Talk:Autism spectrum/Archive 9

This is an archive of past discussions about Autism spectrum. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.

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Lead text

A recent change to "Simplify and shorten the wording in the lead, to make it more easily accessible" has, I think, made it less precise, and the wording is not equivalent. The "impairments in" was changed to "interferes with". An impairment means reduced functionality. Interference might increase or alter in some way that is neither up nor down but still different. The word "repetitive" was changed to "repeated", which doesn't convey the same persistency. I'd prefer something a bit closer to the original:

Autism is a brain development disorder characterized by impaired social interaction and communication, combined with restricted and repetitive behavior, all starting before a child is three years old.

However, the follow-on sentence "These characteristics distinguish autism from milder autism spectrum disorders (ASD) such as Asperger syndrome." repeats the "character..." word, which is to be avoided. But I'm not sure about the first sentence clearly distinguishing AS from autism. For example, the AS article says "AS is distinguished from the other ASDs in having no general delay in language or cognitive development." neither of which are mentioned in the first sentence. So, I think the lead still needs a little work to ensure autism is properly defined and distinguished from the other ASDs. The lead section is short enough that there is room for a little expansion. Colin°^Talk 21:26, 19 November 2007 (UTC)

These characteristics may occur in all ASD's, but it's in Autistic Disorder that symptoms from across the entire triad must be present. That might be made clearer, perhaps with something like: "The presence of symptoms in each of these three area's distinguish autism from milder autism spectrum disorders (ASD) such as Asperger syndrome". Fenke (talk) 22:08, 19 November 2007 (UTC)

Good point, thanks. Even better, we can shorten "The presence of symptoms in each of these three areas" to "This set of signs", and I made that change. Eubulides (talk) 22:21, 19 November 2007 (UTC)

The goal behind those changes was to use simpler words, so that the article is less off-putting to non-expert readers. I see Colin's point about "repeated"/"repetitive" so I changed it back. I wanted to avoid "impairments" as it is a bit too fancy too. I don't quite follow Colin's point about "interferes with" (interference pretty clearly denotes a problem, not a bonus) but I changed it to "impairs". The statement that autism impairs communication is supposed to distinguish autism from the "no general delay in language" in Asperger syndrome. Eubulides (talk) 22:21, 19 November 2007 (UTC)

For some motivation behind these changes, by the way, please see WebMD's autism article, or HealthWise's. These articles are considerably easier to read than Autism, even though their technical quality is quite high. I don't think Wikipedia can match them in being easy-to-read (Wikipedia is much more ambitious, among other things), but on the other hand we can be easier to read, at least in the lead. Eubulides (talk) 22:21, 19 November 2007 (UTC)

I'll look again tomorrow, but just a quick explanation of "interferes": a two-year-old may interfere with the volume control on your TV. It might be louder or quieter, become distorted or just annoy the neighbours. Bad social interaction isn't always diminished/impaired: one can be too extrovert/opinionated/loud or even too friendly for ones own good (loss of self-control or fear of strangers). For definitions, we have to use precise language. I think both "impairs" and "impaired" are better than "impairment" for the reasons Eubulides gives. On the other point: delay is not the same thing as impairment, as it implies the possibility of achieving the same end-point. One's speech may be abnormally delayed but end up normal. Cognitive ability isn't mentioned in the lead. It is here, perhaps, that the difference between HFA and AS become difficult to explain. Colin°^Talk 23:21, 19 November 2007 (UTC)

It's just a small thing (since we've changed it back to "impairs"), but a 2-year-old who interferes with your TV's volume control necessarily impairs the control of your TV's volume, and vice versa. I agree that "impair" and "interfere" have different meanings but the difference doesn't much matter here and "interfere" is more easily understood by more people. As for delay versus impairment, in both cases the article is using terminology taken from the diagnosis standards, which are designed so that AS and autism are mutually exclusive diagnoses. Admittedly there are judgment calls and in practice there is a fuzzy line between AS and HFA, but the big picture is that autism has major impairments with communication, while AS does not, and that is an important distinction between the two diagnoses. Eubulides (talk) 06:08, 20 November 2007 (UTC)

Link to nonexistent "Austimus" in Latin Wikipedia?

This change established a link from Autism to the Latin page for Autism, la:Autismus. But there is no Latin page; when I follow that link I get a "In hac pagina nondum litterae sunt" page, which means the Latin Wikipedia does not have an article with that name. Am I missing something, or should I revert that change? Eubulides (talk) 05:40, 27 November 2007 (UTC)

You mean we're supposed to check those things (d'oh)? Since it's not doing any harm, I'd suggest leaving a talk message for the editor who left it, and if s/he doesn't respond within a few days, then revert. SandyGeorgia (Talk) 05:58, 27 November 2007 (UTC)

Thanks, I left a note on that editor's talk page. This business about foreign-language links remains mysterious to me, as it's unclear whether they're supposed to be maintained by hand or by bots. Wikipedia:Interlanguage links #Links to pages that do not exist suggests that I may remove the link by hand, but other times I've fiddled with that section (by sorting it), a bot has undone the change. Eubulides (talk) 07:18, 27 November 2007 (UTC)

Whenever I encounter something about bots et al that needs an answer, my first stop is at Gimmetrow (talk · contribs)'s page; he seems to know everything about everything, in case you want to explore further. You could also ask at WP:VPT. SandyGeorgia (Talk) 17:03, 27 November 2007 (UTC)

I asked at WP:VPT #Link to nonexistent "Austimus" in Latin Wikipedia? and learned that the foreign-language links are a bit of a messy situation. Graham87 helpfully removed the link by hand, and I see that Duomillia (the original editor) just put the link back in, this time to a real (albeit brief) Latin page. An ironic thing here is that the word autism is in fact derived from autismus, a New Latin word that first appeared in 1910 (in a paper written in German, of course …). Eubulides (talk) 00:20, 29 November 2007 (UTC)

I will slowly work on this article in Latin, translating it bit by bit! :) --Duomillia (talk) 00:24, 29 November 2007 (UTC)

Fever and ASD

There's a new study out reporting that children with ASD who have a fever (body temperature greater than 38°C) have fewer symptoms of irritability, hyperactivity, stereotypy, and inappropriate speech. My kneejerk reaction is that this is a high-quality study but it's just one study and its implications aren't that clear, so it's probably not suitable (at least not yet) for inclusion in the article. Thought I'd mention it here, in case someone else thinks otherwise. It's not in Pubmed yet but here's a citation: Curran LK, Newschaffer CJ, Lee LC, Crawford SO, Johnston MV, Zimmerman AW (2007). "Behaviors associated with fever in children with autism spectrum disorders". Pediatrics. 120 (6): e1386–92. doi:10.1542/peds.2007-0360. PMID 18055656. {{cite journal}}: Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link) Eubulides 04:53, 4 December 2007 (UTC)

I think that any high quality study deserves a mention; Wikipedia may be getting a reputation for quality but I hope it never becomes so well-reputed that it can't describe interesting research. On a more speculative note, I was curious whether MDMA, which transiently increases body temperature, could have a positive effect. While I didn't find any evidence of human trials, there's one group trying to collect Internet reports of whether people with Asperger's or high-functioning autism have noticed beneficial effects.[1] Of course, MDMA has potent psychotropic effects said to make people more "social", and they're thinking about that activity rather than the temperature rise. (Please note that I am not advising anyone try this drug, which has some indications of neurotoxicity) 70.15.116.59 (talk) 06:22, 7 December 2007 (UTC)

Autism does not have room enough to mention all high quality studies on autism. Pubmed reports 11,516 medical-journal articles about autism; even if only 20% are "high quality" that's over 2,000 studies, and there's no way we can mention them all. Please see Wikipedia:WikiProject Medicine/Reliable sources for the standards we are trying to meet here. I don't think Curran et al. 2007 quite meet those standards as they are merely a primary source (we prefer high-quality reviews) and their results are not that clear. As for MDMA, until reliable sources cover MDMA and autism we should not mention MDMA in the article. Eubulides (talk) 06:34, 7 December 2007 (UTC)

The guideline you mention does not say not to use primary sources, just not to interpret them on your own. As for the numbers, I don't think Wikipedia should be designed under a space constraint. It is possible to split articles if they grow too large - so people should add relevant, well-sourced data without trying to decide if it's the most important thing they could possibly say about a topic. (I don't actually think anything about MDMA should actually be added yet - it was just an interesting parallel to the fever study) It is not right that people should be out there waxing floridly on every weapon and monster in every version of a video game without restraint, but people editing autism should feel afraid to mention a good, interesting publication. Yes, there are 11,516 articles - and if you want to go through them all just look them up on PubMed. What Wikipedia has that PubMed doesn't is that it only lists the articles that some passing human being, for whatever personal reason he might have, has picked out as interesting - and I think that is actually worth quite a bit. Peer review for journals focuses on accuracy, with some attention to "significance" in the higher profile journals, but not really whether something is "interesting" in the most vulgar sense of the word. 70.15.116.59 (talk) 04:55, 9 December 2007 (UTC)

The guideline says secondary sources (such as high-quality reviews) are preferred; this helps resolve not only the problem of interpreting primary sources, but also in deciding which are important and which are not (which is the issue here). Wikipedia overall may not have a space constraint, but Autism does; it's already oversize and does not have room to contain reports of every new primary study on autism. Dozens of new primary studies are published every month, far too many to summarize them all on Autism. If there were some important reason to mention this particular study that would be another story, but I don't see it: it's merely a curiosity for now, and an unconfirmed one at that. Eubulides (talk) 05:55, 9 December 2007 (UTC)

For what it is worth, our daughter has Aspergers and we noticed that her behaviour was more modulated (she didn't act out as much) and was more passive after she was sick. We thought that she was just exhausted after using so much energy to get better. On another note, many children have "night terrors" and don't sleep well. My daughter seems to sleep through the night but will wake with dark circles under her eyes and always feel tired. I notice a lot of Aspie kids seem to have these dark circles. Their realities also seem to follow the rules of dreams. Are these children never fully asleep nor never fully awake?63.146.238.102 (talk) 02:54, 11 December 2007 (UTC)

The paper that started this thread said that the interesting thing wasn't that children are calmer when they have fevers (that is unsurprising); it was that their communication and socialization deficits improve. Autism #Other symptoms talks about sleep problems and ASD (not that this addresses your last question). Eubulides (talk) 03:08, 11 December 2007 (UTC)

ok, I could have been clearer. My daughter is also gifted (tested with a 132 IQ at age 3) so communication has always been advanced even compared to NTs. Normally he speech is drawn out on topics and there can be long pauses as her mind moves faster than her mouth. After a sickness, her speech is more relaxed & fluid. It is like she is "here" and not off in her own world. She also seems more empathetic of others rather than her "normal" egocentricity.63.146.238.102 (talk) 04:29, 11 December 2007 (UTC)

Other species

Can an animal, such as a dog or cat, be autistic? Lestrade (talk) 23:05, 4 December 2007 (UTC)Lestrade

Strictly speaking no, since dogs and cats can't speak so the diagnostic criteria for autism proper do not apply. However there is a huge amount of interest in animal models for autism. That is a tricky area. Perhaps there should be a sentence about it in Autism? Anyway, here's a fairly recent review in case you want to explore the subject: Tordjman S, Drapier D, Bonnot O; et al. (2007). "Animal models relevant to schizophrenia and autism: validity and limitations". Behav Genet. 37 (1): 61–78. doi:10.1007/s10519-006-9120-5. PMID 17160702. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)

Interesting to bring that up though, many autistics do speak and do not have speech delays (this has erroneously been called Asperger syndrome). What it brings to my mind is the experiments done on cats by Bernard Rimland which he talks about in his book Infantile Autism (1967). He removed or disabled the reticular formation of the brain in several cats. This is supposed to be an area that handles the ability to associate current sensory input with stored information, so that the current input makes sense. The cats exhibited several behaviors consistent with autism and discontinued them on being given regular doses of vitamin B6. I don't know about his followups on this although I assume there were some. --Bluejay Young (talk) 22:25, 9 December 2007 (UTC)

It's true that some people with autism speak without delays in development, but the diagnosis of autism does require at least one qualitative impairment in communication (one such impairment, for example, would be stereotyped and repetitive use of language), and I can't see a dog or cat satisfying this requirement. Rimland's 1960s work is not much cited these days; for example, Tordjman et al. 2007 don't mention it. Three randomized controlled trials have studied vitamin B6 in humans; the smallest one (8 individuals) found improved verbal IQ in the treatment group and the other two trials found no significant difference, so it's hard to say whether this approach has effects greater than placebo. See Angley et al. 2007 (PDF) and Francis 2005 (PDF). Eubulides (talk) 00:36, 10 December 2007 (UTC)

Neuropsychology

Should Hobson's affective deficit approach be included as another explanation for the social/cognitive deficits found in autistic people? It attempts to explain the emotional symptoms that are largely ignored or brushed over by other theories. This could contribute to the article's viewpoint which states, accurately, that the likely explanation for these deficits lies in combinations of theories (theory of mind, executive function, affective resonance, central cohesion, etc). --Ripcurlprfection (talk) 14:52, 16 December 2007 (UTC)

Is it covered in reliable sources? Further, are they high quality sources suitable for a medical article? If you have some sources, try posting them on the talk page for review and see what other editors say about them. WLU (talk) 14:58, 16 December 2007 (UTC)

I am having difficulty accessing Hobson's research via the internet (PsycInfo has nothing of his online, but I can view a long list of his published work). I will need to return from abroad before I can access the volumes that include his work, so I won't be able to do this properly until later. I should also look further into research into theory of mind deficit (Baron-Cohen, Frith, etc), as Hobson's theory puts ToM deficits secondary to a lack of 'affective resonance' development at an early age.--Ripcurlprfection (talk) 15:27, 16 December 2007 (UTC)

Sure, but if you're running into problems finding his research, he may not be suitable per WP:MEDRS. You could also try [www.pubmed.org pubmed]. WLU (talk) 15:37, 16 December 2007 (UTC)

Advancing Paternal Age and Autism

I think the people would benefit from links to studies of autism, such as the Israeli study published in Sep 2006 in the Archives of General Psychiatry. Full Text of Arch Gen Psychiatry. 2006;63:1026-1032. If you know any other studies and their results relating paternal age and autism, please add to this discussion page. User:Yaz —Preceding unsigned comment added by 71.112.23.82 (talk) 08:04, 31 December 2007 (UTC)

I have heard of that study, and all I want to say is that I believe it's the age of the mother rather than the age of the father that is correlated with autism. But of course, the people taking the questionnaire were men, so they went with what they got. Haplolology ^Talk/_{Contributions} 14:21, 31 December 2007 (UTC)

On second thought (sorry, I only just clicked the link now) it looks like they have answered my objection, so nevermind. Haplolology ^Talk/_{Contributions} 15:02, 31 December 2007 (UTC)

The article currently covers this topic under Autism#Epidemiology and cites Kolevzon et al. 2007 (PMID 17404128), a review article that surveys seven primary studies including the one that you mention. WP:MEDRS suggests that the article should prefer reliable secondary sources like this, so I don't think we need to mention the primary study in Autism; this sort of detail would be more appropriate for Epidemiology of autism. For reference, here's a list of the seven primary studies reviewed. There are four prospective population-based cohort studies, namely Eaton et al. 2001 (PMID 11518482), Croen et al. 2002 (PMID 12108623), Lauritsen et al. 2005 (PMID 16108999*), and Reichenberg et al. 2006 (PMID 16953005*; this is the study you mentioned), along with three population-based case-control studies, namely Hultman et al. 2002 (PMID 12094096), Glasson et al. 2004 (PMID 15184241), and Larsson et al. 2005 (PMID 15870155*). The "*" marks the three studies that looked at paternal age. Eubulides (talk) 17:20, 31 December 2007 (UTC)

Autism and bullying

This change added "Many of these differences in communication can make children the target of bullying." to Autism#Communication. This claim is plausible, but we need a reliable source to back it up. Does anybody know of a reliable source that says this with some authority?

A similar claim was added to Asperger syndrome; the same issue arises there.

I know of one recent study on autism and bullying, which found that children with autism appear to be more likely to bully other children. I'm not sure that bullying is reliably-sourced enough to merit being in Autism, but if it is covered then we should probably tackle this sort of bullying as well. See: Montes G, Halterman JS (2007). "Bullying among children with autism and the influence of comorbidity with ADHD: a population-based study". Ambul Pediatr. 7 (3): 253–7. doi:10.1016/j.ambp.2007.02.003. PMID 17512887.

Eubulides (talk) 09:04, 3 January 2008 (UTC)

Question: Doesn't that study focus on the autistic subpopulation? Avb 12:54, 3 January 2008 (UTC)

The study merely says "children with autism". Its intro says "Children with autism are more likely to be victimized" (than neurotypical children are) and it cites Little 2001 (PMID 11556644) and Marini et al. 2001. Little 2001 is about Asperger's, not autistic disorder proper, so presumably Montes & Halterman 2007 are talking about ASD but are being a bit sloppy about it. Montes & Halterman 2007 also notes "many children with autism require treatment for aggression, suggesting that this population may be at high risk for aggressive behaviors, which may potentially include bullying." and cite Hughes et al. 2002 (PDF), McCracken et al. 2002 (PMID 12151468), and McDougle et al. 2003 (PMID 12672261). Eubulides (talk) 18:21, 3 January 2008 (UTC)

I guess I did not make myself clear. I wondered whether the study said something about bullying within the autistic subpopulation (i.e. the bullying of autistic children by autistic children) versus within the general population (i.e. the bullying of unspecified victims by autistic children). Avb 23:43, 3 January 2008 (UTC)

The latter. Eubulides (talk) 01:31, 4 January 2008 (UTC)

It's kinda hard to read without greater definitions - the only conclusion in pubmed is that kids with comorbid disorders are at increased risk for bullying behaviors, which I read as they bully more. The results section of the abstract I don't find particularly clear. I think the full article would be required to really state anything firm about the study. WLU (talk) 12:58, 3 January 2008 (UTC)

Agreed.

I looked around for some sources; it would be surprising if such an (IMO predominant) problem had not been documented in V RS. One example would be PMID 11934121. Admittedly this study (like the one above) reports on interviews with parents, but the questions asked are real enough and reading the abstract brought back some very painful memories of direct and indirect suffering. Avb 13:19, 3 January 2008 (UTC)

In view of the lack of sources found in PubMed searches, there isn't much by way of scientific research on the subject. This usually means one of two things: it's obviously nonsense so no serious scientist is going to bother with it, or it's obviously true. The former may lead to some negative mention in skeptic sources, that can be used to source Wikipedia content on pseudoscience and the like; the latter generally appears in books by experts and on parent/patient org/government/self-help web sites. Here's a Google Scholar search with a sampling of the latter. Avb 14:07, 3 January 2008 (UTC)

The source you cite, Little 2002 (PMID 11934121) is essentially the same study as Little 2001 (PMID 11556644), which I (just now) mentioned above. Given the number of studies on both sides of this issue (autistic children as bullies / as the bullied) I would prefer a reliable review on the subject to our guessing how to stitch together primary sources. Unfortunately, the best quote I've found on the subject in a reliable review is: "there is more evidence to suggest that children with AS occupy the role of victim rather than victimizer." Tsatsanis KD (2003). "Outcome research in Asperger syndrome and autism". Child Adolesc Psychiatr Clin N Am. 12 (1): 47–63. PMID 12512398. However, this source is about AS, not about autism in general, which is not good for Autism. Also, the review is careful to note that it's just counting papers, and that nobody has measured whether the increased bullying by children with AS outweighs the increased being-bullied. It's easy to speculate what the numbers would be (I certainly have my opinion), but we shouldn't be speculating in this article. Eubulides (talk) 18:21, 3 January 2008 (UTC)

Did you take a look at the Google Scholar search above? This source, for example, is good enough for me to source/attribute the above statement in the AS article, as it states: "This lack of social skills can and often does make students with Asperger Syndrome the object of teasing, victimization, and bullying by their peers". Another one summarizes Little 2001 as "there is considerable evidence that children with AD, because of their awkwardness and other characteristics, constitute easy targets for bullying by peers and others". I hope this helps you with the part of your question about sourcing the AS article and encourage you to check the search results for same regarding the Autism article. This looks promising to me. Avb 01:14, 4 January 2008 (UTC)

As far as I can tell, none of those three citations address autism and bullying. The first two are about Asperger's, not autism or ASD, and as sources are inferior to Tsatsanis 2003 which is already cited in Asperger syndrome. The last one is about bullying in general; it talks about developmental disorders but not about autism or ASD (it's pretty long though; perhaps I missed something). We would need better sources than this. Montes & Halterman 2007 (PMID 17512887) is much better than those three sources, and it's not that good either. The Google Scholar search has 2,380 hits, which I don't have time to investigate. Eubulides (talk) 01:50, 4 January 2008 (UTC)

I do not think that any bulling can be related to any type of autism, of course being one does not say for all. SG4TACOZ! (talk) 01:57, 4 January 2008 (UTC)

The question was whether or not being bullied happens much more often to children with autism than to children in general. Avb 02:23, 4 January 2008 (UTC)

Eubulides wrote: "As far as I can tell, none of those three citations address autism and bullying." -- Once again, the first two are about AS, intended to answer your question insofar as it addresses the AS article. The last relates clearly to autism: I linked specifically to its page #30. Montes & Halterman 2007 (PMID 17512887) is clearly inferior here as it does not address the question at all (it is about bullying, not about being bullied, as already argued). Avb 02:23, 4 January 2008 (UTC)

I don't recall having any questions about the Asperger syndrome article. The link to page 30 did not work for my browser and I did not notice it. I just now read the article you mentioned; here is a citation: Taylor J, Creer C (2004). "Vulnerable populations for bullying" (PDF). Utah Spec Educ. 25 (2): 30–1. The authors are/were staff members of the Utah State Office of Education, and the magazine is an unrefereed house organ. Here's the article's claim about autism: "Because of a general lack of social awareness, many children with autism can be particularly vulnerable to specific bullying situations." The article has no citations; instead, it supports the claim by mentioning an unpublished Internet survey conducted in 2004. However, none of the quoted questions in the survey mention autism. I'm afraid that this source is too weak. It is neither a primary study nor a reliable review article, it is not refereed, and it is far below the usual quality of the sources cited in Autism. Let's hope we can find a better source. Eubulides (talk) 04:39, 4 January 2008 (UTC)

Condition vs. Disorder

In the following text: "... with some seeking a cure and others believing that autism is a condition rather than a disorder," I don't think this is completely accurate. While sometimes advocates of the view that autism is not a disorder accept using the word "condition" as a compromise, it does seem unusual for them to use preference for that word, and most of the advocacy of people with this perspective seem to emphasize the belief that autism is a disorder much more than the belief that autism is a condition. Would anyone mind if I change that text to read, "... with some seeking a cure and others believing that autism is not a disorder"? Q0 (talk) 11:35, 4 January 2008 (UTC)

Did you mean to say "emphasize the belief that autism is not a disorder" (my emphasis)? The word "condition" simply means a state/mode/form of being, which seems neutral enough. If the text said "medical condition" then I could seem how some might think there is an implicit pathology. One problem with just saying that some think "that autism is not a disorder" is that it doesn't offer a replacement. At the end of the article, it says "autism is simply another way of being". IMO, "condition" is an appropriate shortened form of "another way of being". Colin°^Talk 16:33, 4 January 2008 (UTC)

Early Abnormal Physical Growth Patterns

Is there any reason why there is no mention in the article of the recent studies showing abnormal early physical growth patterns found in autistic infants in there first year of life? I don't see any mention of it on the talk page or the related pages. For more information, here is one recent example:[2]. Dtolman (talk) 22:19, 8 January 2008 (UTC)

I think it's covered. Autism #Pathophysiology says "Brain weight and volume and head circumference tend to be greater in autistic children" and goes on to discuss four related hypotheses. The discussion cites four recent review articles. Eubulides (talk) 22:28, 8 January 2008 (UTC)

The linked study in the pathophysiology is discussing the size and shape of the brain. The studies I'm referring to are looking at rates of growth, for the head, and the body as a whole - things that can be measured with just a tape measure - not with internal imaging equipment. Its also something that is being discussed as a early warning sign of autism in an infants first year of life - I think thats interesting because the wikipedia article implies that it can't be diagnosed that early, which is somewhat misleading. Dtolman (talk) 02:12, 9 January 2008 (UTC)

Autism #Pathophysiology mentions "head circumference", which can be measured with a tape. It cites DiCicco-Bloom et al. 2006 (PMID 16807320), a review that discusses head circumference in some detail and cites several studies. Autism #Screening does mention signs by 12 months that suggest evaluation by a specialist. I don't know of any reliable source claiming that one can diagnose autism in the first year; the source you mention, which talks only about head circumference, does not make that claim. Eubulides (talk) 04:50, 9 January 2008 (UTC)

OK thanks - I had missed those. Dtolman (talk) 12:32, 9 January 2008 (UTC)

News story: Rare genetic glitch hikes risk of autism

Thanks, that info has been added to Heritability of autism #Candidate gene loci; see "16p11.2 region". Eubulides (talk) 17:18, 10 January 2008 (UTC)

Thank you, Ling.Nut; it's nice to see you here. SandyGeorgia (Talk) 17:28, 10 January 2008 (UTC)

Helminthic therapy and autism

A gentleman having devoted his life to finding effective treatments for his childs autism (you can read his story here http://www.autismtso.com observed, as others have, that during fevers and illness his child's symptoms vastly decreased. He decided to pursue the idea that autism is an autoimmune condition and after many trials decided to treat his child using TSO from Ovamed. TSO is Trichuris suis ova, or pig whipworm eggs. The result, for him, has been total remission of his child's autism.

He has lectured on the subject and makes a convincing advocate.

The keepers of this board might want to investigate this theme for inclusion here. After all, if it works, getting the word out would be a good thing.

08:24, 23 January 2008 (UTC)

That treatment seems to really open up a can of worms. Q0 (talk) 10:51, 23 January 2008 (UTC)

I know of no reliable sources on the subject. The abovementioned website does not count as a reliable source, I'm afraid. Eubulides (talk) 17:44, 23 January 2008 (UTC)

Slimming down

This article has grown to be 229k (by Google's measure) and takes quite a bit of time to display, particularly on older machines. Now that some of its material is duplicated by subsidiary articles, it's time to prune away some chunks of the duplicated material. I started the job with this change; more work is needed. Eubulides (talk) 07:53, 26 January 2008 (UTC)

another news article; much less hard-science

ABC defends show against outcry by pediatricians
mmm, basic idea is potential risk (real or alleged; I dunno which) of autism formerly caused by vaccination:
- "Critics of childhood immunization have argued that thimerosal, a mercury-based preservative formerly used in vaccines, is a primary cause of an autism in young children."
Ling.Nut (talk) 09:16, 29 January 2008 (UTC)

I dunno, it's a fictional TV show. There are lots of fictional TV shows about autism and I don't see much special about this one. Eubulides (talk) 17:16, 29 January 2008 (UTC)

I did notice that there's a Wikipedia article for the show, Eli Stone, so I added a section to that article, to cover the controversy there. I also added briefer notes to the articles for the co-creators of the show. Sheesh, Wikipedia seems to have detailed articles about every little nook and cranny of the entertainment industry; if only its medical coverage could be that comprehensive! Eubulides (talk) 22:39, 29 January 2008 (UTC)

RE: some points to consider

"Autism is a brain development disorder"

- I was wondering if a more proper label would be 'neurobiological' disorder.

Autism is certainly a neurobiological disorder, but I much prefer the label brain development disorder in the lead because (a) it's easier for the average reader to understand, and (b) it's more specific. Eubulides (talk) 19:18, 1 February 2008 (UTC)

"Early intervention may help children gain self-care and social skills, although few of these interventions are supported by scientific studies."

- I think it is important to note that early intervention is key to helping children develop particular skills- and perhaps indicating that although most interventions are not considered evidence-based, that ABA-based intervention methods are considered evidence-based, best practice when referring to this population Reference: (Perry, A. & Condillac, R. (2003). Evidence Based Practices for Children and Adolescents with Autism Spectrum Disorders - Review of the Literature and Practice Guide" Toronto, Ontario, Canada: Children's Mental Health Ontario.

This is a difficult topic to summarize. As Howlin 2006 (doi:10.1053/j.mppsy.2006.06.007 points out, the claim that early intervention is key is not substantiated by scientific evidence. (By "early" here I mean by age 2 or 3.) And yet many experts believe the claim is probably true. Furthermore, there is some controversy about whether ABA-based methods are better than other approaches. For example, Magiati et al. 2007 (PMID 17683452) found not much difference between behavior and cognitive approaches. The lead is probably not the place to get into that controversy; it's too complicated. However, I agree that the quoted wording was a bit too pessimistic; I changed it to read "Early behavioral or cognitive intervention can help children gain self-care and social skills." I figure the details about substantiation by scientific evidence need not be emphasized so much in the lead (they're covered in the body). Eubulides (talk) 19:18, 1 February 2008 (UTC)

I noticed that you state that early intervention improves self-care and social skills, but what about language and communication ability? I know that Vince Carbone's work in Verbal Behavior takes an ABA-based approach and applies it to teaching language and communication with demonstrated success (Perry, A. & Condillac, R. (2003). Evidence Based Practices for Children and Adolescents with Autism Spectrum Disorders - Review of the Literature and Practice Guide" Toronto, Ontario, Canada: Children's Mental Health Ontario.) There are other interventions that also focus on increasing language and communication. The only reason I mention it, it looks like the only skills that early intervention improves are self-help and social skills, and I am sure that many people would be wondering about the communication aspect of the disorder and whether it can be improved with these methods as well...

Thanks, I changed it to read "self-care, social, and communication skills". I figure that mentioning communication is enough in the lead; we needn't also mention language, as that is a subset of communication. Eubulides (talk) 21:15, 1 February 2008 (UTC)

"With severe autism, independent living is unlikely; with milder autism, there are some success stories for adults,[6]"

- This is very ambigous. I have worked with many children who may be considered "severe" before intervention, and gain skills to be included in school settings without support. Temple Gradin herself states that she was diagnosed with Childhood Autism (which would not be our "Autistic Disorder", and she is living very independently.). Even though she was considered to have severe autism, through intervention, she has been able to overcome communication and social difficulties, and is a very independent woman. I think it is important to not say this without referring to growth and gains over time, as many parents may be reading this and could lose hope as a result. In addition, a study I know of off the top of my head: Seltzer MM, Krauss MW, Shattuck PT, Orsmond G, Swe A, Lord C.(2003). "The symptoms of autism spectrum disorders in adolescence and adulthood". Journal of Autism and Developmental Disorders, Vol 33(6): 565-581. states that there is about a 20% reduction of symptoms overall that appears with age. So, to simply say that "with severe autism, independent living is unlikely" it should be clear whether you are talking about young children with severe autism as having poor outcomes, or an adult with severe autism as not being able to live independently. A summary can be read at: == External links == [3]

The "independent living" was intended to talk about adults, not children (children by and large do not live independently :-), but I can see how this could be misinterpreted. Although there are certainly some success stories, the available statistics suggest that most children with autism do not live independently after they become adults. Howlin et al. 2004 (PMID 14982237) followed up 68 children with autism and found that only 3 lived independently as adults. The statistics for today's children will probably be better but I don't know of any reliable source that says that a child today with autism (much less severe autism) is likely to live independently as an adult. To help remove some of the ambiguity I reworded it to read "Few children with autism live independently after reaching adulthood, but some become successful". Eubulides (talk) 19:18, 1 February 2008 (UTC)

"an autistic culture has developed, with some seeking a cure and others believing that autism is a condition rather than a disorder.[7]" - this contradicts with the brain development, and genetic component mentioned previously. I am not sure if you are trying to capture the mixed feelings of those who have Autism Spectrum Disorders - such as Temple Gradin who is proud to have autism, and says she wouldn't be who she is without it, and the Aspies website where Asperger's Syndrome is celebrated. On the other hand, there are other individuals with ASDs who are particularly challenged by the disorder and seek to find a cure such as Donna Williams who says if there was a cure she would seek it out. Or, are you trying to capture the greater invested community of professionals, parents, etc. who are also divided on this subject? --Svernon (talk) 17:52, 1 February 2008 (UTC)

Sorry, I don't see the contradiction here. The people who believe autism is a condition generally agree that autistic brains develop differently, and that there is a genetic component; it's just that they don't consider the result to be a disorder. The sentence is indeed trying to capture both the Grandin/Aspies position that there's nothing wrong with being autistic and the Williams position that a cure is desirable. Perhaps you could suggest a better wording that would address your concern? Eubulides (talk) 19:18, 1 February 2008 (UTC)

I have re-read it, and it seems to flow nicely now. Looks good!

EWMN

Recently, using Eshkol-Wachman Movement Notation (EWMN), researchers from the University of Florida were able to identify movement patterns in infancy that are precursors to the development of Autism. Reference: Osnat Teitelbaum, Philip Teitelbaum. Does your baby have Autism?. NY, USA: Square One Publishers.

