebMD, 12 Apr. 2010. Web. 25 Feb. 2014.
*Feature, R. Morgan GriffinWebMD. "Caregiver's Guide to Autism Symptoms." WebMD. WebMD, 12 Apr. 2010. Web. 25 Feb. 2014.
*Fundukian, Laurie J., and Jeffrey Wilson. The Gale Encyclopedia of Mental Health. Detroit: Thomson Gale, 2008. Print.
*Fundukian, Laurie J. The Gale Encyclopedia of Genetic Disorders. Farmington Hills, MI: Gale, 2010. Print.
*Narins, Brigham. The Gale Encyclopedia of Nursing and Allied Health. Detroit: Gale Cengage Learning, 2013. Print.
*"Screening and Diagnosis." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 26 Dec. 2013. Web. 28 Feb. 2014.
*"Treatment." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 20 Dec. 2013. Web. 28 Feb. 2014.
*"What Is Autism? Symptoms, Causes, Treatments, and More." WebMD. WebMD, 12 Apr. 2010. Web. 25 Feb. 2014.

If anybody would like to integrate it properly in the article, feel free to do so. Coreyemotela (talk) 19:33, 7 June 2014 (UTC).

Autistic-first language versus person-first language

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

A consensus was reached on Talk:Autism, that Wikipedia's style should favor the phrase "autistic person" rather than "person with autism". We apparently need an entirely separate consensus in cases where "person with autism..." is followed by "...spectrum disorder."

Support because people on the autism spectrum are autistic. That's why it's called the autism spectrum. The terms "autistic" and "on the spectrum" can be used interchangeably as they mean the same thing (aside: "on the spectrum" should be used less often as it is cumbersome). The DSM-5 does not recognize "classic" autism and ASD as separate diagnoses. Wikipedia should reflect the most current style guides and not use the language of outdated references, even if the content of the references is otherwise accurate. Muffinator (talk) 19:07, 7 July 2014 (UTC)

• Oppose "Autism spectrum disorder" is not the same as autism. Thus saying "autistic person" is not the same as saying "person with ASD" Discussion also here [3] and [4] The DSM5 using the term "autism spectrum disorder" Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:34, 7 July 2014 (UTC)

  Calling a person autistic does not preclude the possibility of ASD, nor specify "classic" autism. People with Asperger syndrome are also autistic. Muffinator (talk) 21:24, 7 July 2014 (UTC)

  I disagree with that statement and that is not how I use the term. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:33, 7 July 2014 (UTC)

  @Muffinator:, I agree with Doc James here. I know multiple people with Aspergers on a personal level, and I've worked in a peds/neurobehavioral clinic, many of whose patients have Asperger syndrome, and I've never heard any of them being referred to as having autism or being autistic. It's always that they "have Aspergers" or that they are "on the spectrum". cymru.lass (talk • contribs) 16:09, 11 August 2014 (UTC)

• Oppose Person first language is standard in cases of medical and psychological diagnosis. Individuals who are diagnosed with autism are people first. They are people separate of any diagnosed condition. --BoboMeowCat (talk) 00:03, 8 July 2014 (UTC)

  Incorrect. Autistic people are autistic first, but that is not the discussion necessary here. The question here is whether "autism" and "autism spectrum disorder" should follow the same guidelines. Muffinator (talk) 07:02, 8 July 2014 (UTC)

What exactly are you asking in this RFC? In other words, what is the style guideline now re: ASD and what do you want to change it to? --Holdek (talk) 00:23, 12 July 2014 (UTC)

Instances of "person/people/individual with autism spectrum disorder" should be replaced with "autistic person/people/individual" or "person/people/individual on the autism spectrum". Muffinator (talk) 09:32, 12 July 2014 (UTC)