Text removed from Diagnosis section for discussion and better sourcing. SandyGeorgia (Talk) 23:04, 8 February 2008 (UTC)

This sounds like it's Teitelbaum et al. 2004 (PMID 15282371). As it happens a high-quality review was published this week on early diagnosis of autism: Landa 2008 (PMID 18253102). It has 108 citations but doesn't mention Teitelbaum. So I briefly looked for reviews that do cite Teitelbaum et al. 2004. I found only one: Palomo et al. 2006 (PMID 16685187), which mentions Teitelbaum et al. 2004 in support of the following two remarks: "Home-movie methodology has recently been extended to investigate other questions, such as early motor development in autism and Asperger syndrome", and "we exclude works not focused on children with autism, PDDNOS, or Asperger syndrome". I guess they rejected Teitelbaum et al. 2004 because it studied infants, not children. Anyway, it looks like Teitelbaum et al. 2004 is not that big a deal; it's not being cited by reviews. There are lots and lots of other primary studies on early detection of autism; I'm not sure why we'd want to focus on this one. Eubulides (talk) 06:54, 9 February 2008 (UTC)

So the recently created EWMN article may need a look. SandyGeorgia (Talk) 15:14, 9 February 2008 (UTC)

Have any scientists done any research on....

the relationship of family dog petting history (death of dog) and the disease rate of new born child? My gut feeling is that the new born child found the disease at the later age maybe associated with the family or dwelling dog petting history. By introducing the autism service dog to rehabiliate the child, it could ease the symptom.

http://www.informaworld.com/smpp/content~content=a790001397~db=all

If there is a correlation between the died dog and new born child with the diasease, then it may suggest that the reincarnation theory is on the every corner of the world —Preceding unsigned comment added by 65.49.2.96 (talk) 11:11, 22 February 2008 (UTC)

Not as far as I know. Please see Autism therapies #Animal-assisted therapy for a bit more on the subject. Eubulides (talk) 17:27, 22 February 2008 (UTC)

Well, some literatures have shown that Autism and ADHD are associated with deep fried food. I only partially agree with the findings. I regard the diseases as multifactor related. Because before 1980's, Chinese people eat lots of deep fried food such as Chinese donuts and 油炖子 (deep fried radish doumplin), not many people get such diseases. Deep fried food could be a catalyst but not a root cause of the diseases and this could be analysed by Multi factor analysis technique. The other approaches could be taken from DNA mutation studies, using animal (suhc as dog, rat or mouse) markers to compare with the mutated DNA of sick children. This is only my imaginated ideas and I wish to get scientists to prove them

I reckon that DAT is only a kind of thereapy not a medicine and it eases the surface of the disease not a root cause. My explanation is that if one pretend to treat a sick child as an dog which has the nature of herd/tribal living. By introdusing another dog, it provides a herd living environment to ease the symtom. My this assumption could be wrong though

ARI, DAN!, those "alternative treatments", oxytocin, scientific references for these

Why is there no mention of any of these? There ARE scientific references for the success of at least some of these treatments (especially oxytocin). This article looks like it was partly written by the APA and FDA. And why is there no mention or link to the various 'recovery testimonials/videos' that are in various places, or even to www.autism.com? Unless you want to maintain that ALL of these are complete fakes, it deserves mention. And if they are fakes, I want proof of that. There is an anemic little article on Defeat Autism Now, no link from this one, and no mention of the key players in DAN!, Bernard Rimland who started the ARI, the DAN! "think tank" (I've only been looking into autism for two weeks now)

At least there is a (negative) mention of chelation therapy. Surely there are scientific studies on metal content in the hair of autistic children? Nothing on HBOT (hyperbaric oxygen therapy). Nothing on the "chelation controversies" (4 or 8 hour dosing, when the half-life of DMSA is 4 hours.. No mention *of* the chelation agents either.. No mention of dietary intervention (gluten/casein/soy-free - there must be scientific evidence on this, at least empirical studies). No mention of low-oxalate diets (there is a HUGE controversy there over that versus the "Vitamin K2 protocol"), no mention of oxalobacter (eats oxalate in the gut).

And no mention of the major organizations besides ARI either - Autism Society of America, AutismOne, Autism Speaks (and the recent flap over Katie Wright, which I'm not completely familiar with). No mention of Jenny McCarthy or her book.

Hardly any or no mention of the raging vaccine controversy, or the role of metals and other environmental toxins in autism, or the MMR vaccine (IIRC, introduced about the time autism rates started to skyrocket.

I consider these ommisions shameful - but it is very hard to write ANYTHING about this without either doing what might be considered original research (almost ANYTHING on autism these days when it comes to the ARI or "alternative treatments" is "original research") or POV (almost anything is POV one way or the other - is it POSSIBLE to write about the vaccine controversy without POV? Even if there is convincing evidence one way or the other, if the "accepted status quo" is the other way (and there very much IS one here - mercury and other metals in vaccines is just fine), you are likely to be labeled as being POV.

I'm starting to think that Cult of the Amateur might be right (and I haven't even read it!) and am just going to do what I originally did with Wikipedia - stick to it for info on 1) computers, 2) chemistry and biochemistry, and 3) mathematics. These areas seem to be well written.

I just hope no parent of an ASD child comes to wikipedia and sees the despairing words that there are 'few treatments' (paraphrase). Or I hope she goes elsewhere - like to YahooGroups and the tens if not hundreds of ARI/DAN support groups there..

I might write an section on this, but it would most likely be biased.. Right now, I'm just too mad at the non-inclusion of this information to even think of trying to clean it up.. Anytime in the next several months.. —Preceding unsigned comment added by 216.9.143.237 (talk) 05:17, 25 February 2008 (UTC)

Autism covers a huge topic and uses the Wikipedia summary style to spin off sections into subarticles leaving summaries in their places. There simply isn't enough room in Autism itself to talk about each subtopic in detail: doing justice to the abovementioned topics would require at least doubling the size of Autism, and probably more, and Autism is already on the long side.
The topics you're mentioning are discussed partly in Autism therapies, which is briefly summarized in Autism #Management. Autism therapies discusses chelation therapy, HBOT, dietary intervention in general and gluten-free, casein-free diets in particular. For space reasons, it does not discuss details of each therapy; that is left to still-more-detailed articles like Chelation therapy. I don't know of scientific evidence on soy-free, low-oxalate, or the vitamin K2 protocol, but anything along those lines would be welcome there.
Many other topics are discussed in Causes of autism, which is briefly summarized in Autism #Causes. These include the vaccine controversy, metals and other environmental toxins, the MMR vaccine, and the hair content of autistic children. Again, for space reasons most of these topics have their own subpages, such as MMR vaccine controversy.
Autism organizations and so forth are discussed in Sociological and cultural aspects of autism, which is wikilinked to from the very last sentence in Autism (and is also wikilinked to from the last sentence in the lead). There are many, many organizations like DAN! and Autism Speaks. I'm sure that Sociological and cultural aspects of autism does not do justice to them all and can be improved, but there's not enough room in Autism to mention them. Autism used to have a lengthy "External links" section that pointed to some of them, but this ran afoul of WP:LINKFARM.
Typically, there is no way to prove that a particular treatment is a "fake". At most, all a scientific review can say is that studies have shown the lack of certain desired effects from a treatment, or (more commonly) that there is no reliable scientific support for a treatment.
Autism does not say that there are "few treatments". On the contrary, it says "Many alternative therapies and interventions are available." It does go on to say that "Few are supported by scientific studies." a claim that (unfortunately) is supported by several high-quality sources.
Here is a list of sources relied on most-heavily in Autism #Management for coverage of complementary and alternative medicine. Alternate sources of similar (or better!) quality would be welcome; if you know of any, I'd appreciate their mention here. It can be a difficult subject to cover.

Francis K (2005). "Autism interventions: a critical update" (PDF). Dev Med Child Neurol. 47 (7): 493–9. PMID 15991872.
Myers SM, Johnson CP, Council on Children with Disabilities (2007). "Management of children with autism spectrum disorders". Pediatrics. 120 (5): 1162–82. doi:10.1542/peds.2007-2362. PMID 17967921. {{cite journal}}: Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link)
Schechtman MA (2007). "Scientifically unsupported therapies in the treatment of young children with autism spectrum disorders" (PDF). Pediatr Ann. 36 (8): 497–8, 500–2, 504–5. PMID 17849608.

Eubulides (talk) 17:42, 25 February 2008 (UTC)

Educational therapies

This series of changes replaced:

Available approaches include applied behavior analysis, developmental, and structured teaching.

with:

Available approaches include: applied behavior analysis (ABA), Son-Rise, Floortime, the Lovaas technique, and Treatment and education of autistic and related communication handicapped childrenTEACCH.

There are some problems with this change:

Lovaas is an example of ABA; it's not an independent approach.
Son-Rise has no reliable scientific evidence and shouldn't make this short list.
The change introduces a red link.
Most important, the best source here (Myers et al. 2007, PMID 17967921) lists categories of therapies, not just single therapies, and we should do the same; this article is at too high a level to go into individual educational therapies, which are better discussed in Autism therapies.

I replaced the above text with:

Available approaches include applied behavior analysis, developmental models, structured teaching, speech and language therapy, social skills therapy, and occupational therapy.

citing just Myers et al. Eubulides (talk) 20:20, 24 March 2008 (UTC)

Much better. SandyGeorgia (Talk) 20:42, 24 March 2008 (UTC)

Annie, autism is a featured article, one of Wiki's finest and using only the highest quality, peer reviewed sources. You're introducing text that is not supported by such sources; I suggest you carefully discuss any intended edits to that article on the talk page, as the text you are adding will not survive there, because it is not well sourced and belongs in other articles, even if sourced. SandyGeorgia (Talk) 20:01, 24 March 2008 (UTC)

Dear SandyGeogia,

I wanted to explain that Early Intervention may not only help gain self-care and social skills, but that you can get completely better from it. The word cure is complicated, people think either it means medically or get completely better from it. That's why I also put medical cure, because it's a development disorder. Through early diagnoses and therapy, they can get out of their private world and start to join ours. But they will still be on the autistic spectrum. If I find a reliable source and ref tag, could I add it on the talk page, and can you help me determine if I could change the wording. AnnieTigerChucky (talk) 21:31, 24 March 2008 (UTC)

Annie, see above; the text has already been corrected. SandyGeorgia (Talk) 21:36, 24 March 2008 (UTC)

DSM for autism

The DSM criteria needs to appear as bullets and needs to look formal. It undermines the fact that autism is a medical issue, not a psychology/social/insignificant issue. Please someone rewrite the diagnostic section, to reflect the professionalism of the diagnosis and treatment of autism. I will recuse myself from judging the importance of my suggestion, as I am in the health care field. Just like ADHD, 40% of autism is accurate diagnosis and this page is google's #1 return on the subject. The article has a very manipulative feel. The information is correct, but it seems as if all the "judgment calls" were made by admins who want to balance the two or three conflicting attitudes towards the subject, they themselves without a background on the subject, but also lacking a specialized education covering this subject.

We can't just take the text of DSM-IV-TR and plunk it down on the Autism article; that would raise copyright issues. That being said, specific suggestions for improving the first paragraph of Autism#Diagnosis are welcome. It doesn't matter that you're in the health care field; on the contrary, your expertise will be welcome.
Wherever possible, the information on this page is supported by reliable medical reviews as per WP:MEDRS. The area is controversial, even among medical reviewers, and specific suggestions for improving the information (preferably supported by high-quality citations) is welcome.

Eubulides (talk) 04:45, 30 March 2008 (UTC)

Correct; the text is specifically crafted to avoid the serious copyright issues with the DSM. SandyGeorgia (Talk) 04:49, 30 March 2008 (UTC)

The public has stole the ADHD and methylphenidate wikpedia pages from us, and ever since autism has been getting a lot of coverage+publicity, and our side has been losing ground. I know wikipedia's best admins are fighting the most hot topics like scientology (where I read at least one page within the scientology scope gets reverted every 7 minutes) but I don't want to see this page fall. I'm one of the abandoners of adhd/methylphenidate, and I want to be the first voice to set the stage that I truely think we have a chance at preserving this page to our professional standards and viewpoints. I'm calling for some neutral admins to monitor this page over the next 5-10 years, and not let it gradually slide. Also, please keep an open mind, as all the scientific studies are in our favor, but we're of limited time-resources. I will reply to any rebuttals or questions, below this paragraph. 198.70.210.88 (talk) 12:37, 29 March 2008 (UTC)

Start here..

Please refer to WP:NOTAFORUM, and discuss specific text you'd like to include. SandyGeorgia (Talk) 04:49, 30 March 2008 (UTC)

Thanks for the vote of confidence on the article's quality. It is important that Autism remain neutral and verifiable, and you're welcome to join the editors who are helping out with that. I should warn you that Wikipedia is not supposed to be a soapbox or a battleground for a profession, though. Eubulides (talk) 05:00, 30 March 2008 (UTC)

Medical Privacy

Seems like the posting of un-retouched photos of kids, who are then said to display the symptoms of autism, comes very close to being a violation of their medical privacy. Did they give consent? Did parent's/guardians? C d h (talk) 15:59, 31 March 2008 (UTC)

According to the info on the image pages, the child's mother (User:Andwhatsnext) gave an OK, by uploading the photos herself. These photos are also published on Youtube, for what's that worth. Eubulides (talk) 16:34, 31 March 2008 (UTC)

Cannabis

This change introduced discussion of cannabis to treat autism. The cited source does not support much of the claims made in the newly-introduced discussion: for example, it doesn't talk about adult patients, nor does it talk about psychological impairments. Furthermore, Autism is a high-level article about all of autism, and there's not enough room in it to talk about all the dozens of treatment methods out there. A better place for the discussion of cannabis and autism is Autism therapies. I just now moved the discussion of cannabis to the new section Autism therapies #Cannabis, and supplied a source (Lorenz 1994, PMID 15159680) that's more-reliable than that advocacy website. Eubulides (talk) 21:29, 2 April 2008 (UTC)

There is nothing wrong with autism

It is not a disorder. It is not a disease. It is simply a way of being not understood by the vast majority of the population, who are incredulous and cannot seem to handle those who are different. Like racism and sexism before, the general population sees fault with those deemed not normal. You cannot change the way we are. We simply do not respond or understand - as you may - to the perceived notions of body language and supposed normal ways of communication. Those deemed autistic are not less intelligent ot mentally deficient. They simply do not communicate as the general population does.

Autism: solving the puzzle. —Preceding unsigned comment added by 98.240.53.8 (talk) 07:29, 3 April 2008 (UTC)

Well, I am not an expert or anything, but the word "disorder" means an irregularity. In other words, when somebody has a disorder, though the connotation of the word deems the person as having something wrong with them, it really just means they are not normal. How is normal determined? That I cannot directly explain, as there are too many factors. Mainly, the status of normal is determined per person, depending on each person's view of what is commonplace in society. As you said, racism was something like this. In Europe and America, blacks were seen as having something wrong with them. That was because African-Americans and others were considered different, and therefore they assumed that have a "disorder". However, if you had gone to Africa at that time, having black skin was in no way a disorder. In other words, as long as the majority of the population does not have autism and that the majority of the population believes that autism is different than the norm, autism remains a disorder. As I said before, I am not an expert by a mere passer-by, but I hope this explanation suffices. — Parent5446 ^{(t n c k e l)} 00:11, 7 April 2008 (UTC)

The lead talks about some "believing that autism is a condition rather than a disorder", and the article ends with "others believe that autism is simply another way of being", so the viewpoint that there is nothing wrong with autism is represented in Autism now. Eubulides (talk) 00:55, 7 April 2008 (UTC)

As a person with a mild case of high-functioning autism or what one calls Asperger's syndrome, autism can be a problem when one deals with social situations and how they learn at school. Autism isn't an "abnormal" thing but a minority of people have autism and it's better detected than it once was, as well more educational and behavioral treatments are available. Autism is nowadays perceived less than a disorder or disability, but a different kind of human brain one is born with and more people are being diagnosed or discovered with an ASD. To be dubed a "pandemic" is also questionable or a kind of media hype: autism has been common for all these decades or centuries, but only recently American society is more familiar with autism and ASD than previously when autism was seen as "nerdy" or "crazy" behavior...it's how society in the 21st century views autism in a different way. It's been well-documented autism is more common in males (80% of all cases are in men) but females (20%) can have it too; more diagnosed among upper-class whites and Asians but autism is found in all races and classes; and autism is often a genetically inherited trait in certain families, although more cases of autism/ASD is in families without any history of autism. The enigma of autism continues while more studies, analysis and awareness of autism is actually a good thing for improving the social status of persons with autism and ASD, because when more people are familiar with autism the better chances of autistic people to have fairly normal lives. + Mike D 26 (talk) 21:03, 8 June 2008 (UTC)

Here is a ref that could be integrated

Chicago Tribune "Against the stream - California-based organization advocates alternative measures to deal with autism" April 8, 2008 [4] MaxPont (talk) 16:48, 8 April 2008 (UTC)

Is "it" the article? This is a pretty good article right now, formerly featured etc. Dbrodbeck (talk) 19:11, 8 April 2008 (UTC)

The main points of the Chicago Tribune article are covered in Autism#Management in the paragraph beginning "Many alternative therapies and interventions are available.…" There is more detail in the subarticle Autism therapies. I don't offhand see anything new that the Chicago Tribune article brings: it's a less reliable source than the scientific journal reviews and studies that are currently cited in Autism and Autism therapies. Eubulides (talk) 20:18, 8 April 2008 (UTC)

The more sources you add, the more credible. Chigaco Tribune is a well respected RS, and can add context to the narrow discussions in academic journals and show that this issue is discussed in the public debate outside the peer reviewed journals. MaxPont (talk) 06:41, 9 April 2008 (UTC)

Too many sources, and the reference list gets too long; we have already discarded many sources from Autism (for space reasons) that are better than that article from the Tribune.
The Tribune is a good newspaper, but it's not as reliable a source for autism as the Journal of Autism and Developmental Disorders, Autism, Pediatrics, Annual Review of Public Health, and other sources cited by Autism. For example, the Tribune article says autism is "the fastest-growing developmental disorder in the nation", but this is incorrect: as Autism#Epidemiology points out, it is not known whether autism's true prevalence is increasing. That's the sort of error that one doesn't expect to find in (say) Autism, but which one finds all too often in newspapers, even newspapers as reliable as the Tribune.

Eubulides (talk) 07:00, 9 April 2008 (UTC)

Link Suggestion

This page compiles articles and resources from across the web on Autism. The focus of the page is on children's education and Autism. There are resources for what rights an Autistic child has in school, preparing for kindegarten, and many more focused articles. The articles are from organizations such as Nemours, NICHD, Autism Society of America, among others. Parents looking for additional information on education and Autism will find this site very helpful. Take a look. If you agree, please add it to external links.

[* http://www.education.com/reference/topic/SpecialNeeds_Autism/ Autism Resources for Parents of School Aged Children]

64.81.61.63 (talk) 21:04, 8 April 2008 (UTC)

You can add it to the DMOZ link at the bottom of the article, where it will get wider play. SandyGeorgia (Talk) 21:05, 8 April 2008 (UTC)

"See also" links

I noticed that a few of the sub-pages in this article are only linked-to from the within the paragraph prose. I thought it would be helpful to add this at the top of the History section:

A discussion is surrounding this in MEDMOS at the moment - I think some guidance on this could be included in there. --Matt Lewis (talk) 10:51, 12 April 2008 (UTC)

Templates for other types of "See also" links are in here: {{see}}. --Matt Lewis (talk) 10:55, 12 April 2008 (UTC)

Gernsbacher et al. 2008 on joint attention

Not wanting to interfere with the very nice work that's been done here, but I came across this Gernsbacher et al. article and it seemed to fit right in. Jean Mercer (talk) 00:27, 15 April 2008 (UTC)

That's a lot of text to get through. SandyGeorgia (Talk) 00:31, 15 April 2008 (UTC)

Oh, you mean this article; I'll fix the citation, and leave it to Eubulides to decide if it's got significant traction to be included here. I didn't come across mention in any of the main reviews. SandyGeorgia (Talk) 00:34, 15 April 2008 (UTC)

Retract that: I didn't formt the citation yet because it's not in PubMed and I can't find it in Google scholar, it looks like "recentism" or a primary source that should probably not be included until/unless a secondary source reviews and discusses the work. But I'll wait to see what others say. SandyGeorgia (Talk) 00:39, 15 April 2008 (UTC)

Thanks for the heads-up on the new source. Here's a better citation to that same essay:

Gernsbacher MA, Stevenson JL, Khandakar S, Goldsmith HH (2008). "Why does joint attention look atypical in autism?". Child Dev Perspect. 2 (1): 38–45. doi:10.1111/j.1750-8606.2008.00039.x.{{cite journal}}: CS1 maint: multiple names: authors list (link)

It's the first essay in a 3-part series on a somewhat-controversial subject, published in a non-Pubmed-indexed journal launched last year by the Society for Research in Child Development. The journal apparently solicits series like these, in order to promote dialog about policy. The other two parts in the series are:

Burack JA, Russo N (2008). "On why joint attention might look atypical in autism: a case for a strong policy statement but more nuanced empirical story". Child Dev Perspect. 2 (1): 46–8. doi:10.1111/j.1750-8606.2008.00040.x.
Gernsbacher MA, Stevenson JL, Khandakar S, Goldsmith HH (2008). "Autistics' atypical joint attention: policy implications and empirical nuance". Child Dev Perspect. 2 (1): 49–52. doi:10.1111/j.1750-8606.2008.00041.x.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Given the form and forum it sounds like this material is more appropriate for Controversies in autism, so I moved (and rewrote) it from Autism to there. This change also relocated Autism's somewhat-scattered joint-attention matterial to Autism#Communication, which seems like the logical place for it. Eubulides (talk) 06:25, 15 April 2008 (UTC)

Is this FA prose? And why is this article semi-protected?

I was scanning the article for sub-article wiki-links and this paragraph stood out:

"Many alternative therapies and interventions are available. Few are supported by scientific studies.^[1]^[2]^[3] Treatment approaches lack empirical support in quality-of-life contexts, and many programs focus on success measures that lack predictive validity and real-world relevance.^[4] Scientific evidence appears to matter less to service providers than program marketing, training availability, and parent requests.^[5] Many treatments are probably harmless. Some are not: for example, in 2005, botched chelation therapy killed a five-year-old autistic boy.^[6]"

Is this FA prose? To me, the whole weight of the paragraph seems all wrong. It's interesting that the second line is a single sentence - it doesn't read like it was the original prose. I always worry that FA's are more susceptible to these kind of changes sticking than more organic articles (assuming my guess is true). The whole paragraph reads too conversationally POV-sounding: "Many treatments are probably harmless. Some are not:" is decidedly staccato and pointed too. Can the citation after "parent requests" really back up the tone of the preceding statement? Bear in mind I'm not concerned with any over-riding 'truth' here - my concern is how adhering to a balanced prose style can help irradiate a biased tone wherever it comes from. I noticed that Main article: Autism therapies is very similar in tone too.

My principle interest is the Alzheimer's article - editors are grooming it for FA (an understandable goal for those who want the best), but my major worry is that the little symbol won't necessarily be good for it in the long run. Or should I say two little symbols - why is Autism semi-locked? I can't see anything to warrant it on the Talk page and it could be adversely effecting the article.--Matt Lewis (talk) 02:10, 16 April 2008 (UTC)

I have only edited this page some, but it seems to me that the sentence is not that bad, the second one. It says that most are probably harmless ((so they may not work, but they have no bad effect) but some are not, such as the aforementioned case. Dbrodbeck (talk) 02:28, 16 April 2008 (UTC)

You mean the third one? - it wasn't actually a sentence I specifically called up. The compounding fourth sentence I have a tone issue with (the one ending in "parent requests"). And the beginning and ending sentences have 'tone' issues for me too. I'm not arguing with content (though it's not really weighted at all) - but I've an ear for tone, and it stood out as I found it rough. "Many treatments are probably harmless." - can we say that without a citation? It's not "encyclopedic prose" either - I think that is my point. If this wasn't an FA I may not have mentioned it - but my worry is that if it wasn't an FA I may also not have seen it. --Matt Lewis (talk) 04:46, 16 April 2008 (UTC)

I don't offhand recall the citation directly on point for the "probably harmless" claim. It's a claim that is no doubt true (and I vaguely recall that it used to be sourced) but we can't include it without a source. For now, I removed that claim and filled in the resulting gap with a sourced example of harm, namely nutritional deficiencies from elimination diets. Those interested in the subject might also take a look at: Hediger ML, England LJ, Molloy CA, Yu KF, Manning-Courtney P, Mills JL (2007). "Reduced bone cortical thickness in boys with autism or autism spectrum disorder". J Autism Dev Disord. doi:10.1007/s10803-007-0453-6. PMID 17879151. {{cite journal}}: Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link) Eubulides (talk) 05:48, 16 April 2008 (UTC)

The article is locked because when it wasn't locked, almost all the edits from IP addresses were vandalism, and the resulting process harmed Wikipedia far more than it helped. Occasionally the lock expires, vandalism goes through the roof, and the lock gets reinstated.
The source for the "parent requests" sentence says this: "It appears that program marketing, availability of training, provider preference, and external factors such as parent requests influence the use of specific practices more than whether the practice has any evidence of efficacy." (Stahmer et al. 2005, PMID 16467905)
The prose is certainly not Shakespeare, and no doubt could be improved; any specific suggestions?

Eubulides (talk) 04:31, 16 April 2008 (UTC)

Alzheimer's used to get weird vandalism, but it's subsided of late. ~~What kind is it? I suppose it must be over content if it gets protected.~~ The source is quoted? (ie. "appears") - perhaps it should be a quote then? It can't be right as it is - it's a big statement. I actually have an autistic friend, and I know his mother well (who's retired). I'll see if I can get them involved (even if its just a read through and suggestions). --Matt Lewis (talk) 04:46, 16 April 2008 (UTC)

The above quote ("It appears that program marketing…") is a direct quote from the cited source. Autism paraphrases the source in an attempt to be slightly briefer and clearer. As a general rule I dislike direct quotes in medical articles, as they typically make articles longer and are rarely worth the trouble. More pairs of eyeballs are welcome of course. Eubulides (talk) 05:48, 16 April 2008 (UTC)

Vandalism - sorry, I'm a bit tired. Occasionally the lock expires? Can IP addresses and featured articles co-exist I wonder. --Matt Lewis (talk) 04:54, 16 April 2008 (UTC)

Yes, the current lock on Autism expires July 2. More-controversial featured articles like Autism are often locked, I'm afraid. Eubulides (talk) 05:48, 16 April 2008 (UTC)

I chose to semi-protect this article since there were no constructive contributions being made by IP editors, with the large number of IP edits being instead simple vandalism, often consisting of obscene and insulting comments about autistic people. Tim Vickers (talk) 16:18, 16 April 2008 (UTC)

Prose suggestion

A suggestion:

"Many alternative therapies and interventions are available, though few are supported by scientific studies. Treatment approaches lack empirical support in quality-of-life contexts, and many programs focus on success measures that lack predictive validity and real-world relevance. Scientific evidence appears to matter less to service providers than program marketing, training availability, and parent requests. Many treatments are probably harmless, while others are not. One treatment that has proven deadly is botched chelation therapy, which killed a five-year-old autistic boy, in 2005."

A light copyedit to smoothen out the prose; is that better? · AndonicO ^Engage. 16:35, 16 April 2008 (UTC)

That suggestion was based on this older version, no? But we had to yank out the "probably harmless" bit due to lack of citations; perhaps you could revamp the suggestion to match the newer version? Anyway, I made this change to incorporate the suggested change to the first sentence; generally it's better to say "Although X, Y" rather than "X, though Y", as that gives the reader a better hint that a contrary clause is coming. Eubulides (talk) 19:20, 16 April 2008 (UTC)

Yeah, I based it on the original inquirer's version. Does this look good? I took out "elimination diet," (replaced with "some diets, particularly those that completely eliminate the intake one or more types of food") as I don't think that's a proper term; while more specific, it also sounds a bit awkward, so if I'm wrong, better so. · AndonicO ^Engage. 23:53, 16 April 2008 (UTC)

Hold on a minute, I found a source backing the claim about most treatments being harmless: Angley et al. 2007 (PMID 17925903) say "most interventions are associated with only mild adverse effects" so that can go back in, with revised wording. The "particularly those" part wasn't supported by the source and that phrase is a bit wordy, so how about if we just name one popular diet and a harm from it, as that fits in better with the "For example"? Finally, replacing "killed" with "has proven deadly, causing the death of" added redundancy ("deadly"/"death") but no extra information; was there something wrong with the simpler, shorter "killed"? Anyway, I made this change to incorporate the ideas of this paragraph. Eubulides (talk) 01:09, 17 April 2008 (UTC)

Seems good to me. I thought "killed" seemed a bit more violent, but I guess there aren't many alternatives. · AndonicO ^Engage. 01:16, 17 April 2008 (UTC)

"Killed" seems weird here, because the example doesn't quite fit.

Chelation therapy is not a dedicated autism treatment (it's normally used for treating heavy metal poisoning, and is known to be dangerous if calcium levels are not monitored (it effects the symbiotic magnesium/calcium balance). Occasionally it is tried on diseases like Alzheimer's - and probably anything where people believe heavy metals may be involved. My point is that if it is not controlled properly (ie 'botched') it can kill anyone. None of the elements - the treatment, the botching (especially) or the death - are specifically linked to autism above any other disease or impediment where chelation therapy is used - so it seems odd that it is so highlighted here. I think the preceding lines are the problem - they are too strong.

I'm making this edit:

"Although many alternative therapies and interventions are available, few are supported by scientific studies.[27][94][95] Treatment approaches often lack empirical support in quality-of-life contexts, and many programs focus on success measures that lack predictive validity and real-world relevance.[28] It has been suggested that many service providers place program marketing, training availability, and parent requests above scientific evidence.[96] Most treatments, such as supplementing with vitamin C or omega 3 have mild or no adverse effects,[97] but others can be problematic: a 2007 study found that autistic boys on casein-free diets have significantly thinner bones,[98] and chelation therapy can be fatal if not properly controlled.[99]"

It weights the two problematic examples with two benign ones, and evens the tone of the paragraph. --Matt Lewis (talk) 03:10, 17 April 2008 (UTC)

Not happy with the recent weasly wording "it has been suggested that", here. See WP:AWW, WP:WTA et al. SandyGeorgia (Talk) 04:43, 17 April 2008 (UTC)

I see the following problems with that edit:

It inserted an often, resulting in "Treatment approaches often lack empirical support in quality-of-life contexts". The source says "No studies to date have identified indicators predictive of QoL for children (or adults) with autism." and later "However, to date, there has been little empirical support of programmes for autism in terms of real-world, evidence-based, and QoL contexts. Rather, many autism programmes remain focused on utilising measures of success that lack predictive validity and salience to real-world contexts (e.g. IQ score, academic success)." In light of this, the often is too generous. I'll reword the phrase to "Treatment approaches have little empirical support in quality-of-life contexts"; this matches the source better.

As long as some qualifier is in there.--Matt Lewis (talk) 22:54, 17 April 2008 (UTC)

It inserted the "It has been suggested that" weasel words you mentioned. The source says "It appears that program marketing, availability of training, provider preference, and external factors such as parent requests influence the use of specific practices more than whether the practice has any evidence of efficacy." I don't know of anyone seriously disputing the source's claim, nor is the source mincing its words here; let's just summarize the source rather than weaken its claims.

It needs another citation if "appears" is used. How do people currently know it is a summary of a source, rather that a irrefutable fact (which it could be - but are we sure ehough to put it like this)? Hope you don't mean Wikipedia definition of "weasel words", by the way! --Matt Lewis (talk) 22:54, 17 April 2008 (UTC)

No, by "weasel words" I just meant trying to say something with unduly indirect circumlocutions in an attempt to soften the blow of what an article says. But I don't follow the rest of the comment. The source says "appears", and we say "appears"; what's inaccurate about that summary? Wikipedia is not about irrefutable facts (that would be too hard…), it is about reliable sources and verifiability. Commentary that I've seen about that source (e.g., McGrath 2006) doesn't dispute the conclusion in question. Why should that point need confirmation from another source? Eubulides (talk) 23:51, 17 April 2008 (UTC)

It gives "supplementing with vitamin c or omega 3" as examples of treatments with "mild or no adverse effects", but the cited source says "with only mild adverse effects" (not "with mild or no adverse effects"), and it does not give those two as examples of treatments with mild adverse effects. We shouldn't weaken the source's wording here. The source does give melatonin as an example, so we can use that instead.

It only uses the word "mild" for "Pyridoxine and magnesium" and "melatonin", but for "Omega 3" it said "Gastrointestinal side effects are reported with EFAs including: nausea, diarrhoea, increased belching, acid/reflux/heartburn/indigestion, abdominal bloating, and abdominal pain. Fishy aftertaste is commonly experienced and rare reports of skin rash have occurred.23" - which I took to mean the same as "mild". I added vitamin C (which has no notable side-effects) to weight two examples with two. But we can lose the botched chelation example.

I dunno; to put the devil's advocate hat on, it depends on how often and severe the nausea is; and even vitamin C has adverse effects if you take enough of it. Of course I agree that adverse effects of these treatments are mild in autism treatments, but this source doesn't say that they're mild, and we need a source that says it before we can put it in. The pyridoxine and magnesium section makes it clear that there is real concern about their long-term adverse effects, so we can't use that. Eubulides (talk) 23:51, 17 April 2008 (UTC)

I looked for other reliable sources on this topic. Levy & Hyman 2005 (PMID 15977319) say this about Vitamin C: "Few side effects are described, except in high doses where there might be gastrointestinal upset (including diarrhea) or potential of kidney stones." This isn't close enough to "mild" for my comfort, as kidney stones can be quite painful. I looked for something where L&H say something similar about some other treatment, and the closest thing I found was "No known negative side effects of probiotic agents or a 'yeast-free' diet are reported." Perhaps mention probiotics for another positive example? Eubulides (talk) 01:02, 18 April 2008 (UTC)

It rewords "Although X, Y" to "X, but Y". I've learned from TimVickers that the former style is preferable in medical articles, as it gives the reader more of a clue in advance that X will be contradicted by Y.

Fine if it reads better.

When talking about treatments it rewords "some can be harmful" to "others can be problematic". "Some" is better than "others" here, since it matches the "most" and qualifies the harmful treatments as being in the minority. "Problematic" is longer than "harmful" and seems a bit of an understatement when talking about a therapy that was fatal to the patient. Perhaps it'd be better to omit the phrase entirely; that's shorter, and readers can draw their own conclusions.

Thinking about it your are right about that - it really needs to be omitted - or we must find a better example which is more directly linked to austism and isn't just a botched event!

The event is relevant even if it was botched. A treatment that is dangerous because of botches that are too-probable counts as a dangerous treatment. Eubulides (talk) 23:51, 17 April 2008 (UTC)

The cited source shows that the botched chelation therapy was specifically being used to treat autism. The problem was not that the chelation was "not properly controlled" (which makes it sound like a bit too much agent was administered, or something like that). The problem was that (due to a mixup) the wrong chelation agent was administered, and in the quantity administered it was fatal. The source does not recommend monitoring calcium as a way to prevent such problems in the future; instead, it suggests that Na₂EDTA be removed from hospital formularies, to help avoid future mixups. To my mind "not properly controlled" is both wordier and less accurate than "botched" here.

It's a bad example and needs omitting (as suggested in the last point above).

Please see reply above. Eubulides (talk) 23:51, 17 April 2008 (UTC)

I made this change to encompass the above comments. Eubulides (talk) 06:41, 17 April 2008 (UTC)

The above change is an improvement again, but the "it appears" line is based on the one reference - I still don't find "It appears" encyclopedic language in this context (though it doesn't sound as bad now the balance of the paragraph is improved, I admit), mainly because it is based on just one citation - wouldn't the word "appears" need more than one? I'll look for another to back it up. Balance is surely the key to Wikipedia (here between the language used and the amount of citations given).

By the way, this is what Wikipedia has on "weasel words": "Weasel words are deliberately misleading or ambiguous language used to avoid making a straightforward statement while giving the appearance that such has been made. This type of language is used to deceive, distract, or manipulate an audience."

Why would I want to do that? I hope no-one here is suggesting anything! It looks to me like people have rigid ideas about dealing with "CAM" - but Wikipdia is an encyclopaedia with pretty solid guidelines - if we get it right nobody has to make a value judgement either way (which is how I personally see the subject). I've merely spotted a paragraph that needs (and has now had) improvement - and have had the guts to give it a go. I'd appreciate some faith! --Matt Lewis (talk) 22:54, 17 April 2008 (UTC)

I certainly didn't intend any such implication, and I hope my above comments have addressed the points about "appears" and "weasel". Eubulides (talk) 23:51, 17 April 2008 (UTC)

New review

"Advances in autism genetics: on the threshold of a new neurobiology" Brett S. Abrahams & Daniel H. Geschwind Nature Reviews in Genetics, May 2008 Volume 9 Number 5, p341 doi:10.1038/nrg2346

Could be useful. Tim Vickers (talk) 19:37, 18 April 2008 (UTC)

No kidding! It's an extremely high-quality review, though not easy reading. I made this change to try to keep Autism up-to-date. Thanks for the heads-up. Eubulides (talk) 21:42, 18 April 2008 (UTC)

Hans Asperger

The picture with caption "Hans Asperger introduced the modern sense of the word autism in 1938." is inaccurate. Hans Asperger described what we now know as Asperger's Syndrome in 1944. Autism as the term is currently used was first described by Leo Kanner in 1943, with claims that his observations date back to 1938. While both Asperger and Kanner used the term "autism", their study groups were quite different and should be independently described.

-Sam gamerSRC@gmail.com

Asperger also published in 1944, but his first publication using the word autism in its modern sense was in 1938. See Autism#History for more details. The 1938 publication wasn't widely known (in English-languages sources, anyway) until fairly recently; it's the usual problem that Asperger's seminal work was all in German. I added a citation to the caption to help clarify this. Thanks for pointing out the problem. Eubulides (talk) 06:51, 20 April 2008 (UTC)

Rock Autism Campaign

You know how VH1 Classic is having that Rock Autism Campaign to raise awareness about autism? Should we put a link to their site or something? A pyrate's life for me... (talk) 15:54, 22 April 2008 (UTC)

I wouldn't think so, as it's not notable enough for autism in general. I suggest putting it into World Autism Day and broading the scope of that new page to include Autism Awareness Month, which Rock Autism is part of. Eubulides (talk) 16:22, 22 April 2008 (UTC)

Okay, thanks. I'll have to get on that. A pyrate's life for me... (talk) 15:54, 23 April 2008 (UTC)

Incidence

(Caivanoa (talk) 09:27, 23 April 2008 (UTC)) This is my first attempt at editing a page on Wikipedia, I have been working with autistic children for over ten years as a behavioral interventionist, as you can imagine we are updated on current statistics quite often. The stats given on the autism page of 1 in 166 children being diagnosed with autism, or as it is stated, "6 per 1000 for Autism Spectrum Disorder", is quite outdated. Those statistics are from 2003-2005. Recent statistics are most commonly averaging 1 in 150 children being diagnosed on the autism spectrum. There are many sites that are publishing these stats, but just to give you a few; OpEdNews at http:[[5]] This site reports that numbers of autistic children differ from state to state with the current averages being 1 in 150, yet some states like Massachusetts report having 1 in every 130 children being diagnosed. If you go directly to the Centers for Disease Control and Prevention at: [[6]] you will also find more current statistics of 1 in 150 children, and 1 in 94 of the 150, being boys. These are just simple suggestions, but it is important to keep up with current stats in such a controversial topic like autism, especially because the numbers of diagnosis seem to be growing by the minute. Thank you for your time, (Caivanoa (talk) 09:27, 23 April 2008 (UTC))

The press release you linked to seems to have the same data as in our article. SandyGeorgia (Talk) 15:24, 23 April 2008 (UTC)

Thanks for mentioning the situation. It is a tricky area. The CDC press release says "More recent studies from multiple countries using current diagnostic criteria conducted with different methods have indicated that there is a range of ASD prevalence between 1 in 500 children and 1 in 166 children." which indicates a range of between 2.0 and 6.0 per 1000. It also mentions two recent U.S. studies, a study reporting 6.7 per 1000 in 2000 and a study reporting 6.6 per 1000 in 2002. Our main source here (Newschaffer et al. 2007, PMID 17367287) says "Recent prevalence estimates for the ASDs collectively have been surprisingly consistent, in comparison with the heterogeneity of autistic disorder estimates, falling close to 60 per 10,000." which would be close to 6 per 1,000, the figure Autism reports. One has to remember that the underlying figures vary quite a bit, at least partly due to changes in the way ASD gets diagnosed; for example, a recent British study (Baird et al. 2006, PMID 16844490) reported a prevalence of 11.6 per 1,000. With that range (from 2.0 to 11.6 per 1,000) and with WP:MEDRS in mind, I'd like to see a more-recent reliable review on the subject (as opposed to reporting results from individual studies); in the meantime the "about six per 1,000" matches these new studies pretty closely, all things considered. Eubulides (talk) 20:08, 23 April 2008 (UTC)

I agree that this is way too vague as it is written - "most statistics agree" or anything like that - is not good enough. And you're right - there are so many different statistics on autism, ASD, Aspergers, that don't match - that a clearer scope needs to be given. ALSO - I don't necessarily see it here - but I HATE it when people give a statistic such as "1,000,000 people are diagnosed with autism a year" (I made that statistic up). Diagnosed WHERE? In other words, and especially with people in the US (and I'm from the US....so....) - there is a very ignorant trend to forget the fact that the internet is WORLDWIDE, and that when you give numbers, statistics, rates, etc., they should be specified - 1,000,000 in the US, for example - or 130,000 worldwide. Even if you do cite, it's still not clear and it's not correct. I'm not picking on anyone here - just venting.... Dmodlin71 (talk) 13:31, 18 May 2008 (UTC)

Sometimes I feel autism is actually overdiagnosed by worried parents, but also underdiagnosed as a whole in a larger general population. More and more adults are finding out they have ASD/autism later in life, while the majority of new cases we usually read or hear about are young children (esp. 2 to 5 year old boys, but some experts feel most girls aren't properly diagnosed). The incidence of autism should be an international phenomena, but it's the developed countries like Europe and North America with the right criteria and psychological tests available to detect or diagnose people to have ASD/autism. Now a few people involved in psychiatry and in the autistic community perceive our society is perfectionist and not fully tolerant on autism, therefore you get a "pandemic" or a fanatical push to find out who's autistic or not. Sure, we have media hypes about what's obesity, homosexuality, pedophiles, racists, terrorists, communists, ecological damage, abuse victims, satanic cults, UFO report flaps or other "witch hunts" or "scare tactics" for anyone who's viewed as such and such...autism may be grossly overemphasized as an "illness" or a "crisis" when in fact autism isn't the same issue like for one to have AIDS, cancer or schizophrenia (an actual mental illness). Think of it: autism isn't a brain disease but a different neurological state who needs more assistance in society except autistic people are most likely no different from the majority of people without autism. + Mike D 26 (talk) 21:14, 8 June 2008 (UTC)

MMR remark

Hi, my first talk, so forgive if this has been addressed before.

"there is overwhelming scientific evidence showing no causal association between the measles-mumps-rubella vaccine and autism"

This is a very strong conclusion and I don't believe it's true, and I haven't seen any study reaching such a strong conclusion. As far as I'm aware, they make the weaker 'this evidence does not support a link' which is quite different.

The MMR studies all compare groups of MMR-vaccinated against those who received an alternative measles vaccine. So what the studies show is that the MMR does not contribute significantly differently to other measles shots. Unless there's studies giving the measles shots a clean bill of health, we cannot conclude that about MMR. —Preceding unsigned comment added by 77.102.88.28 (talk) 00:14, 25 April 2008 (UTC)

The cited source (Doja & Roberts 2006, PMID 17168158) supports that claim by saying in its abstract, "In particular, some have suggested an association between the Measles-Mumps-Rubella vaccine and autism. Our literature review found very few studies supporting this theory, with the overwhelming majority showing no causal association between the Measles-Mumps-Rubella vaccine and autism." This is not a single scientific study: it's a review of the scientific literature up to about 2 years ago. I don't know of any more-recent scientific study that would cast doubt on that review's conclusion; on the contrary, the recent scientific studies I know of (Fombonne et al. 2006, PMID 16818529; Richler et al. 2006, PMID 16729252; Uchiyama et al. 2007, PMID 16865547; Baird et al. 2008, PMID 18252754) all found no connection between MMR and autism, and a 2007 review (DeStefano 2007, PMID 17928818) says there is "compelling scientific evidence against a causal association". As for the idea that the MMR studies are all flawed, do you have a reliable source on that? Eubulides (talk) 06:41, 25 April 2008 (UTC)

I wonder when people will learn the difference between "we haven't found any evidence yet" and "there is no evidence"? Even "a review of the scientific literature" is suspect: how much scientific literature is there? Which account am I going to trust most, the account of a parent who noticed nothing wrong with their child until after the child had an MMR--at which point the child's behavior changed drastically--or a vague statement of "the literature has been reviewed"? Science should be about direct observation wherever possible; when did it descend into one bunch of lazy people reading papers written by another bunch of lazy people? And this is not even getting into the thimerosal issue, since (IIRC) the MMR vaccine doesn't use the thimerosal preservative. But really. A mercury-based compound. How does that not cause problems? —Preceding unsigned comment added by 69.47.97.94 (talk) 08:40, 5 July 2008 (UTC)

It is true, you cannot prove the null. That said, when no evidence has been found and people have looked it seems that closes the issue. Science does not work on observations of one kid, or from one parent, it uses controlled studies. Finally, calling scientists that read and write articles lazy pretty much makes it clear that you do not understand science. It is hardly an easy thing to do. Dbrodbeck (talk) 11:59, 5 July 2008 (UTC)

FYI, a quick search of pubmed lists 197 papers with the search terms MMR and autism. 42 of these are reviews. I could go through all the papers and list all the data but that would be "doing a literature review" and this has already been done. If you want to read some of the work that has been done i recommend using pubmed as a starting point. Not all text is available free to the general public (due to the methods by which scientific data is published and journals wanted to get paid) but lots of it is. You can read a summary of all papers findings for free at pubmed and if you are particular interested in getting the actual data it is fairly standard procedure in the academic (although not the industrial!) community to provide raw data on request. Just contact the corresponding author - whose contact details will be listed on the paper. I think you will find that in general scientific papers aspire to be honest and critical of their own work - whatever it shows.Bredon (talk) 11:11, 11 July 2008 (UTC)

Photo in Infobox - Child Stacking Cans

I removed this photo - hope I don't offend someone - cute kid! BUT, I find the photo to be very irrelevant to the top of the main page. Also, as an adult on the autistic spectrum, I find it frustrating when encyclopedic or informational articles on autism always start with and/or concentrate on autism in childhood, because autism doesn't end in childhood - it is a life-long condition. Also, when adults with autism spectrum disorders do research on their condition(s) (and believe me, nobody researches more than autistics) it can become somewhat of an insult to come upon article after article focusing on children, and showing photos of children. It makes it seem, in a way, as if people with autism are, well, "generally children."

Well, not true - in fact, I'm 37, have a degree and an active social life, despite many obstacles and bumps along the way! I agree that childhood is a time of extreme importance in recognizing and learning to cope with the mystery of autism; however, we can't forget that, because autism is a relatively NEW diagnosis in the field of psychiatry, there are still many adults who are discovering and being diagnosed with a condition that they lived their whole life with - always wanting an explanation, and finally finding one. I met a lady who was diagnosed as being on the spectrum at the age of 50. I now believe my grandmother was as well, who died 20 years ago. It's a mysterious world we live in..............Dmodlin71 (talk) 04:24, 4 May 2008 (UTC)

The photo is relevant and useful. First, a diagnosis of autism requires behaviors before three years old; that's why the first sentence in Autism has the word "child" in it. Second, the photo illustrates one of the characteristics of autism, namely restricted, ritualistic, and repetitive behavior. Your point about autism being a lifelong condition is well taken, and if we could find a better photo, one that illustrated autism in adulthood as well as in childhood, that would be better. But in the meantime we have to use what we have; the set of freely-available photos for autism is very limited, and for a general-purpose encyclopedia article like this it is better to have a relevant and useful photo, even if it's not ideal, than to have no photo at all. Eubulides (talk) 06:43, 4 May 2008 (UTC)

Yes, the photo is relevant and should stay. We have what we have, and we have no useful, free adult images. SandyGeorgia (Talk) 16:16, 4 May 2008 (UTC)

Of course if you wished to take a photograph of yourself or, even better, an autism support group that you know of, that would be a great addition to the article. Tim Vickers (talk) 17:03, 4 May 2008 (UTC)

Preferably engaging in some kind of typical autistic behavior such as stimming. I suspect the main reason why there are no adult photos is because adults, even autistics, tend to get a little *embarrassed* about bringing public their stimming habits. Speaking as a self-stimmer and a person with Asperger's Syndrome, I can promise you will never see a photo of me on this page. Soap ^Talk/_{Contributions} 19:38, 4 May 2008 (UTC)

Ok. The picture does show an aspect of autism. Here's a question though - why do we need a photo? What purpose does it serve? I could post a picture of my neighbor's little girl stacking bricks in their front yard - she doesn't have autism - but I could say "here is a girl stacking bricks. Many autistic children develop habits..." If this were an article about Tourette Syndrome, would/should there be a picture of someone blinking or showing some strange tic behavior? Probably not - sort of hard to capture on a photo. That's why you have to EXPLAIN it. In a related vein - if you were writing an article about manic depression - you wouldn't post a picture of someone tearing their hair out while crying over a sink..... or someone bug-eyed because they have insomnia and are experiencing anxiety. It's inappropriate, it doesn't serve any purpose other than drama, and it is a stereotype.

That was my basic objection to the photo. Autism has enough stereotypes and drama. And perhaps if you wanted to show an autistic trait, such as a child stacking or counting - a video would be more appropriate. Dmodlin71 (talk) 13:08, 18 May 2008 (UTC)

ONE more point - the purpose of providing images/photos/diagrams etc. in articles is mainly to illustrate a point to make it more clear. An article about Mt. Rainier couldn't be more complete without at least one picture of the volcano itself. An article about a medication will show a diagram of its molecular structure. The picture gives a clear picture, pun intended, of what is being described. You can describe a child a child stacking cans quite easily - no picture needed. Adding to articles with images like that only serves to make the article LOOK better - but in reality, it just makes the page take longer to load. Dmodlin71 (talk) 13:18, 18 May 2008 (UTC)

I dunno, I can describe Nahuatl without using any images at all (after all, it's a language), but if you visit the Nahuatl article you'll see that it leads with an image of a Nahua woman speaking. Just as with Autism, the image is not strictly needed, but having an illustration helps readers (particularly non-experts) orient themselves to the subject of the article. I think Autism could use more images, not fewer. I'd be reluctant to remove this image, which is one of the best in the article. Eubulides (talk) 19:31, 18 May 2008 (UTC)

Absolutely, if we had a free available image of a ticcing behavior, we would be using it in Tourette syndrome, but we don't have such an image. In this case, there is no reason to delete an image with correct licensing that helps our readers visualize the behavior. I see no reason to remove it. SandyGeorgia (Talk) 19:56, 18 May 2008 (UTC)

I looked at the Nahuatl image and, to be honest, I don't get the point of that picture either! It's all about FIRST IMPRESSIONS though, when it comes to an image that is right at the top of the page when it's opened. And, to be honest, I had very little knowledge of Nahuatl when I went to that page, and if I had only glanced at the page, I would have guessed that it was an ancient, probably extinct language because of the archaic-looking image of the woman at the top.

In the same vein - this article is headed as "autism" along with a picture of a child, right when the page loads. The non-expert could glance and immediately gain the impression that autism is all about children. It's not. And I will also point out that there is no specific citation for the statement in the first paragraph "all starting before a child is three years old." There is an inline cite that leads to the WHO classification and diagnostic criteria page - for CHILDHOOD autism. [7]

The statement made is totally incorrect when applied to the generic diagnosis of AUTISM. On the same ICD page, the childhood autism criteria is followed by ATYPICAL AUTISM, which doesn't require a specific age of onset.

It does everyone a disservice when an article goes strictly "generic." And this article is WAYYY too long and has information that would be better suited for the page on autism spectrum disorders.

However, I'm not touching a thing - just arguing my point - and now I'm done. I've come to the conclusion that the entire article is a mess, and I won't be held liable for trying to make any further changes. Dmodlin71 (talk) 07:05, 28 May 2008 (UTC)

Maybe images are not your cup of tea—no image is perfect, after all, and they have have problems of one sort or another—but for many users an image helps greatly to orient them towards the subject.
As Autism#Classification mentions, there is a bewildering number of terms that mean the same thing. What this article calls autism other sources call autism, autistic disorder, childhood autism, or infantile autism (and there are other names too, like classic autism or Kanner autism). The diagnosis for this condition (under whatever name one uses: as you mention the WHO ICD-10 says childhood autism, but DSM-IV says autistic disorder) requires onset prior to 3 years.

Eubulides (talk) 09:17, 28 May 2008 (UTC)

Daniels et al. 2008

This change was reverted with the comment "If warranted, this would be covered in the Causes of autism article". The study in question (Daniels et al. 2008, PMID 18450879) is about epidemiology, not causes, so I think a better choice for it is Epidemiology of autism. It's just a primary study but it is a major one so (until we get reviews for it) I think it's worth mentioning there. I made this change to Epidemiology of autism to do that. Eubulides (talk) 20:18, 5 May 2008 (UTC)

Anatomy of a meltdown

"Anatomy of a Meltdown" article, written by a 29-year-old with aspergers. He clearly describes what is behind typical tantrum-like behaviors-- the causes, how to deal with them and how to avoid them. http://www.annarosejewelry.com/index.php?main_page=page&id=8&chapter=0 Wikinvisages (talk) 11:36, 9 May 2008 (UTC)

Sales site and blog-ish, which means it's not really appropriate per WP:ELNO, and not a medically reliable source. Not a good choice as an external link. Perhaps suggest it over at the DMOZ. WLU (talk) 13:13, 9 May 2008 (UTC)

Is Autism a Brain Development Disorder or a Neurological Disorder?

Dear SandyGeorgia,
On the autism article it states that it's a brain development disorder. I thought it was a neurological disorder. Wouldn't it be better to say that, it's a neurological disorder where the cells in your brain is mixed up. Unless did a peer view scientific article state that it's a brain development disorder. And I don't see the difference between neurodevelopmental disorder or neurology (neurological disorder). AnnieTigerChucky (talk) 22:06, 12 May 2008 (UTC)

Annie, Eubulides has done most of the writing there, and he is scrupulous about sticking to sources; maybe you could raise the question at Talk:Autism ? SandyGeorgia (Talk) 22:08, 12 May 2008 (UTC)

I suspect the reason is that the article follows the classification used by the World Health Organization, see 2008 ICD-9-CM Diagnosis 299.0 and ICD-10. Tim Vickers (talk) 22:15, 12 May 2008 (UTC)

A brain development disorder is one kind of neurological disorder; there are other kinds of neurological disorders. In a brain development disorder the problem occurs with the ways that neurons develop in the brain. In the more general case of neurological disorders, there is some problem with neurons, but the problem doesn't have to be in the brain (it could be neurons outside the brain), and the problem doesn't have to be in the ways that neurons develop (it can occur after neural development). The autism lead uses the more-specific term, since that conveys more information. Eubulides (talk) 23:12, 12 May 2008 (UTC)

Dear Eubuildes,

since you seem to be a genius in this field.
Although, Autism is a brain disorder, overtime through intense Early Intervention you can cure, but not medically.
I've been trying to prove this point for a while, but it seems not to go anywhere.
Can you help me understand more clearly about why I am not allowed to add that, since it has been handled in other articles.

Such as, Son-Rise with Raun Kaufman. I know I am only pointing out one person, but their has been other success stories, as well for children and adults.

Thanx for listing! AnnieTigerChucky (talk) 01:10, 13 May 2008 (UTC)

Autism #Prognosis says "Children recover occasionally, sometimes after intensive treatment and sometimes not; it is not known how often this happens." (citing Rogers & Vismara 2008, PMID 18444052). Does this serve to make the point? That is, sometimes children become less autistic, and sometimes more (that point is made elsewhere; search for "regressive autism" in the article); we don't know why. There's no good evidence that any treatment is a cure, which is why both Prognosis and the lead say "There is no cure." Eubulides (talk) 04:13, 13 May 2008 (UTC)

Junk Science?

If medicine had diagnosed autism as often in my younger years as it does now, I might have been (mis)diagnosed as autistic. It seems to have taken on an umbrella of diagnoses in an attempt to "classify" behaviors not fully understood by science. That isn't to say it's all a bunch of hooey, but it certainly seems to apply in more situations now than in the past, which leads me to believe being overdiagnosed by the medical community in an attempt to coax parents into believeing there is something wrong with their children and keep purchasing medicine and treatments for them. It is hard to believe it isn't being milked for all of its worth by the medical field. This article would benefit from a counterpoint like this, and there certainly is enough out there to warrant an edit as such.76.214.215.11 (talk) 02:26, 19 May 2008 (UTC)

Autism #Diagnosis already makes a similar point, albeit in less incendiary terms. It says:

"Underdiagnosis and overdiagnosis are problems in marginal cases, and much of the recent increase in the number of reported ASD cases is likely due to changes in diagnostic practices. The increasing popularity of drug treatment options and the expansion of benefits has given providers incentives to diagnose ASD, resulting in some overdiagnosis of children with uncertain symptoms. Conversely, the cost of screening and diagnosis and the challenge of obtaining payment can inhibit or delay diagnosis." (citting Shattuck & Grosse 2007, PMID 17563895)

I don't know of any reliable source that goes so far as to claim that autism is "junk science" or "being milked for all of its worth by the medical field", but if you know of a reliable source please let us know. Best would be refereed journal articles as per WP:MEDRS. Eubulides (talk) 02:34, 19 May 2008 (UTC)

I'm not sure if he was using incendiary terms. Junk science sounds about right. 24.216.189.240 (talk) 22:05, 28 May 2008 (UTC)

"Junk science" doesn't sound plausible to me, but I've been wrong before. Reliable sources, please? Eubulides (talk) 23:11, 28 May 2008 (UTC)

Neurotypical

Could we avoid the use of this neologism. As far as I can tell it's only used within the autistic community. Wikipedia isn't a soapbox, nor is it an autism support group. If you want to mount a campaign to change the English language to placate yourselves, do it somewhere else. 24.216.189.240 (talk) 22:16, 28 May 2008 (UTC)

Neurotypical is a new word, but it's in fairly common use in the scholarly literature. See, for example, Tommerdahl et al. 2008 (PMID 18435849), Cashin 2008 (PMID 18269411), Shafritz et al. 2008 (PMID 17916328), and Stieglitz et al. 2008 (PMID 17665296). I don't see why this article should depart from established terminology, even if the establishment was recent. Eubulides (talk) 23:08, 28 May 2008 (UTC)

Removed from causes, sodium valproate

Removed from Causes section, I'm unsure of one source, ce needed, and this may belong better in Causes of autism:

Some medications taken during pregnancy are known to increase the risk of autism and AS disorders, including the common anti-convulsant drug sodium valproate (Epilim). A 2005 study found rates of autism among children exposed to sodium valproate before birth in the cohort studied were 8.9%.^[7] The normal incidence for autism in the general population is estimated at less than one percent.^[8] SandyGeorgia (Talk) 03:14, 11 June 2008 (UTC)

Further discussion here. SandyGeorgia (Talk) 03:17, 11 June 2008 (UTC)

You beat me to it SandyGeorgia, as usual.... Dbrodbeck (talk) 03:19, 11 June 2008 (UTC)

That is a reasonable primary study, but its results are already briefly discussed in Autism #Causes (in "All known teratogens (agents that cause birth defects) related to the risk of autism appear to act during the first eight weeks from conception….") and in more detail in Causes of autism #Teratogens (in "Teratogens are environmental agents that cause birth defects. Some agents that are known to cause other birth defects have also been found to be related to autism risk. These include exposure of the embryo to thalidomide, valproic acid, or misoprostol, or to rubella infection in the mother. These cases are rare; congenital rubella syndrome is the most convincing.") These quotes are sourced by reliable reviews which (as per WP:MEDRS) should be preferred to citing the primary study directly. Eubulides (talk) 04:34, 11 June 2008 (UTC)

Five point scale

Someone knowledgeable should try and save the following one-line stub Five point scale. I don't know much about the subject but clearly the article as is is deletion-bound. Pichpich (talk) 19:49, 4 July 2008 (UTC)

If it's about the scale by which people evaluate how strongly something applies to them as used in questionnaires, surveys and tests, then I don't see how this is specifically ASD related. A discussion of it in an article about psychological test could be usefull. Fenke (talk) 09:15, 6 July 2008 (UTC)

ADHD, Tourette's, etc.

I recently made this change to attempt to summarize the following text from Steyaert & De La Marche 2008 (PMID 18597114):

"The DSM-IV considers autism as a pre-emptive diagnosis and rules out the concurrent diagnosis of many co-morbid conditions, i.e. attention deficit and hyperactivity disorder (ADHD). Nevertheless, the full criteria for ADHD (approximately 25%), Tourette’s syndrome (approximately 10%) and other conditions are often present and may lead to considerable additional behavioural impairment. It is now increasingly accepted to make these comorbid diagnoses. A broader knowledge of child psychiatric conditions is necessary for a good appreciation of co-morbidity. Structured interviews like the 3di or the DISC-IV are additional tools to assess co-morbid psychiatric disorders."

My summarizing text is a bit inartful, as it contains jargon like "preempted diagnoses" and weird wording like "other of these conditions". Further suggestions on improving the wording are welcome. Eubulides (talk) 08:01, 7 July 2008 (UTC)

ah, now that you've provided the quote, I see the wording problem. One question, before we work on the wording: the TS literature regularly refers to autism as a secondary cause of tics; that is, tics can be part of autism, so how do we avoid a conflict here? If the autism folks are saying to go ahead and make the diagnosis, but the TS folks are saying tics are sometimes attributable to the autism, not a separate TS diagnosis, how do we sort that within the article? SandyGeorgia (Talk) 15:49, 7 July 2008 (UTC)

By "a conflict" do you mean the conflict between a diagnosis of ASD and a diagnosis of TS, or the conflict between what the Autism article says and what the Tourette syndrome article says? When someone presents with both the symptoms of ASD and the symptoms of TS, ASD "wins" and the person is diagnosed with ASD and not with TS. So what you're saying about tics being a part of autism, or autism being a secondary cause of tics, makes sense: if you have both sets of symptoms then you are diagnosed with ASD and you also have tics (I might quibble with the "cause" bit, but those are deeper waters). Tourette syndrome #Diagnosis already says "Hence, other medical conditions that include tics or tic-like movements—such as autism or other causes of tourettism—must be ruled out before conferring a Tourette's diagnosis." so it has this base covered.
Hmm, by "conflict" were you thinking that Autism#Characteristics or Autism#Diagnosis should be addressing this issue? They are correct now, in the sense that if you have those symptoms, you have autism, regardless of whether you also have the symptoms of TS. But perhaps it would help to mention preempted diagnoses here?

Eubulides (talk) 16:06, 7 July 2008 (UTC)

Yes, I'm talking generally about resolving it across articles, and making sure we don't have contradictions. My confusion is that I agree with/follow what you typed above, but the journal article seems to be saying something different, unless I'm misunderstanding or misreading. The journal article seems to be saying more to me: that both diagnoses exist equally and together (think in terms of both inherited, if we had the gene(s) identified and could conclusively prove it), rather than tics being part of autism. Am I misunderstanding? SandyGeorgia (Talk) 16:13, 7 July 2008 (UTC)

Yes, as I understand it the journal article is saying that "increasingly" clinicians are overriding the DSM-IV and diagnosing both conditions simultaneously. Hmm, I guess it is not saying how common that is. It is a tricky situation, no? Eubulides (talk) 16:57, 7 July 2008 (UTC)

Yes, now we're on the same page, but I'm not sure how to "fix it". I'll follow you :-) SandyGeorgia (Talk) 17:02, 7 July 2008 (UTC)

Tantrums

This change added the following comment to the article:

"{fact-check}"

Questions like these are best resolved on the talk page, so I'll move the question here. Autism #Social development currently says "tantrums significantly more common than in children with a history of language impairment". Here are some more details. The cited study (Dominick et al. 2007, PMID 16581226) found that 71% of the children with ASD had tantrums, compared to 23% of the children with language impairment; this has a significance of <0.001. The study's discussion section says "The prevalence of temper tantrums was significantly greater in the ASD group." The study's discussion section also says, "Tantrums occurred in 40% of the ASD children by 2 years of age, as is found among typically developing children. However, tantrums persisted much longer in children with ASD and onset of the behavior continued until age 11 in this sample."

The introduction says, by the way, "No studies have addressed the root of temper tantrums in autism, but clinical experience suggests that children are more likely to have temper tantrums when a change in their routine occurs or when they are denied a desired object or activity." I omitted this part as it's not scientifically supported. Eubulides (talk) 03:29, 9 July 2008 (UTC)

Pointing, commenting, and sharing

The same change replaced:

'they consistently fail to point to "comment" about or "share" an experience at age-appropriate times.'

with:

'they consistently fail to comment about or share a joint experience at age-appropriate times.'

But the cited source (Johnson et al. 2007, PMID 17967920) says:

'At 14 to 16 months of age, the typically developing child will begin to point simply to "comment" about or "share" an interesting object/event (which is called "protodeclarative pointing"). As he points, he will look alternatively between the object/event of interest and the parent. It is the shared social experience, not the tangible object/event, that the child seeks. Children with ASDs consistently fail to point to "comment" at age-appropriate times, and when they do, they are less likely to show positive affect and connectedness during the act.'