Support, only to keep the sentence structure consistent. ^{See below for vote change.--Holdek (talk) 19:11, 22 July 2014 (UTC)} (As to some of the above discussion, I should note that the World Health Organization, at variance with the DSM-5, chose not to abandon the differential diagnosis of disorders on the autism spectrum in its ICD-10, but it's best not to get too far afield, and instead keep this a word order issue. I also don't think it matters if someone is called an "autistic person" or a "person with autism," but it seems that consensus was already established on that issue.) Holdek (talk) 15:24, 12 July 2014 (UTC)

The WHO is not always on the mark about things. And I agree about 'autistic person' v. 'person w/autism.' SW3 5DL (talk) 14:29, 14 July 2014 (UTC)

Regardless, it's a reliable source. Holdek (talk) 12:31, 15 July 2014 (UTC)

Some reliable sources contradict each other, so we have to ask the question of which sources Wikipedia should be aligned with. Muffinator (talk) 19:36, 15 July 2014 (UTC)

If reliable sources contradict each other, then that contradiction should be mentioned in the article, provided it doesn't conflict with WP: UNDUE. Wikipedia doesn't "align" with one reliable source over an other. Holdek (talk) 20:17, 15 July 2014 (UTC)

I was referring to style, not content. NPOV doesn't always work the same way. Muffinator (talk) 22:15, 15 July 2014 (UTC)

Comment. DSM-5 causes considerable difficulty in day-to-day conversation. Most English-speaking people are entirely unaware of the DSM-5 change. So if you call me (a person with what used to be described as high functioning Asperger's) either an "autistic" or a "person with autism", you're definitely going to confuse a whole lot of people. This change in the meaning of a word in the scientific community has deep consequences for people like me who were just recategorized. I can understand the desire to keep this article up to date with DSM's vocabulary - but understand the consequences of what you do in confusing almost everyone who reads it! IMHO, we should use the term "autism spectrum" when you're making broad-brush statements about the entire spectrum of people - and use more tightly focussed terms (even if DSM-V doesn't care to define them) when you're referring to specific pieces of the spectrum. You specifically have to be careful NOT to use the term "autism" in it's new wider meaning unless you really are saying something that's common to all individuals across the entire spectrum. From my personal observations of people at a variety of positions along the spectrum, it's abundantly clear that people on one extreme end share almost no symptoms in common with those at the other extreme. Yet it is clearly the case that it is indeed a spectrum disorder because people can be found with symptoms at every point between those two extremes that aren't all that different to those people immediately to one side or the other of them along the spectrum. My take on this is that there are hardly ANY statements this article might make that would require finding a plural noun covering every single person with an "autism spectrum" diagnosis. That realisation may make this conversation largely become a moot point. If each time you consider which term to use, you were to ask yourself "should I be saying this about the entire spectrum?" - I think we wouldn't have a major issue here. SteveBaker (talk) 02:13, 13 July 2014 (UTC)

The issue then becomes knowing which categorization to use in each instance. "Autism" often refers to the entire spectrum, therefore references specifically to "autistic disorder" as defined by DSM-IV need to be labeled as such. We also run into the issue that the now-deprecated terms of autistic disorder, high-functioning autism, and even Asperger syndrome were not well defined to begin with. Muffinator (talk) 05:15, 13 July 2014 (UTC)

The explanations of what the terms mean, particularly what's new and what's antiquated, and according to whom, should be located in the leads of these articles, perhaps even in the first paragraph. We shouldn't be doing original research here and deciding ourselves what terms are appropriate if there are recent reliable sources using differing terms. Holdek (talk) 21:11, 13 July 2014 (UTC)

• Comment: @Muffinator: The bot sent me. I'm trying to understand the issues here. I'm not a psychiatrist, I'm a virologist, so bear with me. As I understand it, the DSM-5 considers 'classic autism' and ASD the same diagnosis? And you say, "Wikipedia should reflect the most current style guides and not use the language of outdated references, even if the content of the references is otherwise accurate." So the literature is lagging behind this current style, but it is the new way of describing the two? Is that what you're saying? SW3 5DL (talk) 02:30, 14 July 2014 (UTC)