As can be seen from the source, the key notion here is that children with ASDs consistently fail to point, not that they fail to comment. I'll think about a better way to word that and make it clearer, but the wording change that was made isn't right. Eubulides (talk) 03:42, 9 July 2008 (UTC)

I changed "point" to "initiate a pointing gesture" to try to make the (ahem) point more clearly. But I dunno, is it really any clearer? I thought the word "point" was quite clear, in the context; and it's shorter. Other opinions? Eubulides (talk) 05:10, 9 July 2008 (UTC)

How about "they consistently fail to point at objects in order to comment on or share an experience". The word "joint" is redundant in "share a joint" and the phrase is too likely to be misread as drug taking! I think "at age-apropriate times" is confusing and probably not needed here. It is the general behaviour that is or isn't age appropriate, not each an every time they should have pointed. Rephrasing this would probably make the sentence even longer, and I think the reader will assume we are talking about pointing when pointing is expected for the age of the child. Colin°^Talk 11:01, 9 July 2008 (UTC)

Thanks! Done. Eubulides (talk) 16:04, 9 July 2008 (UTC)

Diagnosis of adults

The last paragraph under Diagnosis states, "Adults may seek retrospective diagnoses..." At first I was reading this phrase to mean that adults who currently have a few autistic traits were trying to determine whether they had autism in their past. However the reference describes adults seeking a current diagnosis of autism. So I'm not clear why the word retrospective is included. Also the section as currently written appropriately focuses on diagnosis of children. Nevertheless can a brief description of how adults are diagnosed be included, as there appears to be interest in this topic? NighthawkJ (talk) 04:52, 13 July 2008 (UTC)

Good catch. The source doesn't say "retrospective" or anything like that, so Autism #Diagnosis shouldn't say "retrospective" either. Since the definition of autism proper requires onset before age 3 years, some retrospection will be required, but we can't go beyond what the source says. I removed "retrospective". Unfortunately I don't know of any reliable source on the technical aspects of adult diagnosis, but if something turns up it would be appropriate to add a brief mention here. Eubulides (talk) 05:27, 13 July 2008 (UTC)

Death to bad wording!

I'm actually talking about my own. This edit was my attempt to indicate that the bones of kids on caesin-free diets are thinner compared to peers; previously there was no comparison (i.e. just said 'thinner', but made me think 'thinner than what'?). I couldn't think of a better way to phrase it, but invite the illustrious contributors to this page to smite my poor wording at their leisure. Also a bit of person-first terminology. WLU (talk) 15:03, 14 July 2008 (UTC)

Thanks; I made this change to try to phrase it more concisely. As Sociological and cultural aspects of autism #Terminology suggests, the use of person-first terminology is somewhat controversial; since we can't make everybody happy in Autism I've tended to use whichever terminology is clearer and more concise. Eubulides (talk) 17:31, 14 July 2008 (UTC)

Michael Savage

This change counts as original research, I'm afraid, and doesn't belong in Wikipedia. The change starts with Savage's purposely-over-the-top remarks and then goes on to claim that some interpret autism as an unchecked behavior problem. That claim is no doubt true (just as it's no doubt true that some interpret autism as being caused by witchcraft), but Savage is not a reliable source for it. Also, the claim is not particularly notable (just as the witchcraft claim wouldn't be notable) for this section. Eubulides (talk) 18:02, 18 July 2008 (UTC)

Hi, I made the edit you are referring to. The edit does not endorse the bigotry of Mr. Savage, but illuminates the (albeit shockingly ignorant) nature of some popular misconceptions about autism. I emphasized that Mr. Savage is a political commentator outside of the scientific community. I placed the claim in the history section specifically so that nobody would conflate Mr. Savage's opinion with a valid scientific outlook. I placed the claim towards the end of the article so as to not give it undue weight. Because the claims added to the article refer not to the true nature of autism but to its popular conception, those claims are verified by the links given and thus do not constitute original research. Thanks! Greg Comlish (talk) 18:21, 18 July 2008 (UTC)

The citation to Savage's remarks support only a claim about what Savage said. They do not support a claim that there is a significant set of people who think that autism is "an unchecked behavior problem". Wikipedia is not supposed to rely on guesswork by uninformed commentators. I suggest that this sort of inflammatory material be moved to Controversies in autism, where it is far more appropriate; but even there, the wording must be done more carefully than it was done in this change, as it is original research to claim that Savage's comments represent anything other than an attempt to gain attention. Eubulides (talk) 18:35, 18 July 2008 (UTC)

The citation supports the claims regarding what Michael Savage said, but also what Michael Savage believes and what his national audience sympathizes with. Savage's claims are emblematic of the worst popular ignorance towards autistics. I agree that Savage's remarks are inflammatory. The controversy these remarks are creating in the autistic community only makes them more topical. I agree that these remarks shouldn't be legitimized but people need to know about the biases against autistics. Greg Comlish (talk) 19:30, 18 July 2008 (UTC)

This article is primarily about the disease, its manifestations, its pathology and its treatment. It is appropriate to summarise briefly how autistic people function within society and some of the controversy surrounding this disease, but quoting an uninformed and frankly bigoted "shock jock" is giving undue weight to a view that is absent from reliable sources on this topic. Tim Vickers (talk) 19:00, 18 July 2008 (UTC)

Again, I want to emphasize that Savage's bigotry is not legitimized in the quotes included in the article nor are Savage's words presented as an authoritative, or even valid viewpoint. I agree that Savage's views should never be presented as a scientific description of Autism. Savage's remarks were only used in the context of presenting a popular misconception about Autism. Greg Comlish (talk) 19:30, 18 July 2008 (UTC)

I understand your point, and I don't think that you agree with this buffoon! However, the problem is that the source does not establish that this is a popular misconception. We would need a survey on "Popular misconceptions of autism" to tell us how common such views actually are in the general public. Mr Savage can only speak for himself, his views are his own and are neither notable nor interesting. Tim Vickers (talk) 19:35, 18 July 2008 (UTC)

I think we can deduce from Savage's status as a nationally broadcast commentator that he has a significant audience that is sympathetic with his viewpoints. Greg Comlish (talk) 19:38, 18 July 2008 (UTC)

(bing!)That would be WP:OR for me and Savage may have a large audience but that doesn't mean his opinion counts in the significant circles that debate autism. Michael Savage (commentator) isn't a scientist, activist or otherwise notable figure in autism research or advocacy, right now he's a flash in the pan. His opinion is essentially irrelevant, and it's arguable if it fits in any page on autism (as yet). Definitely not this page. Unless this turns into a sustained interest in autism and the scientific and advocacy community reacts over a longer period, he starts some sort of anti-advocacy in the political arenas or some other sustained contribution, I do not see it as an appropriate mention. WLU (talk) 19:40, 18 July 2008 (UTC)

Indeed, that deduction is the original research. We can only guess what percentage of his comments are the same as the views of his audience. This might reflect their views, but it might not. We'd need a source that explicitly says this is a widely-held opinion to say this as a fact. This might seem obvious to you (and I also agree with you that such ideas are distressingly frequent) but I'm sure that you appreciate that in such a controversial subject we must be very careful indeed when interpreting sources. Tim Vickers (talk) 19:44, 18 July 2008 (UTC)

Ok, minor edits to the language can correct this. Greg Comlish (talk) 19:53, 18 July 2008 (UTC)

The minor edits to the language did not correct this, and I don't see how they can correct it. The revised text still had the claim "Archaic attitudes towards autistics have not disappeared", which is clearly original research: Savage said nothing of the sort, and cannot be used to support this claim. I have moved the material (sans the "Archaic attitudes" bit) to Michael Savage (commentator) #Autism, which is clearly a more appropriate place for this topic. There are plenty of more-notable sources to talk about archaic attitudes, starting with Bruno Bettelheim; Michael Savage is nowhere near a reliable source in this area. Eubulides (talk) 21:52, 18 July 2008 (UTC)

Savage didn't say "Archaic attitudes towards autistics have not disappeared". That statement was a paraphrase of the Autism Society of America, which I also cited, responding to Michael Savage. Greg Comlish (talk) 23:05, 18 July 2008 (UTC)

The claim "Archaic attitudes towards autistics have not disappeared" is followed by a citation to Savage, not by a citation to the Autism Society of America (ASA).

Please see the citation for the ASA Greg Comlish (talk) 22:10, 19 July 2008 (UTC)

First, this is a minor point, but one shouldn't have to refer to the talk page to see what citation supports what material. A citation should appear immediately after the material it supports; it shouldn't be separated from that material by a different citation.
Second, more important, the ASA did not say that Savage's remarks mean that archaic attitudes still persist. It is well known that Savage deliberately makes provocative remarks, and does not necessarily believe his remarks. The ASA's press release says only that Savage's remarks were unsubstantiated and reflect old misconceptions; this is true regardless of whether Savage or anyone else believes his remarks. Eubulides (talk) 00:20, 20 July 2008 (UTC)

Savage is not a reliable source for autism, and should not be cited here.

Savage is not being cited as a source for autism, he is only being used as an example of how lingering biases against austistics persist.Greg Comlish (talk) 22:10, 19 July 2008 (UTC)

Savage is being cited as a source about attitudes about autism. But he is not a reliable source for attitudes about autism. He has no expertise in the field of attitudes about autism, and does not even claim any expertise. It is completely out of place here to cite him. Eubulides (talk) 00:20, 20 July 2008 (UTC)

The ASA source does not say anything about "attitudes", or "archaic", or "disappearing", so it is not a good source for the abovementioned claim.

The ASA specifically says that Savage remarks "reflect the misconceptions of over 50 years ago" and that the ASA "will continue to work with families, people with autism and the broader public to raise awareness of autism spectrum". This fully justifies the claim that archaic attitudes towards austistics persist. Greg Comlish (talk) 22:10, 19 July 2008 (UTC)

It does not at all justify the claim that a significant problem of archaic attitudes persist. At best it would justify the claim that Savage has an archaic attitude. Even that is dubious, as Savage is a provocateur: his livelihood depends on his making outrageous claims, and it is not at all clear that he actually believes what he said about autism. It is original research to leap from Savage's remarks to the conclusion that archaic attitudes persist. Eubulides (talk) 00:20, 20 July 2008 (UTC)

The only thing that the ASA does say about misconceptions of 50 years ago (namely, "refrigerator mothers") is already covered, much better, in Autism #History.

No, they specifically cite Savage's remarks. Greg Comlish (talk) 22:10, 19 July 2008 (UTC)

But, as mentioned above, Savage's remarks in themselves are not a reliable source about anything. It doesn't matter whether the remarks are quoted by Salon.com or by the ASA. What the ASA does say about old misconceptions is already covered, much better, in Autism #History.

Autism #History already cites a much better source on "refrigerator mothers", namely Fombonne 2003.

I am adding to this material by giving a modern example and thereby making it more complete and topical. Greg Comlish (talk) 22:10, 19 July 2008 (UTC)

Adding text does not necessarily add useful material. In this case, the added text is about a "controversy" that is very poorly sourced. If you want something topical, I suggest citing a more reliable source, such as Obama's recent remarks on autism, or McCain's recent remarks on autism. These politicians far more reliable than Savage, whose credibility is zero in all aspects of autism and attitudes about autism. Eubulides (talk) 00:20, 20 July 2008 (UTC)

To summarize, this change cites one completely unreliable source (Savage), and one weak source (the ASA's brief press release) on a topic (refrigerator mothers) for which we already have a much stronger citation (a peer-reviewed medical journal article).

Again, the sources cited are suitable to the claims presented which are relevant to the subject matter you already acknowledge is described in the very same section. This is entirely consistent with the established principle that "Sources should directly support the information as it is presented in an article and should be appropriate to the claims made"Greg Comlish (talk) 22:10, 19 July 2008 (UTC)

There is no need to emphasize the discredited theory of refrigerator mothers here. That topic is already given one sentence and a wikilink, which is more than enough for this section. It is total overkill to devote an entire extra paragraph to a discredited theory. It would make more sense to briefly talk about it in Refrigerator mother, but even there I'd be quite dubious: I don't think the ASA is a reliable source about Savage's attitudes toward autism. Eubulides (talk) 00:20, 20 July 2008 (UTC)

I have moved the relevant material from Autism #History to Michael Savage #Autism, which is a much more appropriate location for it.

I have restored this material citing my arguments here. Greg Comlish (talk) 22:10, 19 July 2008 (UTC)

I suggest discussing further changes of this sort on the talk page first. Autism is a controversial subject already, even without Savage's comments, and it's helpful to discuss controversial changes to Autism before installing them.

I have been active on the talk page in discussing my views and responding to arguments of others. Greg Comlish (talk) 22:10, 19 July 2008 (UTC)

The first we heard of this proposed change was when it was installed, without discussion, into the article here. So far we've had four editors weigh in on this subject, either on the talk page or by reverting your changes. One (you) has favored the change; three have opposed it (TimVickers, WLU, and myself). The consensus so far seems quite clear that the change represents original research, which is not allowed in Wikipedia. Also, as I've argued, this change represents a WP:WEIGHT issue by placing too much emphasis on an obsolete and discredited theory. Please do not simply reinstate this change, which obviously does not have consensus. Eubulides (talk) 00:20, 20 July 2008 (UTC)

Eubulides (talk) 00:35, 19 July 2008 (UTC)

I've cut this addition to the bare minimum that I regard as acceptable. Tim Vickers (talk) 00:37, 20 July 2008 (UTC)

Following up in the new subsection #Stigma below. Eubulides (talk) 01:19, 20 July 2008 (UTC)

Stigma

The combined effect of the abovementioned changes still has real problems.

It's weak and confusing to cite Gray 1993 to support the claim that autism remains a stigmatized condition, after citing Wolff 2004 saying it's been destigmatized. After all, autism is less stigmatized now than it was 15 years ago. Of course there remains some stigma (one example being a tantrum in a restaurant observed by third parties who don't know that the child's autistic) but it's less than it was decades ago, and we shouldn't imply otherwise.
The claim "some media commentators retain much more negative attitudes towards autism" is not supported by the citation to the ASA. The ASA (wisely) did not say anything about Savage's attitude. Also, to be pedantic, the ASA's press release mentioned only one media commentator.

I will try to come up with a more recent and reliable sources about stigmas and attitudes, and use them to improve this part of Autism #History. Eubulides (talk) 01:19, 20 July 2008 (UTC)

I picked the Grey paper since it was cited as a source in this 2003 review. What about this paper instead? It gives a bit more of a balanced viewpoint. Tim Vickers (talk) 01:43, 20 July 2008 (UTC)

Thanks for tracking those down. Sorry, the "2003 review" link doesn't work for me; I get a page saying "Internal Server Error". Do you have a PMID or DOI for it? Chambres et al. 2008 (PMID 18297387) is a single experiment on 88 adults published in a high-quality peer-reviewed journal; obviously this is a much better source than the ASA press release or the dated 1993 source. A recent review would be even better but I didn't find one. How about it if we remove the recent addition and then replace the following text:

"The rise of parent organizations and the destigmatization of childhood ASD have deeply affected how we view ASD, its boundaries, and its treatments.(Wolff 2004, PMID 15365889)"

with this:

"Although the rise of parent organizations and the destigmatization of childhood ASD have deeply affected how we view ASD,(Wolff 2004, PMID 15365889) parents continue to feel social stigma in situations where their autistic children's behaviors are perceived negatively by others,(Chambres et al. 2008, PMID 18297387) and many primary care physicians and medical specialists still ~~exhibit belief patterns~~ express some beliefs consistent with outdated autism research.(Heidgerken et al. 2005, PMID 16119473)"

Eubulides (talk) 03:22, 20 July 2008 (UTC)

I'd go for "...many primary care physicians and medical specialists express beliefs inconsistent with the findings of modern autism research." Otherwise great. Tim Vickers (talk) 03:30, 20 July 2008 (UTC)

I like the "express beliefs", but changing it to "inconsistent with the findings of modern autism research" strays too far from the cited source, which says "While all three groups reflected accurate changes in the DSM-IV diagnostic criteria necessary for autism, results of the study indicated that when compared to experts in the field of autism, specialists and primary providers continue to exhibit some belief patterns consistent with outdated research." I see now that the source says "some", so I changed "exhibit belief patterns" to "express some beliefs" in the draft proposal above. Eubulides (talk) 05:57, 20 July 2008 (UTC)

OK, looks fine to me. Tim Vickers (talk) 21:28, 21 July 2008 (UTC)

Article seems to be biased...

The article seems to be written in such a way so that autism is portrayed as a defect, but apparently, people with autism, such as Amanda Baggs, say that they just think in a different way. Also, it doesn't list strengths such as perfect pitch, advanced visualization skills, ect. Also, in the prognosis section, it says that they are mentally retarded, which seems to be controversial according to this article at http://www.wired.com/medtech/health/magazine/16-03/ff_autism. Giving a regular IQ test to an autistic person is like giving a vision-dependent test to a blind person. —Preceding unsigned comment added by Superyuval10 (talk • contribs) 20:20, 25 July 2008 (UTC)

The article already makes two of the points you mention.

The lead says "an autistic culture has developed, with some seeking a cure and others believing that autism is a condition rather than a disorder."
Other symptoms says "A small fraction of individuals with ASD show unusual abilities, ranging from splinter skills such as the memorization of trivia to the extraordinarily rare talents of prodigious autistic savants."

Prognosis does not say autistic individuals are mentally retarded. It doesn't mention mental retardation at all.
Perhaps you meant the Epidemiology section? It mentions mental retardation, but it does not say that autistic individuals are mentally retarded; it says that there is an association between the two conditions, which is quite a different thing. If the wording is confusing, perhaps you can suggest clearer wording?

Eubulides (talk) 21:56, 25 July 2008 (UTC)

Thanks for the feedback. What I don't like is that the lead asserts that Autism is a disorder in the very first sentence, but then it talks about how some people believe that it's a condition. I take it that the article is saying that there is only one right viewpoint of Autism, and the people who think it's a condition don't know what they are talking about.

About the strengths, they don't just occur in a very small portion of the autistic pop. According to http://www.wired.com/medtech/health/magazine/16-03/ff_autism?currentPage=2:

"On the matter of autistic intelligence, Kanner spoke of an array of mental skills, "islets of ability" — vocabulary, memory, and problem-solving that "bespeak good intelligence." Asperger, too, was struck by "a particular originality of thought and experience." Yet over the years, those islets attracted scientific interest only when they were amazing — savant-level capabilities in areas such as music, mathematics, and drawing. For the millions of people with autism who weren't savants, the general view was that their condition was tragic, their brainpower lacking."

It seems that no-one really cares unless the capabilities are savant-like.

Yes, I did mean epidemiology. But however, like I said, giving a regular IQ test to an autistic person is like giving a vision-dependent test to a blind person. In fact, IQ tests were created by Alfred Binet to measure educational achievement, not intelligence. He didn't come up with the term "IQ" either. If you are wondering if an alternative IQ test would work, then yes (taken from the bottom of p.4 of the http://www.wired.com/medtech/health/magazine/16-03/ff_autism?currentPage=4):

"Last summer, the peer-reviewed journal Psychological Science published a study titled "The Level and Nature of Autistic Intelligence." The lead author was Michelle Dawson. The paper argues that autistic smarts have been underestimated because the tools for assessing intelligence depend on techniques ill-suited to autistics. The researchers administered two different intelligence tests to 51 children and adults diagnosed with autism and to 43 non-autistic children and adults.

The first test, known as the Wechsler Intelligence Scale, has helped solidify the notion of peaks of ability amid otherwise pervasive mental retardation among autistics. The other test is Raven's Progressive Matrices, which requires neither a race against the clock nor a proctor breathing down your neck. The Raven is considered as reliable as the Wechsler, but the Wechsler is far more commonly used. Perhaps that's because it requires less effort for the average test taker. Raven measures abstract reasoning — "effortful" operations like spotting patterns or solving geometric puzzles. In contrast, much of the Wechsler assesses crystallized skills like acquired vocabulary, making correct change, or knowing that milk goes in the fridge and cereal in the cupboard — learned information that most people intuit or recall almost automatically.

What the researchers found was that while non-autistic subjects scored just about the same — a little above average — on both tests, the autistic group scored much better on the Raven. Two individuals' scores swung from the mentally retarded range to the 94th percentile. More significantly, the subset of autistic children in the study scored roughly 30 percentile points higher on the Raven than they did on the more language-dependent Wechsler, pulling all but a couple of them out of the range for mental retardation.

A number of scientists shrugged off the results — of course autistics would do better on nonverbal tests. But Dawson and her coauthors saw something more. The "peaks of ability" on the Wechsler correlated strongly with the average scores on the Raven. The finding suggests the Wechsler scores give only a glimpse of the autistics' intelligence, whereas the Raven — the gold standard of fluid intelligence testing — reveals the true, or at least truer, level of general intelligence."

I'm quite surprised I don't see a mention of this study anywhere in the article. —Preceding unsigned comment added by Superyuval10 (talk • contribs) 22:45, 25 July 2008 (UTC)

"Disorder" is the standard term used in medicine (e.g., see F84.0) and Wikipedia is supposed to emphasize the mainstream view. Autism can and does mention that there's a minority opinion it's a condition and not a disorder, but according to WP:DUE it needs to put the most weight on the mainstream view.
If you follow the citation on savant skills, you'll see that estimates of their prevalence range from 0.5% to 10%. I don't think 10% is a "very small portion", nor does the article say that the portion is "very small", so I'm not sure what bias is being shown here.
Your points about Dawson et al. 2007 (PMID 17680932) are well taken. Currently that paper is discussed in a subarticle of this one; see Conditions comorbid to autism spectrum disorders #Mental retardation. However, I agree that a brief mention of the topic would be appropriate here.
I have just done some research on the subject and now find that a review on the topic was published on it earlier this year; here (PDF) is a preprint. Please give me a day or two to read and digest it. As WP:MEDRS suggests, we should prefer citing reliable reviews to citing the primary sources directly, when reviews are available. This review slipped my notice because it wasn't in Pubmed. I expect that the results of reading this review will change Autism, Epidemiology of autism, and Conditions comorbid to autism spectrum disorders in this topic. Thanks for bringing this topic up.

Eubulides (talk) 00:04, 26 July 2008 (UTC)

OK, to follow up, I read that preprint and made this change to Autism. Thanks again. Eubulides (talk) 06:55, 26 July 2008 (UTC)

No problemo! But I have a couple more criticisms:

Why does the sentence "A small fraction of individuals with ASD show unusual abilities, ranging from splinter skills such as the memorization of trivia to the extraordinarily rare talents of prodigious autistic savants." say that these abilities only occur in a small fraction when the percentage is from 0.5% to 10%? I don't think that 10% is a small fraction. I would like it if the phrase "A small fraction" were to be replaced w/ "0.5% to 10%". Would it also be appropriate to list the autistic savant studies w/ their associated percentages?

In the passage "On the matter of autistic intelligence, Kanner spoke of an array of mental skills, "islets of ability" — vocabulary, memory, and problem-solving that "bespeak good intelligence." Asperger, too, was struck by "a particular originality of thought and experience." Yet over the years, those islets attracted scientific interest only when they were amazing — savant-level capabilities in areas such as music, mathematics, and drawing. For the millions of people with autism who weren't savants, the general view was that their condition was tragic, their brainpower lacking." the context implies that the majority of autistics have these "islets of ability", but only some have savant capabilities. I mean, 0.5% to 10% isn't the majority, and could be considered some, right?

Also, in the book Autism: Explaining the Enigma By Uta Frith, on pp. 6-8, under the section "How Kanner and Asperger described Autism", it says that Kanner and Asperger saw "islets of ability" and a "particular originality of thought and experience" in all children on the ASD. If you don't want to buy the book, then go to http://books.google.com/books?id=1sIxN1qNNDMC&printsec=frontcover&dq=autism+explaining+the+enigma&sig=ACfU3U0JNLaX5gszv_JnhMRCaFESNafrYw#PPA6,M1, where pp. 6-8 can be viewed for free.

Thanks for reading my criticisms. superyuval10 (talk) 22:11, 26 July 2008 (UTC)

It doesn't cost much to give the 0.5% to 10% estimate, so I did that.
Groundbreaking though Asperger's and Kanner's work was, we can't really rely on it for a discussion of what is known about autism today; we need recent reliable sources.

Eubulides (talk) 02:45, 27 July 2008 (UTC)

Heard the............

...... bullshit about what Mike said about Autism. Added his website and the section in said site about his comments. My local radio station still airs his show, as do several others (I have a radio that has GREAT AM reception). He insinuated that "Big Pharma" cooked up this disease to drug and poison the kids, worse commentary. Click on the links provided in cites. 65.173.104.138 (talk) 07:39, 27 July 2008 (UTC)

I picked this radio, originally for use in a emergency situation ( another 9-11, tornado) and to listen to Coast to Coast AM w/ minimal radio interference.65.173.104.138 (talk) 07:46, 27 July 2008 (UTC)

Not notable. Colin°^Talk 08:22, 27 July 2008 (UTC)

It is very notable. See http://www.mediamatters.org/items/200807170005?f=h_top . —Preceding unsigned comment added by 65.173.104.138 (talk) 09:04, 27 July 2008 (UTC)

It isn't. Show me the New York Times, or The Guardian, or BBC News, or CNN... The website already contains a clarification/retraction/call-it-what-you-will. The guy gets paid to be controversial. Colin°^Talk 11:53, 27 July 2008 (UTC)

I agree with Colin. Savage is a provocateur, which means that what he says on the radio isn't a reliable source about anything. It's not even a reliable source for what Savage himself thinks about autism, much less for what anyone else thinks about autism. This sort of material is suitable for Michael Savage, but not for Autism. Also please see #Michael Savage above. Eubulides (talk) 14:45, 27 July 2008 (UTC)

Substandard Evidence and Studies

Wikipedia's article on Autism is poisoned with substandard evidence and dangerous studies-certain articles on Wikipedia say that few children with Autism live independent and that Autistic people lack relationship, employment opportunity, self determinations and other important aspects. These articles are extremely dangerous to people wanting information on Autism because the evidence is corrupt, outdated and very poisoned.

Please be careful about editing Wikipedia things 'cause some very dangerous editors are out there waiting to block whosoever they THINK has committed vandalism or sock puppet but in reality did not really do so!

mcmlxxxviii 10:54, 4 August 2008 (UTC)

This section seems to be largely a duplicate of the next section, #Dangerous Article, so I'll respond there. Eubulides (talk) 02:21, 5 August 2008 (UTC)

Independence and autism

Wikipedia has biased articles on Autism that indicate an extremely dangerous and highly corrupt evidence source network! Too many prejudice studies towards Autism keep saying few individuals with Autism live independent, have opportunity for employment, few have any relationship ability, not mentioning the females with Autism are getting labeled for something else rather than the conditions that are really present.

Making matters worse, flawed studies/evidence are constantly thinking that people with Autism are usually intellect restricted but have either corrupt evidence/Autism studies or nothing at all.

Please be careful although, because Wikipedia has some very dangerous, prejudice editors who wanna block whoever they THINK is making vandalism or sock puppetry. Hurricane Hink fooled me into falsely admitting that nobody outside of me was using multiple names when in realities my sorority partners share the computer with me quite often.

I am Autistic myself and function as a total independent adult woman!

mcmlxxxviii 11:08, 4 August 2008 (UTC)

User:Standingout, do you have specific wording changes in mind? It would be helpful for the proposed changes to cite reliable sources, preferly in peer-reviewed scientific journals; please see WP:MEDRS for advice on reliable sources in this area. Eubulides (talk) 02:21, 5 August 2008 (UTC)

I think the account is blocked as one of multiple accounts related to User:Undercovergals. Fenke (talk) 07:59, 5 August 2008 (UTC)

Yes, but the block of the main Undercovergals account has now expired. Tim Vickers (talk) 15:56, 5 August 2008 (UTC)'

I agree with mcmxxxviii Matsuiny2004 (talk) 21:23, 23 August 2008 (UTC)

ASD

what happened to the ASD spectrum page? There was good information there. If they are going to delete it I would at least like to add some of the sources from that article. —Preceding unsigned comment added by 71.232.93.212 (talk) 16:26, 23 August 2008 (UTC)

Autism spectrum was a short page that was a subset of what was in Autism, and it was a pain to maintain two copies of the same information. A couple of months ago it was proposed on Talk:Autism spectrum to make the former a redirect of the latter, and nobody objected then. Here is a copy of the old Autistic spectrum; what useful information is present there that is absent from Autism? Eubulides (talk) 18:23, 23 August 2008 (UTC)

Thank you. I liked that it gave people an idea of the spectrum. It is hard to discuss autism without knowing the spectrum. What is considered autism is not the entire spectrum. It did include information on aspergers too. I would like to bring it back. I was professionaly diagnosed myself and learned about the spectrum that way. My point is the spectrum is not hte same as this page. This page is for extreme cases. It is important for parent and researchers to understand. It seems like a nice way of integrating these sources too. Why not merge aspergers and autism with autism spectrum? —Preceding unsigned comment added by 71.232.93.212 (talk • contribs) 18:43, August 23, 2008

Currently Autism discusses not just the autistic disorder proper (what you are calling "extreme cases") but autism spectrum disorders (ASD) as well as other related matters such as the broader autism phenotype. Formerly ASD had its own page, but that page was poorly maintained and was duplicative, which is why the redirect was proposed and eventually done. Furthermore, Pervasive developmental disorder is the same subject as ASD; clearly we don't need two pages on the same subject. On Autism spectrum I just now suggested changing the redirect to point to Pervasive developmental disorder instead of to Autism; please follow up there, if you're interested. Eubulides (talk) 00:14, 24 August 2008 (UTC)

That is me matsuiny2004 just continue our discussion. That was posted before our discussion. Matsuiny2004 (talk) 18:05, 24 August 2008 (UTC)

Nomination

It seems there is a debate going on in this discussion page so I would find it appropriate to post such a notice on the accuracy of the said statements in this article. One example I owuld point out is the assumed view that autism is a disorder and a developmental disorder at that. —Preceding unsigned comment added by 71.232.93.212 (talk) 18:55, 23 August 2008 (UTC)

There is no justification for the tag; see WP:V and WP:NPOV, please provide examples of reliable sources that are not accorded due weight. SandyGeorgia (Talk) 19:07, 23 August 2008 (UTC)

71.232 Besides not pointing out any sources, you have failed to point out where this so called debate is on this page. Please read the pages on verifiability and NPOV that have been provided below.

I was not talking about verifiability I was talking about neutrality, which I do not see.

http://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_view

As for verifiability that is a different policy altogether, but even looking at it that way the sources used in what I had brought up are from medical journals which can be ghostwritten and are not the most credible source of information. It does seem that this goes against the policy of wikipedia. There is no true consensus in this article thus making it controversial already and in need of discussion.

http://en.wikipedia.org/wiki/Wikipedia:Policies_and_guidelines

http://en.wikipedia.org/wiki/Wikipedia:V

Again, please see WP:V, verifiability, to present to us any reliable source as explained at Verifiability that is not accorded due weight per WP:NPOV. Parroting back to me the same pages I just gave you doesn't justify the tag, particularly when you've not presented a single example of POV. Please present any sourced info that isn't well represented in the article according to Wiki policies. SandyGeorgia (Talk) 19:23, 23 August 2008 (UTC)

I would like to chime in here and agree with SandyGoergia. No examples have been given, and no sources. This is a very mature article, and has been a FA. Dbrodbeck (talk) 19:34, 23 August 2008 (UTC)

"Autism is a brain development disorder that impairs social interaction and communication and causes restricted and repetitive behavior, all starting before a child is three years old."

here you go

I would also like to point out that ASD is not the same as Autism

thank you 9I will provide source soon —Preceding unsigned comment added by 71.232.93.212 (talk) 19:38, 23 August 2008 (UTC)

71, 232, please sign your comments by adding four tildes ( ~~~~ ) after your entries. Again, please provide examples of sources that meet Wikipedia's policy WP:V and that have not been accorded due weight in the article. Your quote above proves and shows nothing, and tagging articles without explanation can be viewed as disruption. SandyGeorgia (Talk) 19:43, 23 August 2008 (UTC)

http://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-pervasive-developmental-disorders/index.shtml this what I mean about ASD which I feel should be brought back. I do not agree with it, but even it does not define autism and ASD as the same. —Preceding unsigned comment added by 71.232.93.212 (talk) 19:45, 23 August 2008 (UTC)

As for what I posted it is in the article and you regarded such as a quaote. In the history it says you edited it. —Preceding unsigned comment added by 71.232.93.212 (talk) 19:47, 23 August 2008 (UTC)

Please sign your entries by adding four tildes ( ~~~~ ) so we don't get edit conflicts and so we know who wrote what. What do you claim is in the NIH source that is not given due weight in this article? SandyGeorgia (Talk) 19:50, 23 August 2008 (UTC)

I am saying this article does not explain the ASD spectrum and suggest bringing back the ASD page. My problem is that when I type that in it redirects to autism. The two are not the same which I am trying to point out. THe article explains what ASD is which is not simmilar to what Autism as defined here. The two are not the same. I would like the redirect to be changed. Besides that is the wording, but I think many people are being misguided by thinking that this article explains the autism spectrum. The Redirect is my biggest concern.71.232.93.212 (talk) 19:57, 23 August 2008 (UTC)

Actually, Autism does explain the autism spectrum, and ASD, at some length; please see Autism #Classification. It also explains ASD in the lead. Eubulides (talk) 00:14, 24 August 2008 (UTC)

OK, you want a redirect changed, yet you've tagged two different articles (autism and asperger syndrome) as POV, without providing any sources to explain why you think they're POV. SandyGeorgia (Talk) 20:15, 23 August 2008 (UTC)

Can we change the redirect first? I will discuss articles next. —Preceding unsigned comment added by 71.232.93.212 (talk) 20:20, 23 August 2008 (UTC)

To be clear, I think 71.232.93.212 is referring to the article autism spectrum that was converted to a redirect here. I have some sympathy with the idea that ASD deserves its own article, even if it is short. There's also Pervasive developmental disorder and indeed Portal:Pervasive Developmental Disorders. Would ASD be better redirected to PDD? Or is there enough material in each to justify a short article?

WRT bias and the "disorder" debate, please read the above discussions and the archived discussions. It would greatly help if you could bring something new to the discussion, and refer to quality sources that back up any POV. Colin°^Talk 20:27, 23 August 2008 (UTC)

I like the suggestion of redirecting Autism spectrum to Pervasive developmental disorder and have followed up on Talk:Autism spectrum. Eubulides (talk) 00:14, 24 August 2008 (UTC)

I brough it back, but posted for discussion. So just post on the talk page. If what I did was not ok with mods please revert. I will try to contribute to this page too.

71.232 are you aware of how to read your talk page? You can do so by clicking on this link. Please read the messages there and begin to sign your posts. SandyGeorgia (Talk) 20:32, 23 August 2008 (UTC)

71.232.93.212, there's no rush. Remember that some editors are in different timezones and have busy real lives. We all want this to be a great encyclopaedia that covers this subject fairly and well. You've made your point. Perhaps you could spend some time researching sources or pointing out specific aspects of this article that you have problems with. It would also be really encouraging if you can point out bits of the article that you think are good. Colin°^Talk 20:47, 23 August 2008 (UTC)

I would really like to have ASD article back. It is more important. —Preceding unsigned comment added by Matsuiny2004 (talk • contribs) 20:49, 23 August 2008 (UTC)

Please see further discussion in the next section, and in Talk:Autism spectrum. Eubulides (talk) 00:14, 24 August 2008 (UTC)

is it neccessary to redirect the autism spectrum disorders page

Resolved

– This appears to have been satisfactorily resolved on Talk:Autism spectrum. - Eldereft (cont.) 17:53, 29 August 2008 (UTC)

RFCsci: Reason= Is it misguiding to redirect the Autism spectrum disorders page to the "Autism" page 22:55, 23 August 2008 (UTC)

Is it neccessary to redirect the Autism spectrum disorders page?

Please see Talk:Autism spectrum for further discussion; the proposal on the table there is to redirect it to Pervasive developmental disorder, which means almost the same thing as ASD. Eubulides (talk) 00:14, 24 August 2008 (UTC)

As ASD doesn't mean autism, it shouldn't redirect here. Most people on the Austism spectrum i know would say they have Asperger's, not autism. ASD should be a small article, with sections on the different types. Redirecting to PDD would seem to contradict it's common name, no? or is it now the official name somewhere? Yobmod (talk) 11:36, 29 August 2008 (UTC)

Just to follow up, it no longer redirects here, as a result of further discussion on Talk:Autism spectrum. Eubulides (talk) 15:53, 29 August 2008 (UTC)

Dan! and heavy metals

The article on Dan! and on heavy metals is very interesting and is also present on the Italian Wikipedia .--Lennybrown (talk) 17:30, 24 August 2008 (UTC)

I thought I'd document what's going on right now. A series of IP addresses and users (Lennybrown, Francis89, and 151.51.49.254), who I expect are all the same person or are meatpuppets, has repeatedly been trying to add the following text to Autism during the last few hours; so far, all the attempts have been reverted by other editors. This text appears to be derived from it:Autismo, the Italian page on autism, where it is (rightly) marked as NPOV. The text is promoting the WP:FRINGE theory that heavy metals cause autism, and it is obviously a huge WP:WEIGHT violation to give so much prominence to a fringe theory. The text also promotes a heavy-metals organization, DAN!, which again is not the sort of thing that Wikipedia should do. The text is poorly translated from Italian, and some of the Italian words remain; but its main problem is that it's completely NPOV. If Lennybrown/Francis89 persists, I expect that this matter will need to go to the appropriate noticeboard next. Eubulides (talk) 17:37, 24 August 2008 (UTC)

See Wikipedia:Administrators'_noticeboard/Incidents#Suspected_sockpuppets_at_Autism. Tim Vickers (talk) 17:54, 24 August 2008 (UTC)

Thanks. That's now archived here. For what it's worth, one of the agents apparently involved uses the name of Franco Verzella, European president of Defeat Autism Now!, whose web page says he's an Italian M.D. who employs chelation therapy, gluten-free, casein-free diet, etc.; the whole panoply of the heavy-metal theory. Here's the diff. Eubulides (talk) 21:14, 25 August 2008 (UTC)

This is a copy of the text the user is trying to insert. Please do not modify it.

The following discussion has been closed. Please do not modify it.

From a study entitled: Evidence of toxicity, oxidative stress and insult neuronal nell'autismo, carried out by Psychiatry of Texas Southwestern Medical Center at Dallas and published by the magazine "Toxico Environment Health num. November / December 2006 were finally disclosed so official data which declares the close correlation between poisoning by heavy metals and autism. Examples of heavy metals are lead (Pb), mercury (Hg), cadmium (Cd), cobalt (Co), copper (Cu) and nickel (Ni) (Lopez-Artiguez and Repetto, 1993).

The metals are natural contaminants present everywhere in the environment, although the modern industry will have further increased. A report of the Centers for Disease Control, for example, published in 1991 reported that 4 million children under school age in the United States has raised levels of lead (CDC, 1991). Anecdotal reports to several studies indicate that many children with autism have abnormal levels / toxic heavy metals (Holmes et al., 2003; Lonsdale, 2002; Filipek et al., 1999; Eppright et al., 1996; Accardo et al., 1988; Wecker et al., 1985; Shearer et al., 1982).

For example, Filipek et al. (1999) found that 44% of autistic children and psychotics have concentrations of lead in blood greater than two standard deviations higher average.

Both Wecker et al. (1985) that Shearer et al. (1982) found low levels of cadmium in the hair of children with autism / ASD. Lonsdale (2002) discovered that children with autism had a higher concentration of arsenic in their urine compared to healthy control group. Typically are reported abnormal levels of mercury, lead, bismuth, cadmium and arsenic (Lonsdale, 2002; Filipek et al., 1999; Eppright et al., 1996; Holmes et al., 2003; Fido and In-Saad, 2005; Wecker et al., 1985; Shearer et al., 1982).

They found high in particular sulfidril-reactive metals (mercury, cadmium, lead and arsenic are sulfidril-reactive) (Lonsdale, 2002; Quig, 1998). Two studies of paramount importance, Holmes et al. (2003) and Bradstreet et al. (2003), have influenced our knowledge of toxic metals nell'autismo. The study conducted by Holmes et al. (2003) on 94 children with autism who were by sex and age coupled with control of 45, he found that the hair of the first cut (the first ciocche cut for babies) had mercury levels that were statistically far lower than those of group control. Children with autism who were more serious had the lowest levels and children who were less severe had higher levels. The study also gave us information on levels of exposure to Mercury (based on consumption of fish, exposure to mercury through vaccines and amalgams of mothers). Children with autism had higher levels of exposure compared to control. This study suggested that children with autism were unable to eliminate the Mercury that you accumulava within them. Bradstreet et al. (2003) established that when children with ASD and control children were treated with multiple doses of 2, 3-dimercaptosuccinic acid (DMSA) (a chelating agent approved by the FDA), children with ASD espellevano 5 times more mercury than check.

The evidence of studies of Holmes et al. (2003) and Bradstreet et al. (2003) suggests that children with autism may be relatively little detossificatori to children who develop normally.

A recent study completed by Palmer et al. (2006) has ruled that, in Texas, 1000 for each pound of mercury released into the environment, there was an increase of 61% incidence of 'autism. This study was one of the first to show a correlation between mercury released into the environment and incidence of autism. It is important to note that mercury is inhaled almost completely absorbed by the lungs and crosses the placenta is that the blood-brain barrier (Berlin et al., 1969; Yokel et al., 2006).

Further evidence of a toxic heavy metals comes from 'Autism Research Institute. L 'Autism Research Institute has collected data from more than 22,300 parents of children with autism behavioral effects of biomedical interventions. Surveys cover a list of 45 drugs, supplements 23 non-drug treatments or biomedical and 9 special diets. He was asked parents to classify treatments on a scale of 6 points. Of these 77 choices, parents have ranked as the highest treatment of chelation (or removal of heavy metals) 76% of parents said their children "was better" with this treatment. The second treatment was the diet without gluten and casein to 65% (ARI, 2006).

Evidence of a lack of glutathione and oxidative stress in children with autism Five recent studies have shown that oxidative stress and / or lipid peroxidation are greater nell'autismo (Yorbik et al., 2002; Chauhan et al., 2004; Zoroglu et al., 2004, James et al., 2004; Sogut et al., 2003).

Sogut et al (2003) and Zoroglu et al. (2004), have found an increased oxidative stress and antioxidant enzyme in children with autism compared to a control group normal, equal for sex and age.

Sogut et al (2003) have found that children with autism have higher levels in red blood cells of nitric oxide and glutathione perossidase.

Zoroglu et al. (2004) have found increased nitric oxide in red blood cells and increased levels of substances thiobarbituriche acid-reactive.

Chauhan et al. (2004) have found that the lipid peroxidation was increased and decreased antioxidant proteins in children with autism. In addition, and more importantly, there was a correlation between the decrease in protein antioxidants and the loss of skills previously acquired. Specifically, the protein levels of antioxidants (serum ceruloplasmina and trasferrina) were reduced even further in children who had lost skills previously acquired. Children with autism who were not regressed and children the control group had levels similar. These findings imply a possible role of oxidative stress in the development of clinical symptoms dell'autismo regressive.

James et al. (2004) found lower levels of glutathione plasma and highest concentration of oxidized glutathione in children with autism compared to the control group. The pià low ratio ossidoriduzione of glutathione reduced compared with oxidized glutathione indicates an increase of oxidative stress. Even James et al. (2004) found that levels of plasma cysteine were lower in children with autism and, as said earlier, the cysteine is the precursor of glutathione. In the study by James et al. (2004), 19 of the 20 children had lost capacity previously acquired.

James et al. (2004) affirmed that the increased susceptibility of oxidative stress (environmental, intracellular or both) and damaged the ability of methylation may have a role in the development of clinical symptoms dell'autismo regressive Other evidence for a lack of glutathione is in view nell'autismo disease. Low levels of glutathione can be the basis for many of systematic abnormalities associated with autism. Nell'autismo there is evidence to:

1) oxidative stress and lipid peroxidation

2) toxicity, as the phenolic compounds (Edelson and Cantor, 1998) and toxic metals (Lonsdale, 2002; Filipek et al., 1999; Eppright et al., 1996; Holmes et al., 2003);

3) difunzioni immune, as immune responses and damaged or altered disregolazione of immune inflammatory cytokines (Cohly and Panja, 2005; Warren et al., 1990, 1992.1995)

4) gastrointestinal damaged integrity, as illnesses and increased epithelial intestinal permeability (D'Eufemia et al., 1996; Wakefield et al., 1998, 2000; Furlano et al., 2001; Horvath et al.1999).

The glutathione is important in each of these pathological processes.

Other hypotheses Were assumed many other causes that could lead to forms of autism in an individual. In most cases these assumptions have not yet been confirmed scientific, and are accepted only by a small minority of scholars.

-- Insulto environmental valid as a factor which, insults ambietali and / or pharmacological scatenino autism, which presents symptoms fully superimposable all'avvelenamento mercury or other heavy metals, toxic.

-- Establishing genetic factor valid as the fact that some healthy subjects have, perhaps, a form of weak predisposition towards absent / weak response to environmental insults and / or pharmacological.

-- Precocità pharmacological treatment is found that in infants, the immune system is still in formation and thus not efficient and / or vulnerable. The introduction of drugs to prevent or eradicate infectious diseases, is devastating for the immune system, metabolic and neurological.

-- Some are no longer accredited theories which postulavano alter the mother-child relationship as a cause of ignition of autistic disorder, let alone a psychological origin of it.

-- Autism is one of many diseases that are related by some scholars to a poisoning by mercury. According to them, visible improvements are found in autistic undergone chelation and correction of errors metabolic and neurological disorganizzazioni.

-- Shock of strong psychological impact received in childhood, in the first eight / ten months of life, so strong as to close the personality of the individual in a kind of bell jar, as if trying to be invisible and therefore not from any attaccabile return the episode or a similar episode. The person involved must be a relative stratto, someone that the individual autistic continued to see in his ambiante, in this way, this "someone", has caused much to keep alive the memory of an traumatic in his mind. Over time the fear took the upper hand, has turned into terror and / or terror hidden, everything and everyone. Even surgery, anestesie, medical treatment of a certain seriousness can be equated to shock. A parent who assists becomes unwittingly, who then will remain alive the memory!

-- Treatments: vitamins, minerals, milk, tranquility, and few changes made to grades, small victories, music and other children.

== Autism and DAN! ==

The movement DAN! (Defeat Autism Now!) was founded in 1995 by Dr. Bernard Rimland - founder of ASA (Autism Society of America) and ARI (Autism Research Institute) of San Diego - and doctors Sidney Baker and Jon Pangborn.

The ARI, founded in 1967, has as its central purpose the search for new therapeutic perspectives within the official medicine, a new point of view of treating autism is no longer seen in its symptoms, but in its causes.

The ARI supports the theory that autism is not a neurological disease origin, but rather a mismatch biochemical caused, most likely, from a genetic vulnerability that makes some children ill-adapted to eliminate chemicals and heavy metals, introduced into their bodies through vaccines, drugs, dental amalgams, heavily polluting agents present in the environment, and even more heavily, the interaction of some of these factors. These cases lead to a biochemical decompensation, which in turn becomes a cause of neurologic decompensation, in turn cause the loss of skills. Dr. Bernard Rimland maintains that heal and restore the biochemistry of the body, through Biomedicine, leading to physical recovery of the affected, that at this point is in optimum condition for a return of deficits also mental and relational. The promoters of this treatment is talking about positive results of small patients, each with its personnel procedures and nursing second strict medical practices, depending on the specific degree of damage, but there is no evidence and scientific publications that confirm these results. In order to disclose these scientific information to the families of children belonging to the autistic spectrum, sull'Autismo Research Institute (ARI) convene the first intercontinental conference DAN! in January 1995 in Dallas. The following were present about 30 speakers, including doctors and scientists with specialties in research and treatment of autistic syndrome. There were represented areas of research in biochemistry, psychiatry, neurology, immunology,allergology, genetic research and gastroenterology. From that first conference DAN! originated, multidisciplinariamente, publication of the first official document with guidelines, practical experience and protocols on the treatment of pluridisfunzioni present in subjects covered in the autistic spectrum. This first document, represents the starting point for each subsequent refinement of the protocols of care by those doctors and specialists who wish to bring their contribution of aging. The document, "Manual Clinical DAN!" Published in the first edition in 1996, has undergone upgrades in 1997, 1999, 2001, 2002, represents evolutivamente, a common specification for the medical approach to treatment of pluridisfunzioni of the subjects covered in autistic spectrum. The biennial conferences are intended to upgrade all doctors concerned, the most recent refinement of diagnosis and treatment.

Italian page

I now see that 10 minutes ago the POV tag was removed from the Italian page, after 3 solid days of no changes, by the Italian user Mkultra. If you go and edit the Italian page to remove the marker, that is hardly a sign that the POV problem has been fixed! Furthermore, even if the Italian page says something, that is not evidence for English Wikipedia: Wikipedia does not count as a reliable source for Wikipedia. Eubulides (talk) 18:14, 24 August 2008 (UTC)

Claim of stem-cell cure in 2007

This set of edits inserted the following claim:

Notwithstanding the aformentioned, in early 2007, E. Michael Molnar, M.D., a world authority on fetal and xeno stem cell transplantation, in collaboration with several pediatricians, treated fifteen severly autistic children under the age of ten years with xeno stem cell transplantation. All fifteen children were normal until eighteen months. The majority of treated children can now attend normal school, with select parents preparing their children for eventual college (reference, Stem Cell Transplantation, 2006, Author, E. Michael Molnar, MD, First Edition,Medical and Engineering Publishers Inc.)

The cited source (Molnar 2006) is not a reliable source on autism (or on stem cell transplantation, for that matter); but even if it were, it could not be a source for events that are alleged to have taken place in 2007. At any rate, I suggest moving this topic to Talk:Autism therapies. Please see Autism therapies #Stem cell therapy for more info on the subject: it cites a far more-reliable source on the topic. In the mean time I undid the addition, moving the claim here. Eubulides (talk) 06:31, 2 September 2008 (UTC)

Causes or sign

I read in the first alinea
Autism is a brain development disorder that impairs social interaction and communication and causes restricted and repetitive behavior, all starting before a child is three years old. This set of signs distinguishes autism ... et cetera
I have problem with the term "causes" and later on it is a "sign". So has every autist before the age of three restricted and repetitive behavior or do most of them? In the first case you say that you can diagnose allmost to a certainty that someone with that behavior has autism...
Change to Something like this
Autism is a brain development disorder that impairs social interaction and communication. The most prominent signs before the age of three are: restricted and repetitive behavior, problems on the field of Theory of Mind,...
On later age, as an autistic person has developed, these signs could become less prominent and so makes Autism more difficult to diagnose. 212.238.232.152 (talk) 09:09, 16 September 2008 (UTC) Tdk

Thanks for reporting this ambiguity. I made this change to try to clear things up. Eubulides (talk) 20:56, 16 September 2008 (UTC)

Tdk "problems on the field of Theory of Mind,..., age of three" is pointed out to me by an user in the NL wiki is not accurate. Theory of Mind problems are messurable after the age of 4. 212.238.232.152 (talk) 11:34, 26 September 2008 (UTC)Tdk

Sorry, I don't follow this comment. "problems on the field of Theory of Mind,..., age of three" is not a quote from Autism. This talk page is about Autism, not about some other page. Eubulides (talk) 16:44, 26 September 2008 (UTC)

External link

I would like to know why my recent addition of "Partners in Policymaking" (www.partnersinpolicymaking.com) was removed with no apparent explanation. This is a free site for parents and adults with disabilities that teaches advocacy skills, how to obtain employment, community living, etc. It has proven extremely useful to literally thousands of parents and people with disabilities. It is not an "advertisement" under Wikipedia rules. Partners is funded by the U.S. government and the State of Minnesota. It is available at no charge to participants. Similar programs are found in 30 States and are funded abroad by at least four European countries.Edburke317 (talk) 20:23, 16 September 2008 (UTC)

Please see Wikipedia:Manual of Style (medicine-related articles)#External links. Maralia (talk) 20:44, 16 September 2008 (UTC)

Also, please see WP:LINKS for Wikipedia's guidelines on external links. The link you added does not meet the criteria listed in What should be linked or Links to be considered. This is an article about autism with international scope, and there are hundreds of autism-related organizations that would be equally deserving of a link here, if not more so. I see that at the same time you added the link to Autism, you also added it to Down syndrome, Mental retardation, Blindness, and Cerebral palsy; this verges on WP:LINKSPAM and is generally frowned on. I see you've asked the same question at Talk:Down syndrome #Removal of recent addition so I'll respond there as well. Eubulides (talk) 20:47, 16 September 2008 (UTC)

First of all, beyond a bureaucratic knowledge of Wikipedia rules, I would like to know what qualifications people might have to judge what is relevant or not to an article on autism (or any other disability for that matter). I have spent the past 30 years working with and for people with autism and other developmental disabilities. I would think that one of the primary purposes to even have an article on autism, beyond the basic and imperfect description of what it is, would be to discuss possible methods of helping people with autism to adjust to society and having society adjust to people with autism. For decades, parents of children with autism have been subjected to almost unimaginable form of charletanism in terms of diagnostic and "treatment" gymnastics. The only reason people with autism are even entering society today is due to parental advocacy. It is not due to the work of clever professionals (of which I am one). It is not due to miraculous "treatments" or "cures." It is due to parents who have joined together as advocates and fought to have their children included as valued participants in everyday settings. THAT is what the Partners in Policymaking program is about.

The Partners program does have equal relevance to other disabilities precisely because advocacy is a cross-disability skill. The suggestion that the posting of this program as an External Link on more than one site constitues "spam" is an insult to the thousands of parents and adults with disabilities who have spent months of their time in training to become proud Partners graduates.

The only purpose in posting the link to the Partners in Policymaking program was to provide parents and adults with disabilities with a source of information and training at no cost. Virtually every other External Link listed on disability-related pages requires people to pay annual dues, if they want the listed group's full array of services.

If your organisation is internationally-renowned, it might be possible to mention it in the article on Autism therapies, however as you will know there are a very large number of these organisations and this article would rapidly degenerate into a list of links if we let everybody advertise their personal organisation here. Tim Vickers (talk) 03:47, 17 September 2008 (UTC)

But dmoz (the only link allowed) is not internationally renowned, just it's popular inside internet and in fact its barely popular (only for webmaster, cio and such). So, in this case wikipedia is acting allowing "me and my friends" but the rest. Or, you could say wiki-autism (pun intent)--201.222.151.131 (talk) 04:02, 17 September 2008

DMOZ acts as a standard resource for people looking for more information on the web and can list hundreds of organisations - which we can't. To be honest I don't think it is all that much more useful than Google myself, but it does seem widely-used and there is something to be said for having a standard format for our readers. Tim Vickers (talk) 04:13, 17 September 2008 (UTC)

It may also be helpful to take a look at WP:MEDMOS #Audience, including the caution about adding '"helpful" external links, such as forums, self-help groups and local charities'. Eubulides (talk) 06:00, 17 September 2008 (UTC)

Thanks for the thoughts on how best to proceed! Actually, the Partners in Policymaking program is not a "therapy," so it would not fit in there. I can understand the fear about "opening the floodgates," however, please note that, (a) this is not a "personal organization," (b) it transcends specific "treatments" or "schools of thought" on autism per se, and (c) it attempts to serve an international audience. With autism being one of the most baffling of human disabilities, it is amazing that at present Wikipedia only offers one External Link for readers. Compare this with articles related to other disabilites or medical conditions that are far better understood in terms of etiology and treatment. Simply put, I believe that little harm would be done by adding a single line to the "External Links" section of this article to provide parents and interested others with what might be a free, useful resource. As this has also become a reference point for my suggested addition of a link to the Partners in Policymaking program to the Down syndrome article, I would also make the case that with a 90%+ abortion rate, based almost entirely on word of mouth opinion (as opposed to actual contact with families supporting/people with Down syndrome),it would also seem important to add a line here as well.Edburke317 (talk) 20:09, 17 September 2008 (UTC)

Wikipedia offers "only one" external link (which is the DMOZ linking to potentially thousands of resources), but this article offers hundreds of reliable sources on the most current thoughts about autism by notable scholars. PIPM is a single website for a single state in a single country in a single language. It doesn't even seem to focus on autism. I don't believe it meets with the criteria required by WP:EL. WLU (t) (c) ^{(rules - simple rules)} 20:28, 17 September 2008 (UTC)

Also, it's common for high-quality medical articles in Wikipedia to have few, or no, external links. See, for example, Alzheimer's disease, Asperger syndrome, Chagas disease, Prostate cancer, Subarachnoid hemorrhage, and Treatment of multiple sclerosis, all featured medical articles. Partners in Policymaking is certainly a worthy organization, but many other organizations are no less worthy, and are more focused on autism; these include Autism Europe, Autism Research Institute, Autism Society of America, Autism Speaks, MIND Institute, National Autistic Society, Yale Child Study Center and many others. If we were to add a link to an autism organization, it would be to one of these organizations; but as the abovementioned Wikipedia citations suggest, we should leave well enough alone. Eubulides (talk) 20:43, 17 September 2008 (UTC)

Media

The way the media portrays autism makes it seem that alot of children have it. I know ADD is common but autism is a real condition and not many people can be in the club. —Preceding unsigned comment added by 67.60.77.248 (talk) 00:14, 19 September 2008 (UTC)

Autism #Epidemiology talks about this; if there's something there that's not clear, please let us know here. Eubulides (talk) 05:07, 19 September 2008 (UTC)

Presents clinical

This edit changed "first gives signs during infancy" to "first presents clinical signs during infancy". But "presents clinical signs" is medical jargon, and WP:MEDMOS #Audience suggests that we write for the general reader rather than for healthcare professionals. What was incorrect about "first gives signs" that required inserting the jargon here? Is there some better way to phrase it, which doesn't involve the jargon? The article already has too much medical terminology as it is, and I'd rather avoid making the problem worse, if possible. How about if we change it to "first shows signs during infancy"? Eubulides (talk) 16:48, 25 September 2008 (UTC)

TimVickers changed it to "first appears during infancy", which is even better. Thanks! Eubulides (talk) 16:59, 25 September 2008 (UTC)

Grammatically it works in a certain way, so it's not easy to add 'people' afterwards Logictheo (talk) 17:08, 25 September 2008 (UTC)

I agree that "appears" is even better. Thanks. --Tryptofish (talk) 17:29, 25 September 2008 (UTC)

I've made an edit that tries to say this in a more informative way. (I also at the same time removed the "relapse" part, since you really can't have a relapse without first having a remission.) Looie496 (talk) 18:17, 25 September 2008 (UTC)

I'm afraid that "manifests itself as a pattern of different social interactions" is (a) much harder for the average reader to understand than "appears", and (b) not quite right, since autism is a triad of symptoms, and social interactions are just one leg of the triad. Let's just leave it as "appears"; it's simple, elegant, and to the point. The social-interaction bit is already mentioned in that paragraph and there's no need to duplicate that mention. Eubulides (talk) 05:25, 26 September 2008 (UTC)

Just to clarify, it's better to avoid medical jargon like "presents" and "clinical" and "manifests" and so forth, if we can avoid it. Eubulides (talk) 05:26, 26 September 2008 (UTC)

Autism Video

Is there a good place in this article for this video? It's about a new discovery about Autism.

http://www.youtube.com/watch?v=c0tSAxS1ZW4 —Preceding unsigned comment added by 151.188.213.150 (talk) 17:46, 25 September 2008 (UTC)

Sorry, no; it's not a reliable source. Please see WP:MEDRS for the sorts of sources that we are looking for in this article. Eubulides (talk) 17:58, 25 September 2008 (UTC)

Reviews vs studies etc.

These changes had some good rewordings but also some problems:

The correct term is "review", not "study", when we're talking about a scientific Review. For more, please see secondary source in WP:MEDRS #Definitions.
"Cases of PDD-NOS comprise the vast majority of ASD diagnoses; Asperger's occurs at a rate of about 0.3 diagnoses per 1000 population" sounds really awkward and it's not accurate. A case is not a diagnosis. Prevalence does not count diagnoses per population.
Let's not wikilink dates like 2000s, please.
"it is possible that a real increase in the rate of prevalence of autism itself is occurring, and hitherto". There's no such thing as a "rate of prevalence". Also, the cited source doesn't make this claim.
"and the unclear definitional boundaries of autism itself" The cited source doesn't make this claim.
"The autistic pride movement shows noticeable similarities to Deaf culture." This claim is speculative and unsourced.

I made this change to try to improve on things. Eubulides (talk) 22:29, 26 September 2008 (UTC)

Fair enough, thank you for helping. I will continue to make minor edits when I have time. I'll try and be more careful about sticking strictly to the sources, as I can see that this section of Wikipedia is a lot stricter about that than most of the other articles I edit (which is partly why I've done so little here). Soap ^Talk/_{Contributions} 00:24, 28 September 2008 (UTC)

Bashing greeks

What I think is a vandal added "Greek state" as a reason for editing the article. What has the Greek state to do with it? It seems they just want to add a bad name for the country Greece. Is there a smaller or greater relation, or do you think the 'summary' was random? Logictheo (talk) 06:50, 1 October 2008 (UTC)

Let's please focus on improving Autism rather than worrying too much about the motivation for WP:VANDALISM. Eubulides (talk) 07:45, 1 October 2008 (UTC)

Special issue of Neuropsychology Review

A forthcoming special issue of Neuropsychology Review will be devoted to ASD. It looks like it will have multiple useful sources for Autism. I'm putting in a notice here to help remind us to take a look at it when it comes out. Here's the intro (the rest of it isn't published yet): Baron IS (2008). "Autism Spectrum Disorder: complex, controversial, and confounding". Neuropsychol Rev. doi:10.1007/s11065-008-9070-1. PMID 18846426. Eubulides (talk) 16:51, 13 October 2008 (UTC)

Is there an active WikiProject about autism?

I have just finished writing an article about Denise Phua, a Singaporean politician dedicated to helping the special needs (especially autistic) community in Singapore. The article is currently on peer review in preparation for a GA nomination. Is there an active WikiProject about autism, which I can approach to request peer reviewers? I looked around but could not find any. If no such WikiProject exists, consider creating one. --J.L.W.S. The Special One (talk) 12:30, 17 October 2008 (UTC)

As this talk page's header indicates, Autism is currently under the scope of 5 WikiProjects: Psychology, Medicine, Medical Genetics, Neuroscience, and Neurology. If you are interested in starting an autism wikiproject, I suggest starting a discussion on the most-likely talk page among these projects, and seeing how much interest and help you can get. A wikiproject for autism was proposed in June, and had been proposed earlier too, but has not yet gotten much support. (It's not enough just to have a wikiproject page, of course; you also need editors who actively contribute to the wikiproject.) You might also check into Wikipedia:Notice board for autism-related topics, a page that used to be active but is now somewhat moribund. Eubulides (talk) 17:06, 17 October 2008 (UTC)

I would just like to point out that of the four users listed under the heading Active contributors on autism-related topics, only one of them seems to be still actively editing any autism-related pages. Two of the others are still active users and one of them has left probably for good. The list also excludes all of the people who are the most prolific contributors on autism-related articles. Soap ^Talk/_{Contributions} 18:43, 17 October 2008 (UTC)

The five WikiProjects seem to focus on the medical and neurological aspects of autism, rather than the sociological and cultural aspects. Would these WikiProjects be interested in peer reviewing an article about a Singaporean politician dedicated to helping the local special needs community? If so, I will go ahead and ~~canvass~~ advertise the peer review at the talk pages of those WikiProjects.

If there is no WikiProject Autism, one should certainly be created. It would have great potential to help fight systemic bias by encouraging collaboration on autism-related articles. While autistics tend to be technically inclined, their poor social and communication skills may get them into trouble when editing - a WikiProject Autism may help them in those aspects. Unfortunately, I am unlikely to create or join such a WikiProject, as I only work on Singapore-related articles; there is very little overlap between Singapore-related articles and autism-related articles.

Regardless of whether a WikiProject Autism exists, Wikipedians who are interested in autism-related topics (such as those replying to this thread) are invited to participate in the peer review of Denise Phua. By pointing out issues which can be addressed, you will help the article attain GA status. --J.L.W.S. The Special One (talk) 09:05, 18 October 2008 (UTC)

Rain and TV watching

I just heard that rain might be a cause to autism. They said children who live in places with more precipitation are more likely to have autism. According to WTAE news, children who live in a region with more precipitation are more likely to stay indoors. This may cause them to be in contact with more television accessibility as well as cleaning products.Laluff (talk) 02:38, 4 November 2008 (UTC)laluff

That unlikely hypothesis is discussed in ~~Causes of autism #Television watching~~ Causes of autism #Rain. Eubulides (talk) 02:45, 4 November 2008 (UTC)

Should We Insist on Eye Contact?

Should We Insist on Eye Contact with People who have Autism Spectrum Disorders, IRCA Articles, Access Autism [sic].