The DSM-5 uses a unified diagnosis of "autism spectrum disorder" that includes what was previously referred to as autism or Asperger's, as well as similar diagnoses such as Rett syndrome. Parts or subsections of the spectrum are no longer diagnosed individually. I hope that answers your question. Muffinator (talk) 02:39, 14 July 2014 (UTC)

Yes, it does. Since this is the way things are done now, then I suggest, as Holdek says above, that the lede reflect the changes and add in the appropriate reliable source, in this case the DSM-5, and make whatever style changes are necessary to the relevant article(s). Which is another way of saying, Support. SW3 5DL (talk) 03:27, 14 July 2014 (UTC)

• Oppose Calling someone an "autistic person" implies that they have autism. According to the DSM V, autism is no longer a possible diagnosis, so it would be misleading to refer to anyone with ASD as "autistic". In common language, referring to someone as "autistic" implies something more specific than ASD, and I think it's important that this article remain understandable to your everyday reader. Wording as chosen by the American Psychiatric Association also uses "individuals with ASD" --Iamozy (talk) 01:24, 15 July 2014 (UTC)

Oppose. I've thought about this some, and I'm going to change my vote. It seems like unnecessary instruction creep that endorses a particular POV. Upon reflection, the consistency argument is not enough to make editing the numerous autism and ASD-related articles more cumbersome. Holdek (talk) 19:11, 22 July 2014 (UTC)

If it's instruction creep, that implies that it's unimportant, and uncontroversial, in which case why do we need consensus in the first place? Muffinator (talk) 05:10, 27 July 2014 (UTC)

Instruction creep is important though. That's why we need consensus to add more to the MOS. Holdek (talk) 05:10, 28 July 2014 (UTC)

So it's an important enough distinction that we need to amend the MOS before making any changes, but not important enough to actually amend the MOS. Sound like a Catch-22 to me. Muffinator (talk) 07:15, 28 July 2014 (UTC)

We don't need to amend the MOS at all, is what I'm saying. Holdek (talk) 13:36, 28 July 2014 (UTC)

• Comment. I'm still a little wet behind the ears here, but considering that DSM is almost exclusively used in the US,[5] do WP:UNDUE and WP:UCN come into play here? Or is it that DSM is reflecting the current diagnosic terminology and it's the ICD that is outdated? Little pob (talk) 08:17, 25 July 2014 (UTC)

As far as contradictions between the DSM and the ICD on this issue: since both are established, respected authorities, I do not think Wikipedia should be choosing one over the other in any type of MOS. --Holdek (talk) 19:25, 25 July 2014 (UTC)

Compared to the DSM, the ICD is outdated, but since this discrepancy arose recently (DSM-5 was published in May 2013), there aren't many reliable sources comparing the two. Speaking purely form personal speculation, I think the ICD-11 will more closely resemble the DSM-5, but an international document has a longer review process than that of one country, and one of the major criticisms of DSM-5 was that it was rushed. Muffinator (talk) 21:06, 25 July 2014 (UTC)

The DSM is very widely used. It is published by an American organization, but it is used preferentially by most psychiatrists in developed countries (and psychiatry-affiliated programs; for example, it is widely used by European special education staff). WhatamIdoing (talk) 05:28, 27 July 2014 (UTC)

• Support for consistency with other articles and for using common sense. I really need that username (talk) 20:41, 5 August 2014 (UTC)
• Oppose because autism has been for most of its diagnostic history an individual condition rather than purely an umbrella term. This extends to popular usage, in which "he has autism" can be contrasted with "he has Asperger's". This being said, "person on the autistic spectrum" can get repetitive, so as always, I advocate varying wording - to the extent that it isn't misleading, as "autistic person" could be - for prose freshness. Tezero (talk) 00:43, 6 August 2014 (UTC)
• Oppose. The OP is over-reaching. A recent RfC was closed with a consensus to use the formulation "autistic people" in the Autism article. Nowhere was it suggested that this was an RfC about developing a rule of style for the whole of Wikipedia, and the result of the RfC should not be generalised, in particular, because the closer was explicit in saying that consensus was weak. There's no reason at all why it should not be acceptable for different articles to use slightly different formulations, with respect either to autism or ASD (or if there is, the reason needs explaining). Formerip (talk) 20:25, 6 August 2014 (UTC)

  You are correct that the consensus on Talk:Autism was labeled "weak" and the discussion was re-opened on those grounds. Therefore, any consensus on this page has to stand on its own, not referencing another consensus. Muffinator (talk) 18:26, 7 August 2014 (UTC)

• Oppose per FormerIP. Dbrodbeck (talk) 22:07, 6 August 2014 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Assessment and Diagnosis Sandbox Edits for Autism Spectrum Disorder

Hello all, I have made changes in my Sandbox about this topic focusing on evidence-based assessment and diagnosis. It would be great if people would look at it and leave comments on my talk page before I post it on the article.

The sandbox link can be found here (https://en.wikipedia.org/wiki/User:Murph93/sandbox).

I appreciate it! YenLingChen (talk) 20:39, 3 November 2014 (UTC)

It is unclear why "your sandbox" is user Murph93. Also, those edits will not work for a large number of reasons, not all of which I have time to explain. Please have a look at WP:MEDMOS, WP:MEDRS and realize that the DSM is EXTREMELY strict about their content, which we have to take great care in replicating. Also, YenLingChen, you should be following this talk page, not expecting users to post to your talk page about an article. SandyGeorgia (Talk) 23:31, 3 November 2014 (UTC)

as I wrote elsewhere, thanks for the heads up, YenLingChen. feedback:

I don't see in-line sourcing anywhere in that draft content. I would revert that immediately, if you added it to the article

in general a lot of this is technical (for example "A cut scores", "B cut scores", with no explanation of what that means) and I suspect there is a lot of copyright violation in it. (without sources it would be a lot of work to tell) Per WP:MEDMOS things should be written in plain English.

with regard to sections, please do see WP:MEDMOS

with regard to "local resources", you are doing part of what wikipedia is not - namely we are not a directory and we are not a self help guide. Please don't add that section to WP

there is some feedback. I am just going to post a link to this responses in the rest of the remaining posts you made> Jytdog (talk) 00:16, 4 November 2014 (UTC)

and see User_talk:YenLingChen Jytdog (talk) 00:20, 4 November 2014 (UTC)