-- Wavelength (talk) 17:31, 6 November 2008 (UTC)

Autism is a neurodevelopmental disorder

Although we want people to understand vocabulary there is links to the following articles to explain. It doesn't make sense that the article explains that is a brain development disorder linking to nerodevelopmental disorder. Their isn't even a reference footnote to it. I looked through the reference list and on the sixth reference -- the scientific journal says that it is a nerodevelopmental disorder, which would be more accurate (e.g. Attention-Deficit Hyperactivity Disorder is refered to as a being a neurobehavioral developmental disorder not a behavior development disorder). I wanted to see other people's opinion before changing the vocabulary and to add the reference tag. Here is the URL for the reference footnote -- http://en.wikipedia.org/wiki/Autism#References. It's the sixth one down. Thanx! ATC (talk) 20:46, 9 November 2008 (UTC)

The question is, should Autism use jargon that is standard in medicine, or (as per WP:MEDMOS #Audience) substitute less commonly-used but more-understandable phrases? "Neurodevelopmental disorder" is the normal and accepted medical term, but it is also a phrase that most readers won't know. A few reliable sources do use the phrase "brain development disorder" to describe autism, for example: Honey K (2008). "Attention focuses on autism". J Clin Invest. 118 (5): 1586–7. doi:10.1172/JCI35821. PMC 2336894. PMID 18451989. It is true, though, that "neurodevelopmental disorder" is far more common, so there is a judgment call here as to whether it should be preferred to "brain development disorder".
For an example of the jargon problem, please see Talk:Sociological and cultural aspects of autism #For someone who has Asperger's, all Wikipedia's aspergers sections are HARD AND STRESSFUL TO READ., a comment about a related article that could just as easily apply to Autism.

Eubulides (talk) 01:25, 10 November 2008 (UTC)

Vitamin D and Africa

I am finishing an RN program, and one of my instructors mentioned that some authorities are now questioning if lack of vitamin D plays a role in raising the risk for autism. Vitamin D can be taken orally or it senthisized in the body from exposure to sunlight. Apparently autism is almost nonexsistent in Africa where people have lots of exposure to the sun. Also in the USA it is supposed to be more prevalent in northern states than in the south, where again, there is more exposure to the sun. Unfortunatly I have no references, but maybe someone more attuned to Wikipedia would like to investigate this as it is a very important issue. —Preceding unsigned comment added by Johnhenney (talk • contribs) 17:09, 11 November 2008 (UTC)

If there are more reliable sources, we could certainly expand Causes of autism#Vitamin D. If I recall correctly, the north/south disparity was better explained by urbanicity, though of course this would also require a source. - Eldereft (cont.) 18:20, 11 November 2008 (UTC)

The vitamin D hypothesis is untested, and there is no scientific evidence about it; at this point it's merely a guess and its coverage in Causes of autism is more than adequate.
The prevalence of autism in Africa has not been studied and is unknown; see Mankoski et al. 2006 (PMID 16897390). I expect that Johnhenney's instructor, or the instructor's source, just made up the part about Africa. Anyway, thanks for bringing it up: I added a new subsubsection Epidemiology of autism #Africa on that topic. Eubulides (talk) 18:39, 11 November 2008 (UTC)

There's something being studied about Somali refugees though, isn't there? I heard the incidence rates with them were nearly 1 in 4 (totally pulled out of my @r$e). Granted, there are almost definitely other variables at work, but that still means that it's not necessarily an "non-Africa" thing. 74.46.203.165 (talk) 19:41, 8 December 2008 (UTC)

I've heard of anecodotal reports of a higher rate of autism among Somali refugees in other countries, but no scientific evidence, and nothing yet published in a peer-reviewed journal or similar reliable source. Eubulides (talk) 20:37, 8 December 2008 (UTC)

I suspect white people in America have healthier Vit D levels than blacks in Africa. Reasons: 1) The American Southwest gets as much sunlight as most of Africa does; Australia gets quite a bit more. That Africa is the hottest, sunniest, or driest continent is nothing but a common misconception. 2) Most Africans have dark skin, which blocks out sunlight and therefore slows down production of vitamin D. 3) Even in the poorest areas of the world, most people spend most of their day indoors and wearing clothes, thus reducing sunlight exposure to a level much below what humans originally evolved for. 4) To make up any deficiencies that do exist, us rich Westerners eat vitamin D supplements in our food almost every day whether we realize it or not; I'd be willing to bet most Africans don't get those vitamin supplements. Soap ^Talk/_{Contributions} 22:28, 8 December 2008 (UTC)

New meta-analysis of functional neuroimaging

Here's a recent meta-analysis that may be worth folding into Autism #Pathophysiology:

Di Martino A, Ross K, Uddin LQ, Sklar AB, Castellanos FX, Milham MP (2008). "Functional brain correlates of social and nonsocial processes in autism spectrum disorders: an activation likelihood estimation meta-analysis". Biol Psychiatry. doi:10.1016/j.biopsych.2008.09.022. PMID 18996505.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Eubulides (talk) 00:38, 13 November 2008 (UTC)

Autism and physical attractiveness

I read in my encyclopaedia that people who have autism are generally "physically attractive." Was there some study or something back then (1970s) which lead doctors/psychologists to make such a subjective conclusion? HomerChimpson (talk) 02:48, 22 November 2008 (UTC)

The whole story sounds invented to me. Which encyclopedia was that, and where did it say it, exactly? Eubulides (talk) 06:25, 22 November 2008 (UTC)

It's real; it's Hans Asperger's wording. However, most people now believe that he was making a comparison to other syndromes such as Down's, Apert's syndrome, etc., the majority of which involve some sort of physical deformity. Soap ^Talk/_{Contributions} 11:10, 22 November 2008 (UTC)

You can find a source for this in Uta Frith's book Autism and Asperger Syndrome, which mentions it three times since it is a compilation of essays by different researchers. The book also includes Asperger's original paper, translated into English, and apparently still the only available English translation of the paper anywhere. I used to have the book but I don't have access to it right now; I searched the book in Google Books for "attractive appearance" and I found it on page 10, but that doesn't give the context I remember, which seemed to imply that Asperger was saying that children with AS are attractive by comparison to the other kinds of kids that turned up at mental institutions, not to the general population as a whole. Soap ^Talk/_{Contributions} 19:44, 22 November 2008 (UTC)

Hi Eubulides, it was in Funk & Wagnalls New Encyclopedia 1975 edition. HomerChimpson2 (talk) 02:53, 5 December 2008 (UTC)

Preliminary magnetoencephalography study

This edit added the following text to Autism #Communication:

"Researchers at Children's Hospital of Philadelphia reported in 2008 that comparisons of real-time magnetoencephalograms of normal and autistic children have shown that autistic individuals respond to sounds about 20 milliseconds slower, making it more difficult for them to process syllables in continuous speech.^[9]"

Thanks for bringing this to our attention. However, there are some problems with the edit:

The study has not yet been published in a peer-reviewed journal.
As the cited source makes clear, the study's results, although promising, are preliminary.
As per WP:MEDRS, for medical facts and figures like this it's better to use secondary sources such as reliable reviews, as is true for almost all the other sources used in that section.

All things considered I think in this particular area it's better to cite a reliable review rather than a news article about a primary study that hasn't been published in the literature. I looked for such a review, and found one directly on point: Roberts et al. 2008 (PMID 18336941), a recently published reliable review by the same group at the Children's Hospital of Philadelphia. The review is not quite as up-to-date as the CBS news article, but it's considerably more reliable, which is better for an encyclopedia. I also suggest moving this point from Autism #Communication (which talks about symptoms) to Autism #Pathophysiology (which talks about mechanism, a better location for this particular point). I plan to draft a change along these lines, once I have time to read Roberts et al.

Anyway, the bottom line is: thanks again for bringing this news item for our attention, and we'll use a review to improve the topic's coverage further. Eubulides (talk) 22:17, 1 December 2008 (UTC)

I'm disappointed to see what has been done to my contribution. As originally written, it said something. Now, as edited, it says nothing. In toto, the Autism article reads like a dreary excerpt from a technical journal, not an encyclopedia entry. As a career electrical engineer, I tend to avoid reading Transactions of the IEEE for that reason, as such arcane writings only seem to satisfy someone's academic "publish-or-perish" requirements, not the needs of the average Joe. —Quicksilver^{T @} 08:11, 2 December 2008 (UTC)

Unfortunately, the original text was not supported by a source that is reliable according to WP:MEDRS guidelines. For Wikipedia purposes it's better to have boring and reliable text than interesting and unreliable. Better yet, of course, would be both sprightly wording and reliable sources; specific suggestions for improving the existing wording are welcome. I did change "structural anomalies" to "delayed responses"; hope this helps. Eubulides (talk) 08:50, 2 December 2008 (UTC)

Rimland-centered history

This edit added the following text:

This so-called “refrigerator mother” theory was popularized by Bruno Bettelheim and inflicted a tremendous sense of guilt on the already traumatized mothers, who were unjustly blamed for their child’s condition. Bettelheim’s specious theory was discredited by Dr. Bernard Rimland , who wrote the landmark 1964 book Infantile Autism: The Syndrome and Its Implications for a Neural Theory of Behavior . In this book, which is credited for bringing autism out of the dark ages, Rimland concluded that based on his research, autism was caused by biochemical and physiological factors, including genetics. Not content with merely explaining the origins of autism, Dr. Rimland devoted his life to finding out everything he could about this mysterious condition, including prevention, treatment and possible contributing factors . In 1965, Rimland , known as “the father of modern autism” (and the father of an autistic son himself ), formed the Autism Society of America, the largest parent–based organization in the country, with over 100,000 members. In 1967, he founded the Autism Research Institute, which was (and is) devoted to scientifically based research on treatments, causes and prevention.

This text is unsourced, and attempts to rewrite the history of autism from the perspective of Bernard Rimland. It would be better to use a reliable source for this sort of thing: I suggest Wolff 2004 (doi:10.1007/s00787-004-0363-5). Eubulides (talk) 02:48, 13 December 2008 (UTC)

I see now that the same editor has reinserted nearly the same text (except this time with a misspelling), without discussion. This text is unsourced and is not neutral. Please discuss changes like this, instead of simply reinserting them.
I just now checked, and Wolff 2004 (doi:10.1007/s00787-004-0363-5) does not even mention Rimland, which suggests that this newly added treatment of Rimland does not pass the WP:WEIGHT test either.
For now I have merely tagged the new addition, but really, the whole thing should get reverted. We should be using reliable sources like Wolff on the history of autism.

Eubulides (talk) 08:14, 13 December 2008 (UTC)

Controversy section

This set of edits introduced the following text in what appears to be a new section Controversy:

"Some critics have argued that true autism is still rare and Autism Spectrum Disorder is not an epidemic but rather a result of a purposeful broadening of diagnostic criteria for poorly misunderstood and widely varying delays. Educators have noted a reclassification of children who were previously placed in special education for reasons varying from expressive receptive language delay to some level of retardation. Some critics question whether high functioning ASD (such as Aspergers) is in fact a disorder since children with high functioning ASD generally go on to live normal lives and are often more intelligent than average. Some have argued that the diagnostic criteria for autism are meant to reflect an extremeness of impairment in social skills and communication as well as behavioral repetitions and that poorly trained evaluators have loosely applied these diagnostics. It's also been argued that some highly intelligent and normal children follow an abnormal development curve exhibiting "autistic like" symptoms such as lack of communication, aloofness and intense interests early on. It is difficult to offer a prognosis for late talkers who are often put on the radar for autism and it is likely that the diagnostic rates and criteria for autism disorders will remain controversial."

This text is entirely unsourced, which runs afoul of WP:V. Also, it repeats material that is already in Autism; for example, its first point largely duplicates the following text in Autism #Epidemiology:

"This increase is largely attributable to changes in diagnostic practices, referral patterns, availability of services, age at diagnosis, and public awareness, though unidentified contributing environmental risk factors cannot be ruled out. It is unknown whether autism's prevalence increased during the same period ..."

Please take the time to read the existing Autism and Controversies in autism articles. I also suggest reading Wikipedia policies and guidelines such as WP:V, WP:OR, WP:RS, and WP:SOAPBOX. For now, I have reverted the change, as it is duplicative and unsourced. Eubulides (talk) 04:48, 19 December 2008 (UTC)

FWIW, I support the removal by Eubulides. AKRadecki^Speaketh 18:46, 19 December 2008 (UTC)

I also concur with the removal of this text, which runs afoul of WP:V, WP:UNDUE and WP:WEASEL. SandyGeorgia (Talk) 22:56, 19 December 2008 (UTC)

Same here, glad it is gone, it had no place here for the above reasons. Dbrodbeck (talk) 01:34, 20 December 2008 (UTC)

Hormones

Cause of Autism: When a child has much more male hormones than females hormones, or he only has male hormones and no female hormones, he will become autistic. The behaviors of the autistic children show that this is true. Our behaviors are affected by the hormones that we possess. Madonnacheung (talk) 03:21, 29 December 2008 (UTC)

If only it were that easy. --Uncle Milty (talk) 03:30, 29 December 2008 (UTC)

This topic is covered in Causes of autism #Fetal testosterone; I suggest directing further discussion to Talk:Causes of autism. Eubulides (talk) 03:35, 29 December 2008 (UTC)

Autism and cyclic AMP

Please consider adding:

Cyclic AMP is a signal transduction enzyme altered in Fragile X which is implicated in autism behaviors and several autism theories.

The cyclic AMP phenotype of fragile X and autism. Kelley DJ, Bhattacharyya A, Lahvis GP, Yin JC, Malter J, Davidson RJ. Neurosci Biobehav Rev. 2008 Oct;32(8):1533-43. Epub 2008 Jun 17. Review.

Functional connectivity does not adequately describe the changes in autism connectivity because underconnectivity and overconnectivity are present.

Kelley, Daniel. The Functional Autism Connectome. Available from Nature Precedings <http://dx.doi.org/10.1038/npre.2008.2724.1> (2008) http://precedings.nature.com/documents/2724/version/1

Djkmed (talk) 17:19, 1 January 2009 (UTC)

I'm afraid that that theory, while a worthy one, needs to compete with dozens if not hundreds of similar theories in the area. See, for example, the November 2008 issue of the Journal of the International Neuropsychological Society, which has eight articles in that area. We don't have space to cover all this work in Autism, and as per WP:MEDRS we need to rely on high-quality reviews published in refereed scientific and medical journals to help us decide what to put in. Maybe in a few years, if and when the connectome theory of autism becomes more notable and reviewed, we could put it in then. In the meantime I suggest adding a line or two to Heritability of autism somewhere, but it should refer to a refereed medical journal article and not to a prepublication disseration. Eubulides (talk) 20:05, 1 January 2009 (UTC)

poor writing style

This article is poorly written. I have perfect test scores and a Ph.D., yet I was bothered by the overly technical content. Perhaps the main problem was the lack of explanatory info at the beginning, before diving deep. Also having all the PDD stuff at the beginning, when it is really an aside for the subject of the article. Am amazed that this article passed as an FA. NOT a pleasure to read. TCO (talk) 05:53, 3 January 2009 (UTC)

Specific suggestions for wording improvements would be welcome. Or if that's too much work, perhaps you could identify exactly which phrases were hard to understand? Editors who have seen this stuff over and over again often don't see problems like that, and a fresh pair of eyes can be quite helpful. Eubulides (talk) 06:02, 3 January 2009 (UTC)

Let me think about it. There were some ideas given in my post. I have heard there is a general problem with engaging readability on wikipedia. Part of this is just good style. But also has to do with technical content especially at front of the article. Also have seen some pattern on math technical articles of them being too technical, for e general (even smart general audience). I could probably struggle through and read it. but seriously, don't think it met normal standard of engagingness for a popular (encyclopedia is popular) article. suggest more of the basic so what content at front and technical issues (where it fits in DSM etc.) further back. sorry if this is not more specific, but it is honest (and I think correct) criticism from a reader (not writer) POV. TCO (talk) 02:39, 4 January 2009 (UTC)

The only specific idea I saw in the original post was about "having all the PDD stuff at the beginning". I just now attempted to fix this problem by removing the phrase "such as pervasive developmental disorder not otherwise specified (PDD-NOS)" from the lead paragraph. More suggestions are welcome. Eubulides (talk) 05:56, 4 January 2009 (UTC)

I am approaching this as an interested and intelligent reader. Saw a refernce to the term on the web and wanted to read more to know the basics as I have heard the term but don't really understand it. Would be better served by some other webpage than wikipedia given the non-interesting prose here. I mean look at the article on Hottentots or Matthew c Perry. Tehy read and give you some interesting window to something. Autism is INTERESTING, too. But you don't get that from this article, the way it's written now. I am not an expert on good writing, I just recognize the difference as a reader. Perhaps bringing someone in like this would help: User:Tony1. He's kind of more of a Elements of Style pusher, but he also might have some thoughts on making the article suitable and INTERESTING to a general audience. Some random thoughts:

Look at the first sentence. Do you need all the "and" constructions (those tend to be boring to the reader and loquacious and overcautious (you get the idea?) when it is just citing multiple similar things like "sticks and twigs".
Still on first sentence, are all these tough technical terms needed at the beginning. I mean I'm trying to get the basic concept here. Not read clinical or psychospeak ("impaired social interaction"). The captioned picture on the side was much better however.
Entire intro section seems too long. Making it shorter might force you to be more crisp about (basically) what autism is. The caveats and disputed areas and more formal definitions could be kept in the meat of the article.
Move classification deeper into the article. At least after characteristics, which is the most important thing to learn first for someone with limited knowledge and who may not bother reading the whole article. This is not a review article for a journal.

Hope the above helps. I really have a point here, but am struggling to get it accross as I'm not a super communication expert either. I do appreciate that you are a volunteer, not a paid writer. Same with me. TCO (talk) 07:01, 4 January 2009 (UTC)

Tony1 had a go at the article, but maybe we can have him look at it again.
We've just now reworded the 1st sentence to break it up a bit. Alas, the "multiple similar things" are all subtly different, and are worded carefully to match the official diagnostic criteria (which are the cited source here) so I don't easily see how we can get rid of all the "and"s.
Likewise for the "impairs social interaction". The cited source says "qualitative impairment in social interaction, as manifested by at least two of the following:" and we've summarized that as "impairs social interaction". I don't offhand see how to simplify this further.
The intro is a bit shorter now.
I moved Classification to be after Characteristics.

Hope this helps, and again, thanks for the suggestions (and for any further suggestions you can think of). Eubulides (talk) 08:58, 4 January 2009 (UTC)

The first sentence feels awkward in that it says that autism "impairs social development" and "produces" repetitive behavior. Whether the source says it or not, it seems more correct to say that autism is characterized by these behaviors, similar to the lead of the Down's syndrome article. II | (t - c) 01:05, 10 January 2009 (UTC)

The third sentence is unclear. What signs are referred to? Impaired communication and repetitive behavior are not present in the milder forms? Also, I removed communication since that is a synonym for social interaction, and restrictive is vague and highly similar to repetitive. II | (t - c) 01:11, 10 January 2009 (UTC)

The link used for the intro sources now leads to an assessment. I don't know where the DSM-IV online is. What the link does have on autism supports my above point: it doesn't say autism causes anything, but says it has essential features which manifest [8]. II | (t - c) 01:19, 10 January 2009 (UTC)

Thanks for the comments. Basically, the "signs" referred to are any and all of the signs. If any core sign is not present, then it's not autism proper, but it may still be ASD. "Communication" is not a synonym for "social interaction", at least, not in DSM-ese. Communication is primarily about language skills, whereas social interaction is more often non-lingual. "Restrictive" is not the same as "repetitive": the former means a narrow range of interests, the latter means doing the same thing over and over again. The link was indeed broken but Google Books URLs are not reliable, so I fixed it to point to the more-stable CDC. Eubulides (talk) 08:16, 10 January 2009 (UTC)

New epidemiology analysis concludes that increased autism rates not due to broader diagnosis

Noticed this article at EurekAlert today. The study is here. Not yet in PubMed, it appears. II | (t - c) 23:55, 9 January 2009 (UTC)

Thanks for the heads-up. That single primary study is too much detail for Autism, so I put it into Epidemiology of autism #Changes with time. Eubulides (talk) 00:32, 10 January 2009 (UTC)

Screening

CAN YOU PLEASE INCLUDE THE FOLLOWING PARAGRAPH UNDER THE SCREENING SECTION. THE PETITION IS TO HAVE ALL CHILDREN ASSESSED OF A MULTITUDE OF SPECIFIC LEARNING DIFFICULTIES

In Scotland, David Ballantine a member of the cross party group on dyslexia put forward a petition through the Scottish Parliament Petitions Website. The petition called:

"On the Scottish Parliament to urge the Scottish Government to consider the need for legislation to provide a standardised assessment of all schoolchildren by the age of 8 which will inform parents, pupils and educators as to whether the pupil is at risk of developing a specific learning difficulty."

The petition was contrary to the other view that children should not be identified with Autism as it was felt that a significant proportion of these children who were Autistic and not identified did not have appropriate learning strategies in place and that it was the right of the child to know if they had a learning difficulty that would inhibit their education.

The petition runs till the 20th February 2009 and was accepting signatures from all over the world. Scottish Parliament Petitions Website —Preceding unsigned comment added by David Ballantine (talk • contribs) 21:05, 11 January 2009 (UTC)

I'm afraid this sounds very much like WP:RECENTISM and WP:ADVOCACY and therefore inappropriate for Autism #Screening. Eubulides (talk) 21:36, 11 January 2009 (UTC)

Agree. SandyGeorgia (Talk) 14:22, 18 January 2009 (UTC)

Plagiarism text

I reverted text attributed to Fitzgerald that Kanner plagiarized Asperger: [9] this text needs to be sorted and properly sourced. SandyGeorgia (Talk) 14:22, 18 January 2009 (UTC)

Which was reinserted, and then I reverted it too.... Dbrodbeck (talk) 14:56, 18 January 2009 (UTC)

Fitzgerald's theory is possibly true, but it's a serious charge and the source is not reliable enough to be worth mentioning here. Here's Fitzgerald's allegation (I've omitted his footnotes):

'Hans Asperger was the first pioneer of autism research, and not Leo Kanner. I have no doubt that Leo Kanner was aware of Hans Asperger's 1938 paper because he mentions that "since 1938, there have come to our attention a number of children.... ' Sadly he did not mention Hans Asperger's name. This is plagiarism, Asperger and Kanner spoke the same language and came from the same city, Vienna. During World War II, Leo Kanner had much contact with medical refugees from his native country. Nonattribution or in this case plagiarism is always sad and is usually exposed even if it takes 60 years, as in this case.' Fitzgerald M (2008). "Autism: Asperger's Syndrome—history and first descriptions". In Rausch JL, Johnson ME, Casanova MF (ed.). Asperger's Disorder. Informa. pp. 1–6. ISBN 0849383609.{{cite book}}: CS1 maint: multiple names: editors list (link)

My Google Books preview stopped just before most of Fitzgerald's references section, but the likely citations are probably Asperger 1938 (Wien Klin Wochenschr 51: 1314–7), Kanner 1942 (Nerv Child 2: 217–50), and Lyons & Fitzgerald 2007 (PMID 17922179). The last source, coauthored by Fitzgerald, presents the evidence in question without once saying the word "plagiarism", and it also gives a plausible explanation for why it might not have been plagiarism.
Fitzgerald is noted for making poorly-supported claims about historical figures. For example, he's speculated that Mozart had autism, which goes significantly beyond what the evidence says; see Ashoori and Jankovic 2008 (PMID 18644922), which briefly discusses the Mozart-had-autism theory along with the Mozart-had-Tourette's theory.
My guess is that Fitzgerald's charge of plagiarism didn't make it into the peer-reviewed journal because the reviewers objected, so he stuck it into a book with lower editorial standards. As such, the source is not reliable enough to be mentioned here.

Eubulides (talk) 20:07, 18 January 2009 (UTC)

I concur that Fitzgerald's self-publications aren't reliable enough for publication here; peer reviewed sources are preferable for such a claim. SandyGeorgia (Talk) 00:10, 19 January 2009 (UTC)

In Fitzgerald's defense, the accusation was published in a book (ISBN 0849383609) that Fitzgerald himself didn't edit. However, there's no sign of peer review in the book. At any rate, it's a less reliable venue than the Journal of Autism and Developmental Disorders, which published Lyons & Fitzgerald 2007 (PMID 17922179), the source I find far more reliable. Eubulides (talk) 00:19, 19 January 2009 (UTC)

The term 'overwhelming' should not be used to describe evidence

In the section 'Causes', a statement reads "there is overwhelming scientific evidence showing no causal association between the measles-mumps-rubella vaccine and autism." The term 'overwhelming' generally refers to an emotional reaction to some event. I wonder if in the case of this article the editor upon seeing the evidence, was so overwhelmed that she had to stop reading the articles and lie down in order to regain her faculties. But even so, anyone's emotional response to some piece of evidence is epistemologically irrelevant to the evidence being considered. Rather, evidence is a thing that exists outside of the observer and can be assessed by the observer on what justificatory qualities are attached to the evidentiary object. --Phiborjam (talk) 07:43, 4 February 2009 (UTC)

Your comment shows a lack of familiarity with the way many people talk about psychology research (or other) findings. In the U.S. at least, "overwhelming evidence" is a common phrase indicating that the weight of the evidence (objectively considered) is highly unbalanced, and that the weaker side's arguments are "overwhelmed" by a far greater or more compelling body of evidence in favor of a different conclusion.

Nevertheless, the sentence in the article was strangely phrased, though not for the reason you gave. I have changed the phrasing. Thank you for calling attention to it. -Do c t orW 08:07, 4 February 2009 (UTC)

This topic has come up before; see Talk:Autism/Archive 9 #MMR remark. Briefly, the cited source (Doja & Roberts 2006, PMID 17168158) supports the word "overwhelming", by saying in its abstract, "In particular, some have suggested an association between the Measles-Mumps-Rubella vaccine and autism. Our literature review found very few studies supporting this theory, with the overwhelming majority showing no causal association between the Measles-Mumps-Rubella vaccine and autism." I reworded the sentence in question to match the source better, as it had strayed a bit with the recent editing. Eubulides (talk) 08:43, 4 February 2009 (UTC)

March issue of Br J Hosp Med

The current issue of the British Journal of Hospital Medicine contains the following articles, which may be of interest, though I lack ready access to them:

Jordan R (2009). "Medicalization of autism spectrum disorders: implications for services". Br J Hosp Med. 70 (3): 128–129. PMID 19273998.
Lord C, Bishop SL (2009). "The autism spectrum: definitions, assessment and diagnoses". Br J Hosp Med. 70 (3): 132–135. PMID 19274000.
Deeley Q, Murphy D (2009). "Pathophysiology of autism: evidence from brain imaging:". Br J Hosp Med. 70 (3): 138–142. PMID 19274001.
Aldred CR, Green J (2009). "Early social communication interventions for autism". Br J Hosp Med. 70 (3): 143–145. PMID 19274002.

Eubulides (talk) 07:01, 12 March 2009 (UTC)

HBOT

A recent edit introduced discussion of Rossignol et al. 2009 (doi:10.1186/1471-2431-9-21) published yesterday, a double-blind study on hyperbaric oxygen therapy (HBOT). As far as therapies go Autism does not mention primary studies, but relies on reliable reviews as per WP:MEDRS, so I moved the discussion to Autism therapies #Hyperbaric oxygen therapy. Eubulides (talk) 15:47, 14 March 2009 (UTC)

Kanner image

I have twice removed the image of Kanner from the article, as I am not seeing how it is necessary in any way. I have no doubt that Kanner is significant to the history of autism (I profess I don't actually know much about the topic) but I am not seeing how knowing what he looks like aids the reader in any way. Per the non-free content criteria point 8, "Non-free content is used only if its presence would significantly increase readers' understanding of the topic, and its omission would be detrimental to that understanding.". Could it please be explained how not knowing what Kanner looks like would be detrimental to understanding? J Milburn (talk) 21:31, 12 March 2009 (UTC)

Ah, you didn't mention that it was a non-free image in your edit summary and I didn't realise that was the case. Looking at the policy, I agree with you - this image isn't necessary for the reader to understand the topic. Tim Vickers (talk) 23:12, 12 March 2009 (UTC)

I'm with you on this. Now what about Hans Asperger's photo? Tim D (talk) 23:29, 12 March 2009 (UTC)

I disagree. It's important for non-expert readers to know that autism was discovered by, and to some extent is a construct of, human psychologists, and that autism is not determined by abstract scientific principles or by God or whatever. It's essential for the article to put a human face on the history of autism research, and the image helps to significantly and easily increase readers' understanding of this part of the topic. I will take a look at rewording the caption to make this point clearer. As for Asperger's photo, the same point applies to it as well. I don't see a consensus at Wikipedia:Files for deletion/2009 March 11 #http://en.wikipedia.org/wiki/File:Asperger_kl2.jpg to remove that image, and it's premature to be removing the use of the image here while discussion is still ongoing there. Eubulides (talk) 23:39, 12 March 2009 (UTC)

I don't think that people need to see an actual face in order to comprehend that a human being is behind something. If you say "/something/ was discovered by /So-and-So/," and a reader wants to see a picture, all you need is a link to So-and-So's biography article, and there they'll have it. Easy as that. Tim D (talk) 23:46, 12 March 2009 (UTC)

It's very rare for anyone to need to see an actual face for anything. For example, Andre Malraux doesn't discuss Malraux's face, so what is that fair-use image of Malraux doing there in the lead for that article? The standard "people need to see an actual face" is not the standard that Wikipedia uses for fair-use images, and we . Eubulides (talk) 23:53, 12 March 2009 (UTC)

I'd say it's pretty clearly different when the article is about the person pictured Tim D (talk) 00:04, 13 March 2009 (UTC)

I don't see the difference from the point of view of Wikipedia policy. The policy doesn't say that a fair-use picture of Joe Schmoe can be used only in an article named Joe Schmoe; it says that the picture can be used in an article Whatsit only if the picture significantly affects reader understanding of Whatsit. The photos of Kanner and of Asperger significantly affect reader understanding of the history and classification of autism. Eubulides (talk) 08:13, 13 March 2009 (UTC)

Asperger seems to me to be much more important to the history of autism than Kanner. Is that an accurate summary Eubulides? Or are they of equal importance? Tim Vickers (talk) 23:43, 12 March 2009 (UTC)

Reliable sources rate them about equally as pioneers. For example, please see:

Lyons V, Fitzgerald M (2007). "Asperger (1906–1980) and Kanner (1894–1981), the two pioneers of autism". J Autism Dev Disord. 37 (10): 2022–3. doi:10.1007/s10803-007-0383-3. PMID 17922179.

This source gives an edge to Asperger, but I imagine it wouldn't be hard to find another source which would do the same for Kanner. Eubulides (talk) 23:53, 12 March 2009 (UTC)

Hmmm. While neither image is necessary for a reader to understand the topic, I suppose it is a valid argument that showing the "discoverers" of autism is encyclopedic content and could "significantly increase" the reader's understanding of the topic - I think we can all agree that these are obviously not purely decorative images. Tim Vickers (talk) 01:43, 13 March 2009 (UTC)

(outdent) Further research shows that the Kanner image is out of copyright; I have updated File:Kanner kl2.jpg accordingly and have restored it to this article. Eubulides (talk) 01:22, 14 March 2009 (UTC)

What make you sure "The photograph was published in 1955 without a copyright notice." I don't see that information explicitly on the full record or marc record (found with this Google search) but I'm not familiar with that system. Why does the NLM feel the need to watermark their image if it is public domain? Colin°^Talk 13:47, 14 March 2009 (UTC)

The photograph was deposited in the NLM as a single photo. It was autographed by Kanner but there's no copyright notice on it. The NLM routinely puts its watermark on many of its public-domain images (see, for example, its portrait of Joseph Leidy), so the presence of a watermark on Kanner's photo is not a useful indicator. Just to be safe I did a copyright search for the photo and came up empty, so even if there were a copyright notice on it we would be safe. Eubulides (talk) 22:40, 25 March 2009 (UTC)

Ok, that problem seems to be sorted. The image of Asperger is currently at IfD. For future instances, the general practice is that a single non-free image of a deceased person in their biography is acceptable, as knowing what the person looks like is important for a full understanding of the person. Knowing what the scientists look like is not necessary for a full understanding of a disease, or, if it was, then the appearance of the scientist would be discussed in the text. J Milburn (talk) 12:27, 14 March 2009 (UTC)

Speech therapists etc.

A recent edit to Autism added the unsourced phrase "Many problems can be treated with the help of physical, occupational, and speech therapists." But Autism already covered that topic, saying "Available approaches include applied behavior analysis (ABA), developmental models, structured teaching, speech and language therapy, social skills therapy, and occupational therapy." and citing Myers et al. 2007 (PMID 17967921). The new phrase is redundant and (contrary to WP:V and WP:MEDRS) isn't sourced. It should be removed, or sourced and better-integrated with the existing text. Eubulides (talk) 17:39, 25 March 2009 (UTC)

I'd say removed. SandyGeorgia (Talk) 17:44, 25 March 2009 (UTC)

Autism in Media

should there be a mention about how autism is treated in fiction and stories written about Autism Tydoni (talk) 05:45, 28 March 2009 (UTC)

Please see Sociological and cultural aspects of autism #Scholarship and literature for that. Eubulides (talk) 06:06, 28 March 2009 (UTC)

Biological motion

A cool study recently came out in Nature:

Klin A, Lin DJ, Gorrindo P, Ramsay G, Jones W (2009). "Two-year-olds with autism orient to non-social contingencies rather than biological motion". Nature. doi:10.1038/nature07868. PMID 19329996. {{cite journal}}: Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link)

Not sure whether or how this should be put into Autism, though, as it's just a primary study and WP:MEDRS suggests caution in this area. Eubulides (talk) 16:18, 31 March 2009 (UTC)

Asperger image

A recent edit removed a reference to a new image Image:Asperger-Vienna-clinic.jpeg with the comment "The consensus at the FFD page was clear- an image of Asperger is not required. This image is not being used in a different way." Two points:

"This image is not being used in a different way" Good point, and I moved the image to Autism #History, the section where it should have been put in the first place. The image now directly illustrates the following discussion of the historical period when Asperger co-discovered autism.