Out of place and in need of refs

This needs work

Extended content
The following discussion has been closed. Please do not modify it.
"There has been no current medical testing, such as blood work or brain scan, to diagnose autism (Gale Encyclopedia of Genetic Disorder), but there is some developmental screening that should be done during regular well-child doctor visits. These screenings should be done at every visit starting at nine months to twenty-four or thirty months and continue in children at high risk for developmental problems due to preterm birth, low birth weight, or other reasons (CDC). According to the Gale Encyclopedia of Mental Health, Nursing and Allied Health, Genetic Disorders, (CDC) the Centers for Disease Control and Prevention, and WebMD there are three main developmental markers that are directly affected by (ASD) autism Spectrum disorder. The severity of the impairments varies individually, but the same markers are always considered. The three developmental areas that are affected in someone that has (ASD) are their social interactions and relationships, verbal and nonverbal communication skills, and behavioral issues and there are also a few other aspects other than developmental that are affected in people with (ASD) autism spectrum disorder, such as sensory problems. One of the markers mentioned above used to help diagnose autism spectrum disorder is social interactions and relationships. This developmental marker is basically how someone can connect with others (Gale Encyclopedia of Nursing and Allied Health). In infants, (ASD) autism spectrum disorder is first demonstrated in social interactions and relationships when the infant fails to maintain eye contact, or seems uncomfortable when being picked up or held. They may cry, or become limp or tense. They may also seem to have no bond with parents or caregivers. (ASD) prevents them from having the ability to pick up on social cues. This lack can sometimes cause uncontrolled emotional outbursts. It will affect their relationships with others their own ages and they may not be able to express themselves appropriately (WebMD). Autism spectrum disorder also has an effect on the sense of empathy and this lack can challenge the full understanding of someone else’s emotions, such as pain and sorrow (WebMD). According to Gale Encyclopedia of Nursing and Allied Health, and the Gale Encyclopedia of Genetic Disorder, and also by WebMD is that verbal and non-verbal communication varies on an individual basis, and is one of the first warning signs of this disorder. Warning signs listed by WebMD are your child does not babble or coo by twelve months, does not gesture, such as point or wave by twelve months, does not say single words by sixteen months, does not say two-word phrases on his or her own, and does not make a facial expressions or respond to your facial expression. Common signs are different in each case. Some children may not speak at all, can only use two words at a time, or they can have a large range of words but cannot hold a full conversation (Gale Encyclopedia of Nursing and Allied Health). According to Gale Encyclopedia of Genetic Disorders, another aspect that has appeared in children is the constant repeating of meaningless words or phrases. One of the other developmental markers highlighted in the detection of (ASD) are behavioral issues. In children, detecting autism, can manifest itself in the unique ways they play with toys and other objects, such as repetitive lining of the toy in certain ways (WebMD). They also need to have strict routine and constant familiarity, and are very resistant to change. They have continuous body movements or patterns of behavior, such as hand flapping, spinning, or body rocking (WebMD) and other characteristics, such as temper tantrums or screaming fits, hyperactivity, and inappropriate laughing or giggling, are shown (Gale Encyclopedia of Genetic Disorders). One of the other behavioral issues is the fixation or obsessive interest in an activity, idea, or person (Gale Encyclopedia of Genetic Disorders). Even though there are three major components that are affected by (ASD) autism spectrum disorder, there are other symptoms that factor in as well, such as sensory issues. A large percentage of children seem overwhelmed by these senses and react badly to certain sounds by sometimes banging their heads and obsessing with how objects feel under their fingers. There is no cure for this disorder at this time, but early detection, intensive therapy, and knowledge are the best forms of treatments. Medication can be helpful, also. One form of therapy is behavioral training and management where positive reinforcement, self-help, and social skills training are used to improve behavioral and communication skills (WebMD) and other treatments, such as speech therapy can be used to develop and improve language skills. Occupational therapy can help develop motor skills and teaches self-help and functional skills like grooming. There are many other therapies that can be used to manage the symptoms of (ASD) autism spectrum disorder such as applied behavioral analysis, auditory integration training, dietary interventions, music therapy, physical therapy, sensory integration, and vision therapy(Gale Encyclopedia of Nursing and allied Health). No medication has been developed that will cure (ASD) autism spectrum disorder, but they have found some drugs have an effect on the symptoms (CDC). These medications are used to treat things like anxiety, depression, hyperactivity, anger and aggression. Ritalin, Luvox, ReVia, Methylphenidate, and lithium are types of remedies (Gale Encyclopedia of Mental Health). Treatment, whether it’s therapy or medication must be consistent and with family support (Gale Encyclopedia of Nursing and Allied Health).The knowledge of the symptoms of (ASD) is key to the effectiveness of home treatment (WebMD). Families must educate themselves as well as stay in constant communication with others that are involved in the care of the child (WebMD). According to Gale Encyclopedia of Mental health the most popular alternative treatment is megavitamin therapy because some studies have shown that Vitamin B6 with Magnesium can improve eye contact and speech, and lessen tantrums behavior."

What it has to do with evidence based assessment I am not sure Doc James (talk · contribs · email) 01:39, 5 November 2014 (UTC)

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