"The word autism first took its modern sense in 1938 when Hans Asperger of the Vienna University Hospital adopted Bleuler's terminology autistic psychopaths in a lecture in German about child psychology. Asperger was investigating a form of ASD now known as Asperger syndrome, though for various reasons it was not widely recognized as a separate diagnosis until 1981."

"The consensus at the FFD page was clear- an image of Asperger is not required" The consensus at the FFD page was that a simple portrait of Asperger's face, made well after his discovery of autism, was not required. The new image is quite different: it shows Asperger at work, conducting a psychological test of a child, in the clinic where he discovered autism, near the time when the discovery was made. As such, it is a historical photograph that is directly relevant to the article's discussion.

A followup comment at User talk:Eubulides #Asperger image argued that adding the new image was "bordering on disruptive". That is certainly not the intent. The intent is to illustrate the discovery of autism, which is an important topic within Autism. We know of no free image on the topic, and given the topic's historical nature it will be impossible to generate a free image on our own. Eubulides (talk) 18:13, 17 March 2009 (UTC)

And now you're just wikilawyering. Sure, the fact Asperger discovered or named or developed or whatever is significant, but why is how he looked at the time? What do you actually see the image as illustrating, that needs to be illustrated? That sentence works perfectly fine without illustration- it's not like you read it and think "hmmm, I wonder what Asperger looked like when he was doing experiments?". J Milburn (talk) 18:18, 17 March 2009 (UTC)

"And now you're just wikilawyering" This is not wikilawyering: it is improving the encyclopedia. The old image was objected to because it was just a portrait of Asperger's face, which is not that relevant to Autism. The new image is quite different: it's a portrait of Asperger in action, doing what he was doing when he discovered autism, a topic highly relevant to Autism.
"why is how he looked at the time?" The image is not just one of Asperger's personal appearance: it is an image of Asperger testing a child, and it gives the reader an easy-to-see impression of how psychological research was conducted back then. Asperger's white coat indicates that he was using a medical approach (as opposed to other approaches, common at the time); his one-on-one encounter with the child shows how data were collected.
"That sentence works perfectly fine without illustration" No it doesn't. It doesn't convey any of the points mentioned in the previous bullet.
I see now that you removed the image again, with the comment " New image is strikingly similar to the one just deleted." No, actually, the new image is not at all "strikingly similar". They are quite different. Are you sure you're looking at the correct images? Here they are again:

The two images are strikingly different. One is just Asperger's face, as an older man, long after the research in question. The other one is contemporaneous, and focuses on the autism research, not on Asperger per se.

I have the impression that this image was removed from Autism without a clear understanding of autism, the history of autism, or why Asperger's involvement was so important. Please take the time to read the article and its historical sources to get a better feeling for what's important (and what's not) about the history of autism. Here are some good sources, which Autism already cites:

Wolff S (2004). "The history of autism". Eur Child Adolesc Psychiatry. 13 (4): 201–8. doi:10.1007/s00787-004-0363-5. PMID 15365889.
Lyons V, Fitzgerald M (2007). "Asperger (1906–1980) and Kanner (1894–1981), the two pioneers of autism". J Autism Dev Disord. 37 (10): 2022–3. doi:10.1007/s10803-007-0383-3. PMID 17922179.

and here is another source (cited by the image itself):

Frith U (1991). "Asperger and his syndrome". In Frith U (ed.). Autism and Asperger Syndrome. Cambridge University Press. pp. 1–36. ISBN 0-521-38608-X.

Eubulides (talk) 19:22, 17 March 2009 (UTC)

I'd honestly love to read about Asperger, Asperger's syndrome and autism, I'm sure eventually I will (a book I read skirted on it recently, but ended up going in a different direction- I digress). However, I do not need to be an expert on the subject to contribute here- just as I do not expect you to be an expert on Wikipedia policy. If you believe that this image is necessary, can you honestly say you would have added it if the previous image had been deleted? Perhaps they are not actually strikingly similar, but when an image of Asperger is removed, adding an image of Asperger with a child and claiming it is unrelated to the previous discussion is stretching it a little. However, I am happy to treat this as unrelated to the previous discussion, provided you do not add the image to the article until there is a clear consensus to do so (as explained in the non-free content crtieria, the burden of proof to demonstrate the image necessary lies with you). As such, let us now look at the merits of this image. What does it show? Asperger, in a white coat, talking to a child. Why does there need to be an image of that? The photo itself is not famous, and nor is the appearance of what it shows significant- perhaps his methodology is, but methodology should be discussed rather than illustrated. In what way does this really increase the readers' understanding in the way that text alone would not? J Milburn (talk) 19:37, 17 March 2009 (UTC)

"can you honestly say you would have added it..." Absolutely. Autism needs images about its two pioneering researchers, just as Tourette syndrome needs an image of Tourette and Schizophrenia needs an image of Bleuler. When I first helped to edit Autism to reach FA status, one of the important parts of that editing was to add images relevant to autism, including images for Asperger and Kanner, the two research pioneers for autism. Had the old Asperger image not been available, I would have searched for and found this one (or perhaps another non-free one).
"Perhaps they are not actually strikingly similar" Agreed. They are quite different. Thank you for conceding the point.
"claiming it is unrelated to the previous discussion" No such claim was made.
"The photo itself is not famous" There is no requirement in Wikipedia policy that the photo itself must be famous.
"What does it show? Asperger, in a white coat, talking to a child." No, it shows Asperger testing a child. The distinction is important. Asperger is not just idly talking to a child: he is doing psychological testing, which was essential for his research that discovered autism.
"nor is the appearance of what it shows significant" Yes, the appearance is significant. It expresses details about the early discovery of autism that are not in the text and which would not be easily movable to the text. Please see the above bullet with the text "The image is not just one of Asperger's personal appearance".
"methodology should be discussed rather than illustrated" Not when an illustration is a more ~~convenient and~~ immediately-accessible way of conveying the relevant information. Furthermore, in this particular case, the illustration conveys relevant information that we have no other reliable source for.

Eubulides (talk) 19:57, 17 March 2009 (UTC)

No, you're just plain wrong here. The article does not need images about its two pioneering researchers, as the IfD clearly indicated. A free image of a researcher would be nice, but showing what the researchers looked like does not help the reader in any way. If there is no reliable source, it can hardly be considered significant, and if the information is conveyable by text, it should be conveyed by text, even if the image is more convenient. It would be more convenient to use images from news websites than use loosely related images or have no illustrations at all- we do not use images merely to be "convenient". This image is not in any way improving the article, and has clearly been added only because the previous image was deleted. Please simply explain to me what the image is illustrating, and why it is imperative that that is illustrated. Vague mentions of white coats aren't really working for me. J Milburn (talk) 20:21, 17 March 2009 (UTC)

Again, this new image is not about "showing what the researchers looked like"; it is about showing how autism was discovered.
"If there is no reliable source" There is a reliable source: the image itself. It is this image that Frith's book Autism and Asperger Syndrome (ISBN 052138608X; a reliable source) uses to illustrate how early research was done. Frith's book doesn't use text to say that children were tested one-on-one at tables by men with white coats, and it doesn't need to use text to say it; it uses the photo. Autism can and should do the same.
"we do not use images merely to be 'convenient'" Fair enough; I struck the word "convenient" from my previous comment. The rest of the point still stands, however. Images are highly-useful ways of conveying relevant information that cannot easily be conveyed in any other way.
"Please simply explain to me what the image is illustrating, and why it is imperative that that is illustrated." Briefly, the image shows how autism was discovered. It is important to illustrate (and not merely describe) historical events in autism.
Given the above discussion, it appears that an impossibly high standard is being asked for in this particular case. I don't know of any article in Wikipedia that would meet the standard that it must be "imperative that that is illustrated". Every single Wikipedia article that uses a non-free image can obviously be rewritten to not use the image, without violating Wikipedia policy, so it is never imperative to use a non-free image.
I have asked for a third opinion.

Eubulides (talk) 20:59, 17 March 2009 (UTC)

There is no need to illustrate the research. Yes, others do, but we have much stricter rules, and no doubt they discussed the matter for longer than a couple of paragraphs. An impossibly high standard is not being asked for- you're just realising how unneeded this image actually is. Compare to the use of paintings in visual arts articles, or compare to the use of old photos in articles about demolished buildings. A picture of Asperger doing his research is not needed- the article was fine without it. It does not tie to the text- at no point does the reader think "hmm, I wonder what Asperger looked like when he was doing his research?" Compare with my above examples- when reading the article, the reader is certainly going to think "I wonder what X looked like", and that's why the image is needed. J Milburn (talk) 21:08, 17 March 2009 (UTC)

"There is no need to illustrate the research" By these standards, there is no need to illustrate anything.
"Yes, others do, but we have much stricter rules, and no doubt they discussed the matter for longer than a couple of paragraphs." Sorry, I can't really parse that. But if the comment is referring to Frith's book, yes, it did discuss the history of autism research for more than a couple of paragraphs, and it also had multiple illustrations where Autism #History has just one. Clearly illustrations help, both here and in Frith's book; but the number of illustrations in Frith's book doesn't directly bear on the number of illustrations here, as Frith's book is meant for the expert, whereas Autism is aimed at the general reader.
"An impossibly high standard is not being asked for" I don't see why not. I don't see how any image can meet the standard that it is "imperative that that is illustrated". Images are never imperative. One can always omit them, albeit at the cost of an inferior encyclopedia.
"you're just realising how unneeded this image actually is" Not at all. The image significantly increases the reader's understanding of the topic.
"Compare to the use of paintings in visual arts articles, or compare to the use of old photos in articles about demolished buildings." Those images aren't "imperative" either. No image is "imperative".
"It does not tie to the text" Sure it does. It directly ties to the Autism #History text "The word autism first took its modern sense in 1938 when Hans Asperger of the Vienna University Hospital adopted Bleuler's terminology autistic psychopaths in a lecture in German about child psychology. Asperger was investigating a form of ASD now known as Asperger syndrome ...".
"Compare with my above examples- when reading the article, the reader is certainly going to think 'I wonder what X looked like'" That is not the standard that WP:NFCC uses. It's not required that a reader must certainly think 'I wonder what X looked like' before we can include the corresponding image in Wikipedia.
What appears to have occurred here is an overly enthusiastic interpretation of WP:NFCC, an interpretation that comes at the expense of a better encyclopedia, and an interpretation that many other editors do not share.
In Autism #History we have a directly relevant historical image that significantly increases readers' understanding of the topic, and which has no free alternative (and for which, for obvious reasons, there's not likely to be a free alternative).
As shown in #3rd opinion on Asperger image, we also have a third opinion in favor of the image. I restored the image for now.

Eubulides (talk) 08:54, 18 March 2009 (UTC)

As a sometimes editor of the page I imagine I have a vested interest in this, but I have not come out with my feelings and opinions about this until now. The image is necessary and useful simply for the reasons Eubulides entered above. I should also note that knowing that the reader is thinking seems to actually be an impossibly high standard, unless we start surverying every reader of the encyclopedia. Dbrodbeck (talk) 11:24, 18 March 2009 (UTC)

3rd opinion on Asperger image

A 3rd opinion on this matter was requested. I should state first that I am an inclusionist with regards to Wikipedia; More content, especially when it is of varying types, is one of my highest goals with regards to Wikipedia. I personally believe that the picture would fit well with the article. It is small (and therefore easy on bandwidth for the end-user), it provides an illustration of both Asperger as well as the climate in which his studies were conducted. It does not provide a direct benefit, but it pays out in spades with regards to it's secondary and tertiary value, both by engaging the reader (Images demarcate places of interest, and their summaries often work well to summarize the section they are surrounded by). Images like this have precedent; would you argue that the picture of Leslie Lamport is unnecessary in http://en.wikipedia.org/wiki/Parallel_computing , or that the picture of Risperdal in http://en.wikipedia.org/wiki/Schizophrenia are unnecessary? True, they add no direct benefit, but with 1 look at the picture of the pills, I realized that the section was there because the section was about medications. Then, reading the caption, I learned that Risperdone (commonly called Risperdal) is a common treatment for Schizophrenia. Leslie Lamport... Well, I can't really argue for his inclusion in the article on second thought; it doesn't exactly add much. But I still feel that this picture would add more to this article than it would take away. 24.205.53.113 (talk) 01:12, 18 March 2009 (UTC)

First, the image helps satisfy folks' natural curiosity about what Asperger might look like. That's info that can't be conveyed in words, not even by the proverbial thousand words a picture is sometimes estimated to be worth (on average, I suppose-- cynical lol). Second, the image conveys a sense for the care that Asperger appears to have had for kids debilitated by this condition in a way that words cannot. I recognize that images can be abused to convey things that are misleading, but it seems to me this picture is quite straightforward and NPOV. Third, the image conveys an enhanced sense of the clinical environment in which Asperger worked in his day, in a way that words would be essentially useless to convey. Fourth, the image adds to the article by providing a visual reference independently of text. I know Wikipedians tend to be text oriented or we wouldn't bother to participate much, but there's an additional aspect of an arguably well-chosen image like this that adds to the article, which is an intuitive judgment that upon demand for proof that it helps the reader, doesn't stand a chance to prove to a determined naysayer. Fifth, if push comes to shove, experience has taught that among the vocal minority of WP users who cluster around the notion that "non-free" images are anathema to WP the determination to remove such images to the maximum feasible extent is strong, and that users who are thusly oriented have pretty-much figured out how to get their way if they set their sights on a target. So offhand I give this image less than a 50-50 chance at surviving-- but who knows? Now comes the probable dilemma, per NFCC #8, of proving to the satisfaction of the vocal minority that show up regularly at WP:NFCC the policy, WP:NFC the guideline, WT:NFC the talk page for both the policy and related guideline, and at WP:FfDs, that the image significantly enhances readers' understanding of the topic, and that the removal of the image "would be detrimental to that understanding". To an opponent of such images you can't prove such a proposition-- it's tough to express at all, and impossible to fully express. IOW, either you like it or you don't, whatever your reasons might be that are largely unexpressable in words alone. Sad in a way, but a fact of life on the wiki. In sum, I think an image such as this is helpful and an excellent addition to the article even despite its crappy graphic resolution. But based upon experience I don't expect it to be around for very long. ... Kenosis (talk) 05:14, 18 March 2009 (UTC)

24.205..., you have completely and utterly missed the point. This image is non-free- please review our non-free content criteria and non-free content guidelines. The points you raise do not address the issue of whether we are justified in using an image for which we have not been given permission; the images you compare this to are free. If this image was free, I would have no opposition to its inclusion. Kenosis- what you say may be correct, but the reader does not need to know what Asperger looked like (if they genuinely have interest about him, they would be reading the article about him, rather than this one) and, as you state, it isn't really our job to throw in images to help the reader form opinions about how Asperger cared for the children- that's hardly the point of this article, nor is it discussed, nor is it important to this subject matter. The same is true of the clinical testing- if it's really important, it would be discussed. Adding a "visual reference" is not enough- it has to actually show something in particular that needs to be shown. Further, here is really not the place for random sandboxing- to a paranoid reader, you may give the impression that you are trying to villify me by insinuating I am part of some sort of cabal of users who have an irrtational hatred of non-free content. If that was to be implied, then people are really going to stop taking what you say seriously. Even if true, trying to imply my opinion is null and void because I'm one of "them" really isn't an acceptable way to debate a subject. It just makes you sound like a conspiracy theorist. J Milburn (talk) 20:41, 18 March 2009 (UTC)

I was not aware it was non-free; In that case, the case to delete it is much stronger, though I still feel it adds to the article. EDIT: and I am sorry that what I said gave the impression that I was attempting to pidgeonhole you into a stereotype of deletionism. 24.205.53.113 (talk) 10:42, 21 March 2009 (UTC)

The term "non-free" is misleading-- highly misleading. It does not mean that it involves financial cost, or even risk of financial cost, but rather that the image lacks an explicit "free" license such as the GNU Free Documentation License or other explicit license such as listed in Wikipedia:Image_copyright_tags/Free_licenses. Most often it is impossible to verify the authenticity of these licenses that are commonly attached to an entirely anonymous source. There is a vocal minority of WP users who've found a niche for themselves searching the wiki for "violations" of this ideological position that anything that's not explicitly free-licensed needs to be removed unless it fits into one of the very narrow exceptions developed at WP:Non-free content and WP:Non-free content criteria. And frankly, the reasons given for removal of such images are frequently quite subjective, and more than occasionally go so far as to misrepresent the actual policy and related guideline page that've been developed. Many of the users who go 'round the wiki asserting this position appear to see it as a mission to purge a plague that has set upon the wiki, and have developed plenty of ammunition in support of the position, which is most typically escalated until the target image is removed. So, good luck. I hadn't been following this closely, but I note that as of now the image has been removed at this stage. Not surprising actually. C'est la vie, I suppose. Nonetheless, my compliments to the editors at this article for the work that y'all have done. ... Kenosis (talk) 16:06, 6 April 2009 (UTC)

Is this discussion about the non-free status or the use for Asperger's portrait, or similar picture, in the article? Fenke (talk) 02:23, 22 March 2009 (UTC)

A picture of Asperger - interacting with a child - does illustrate that autism affects real people more clearly then words could and it makes the content of the article more real then words, or even the MRI images, ever could. So, I'd say keep for the reason that it does enhance the article. But a possible copyright violation would be a stronger, more practical reason, to not include them. Fenke (talk) 02:23, 22 March 2009 (UTC)

One more from the peanut gallery agreeing with the importance of using appropriate photos to humanize the topic - within guidelines, of course. I think this is a nice photo and like what it conveys. (But I'm also the mom of the red-haired boy on the autism pages here, so it may already be obvious that I agree with the general illustration concept.) Andwhatsnext (talk) 05:49, 22 March 2009 (UTC)

The above opinions will be ignored

As a procedural matter, opinions expressed on this talk page will be ignored, when the question is whether the image should be deleted from Wikipedia. If you want your opinion on that matter to count, please add a Keep or Delete comment to Wikipedia:Files for deletion/2009 March 18 #Asperger-Vienna-clinic.jpeg. Eubulides (talk) 06:45, 22 March 2009 (UTC)

Or better, add a read arguments instead of just a Keep or Delete vote. --Damiens.rf 19:44, 6 April 2009 (UTC)

The definition of Autism

Recently I read in my local newspaper about the expanding of the definition of Autism. They said it now includes anything that may just be a habit or phobia that is similar to "Autism's" traits. Isn't that essentially saying that Autism isn't real and they don't know what else to call it? Autism, a neurolgical developmental condition, it is more common in males, it occurs usually in infancy. It can be diagnosed with symptoms effecting three behavioral domains, social delelopment, communication, and repetitive behavior. Language delays are also common in children with autism spectrum disorder. —Preceding unsigned comment added by 148.4.9.214 (talk) 22:16, 5 March 2009 (UTC)

As per WP:MEDRS #Popular press, newspapers are unreliable sources for medical facts and figures. But saying autism "may be just a habit" is pretty far out; perhaps you misunderstood the newspaper, or perhaps the newspaper is even less reliable than is usual for newspapers. Eubulides (talk) 04:09, 31 October 2008 (UTC)

The other issue is that autism is a condition defined by a series of symptoms. People know what causes certain types of autism but for the most part it is a bundle of symptoms that appear to have common traits. By the way- it isn't a casual connection - there are LOTS of related traits. SO people are struggling how to classify these symptom groups more and more precisely so proper medical and social intervention can be put in place to deal with it. Alex Jackl (talk) 15:50, 3 November 2008 (UTC)

Perseveration

I think the phrases "Restricted Behavior" should be replaced with "perseveration" which is the word most often used in professional circles. "restricted behavior" seems to be a muddy area between "perseveration" and "ritualistic" and "sameness" which are in fact three different behaviors. Smibbo (talk) 05:12, 4 March 2009 (UTC)

DSM-IV-TR doesn't say "perseveration"; it says "restricted repetitive and stereotyped patterns of behavior, interests, and activities".[10] What reliable source says "perseveration"? Eubulides (talk) 06:23, 4 March 2009 (UTC)

The basic, general definition of autism

We must remember that the two key traits that autism is classified as, is a person who is unable to form relationships with others or communicate with others. Other factors such as repetitive behaviour are secondary traits and should't be considered as the primary defining factors. sirrod2000 —Preceding unsigned comment added by sirrod2000 (talk • contribs) 10:09, 10 April, 2009 (UTC)

If one goes with the DSM definition, repetitive/stereotyped patterns of behaviors or interests are actually a major and necessary component to the diagnosis of autism. -Tim D (talk) 17:09, 10 April 2009 (UTC)

I'm thinking about translating the article into Russian..

..because the article is both highly-visited and very short in RuWiki.. ..and I was wondering if the latest English version is "the best to choose", or maybe there were some disputed changes lately, and I better take some "more stable" version, because the FA status was assigned rather long ago in WikiTime.. --CopperKettle 09:44, 6 February 2009 (UTC)

Most of the changes since FA have been to add reliable sources that were published after FA status. It's fairly stable except for that. Eubulides (talk) 15:58, 6 February 2009 (UTC)

Seconded - good luck! - Eldereft (cont.) 21:06, 6 February 2009 (UTC)

Thank you! I've started.. --CopperKettle 12:03, 19 February 2009 (UTC)

There's one question:

There are two definitions of autism in the article that diverge a bit, IMHO:
Autism is a highly variable brain development disorder
and
Autism is one of the five pervasive developmental disorders
The first one is close to ICD Q00-Q07 (as far as I understand), the second refers to ICD10 F84. Is it O.K.? I've asked at the Neurodevelopmental disorder if the article fits into ICD Q list. Or maybe the latter article is vague and overlaps several ICD sections.. --CopperKettle 12:03, 19 February 2009 (UTC)

Thanks for the comments. Q00–Q07 refers to congenital deformations, which can easily be seen as physical anomalies without fancy new hardware. In contrast, ICD10 F84 refers to disorders that historically were diagnosed solely by behaviors, and where no physical anomalies could be detected. Nowadays of course with fMRI and all, these divisions are blurring together. Autism is a developmental disorder of the neurons in the brain; this is currently summarized as "brain development disorder" because the lead sentence needs to be short, but perhaps you're right that the phrase causes confusion with the physically obvious disorders, so maybe we should change it to "neurodevelopmental disorder" (ugh) or "disorder of neural development" (double ugh). (I say "ugh" because many readers won't know what those phrases mean.) What do you think? Eubulides (talk) 18:48, 19 February 2009 (UTC)

I think the present formulation could stay, but thank you for explaining, it could be useful for the translation! --CopperKettle 11:06, 20 February 2009 (UTC)

Another quote:
Its individual symptoms occur in the general population and appear not to associate highly, without a sharp line separating pathological severity from common traits.[14]
- seems a little clumsy: "separating severity from traits" - maybe better would be "separating pathological from common traits" or somehow otherwise? Because severity has a bit of "adjective" role (don't know the exact phraseology of linguists), trait is a "noun".. Maybe: "separating pathological manifestation from common traits"? Best regards, --CopperKettle 16:04, 19 February 2009 (UTC)

How about "separating pathologically severe from common traits"? Eubulides (talk) 18:48, 19 February 2009 (UTC)

Seems fine to me. (0: --CopperKettle 11:06, 20 February 2009 (UTC)

Autistic toddlers have more striking social deviance; for example, they have less eye contact and anticipatory postures and are more likely to communicate by manipulating another person's hand.[16]
- meaning they mainly tug adults by hand to get what they want? (Translating word-for-word could expand the meaning to something akin to sign language, so I want to say in the Russian version: "they manipulate the other's hand to get something they want\indicate something they want"). --CopperKettle 12:58, 23 February 2009 (UTC)

Yes, that's what it means. Some nonverbal low-functioning autistic people use a sort of baby-like "hand and mouth" communication. I think it's somewhat akin to what you'll find if you ever try to talk to a young child who doesn't speak English. If they want you to do something theyll just bring you right over to wherever you have to be to do it. It doesnt necessarily indicate that they can't understand language spoken to them, just that they can't use it themselves. Soap ^Talk/_{Contributions} 13:35, 23 February 2009 (UTC)

"desynchronization of vocal patterns with the caregiver"
-- another part that baffles me. I did a short search on "vocal pattern autism".. and thought it would be faster to ask here. --CopperKettle 19:40, 25 February 2009 (UTC)

I don't really know for sure what they mean there, but I am pretty sure that 'vocal patterns' in this sense isn't something related to autism; a child speech pathologist would be able to tell if there is some very specific narrow meaning assigned to that phrase in this context. Otherwise I would assume it just means that the rhythm of speech, i.e. phonology, does not match that of the child's parents as would that of a normal baby. Normal babies can perceive human speech with a different part of the brain than what they use to process other sounds; I remember reading in Donna Williams' autobiography that human speech was just another kind of sound and she found it difficult both to speak clearly and to hear clearly when she was very young. --- Plodoppum, away-from-home account of Soap

That terminology is derived via the cited review from the primary source, Trevarthen & Daniel 2005 (PMID 16182487), which analyzed videos of a 11-month-old child later diagnosed with autism. The child had problems developing a social rhythm when interacting with her father. I made this change to try to make it a bit clearer. Eubulides (talk) 23:34, 25 February 2009 (UTC)

"Does not imply sickness"?

Autism is one of the five pervasive developmental disorders (PDD), which are characterized by widespread abnormalities of social interactions and communication, and severely restricted interests and highly repetitive behavior.[11] These symptoms do not imply sickness, fragility, or emotional disturbance.[12]

I'm interested in the correct meaning of "not imply sickness.." etc. I have a general feel... but.. would be greatful if someone expands what exactly it means here, for better translation. Cheers, --CopperKettle 10:04, 4 April 2009 (UTC)

That last sentence is intended to summarize the following passage from the source, Rapin & Tuchman 2008 (PMID 18929056):

Autism "has a wide range of severity and is defined dimensionally, which means that it has fuzzy borders that overlap normality at one extreme and profound intellectual impairment with other evidence of severe brain malfunction at the other. Children who have autism are not ‘‘sick’’ or ‘‘fragile,’’ nor are they ‘‘emotionally disturbed,’’ despite the behavioral nature of many of their symptoms."

Hope this is enough. Eubulides (talk) 16:47, 4 April 2009 (UTC)

Thank you! --CopperKettle 16:51, 4 April 2009 (UTC)

"..more than the final product".

A strange choice of words, IMHO:

Autism appears to result from developmental factors that affect many or all functional brain systems,[59] and to disturb the course of brain development more than the final product.[60]

. - maybe the "timing of brain development" or "timing of major steps in brain development" would be more readable? Of course I'm not a native speaker, just a personal opinion. --CopperKettle 12:55, 6 April 2009 (UTC)

Thanks, changed it to "timing". Eubulides (talk) 14:38, 6 April 2009 (UTC)

what localized anomaly?

Neuroanatomical studies and the associations with teratogens strongly suggest that autism's mechanism includes alteration of brain development soon after conception.[5] This localized anomaly appears to start a cascade of pathological events in the brain that are significantly influenced by environmental factors.[61]

First clause does not say of any precize anomaly, moreover "early alteration" in a tiny developing brain implies a widespread effect (on the brain as a whole). Then follows another clause that says "This localized anomaly". Localized on what scale? The latter sentence seems to contradict the former and earlier sentences that tell of "many or all brain systems". --CopperKettle 13:21, 6 April 2009 (UTC)

Thanks again, removed "localized". Eubulides (talk) 14:38, 6 April 2009 (UTC)

High serotonin leads to structural abnormalities?

Several neurotransmitter abnormalities have been detected in autism, notably increased blood levels of serotonin. Whether these lead to structural or behavioral abnormalities is unclear.[58]

- Does the "lead" here means "cause" or "lead the investigation" \ "linked to"? Thanks in advance, --CopperKettle 06:22, 7 April 2009 (UTC)

Either interpretation would be correct, but interpreting it as "cause" is more useful, so I changed "lead to" to "cause". Thanks again for mentioning problems like this one. Here's a quote from the source, if that helps:

"The significance of neurotransmitter abnormalities in autism is not clear at this time. Atypical neurotransmitter levels could precipitate morphological abnormalities, as is suggested by some research regarding the effects of early exposure to serotonin. In addition, altered neurotransmitter levels could be closely linked to specific behavioral symptoms (e.g. opioid levels could affect and/or be affected by levels of repetitive behavior)." —Penn 2006 (PMID 16484102), p. 63.

Eubulides (talk) 06:39, 7 April 2009 (UTC)

Mirror system: same species only?

The MNS operates when an animal performs an action or observes another animal of the same species perform the same action.

- probably a little error; I thought that monkeys should be able to learn from humans. --CopperKettle 06:54, 7 April 2009 (UTC)

I think that "of the same species" was stolen from Mirror neuron, which actually says "(especially by another animal of the same species)" and cites Rizzolatti & Craighero 2004 (PMID 15217330). The bit about the species therefore wasn't quite right. Anyway, it is not that important here, so I removed it. Thanks again. Eubulides (talk) 07:18, 7 April 2009 (UTC)

A tale of two networks

The two networks are not negatively correlated in people with autism, suggesting an imbalance in toggling between the two networks, possibly reflecting a disturbance of self-referential thought.[78]

- does this mean that in the autistic brain both networks are activated at the same time in contrast to normal people in whom they activate more in a swing pattern? --CopperKettle 13:16, 7 April 2009 (UTC)

Yes. Thanks for mentioning the ambiguity; I added an "in time" to try to clarify. Eubulides (talk) 20:28, 7 April 2009 (UTC)

Internal flame

Hyper-systemizing theory hypothesizes that autistic individuals can systematize—that is, they can develop internal rules of operation to handle internal events — but are less effective at empathizing by handling events generated by other agents.[42]

- I would be thankful for clarification of the "internal events" here. Is is thoughts or\also physical events controlled by the autistic person only? Best regards, --CopperKettle 14:06, 8 April 2009 (UTC)

"Internal" means internal to the brain; I added that. This edit also addressed some other issues; please see #E-S theory below. Eubulides (talk) 20:19, 8 April 2009 (UTC)

Predicting or explaining?

A strength of the theory is predicting stereotyped behavior and narrow interests;[90]

- does "Executive disfunction" view theoretically predict (explains) the two autistic features or is there more or less reliable practical tests that allow predicting the extent of these two symptoms in the person's future as he\she grows up? --CopperKettle 16:16, 8 April 2009 (UTC)

The former interpretation is intended; it explains those features, but doesn't predict their future course. Eubulides (talk) 20:19, 8 April 2009 (UTC)

Maps well from

In a couple of places "mapped well from" was replaced with "mapped well with". In English, when I say "theory A maps well from B", I mean that theory B explains many of the features of A. It's intended as an allusion to mathematical mapping, the idea being that we have an (unexplained, and approximate) function from elements of B to elements of A. The phrase "theory A maps well with B" doesn't have this connotation, so I'd prefer changing it back to "mapped well from". Or perhaps a better, clearer wording could be proposed? Eubulides (talk) 20:20, 8 April 2009 (UTC)

Oh, when I was mistaken; sorry; feel free to change back! --CopperKettle 17:22, 13 April 2009 (UTC)

Thanks, done. Eubulides (talk) 21:13, 13 April 2009 (UTC)

E-S theory

I revised Autism #Neuropsychology to incorporate a new review on the topic, Baron-Cohen 2009 (PMID 19338503); this affects some of the wording problems discussed above, and (I hope) fixes some of them better. Eubulides (talk) 20:19, 8 April 2009 (UTC)

Thank you! --CopperKettle 17:22, 13 April 2009 (UTC)

Residential care and estate planning

After childhood, key treatment issues include residential care, job training and placement, sexuality, social skills, and estate planning.[121]

- "residential care" meaning "living in an instutution away from home"? "Estate planning" meaning roughly "fill the inheritance papers to give the autistic person's estate to someone"? Just a clarification; the terms are translated a bit ambiguously in the Eng-Rus dictionaries. --CopperKettle 17:22, 13 April 2009 (UTC)

Your interpretation is basically correct in both cases. Just to make sure we're on the same wavelength, estate planning also includes things like rearranging one's financial affairs for tax and other purposes, i.e., it's more than just documenting one's existing financial state and bequest intents. Eubulides (talk) 21:13, 13 April 2009 (UTC)

Sex ratio

The sex ratio averages 4.3:1 and is greatly modified by cognitive impairment: it may be close to 2:1 with mental retardation and more than 5.5:1 without.[7]

- doesn't it just mean that in girls new cases of autism (incidence) are combined with retardation more often than in boys? Would be interesting to know exact percentages (% of A+R in girls vs. in boys) --CopperKettle 13:32, 15 April 2009 (UTC)

The "more often" sounds plausible, but I don't know of any reliable sources to that effect. Note the "may be": this "may be" comes from the source, and indicates that the "2:1" is somewhat speculative. The source says nothing to answer your question. Eubulides (talk) 16:53, 15 April 2009 (UTC)

Mid-1900s = 1900-1910?

Kanner's reuse of autism led to decades of confused terminology like infantile schizophrenia, and child psychiatry's focus on maternal deprivation during the mid-1900s led to misconceptions of autism as an infant's response to "refrigerator mothers".

- or maybe it was meant as "in the middle of XX century"? Thank you in advance, --CopperKettle 19:08, 15 April 2009 (UTC)

The intent was that the 1900s began in 1900 and ended in 1999, just as the 1800s began in 1800 and ended in 1899. (Unless, perhaps, the context establishes that we're talking about the 1800s versus the 1810s, or the 1900s versus the 1910s, etc.) I see that the next sentence begins "Starting in the late 1960s", which does indeed mean that the use of "1900s" was confusing there. As it happens, the phrase "during the mid-1900s" was redundant, because of that "Starting in the late 1960s" in the next sentence, so I removed it. Thanks for pointing out the confusion. Eubulides (talk) 19:35, 15 April 2009 (UTC)

Fever

A recent edit added this text:

"Recently, studies at the Albert Einstein College of Medicine of Yeshiva University, published in the Brain Research Review, suggest there is a direct link between low grade fevers and the improvement of symptoms, with research ongoing."[11][12]

I looked for reliable sources on the subject (in the sense of WP:MEDRS) and found these:

Mehler et al. 2009 (PMID 19059284) "hypothesize that febrigenesis and the behavioral-state changes associated with fever in autism depend upon selective normalization of key components of a functionally impaired locus coeruleus-noradrenergic (LC-NA) system". This corresponds to the popular-press accounts cited above.
Curran et al. 2007 (PMID 18055656) "The data suggest that these changes might not be solely the byproduct of general effects of sickness on behavior". This is a much less speculative interpretation of the data

I didn't find any reviews on the subject. As per WP:MEDRS we should be leery of citing (in effect) one primary source on this topic, particularly when the source is clearly speculating and its speculations haven't been confirmed by outsiders, so I reverted the change for now. Eubulides (talk) 22:36, 15 April 2009 (UTC)

Yes, this looks much too speculative to be currently included in the top-level article, but it is interesting and verifiable, so is there a more specialised sub-article that might accommodate this material? Maybe in Causes of autism? Tim Vickers (talk) 22:41, 15 April 2009 (UTC)

Unfortunately this is speculation on the mechanism of autism, not on the cause of autism. The hypothesized mechanism could operate due to a variety of causes, and could operate either pre- or post-natally. So, I guess it would belong to a (new) subarticle Mechanism of autism; this article could contain other speculations too (there are lots of them...). Which brings up a question I've been meaning to ask for a while; please see #Time for new subarticles? below. Eubulides (talk) 00:42, 16 April 2009 (UTC)

Well, for something to be a cause, it must have a mechanism - it isn't possible to cleanly separate the two, especially when cellular states like oxidative stress are already listed as "causes" in that article. Tim Vickers (talk) 00:57, 16 April 2009 (UTC)

True, true. OK, I added a new section Causes of autism #Locus coeruleus–noradrenergic system (whew! what a title!). If we create a Mechanism of autism article I think this section (plus a couple of others in Causes of autism) should be moved to it, but in the meantime it's the best home we have. Eubulides (talk) 01:52, 16 April 2009 (UTC)

Seems sensible. I came straight from Susan Boyle to here, Wikipedia is wonderful! Tim Vickers (talk) 02:01, 16 April 2009 (UTC)

Time for new subarticles?

Autism is getting a bit large; is it time to split it into subarticles? Currently, the longest sections, which would presumably be the first candidates for subarticles, are Characteristics (which could be split off into a new subarticle Characteristics of autism) and Mechanism (which could be split off into a new subarticle Mechanism of autism). One thing that's holding me back, to be honest, is that I'd want these new subarticles to be Featured Articles, and given the currently daunting editorial and bureaucratic overhead of creating featured articles, and the evident difficulty of raising existing subarticles such as Causes of autism to Featured quality, means that perhaps we should let sleeping dogs lie. Eubulides (talk) 00:42, 16 April 2009 (UTC)

There are already subarticles for causes, therapies, epidemiology, and sociological and cultural aspects. Those aren't even GA, but then they are also some of the toughest subjects to deal with on WP. I'm not sure what's bureaucratic about FA but it is certainly daunting editorially. There's nothing stopping you creating the sub-articles while leaving Autism untouched for the present. Do you think you have enough material to expand these sections? It wouldn't be worth doing if there wasn't a GA-worth of material to write, but aiming for FA for a daughter article is a very high bar IMO. Colin°^Talk 07:31, 16 April 2009 (UTC)

Underdiagnosis in girls

This series of edits inserted the text "Some autism sources are saying, however, that autism in girls might not be seen as commonly as for boys even though the girls are autistic.", citing a January ABC News story. However, the story does not state that girls are more underdiagnosed than boys are; it merely says that girls are underdiagnosed. (Mainstream opinion is that girls and boys are both underdiagnosed.) Furthermore, the ABC News story is reporting on what is apparently unpublished research; a quick search in PubMed for medical research articles published by Brenda Myles reports nothing since her 2003 paper on social stories (PMID 14516061). We can't base an encyclopedia on unpublished research. As per WP:MEDRS, the Autism article should be based on reliable secondary sources such as peer-reviewed review articles in medical journals. As WP:MEDRS #Popular press points out, ABC News and other popular-press media outlets are generally not reliable sources for science and medicine information. Instead, when talking about over- and under-diagnosis the article should be citing high-quality sources like Dover & Le Couteur 2007 (PMID 17515625), Shattuck & Grosse 2007 (PMID 17563895), and Baird et al. 2003 (PMID 12946972) (this is not meant to be an exhaustive list; it's just some examples). For now, I removed the text in question. Eubulides (talk) 20:00, 17 April 2009 (UTC)

The newsarticle does suggest that girls are 'more underdiagnosed' then boys, and if it doesn't say so straght up, there is really no other way to reasonable interpret the text. But it's still only a news article. Fenke (talk) 00:20, 19 April 2009 (UTC)

I agree that the news article clearly suggests that in general girls are more underdiagnosed than boys. However, as you mention, the article doesn't say so straight up, which is part of the reason this source is unreliable. Separately, I looked for research articles on this topic, and came up empty. Eubulides (talk) 01:03, 19 April 2009 (UTC)

Connection to wireless?

Perhaps we should add to the possible causes something about wireless technologies. This is a hypothesis recorded in PubMed (PMID 14962625).

One study proposed recovery is helped when reducing wireless exposure: http://www.buergerwelle.de/pdf/emr_autism_acnem_final_1.pdf
This finding provokes other articles: http://www.computerweekly.com/Articles/2007/11/19/228184/wi-fi-linked-to-childhood-autism.htm and http://www.eetimes.eu/uk/203102992;jsessionid=A2CXRAF3VXNS0QSNDLRCKH0CJUNN2JVN
One article finds a cluster in a place with high wireless exposure: http://www.latitudes.org/articles/electrical_sensitivity_articles.html

We may ask ourselves the following questions:

Is Autism genetic? Wireless has been correlated to DNA/genetic effects (European REFLEX study/Lai study) and infertility (some studies in PubMed)
Is Autism environmental? Andrew Goldsworthy explains the mechanism by which electromagnetic fields can weaken tight-junction barriers (through removing calcium ions from membrane surfaces, enabling cell membrane leakage), thus increasing our susceptibility to environmental toxins/allergies. (http://www.der-mast-muss-weg.de/pdf/studien/04Goldsworthy_Thesaloniki.pdf)
Is Autism related to neurotransmitters and neurodevelopment? The calcium efflux effect may also have effects on neurotransmitters since Calcium plays a significant role in the inter-neuron synapse in the release of neurotransmitters?

So directly or indirectly, wireless technologies may play a role in autism. And interestingly, autism rates start soaring around the time wireless becomes more popular (well, but it is debated whether that is just due to public recognition) Pensees (talk) 23:28, 12 March 2009 (UTC)

Best as I can tell, the hypothesis is based simply on a correlation, and the recovery study leapt directly from heavy metals to autism. Until there is actually some good empirical evidence out there, new hypotheses like this should probably stay out of this article. Tim D (talk) 23:38, 12 March 2009 (UTC)

This hypothesis that cell phones (or other wireless devices) cause autism has been around for quite some time. It hasn't been supported by any reliable sources (certainly the ones listed above are not reliable enough to make the cut for Autism). I suggest adding a new section to Causes of autism, which has lower standards for sources. A good place to put it would be between the section Causes of autism #Paracetamol and Causes of autism #Rain; this is because the latter section discuss the theory that watching television causes autism. Eubulides (talk) 23:45, 12 March 2009 (UTC)

If EMFs play a part in mercury exposures (as also suggested by PMID 18819554), that might help explain why heavy metal - autism link is so difficult to prove -- if it depends upon another parameter (whether powerline EMFs or wireless EMFs), levels of which may be different in different research environments. A book of testimonies of people whose health is sensitive to wireless technologies suggests a connection to their dental appointments and mercury amalgam (http://www.feb.se/FEB/electro-hypersensitivity-book.pdf). Pensees (talk) 00:17, 13 March 2009 (UTC)

I forgot to mention also, award-winning medical and science journalist Blake Levitt had also posited a connection between EMF and autism in her book Electromagnetic Fields. This is probably the book that really grabbed my attention about the issue. Pensees (talk) 00:20, 13 March 2009 (UTC)

That is, however, not a peer reviewed piece of writing (from what I can gather from Ms. Levitt's website). It seems the above are weak, and, that much of the ideas presented here are either synthesis or OR. Dbrodbeck (talk) 00:43, 13 March 2009 (UTC)

I've never read anything supporting this theory in any peer-reviewed journal. I read AJIDD (fromerly AJMR) and I&DD religiously and a few others on occasion, and haven't seen any mention of this. I work with adults with intellectual disabilities and autism, and have a grad degree in the field. This is not an accepted theory in the field.Guinness4life (talk) 20:40, 19 April 2009 (UTC)

Gender bias

It's highly accurate that Autism will primarily affect boys/men more often than the girls/women. We students at the Univ of Wisconsin in Eau Claire are on another subject on Autism, which is not always addressed directly: gender bias. We're trying to raise discussion about the fact Autistic females may be more prevalent than the Autism studies are telling us. Furthermore, girls/women may be overlooked in regards to Autism. The sources, however, should be autism/medical studies, not newspaper matters. And also, the prevalence for intellectual disability in autistic people is being conflicted. Our college class could use help on this matter.

Intellectual disability in the regards to autism has varied depending on sources. Please tell us whatever connects autism to having mental disability-our class could sure use information about it.

12.227.185.235 (talk) 19:02, 14 April 2009 (UTC)

Anecdotally, I will tell you that males greatly outnumber females with Autism, and I'm unaware of any research to the contrary (the NIH for instance says males are 4X more likely); additionally, in general males are overrepresented amongst all individuals with intellectual disabilities.

Look at the IQ curve. Male IQ curve is flatter (platykurtic), female curve is more closely grouped around the mean (leptokurtic); mean IQ's for both sexes are about the same, though. I don't think debating something that's plainly obvious is a fruitful area of research. Some conditions occur disproportionately to one sex. Breast cancer, Rhett's, etc. That there is a sex difference is largely a statistical fact. Why there's a sex difference is a very important question, though.

What connects Autism with Intellectual Disability? Good question. That's part of the research. No definitive answers now, only that it does correlate to a high degree. So do seizures, though. It's becoming less obvious whether it's causally related or co-occurent.

Check AJIDD or "The Journal of Autism and Developmental Disorders" or something along those lines if you'd like to learn moreGuinness4life (talk) 21:05, 19 April 2009 (UTC)

See PMID 9813776 and PMID 9033466 for details of the relationship between Autism and Tuberous sclerosis, a genetic disease that often causes mental retardation and epilepsy. There may be other such associations, some undiscovered. Colin°^Talk 21:56, 19 April 2009 (UTC)

Thanks for the information, although our IP address has changed: it's now 173.26.85.192; it was originally 12.227.185.235. Please contact us at our new number=173.26.85.192

"Condition rather than a disorder"?

Quote, from introduction: "...with some seeking a cure and others believing that autism is a condition rather than a disorder." I think this is unclear; the definition of "condition" is very close to "disorder", and there has to be more explanation here--maybe, "a neutral trait" instead of "a condition"? I'm still not happy with this, though, because it implies that autistic people either want a cure or believe autism cannot be described as "a disorder". The actual situation isn't divided into those two camps; people basically have their own diverse opinions about it. For example, it's common to not want a cure and still consider yourself disabled, or emphasize that autism is a neurological condition and not a disease, or agree with a cure for specific symptoms but not for the core autistic neurology, or even consider themselves superior, not just non-disabled--it's very complicated; I think that description gives a false impression. I would recommend just saying people have a lot of different opinions about it, ranging from "cure me now" to "I'm not even disabled", and link to pages on things like curing autism and the neurodiversity movement. --Chaoticidealism (talk) 21:37, 20 April 2009 (UTC)

The cited source says "condition" and so we should be careful about substituting different terminology. The lead is supposed to use summary style (see WP:LEAD and WP:SUMMARY), so it's OK if it presents a simplified version of reality, as long as it's correct and not simplistic. Here's what the cited source says on the topic: perhaps you can think of a better way to summarize it concisely?

"The way in which we think of people with autism may also change. For example, autism may come to be thought of as a neurodevelopmental condition, rather than a neurodevelopmental disorder, as ‘pure’ autism becomes the norm (see Baron-Cohen, 2000 and Gernsbacher, Dawson, & Mottron, 2006 for debates). This is because the proportion of autistic individuals with an associated learning disability has changed considerably, so that the number of people at the non-learning disabled end of the spectrum now significantly outnumber those whose IQs are under 70." —Rajendran & Mitchell 2007, doi:10.1016/j.dr.2007.02.001

Eubulides (talk) 22:54, 20 April 2009 (UTC)

- Try this link if you want to talk about changing perceptions of autism, from the national review of medicine--

http://www.nationalreviewofmedicine.com/issue/2006/04_30/3_patients_practice05_8.html —Preceding unsigned comment added by Chaoticidealism (talk • contribs) 12:09, 22 April 2009 (UTC)

Thanks for the link. In the meantime I had already changed the lead to use different wording and cite Silverman 2008 (doi:10.1017/S1745855208006236) instead. Silverman is more recent and is peer-reviewed, so it should be a better source for this sort of thing. Eubulides (talk) 20:54, 22 April 2009 (UTC)

Likelihood of Autism in Babies

If someone with autism has a baby, what is the likelihood that the baby will have autism? 75.135.76.200 (talk) 01:06, 22 April 2009 (UTC)

I've looked for research on that and been unable to find it. It's possible it may not exist yet, since the first generation of parents diagnosed autistic as children are only now beginning to have children of their own. Many people with children are diagnosed as adults, but apparently there's a selection-bias problem with studying these people.--Chaoticidealism (talk) 11:51, 22 April 2009 (UTC)

ASDs in introduction

A recent edit (now reverted) replaced this:

"The autism spectrum disorders (ASD) also include related conditions such as Asperger syndrome that have milder signs and symptoms"

with this:

"The autism spectrum disorders (ASDs) also include related conditions such as Asperger Syndrome, Childhood Disintegrative Disorder, PDD-NOS, and Rett Syndrome, which have different but related signs and symptoms"

using the change comment "Instead of just mentioning Asperger's as another ASD, I listed all ASDs. Am unsure whether this belongs in the introduction or whether it should be in the "diangnosis" section". There were some problems with this change:

Childhood Disintegrative Disorder and Rett Syndrome are not ASDs. (The cited source says this.)
- The DSM-IV lists CDD and Rett's under pervasive developmental disorders. I think this is a more relevant source than the one listed in the footnotes.--Chaoticidealism (talk) 11:55, 22 April 2009 (UTC)

Autism spectrum disorder (ASD) and Pervasive developmental disorder (PDD) are distinct notions; the former is a subset of the latter. For Autism, it's far more important for the lead to mention ASD rather than PDD: ASD is generally regarded to be a spectrum of conditions of which autism is the primary example, whereas non-ASD PDDs are not that closely related to autism. Many of the points in Autism are also about ASDs in general (just look for "ASD" in the body of the article), whereas almost none of the points in Autism are about PDDs in general. The lead should focus on what the article is about, and the article is primarily about ASDs, not PDDs in general.

Are we aware, then, that the Wikipedia page on Autism Spectrum disorder lists PDDNOS, Rett's, and CDD as autism spectrum disorders? In general, that's how they're listed--check that source again; it may be a minority opinion that CDD and Rett's are not part of the spectrum, and if it's minority, then you can't list it as accepted fact. For example, Autism Speaks lists both CDD and Rett's as autism spectrum disorders: http://www.autismspeaks.org/whatisit/faq.php --Chaoticidealism (talk) 02:44, 23 April 2009 (UTC)

That was an error in Autism spectrum, in that the text disagreed with the cited source. I fixed the text so that it referred to PDD and not ASD. (Did I say that the naming conventions in this area are confusing? :-) Some sources (including Autism Speaks) list CDD and Rett's as being ASDs, but my impression is that they're in the minority among recent high-quality sources (the Autism Speaks website is lower-quality than the sources cited here). Eubulides (talk) 03:15, 23 April 2009 (UTC)

I agree that the wrong source was used in the footnotes; they mistakenly referred to Myers et al. 2007 (PMID 17967921), where what was intended was a different paper published by the same group (the Council on Children with Disabilities), namely Johnson et al. 2007 (PMID 17967920). (I just now fixed that.)
DSM-IV is not more relevant to this issue than Johnson et al. 2007 (PMID 17967920) is. Johnson et al. is devoted specifically to ASD, whereas the DSM-IV is a more-general source that talks about many disorders and spends only a relatively small amount of space on ASD. Furthermore, DSM-IV is dated now (and is being revised), whereas Johnson et al. 2007 is more up-to-date and is a more-reliable source on the current understanding of how to classify these conditions.

Eubulides (talk) 20:05, 22 April 2009 (UTC)

The change loses the point that autism proper has more-severe symptoms than Asperger syndrome and PDD-NOS do.
- PDD-NOS need not have less severe symptoms. The way it's defined (DSM), it simply means a PDD that doesn't fit into any of the other diagnostic categories. Technically, it can be more severe than most cases of autism, but not meet enough criteria in one sub-part (for example, profound deficits in communication and social interaction, but mild difficulty with repetitive behavior). Additionally, Asperger's and regular Autism can overlap, to the point that some Asperger's cases are more severe than some Autism cases. Autism is simply defined in terms of more numerous diagnostic features, not necessarily more intense.

By the same token, technically mumps is not milder than Ebola hemorrhagic fever, since a (very) few people with mumps die from it, whereas some patients with Ebola beat the odds and survive. By any normal standard Ebola is more of a cause of concern to a patient than mumps, so what adjective should be used to tell a non-expert reader this? If "milder" isn't the right adjective, which adjective would be better? Eubulides (talk) 20:05, 22 April 2009 (UTC)

Asperger's is generally milder than Autism, of course; it's just that AS isn't defined by being milder, but by having fewer diagnostic features. If we leave it that way, we make it seem like we're saying "Asperger's is a milder version of Autism", which is technically false because it's not severity that defines it but a difference in exactly which traits there are. Maybe I'm just being picky.--Chaoticidealism (talk) 02:40, 23 April 2009 (UTC)

It's fine to be picky, if that results in improving the encyclopedia. The text doesn't say that AS is defined by being milder; it says only that AS has milder symptoms. Perhaps someone can think of better wording? We don't want to lose the comparison between the two conditions, but if "milder" can be improved on, let's improve on it. Perhaps we should replace "milder" with "fewer"? Eubulides (talk) 03:15, 23 April 2009 (UTC)

This material in the lead is covered at some greater length in Autism #Classification, and is intended to summarize that section. It's not clear to me that the lead needs to mention PDD-NOS specifically, particularly since PDD-NOS is an acronym, and spelling it out would take up a lot of room, and the lead is supposed to be short. Eubulides (talk) 22:54, 20 April 2009 (UTC)

Brevity suggestion--Don't list any Autism Spectrum conditions; just leave the link to the ASDs, and remove mentions of severity. "Autism is one of a wider group of pervasive developmental disorders." Autism spectrum is a term that's not too well defined and seems to change depending on the researcher's opinion of what autism is; but "pervasive developmental disorder" is defined in both the ICD-10 and the DSM-IV as the larger grouping to which autism belongs.

This is too brief, as it omit the important point that autism is at the more-of-concern end of the autism spectrum. Also, it would make the introduction more confusing, as the distinction between ASDs and PDDs is a confusing area and is not really important enough to be raising to the level of the lead. (Also, I think it's helpful to mention one other example of ASD in the lead, though that's not as crucial as the other two points.) Eubulides (talk) 20:05, 22 April 2009 (UTC)

The admin removed a link I had posted on this page

I posted an informational, relevant link recently to Wikipedia and I received notification that it has been removed from the article. —Preceding unsigned comment added by Moonman239 (talk • contribs) 13:57, 23 April 2009 (UTC)

Please see WP:ELYES for the sort of external links that Wikipedia looks for. There are thousands of informational, relevant links about autism that could potentially be added to this article, and obviously we can't add them all. I'm afraid that the link you added (a web site purportedly written by a 13-year old, and touting homeopathic and other treatments) doesn't come close to making the cut for this article. Eubulides (talk) 19:48, 23 April 2009 (UTC)

I agree, that is not even close to being a possible link. Tim Vickers (talk) 20:10, 23 April 2009 (UTC)

Mercury intoxication, Geier, etc.

A recent edit added the following text:

"Recent research however has found evidence that children with autism spectrum disorders, but not Asperger's suffer from significant mercury intoxication and will benefit from treatment.[Geier et al. 2009, PMID 18817931; Nataf et al. 2006, PMID 16782144]"

I'm afraid that these sources are not reliable according to the usual Wikipedia standards. Mark Geier and his son David are well-known in the area of autism for promoting WP:FRINGE theories about autism. The Nataf et al. paper is more respectable (which is not saying much, I'm afraid), but it does not say that children with ASD have significant mercury intoxication; instead, it measures porphyrinuria. Also, both of these sources are primary sources, and Autism should be citing reliable secondary reviews rather than dipping directly into primary sources. Since this text is quite weakly-sourced, I have reverted it for now. Please see WP:MEDRS for the sorts of sources that should be used for medical facts and figures in Wikipedia. Eubulides (talk) 19:27, 24 April 2009 (UTC)

Porphyrinura is too vague. The study found elevated pentacarboxyporphyrin, precoproporphyrin, and coproporphyrin in the urine of autistic kids. All three of these elevated is a biomarkers for mercury intoxication.

"The urinary porphyrin and CARS score correlations observed among study participants suggest that mercury intoxication is significantly associated with autistic symptoms." is the conclusion by the paper about this. —Preceding unsigned comment added by Stengl (talk • contribs)

The title of Nataf et al. 2006 (PMID 16782144) is "Porphyrinuria in childhood autistic disorder: implications for environmental toxicity". The authors directly tested urinary porphyrin levels; they did not test mercury. The very brief discussion about mercury intoxication is sheer speculation on the part of the authors; the study itself provides no basis for any conclusion about mercury intoxication, and the study is not a reliable source for mercury intoxication.
More generally, there are thousands of primary studies on the causes of autism; Autism should not reach down and emphasize this particular single study to the exclusion of all the others. As WP:MEDRS says, the way we apportion weight in cases like this is to look at what reliable reviews say on the subject, and cite those reviews, not the primary studies that underly the reviews. And what reliable reviews say is that autism has a large genetic component (there is good science behind this), that it may have environmental triggers, and that there's no scientific evidence yet as to what those triggers are. For more on this subject please see (for example) Newschaffer et al. 2007 (PMID 17367287).

Eubulides (talk) 23:45, 24 April 2009 (UTC)

Per Wikipedia:MEDRS#Respect_secondary_sources, Eubulides is completely right; a few studies do not overturn the general consensus within the medical community that mercury is a blind alley and unsupported by research. Get a recent review article published in a high-impact journal supporting this and it may be suitable for the page, but single studies by individuals known for advocating generally unaccepted studies, are not sufficient for even short assertions like this. The mercury idea should be reserved mostly for debunking and the sections dealing iwth society and social aspects. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:46, 25 April 2009 (UTC)

Inappropriate image title

The title of the image used to represent the "repetitive behaviour" section is inappropriate and not encyclopedic. "Sweetypie" has no place in the title and should be removed with immediate effect. I have also raised this major concern on the talk page of the image itself. Brendan Heron (talk) 21:56, 26 April 2009 (UTC)

The pic is fine, it does a fine job illustrating the behaviour, and, well, the kid seems a sweetiepie...Dbrodbeck (talk) 00:39, 27 April 2009 (UTC)

"the kid seems a sweetiepie"... this basically underlines the NPOV violation I'm talking about. Yes, the image is fine, but the file name is beyond unacceptable. Brendan Heron (talk) 01:31, 27 April 2009 (UTC)

As noted on the talk page of the file, that was a joke. I doubt anyone else finds this an NPOV violation, however, if they do, I am sure they will chime in here. Dbrodbeck (talk) 02:05, 27 April 2009 (UTC)

The file name is meaningless and is not apparent to any reader, only editors. A file name can't be NPOV. This is kinda a waste of time. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:10, 27 April 2009 (UTC)

If you're worried about the filename, copy the image and upload it yourself under a more descriptive title. Tim Vickers (talk) 18:39, 27 April 2009 (UTC)

New genetic study (GWAS) results in Nature (ASD)

Noticed in the news, might be useful to add in the "heritability of autism" (or ASD?) article:

News at the Wired
Common genetic variants on 5p14.1 associate with autism spectrum disorders - Nature abstract;

--CopperKettle 16:26, 1 May 2009 (UTC)

I think Eubulides already picked up on that one with this edit. Soap ^Talk/_{Contributions} 16:33, 1 May 2009 (UTC)

Oh, nice! --CopperKettle 16:44, 1 May 2009 (UTC)

Autism introduction

This is how it is:
Autism is a brain development disorder characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old.^[10] The autism spectrum disorders (ASD) also include the related conditions Asperger syndrome and PDD-NOS, which have fewer signs and symptoms.^[11]

Autism has a strong genetic basis, although the genetics of autism are complex and it is unclear whether ASD is explained more by multigene interactions or by rare mutations.^[12] In rare cases, autism is strongly associated with agents that cause birth defects.^[13] Other proposed causes, such as childhood vaccines, are controversial,^[14] and the vaccine hypotheses lack any convincing scientific evidence and are biologically implausible.^[15] The prevalence of ASD is about 6 per 1,000 people, with about four times as many males as females. The number of people known to have autism has increased dramatically since the 1980s, partly due to changes in diagnostic practice; the question of whether actual prevalence has increased is unresolved.^[16]

Autism affects many parts of the brain; how this occurs is not understood. Parents usually notice signs in the first two years of their child's life. Although early behavioral or cognitive intervention can help children gain self-care, social, and communication skills, there is no known cure.^[17] Not many children with autism live independently after reaching adulthood, though some become successful,^[18] and an autistic culture has developed, with some seeking a cure and others believing autism should be tolerated as a difference and not treated as a disorder.^[19]

This is my opinion:
Autism is a neurodevelopmental disorder characterized by impaired social interaction and communication, and by restricted and repetitive self-stimulating behaviors. These signs all begin before a child is three years old.^[10] The autism spectrum disorders (ASD) also include the related conditions Asperger syndrome and PDD-NOS, which have fewer signs and symptoms.^[11]

The cause for Autism is not yet known, although scientists hypothesize that Autism has a strong genetic basis. The genetics of autism are complex and it is unclear whether ASD is explained more by multigene interactions or by rare mutations.^[12] In rare cases, autism is strongly associated with agents that cause birth defects.^[13] Other proposed causes, such as childhood vaccines, are controversial,^[14] and the vaccine hypotheses lack any convincing scientific evidence and are biologically implausible.^[15] The prevalence of ASD is about 6 per 1,000 people, with about four times as many males as females. The number of people known to have autism has increased dramatically since the 1980s, partly due to changes in diagnostic practice; the question of whether actual prevalence has increased is unresolved.^[16]

Autism affects many parts of the brain; how this occurs is not understood. Parents usually notice signs in the first two years of their child's life. Although early behavioral or cognitive intervention can help children gain self-care, social, and communication skills, there is no known cure.^[17] Not many children with autism live independently after reaching adulthood, though some become successful,^[18] and an autistic culture has developed, with some seeking a cure and others believing autism should be tolerated as a difference and not treated as a disorder.^[19]

Comment:

There is nothing that reads that some parent's of autistic children claim to have become neurotypical from intensive early intervention therapy, e.g., actress Jenny McCarthy who claimed that Defeat Autism Now! (DAN!) and Applied Behavioral Analysis (ABA) has cured her son from Autism; Samahria and Barry Neil Kaufman—founders and presidents of the autism therapy Son-Rise, claimed that this therapy enabled their son to go from severe autism, with an under 30 IQ to neroutypical.
There was a recent study that reads that ASD now affects 1 out of 150 people. If you type it in Google, you'll come up with a lot of results with that ratio and I can't find it in a scientific journal though.
The heading picture could also be interpereted as a child with obsessive compulsive personality disorder rather then autism. I've searched through pictures and couldn't find a child staring out into space besides this one of Raun Kaufman, although it was never proven whether he was autistic or not, thats generally a core of what kids with autism look like—they stare out in space. Could someone find a better picture of a kid looking lost into space, since this indicates point-of-view, and lacks scientific data. ATC^{. Talk} 18:00, 3 May 2009 (UTC)

'staring off into space' would be difficult to see, stacking stuff is pretty easy to see. Blind people often look as if they are 'staring into space' so one could then argue that a pic of a kid that is 'staring into space' would look like a visually impaired kid. The picture is fine as far as I can tell. (That said, I am visually impaired, and I have an autistic kid....) Dbrodbeck (talk) 21:14, 3 May 2009 (UTC)

NOTE: For the benefit of other readers, I've highlighted the parts you've changed in your two paragraphs up above. I hope this is OK. Soap ^Talk/_{Contributions} 18:11, 3 May 2009 (UTC)

Thank you. I appreciate that! ATC^{. Talk} 19:03, 3 May 2009 (UTC)

To respond to the points one by one:

"~~brain development~~ neurodevelopmental disorder". This sort of suggestion comes up every now and then, most recently at #I'm thinking about translating the article into Russian.. above, where it was suggested to change "brain development disorder" to "pervasive developmental disorder". The start of the article should be easy to read, and that we should defer more-challenging technical language for later; this is because many readers use the topic sentence to figure out whether the article is about the subject they are interested, and if the topic sentence is hard-to-understand these readers will be frustrated. How about a different idea instead? change "brain" to "brain-cell". This wording is nearly as easy to understand as "brain development disorder", and more accurate, so I did that.
"restricted and repetitive self-stimulating behavior". This disagrees with the cited source, which doesn't talk about self-stimulation. The hypothesis that repetitive behaviors in autism are self-stimulating is speculative and is not well-supported by reliable sources.
"The cause for autism is not yet known, although scientists hypothesize that autism has a strong genetic basis. ~~although~~ The genetics of autism are complex and it is unclear whether ASD is explained more by multigene interactions or by rare mutations." The cited source doesn't say anything about "not yet known" or "scientists hypothesize". It's not controversial among reliable sources that autism has a strong genetic basis, and it is misleading to emphasize so strongly in the lead that the genetic underpinning of autism is a hypothesis.
"There is nothing that reads that some parent's of autistic children claim to have become neurotypical from intensive early intervention therapy" Actually, there is. Autism #Prognosis says "Children recover occasionally, so that they lose their diagnosis of ASD; this occurs sometimes after intensive treatment and sometimes not."
"There was a recent study that reads that ASD now affects 1 out of 150 people" This is already in the lead, which says "The prevalence of ASD is about 6 per 1,000 people".
"The heading picture could also be interpereted as a child with obsessive compulsive personality disorder rather then autism" The caption helps to make it clear that the illustration is not of OCD. I don't see a specific proposal for improvement here. If we don't have an alternative illustration available, then we should use the best we have.

Eubulides (talk) 07:39, 4 May 2009 (UTC)

Thanx for explaining! Regarding, brian-cell developmental disorder is worse. I have a few ideas: neurological brain developmental disorder; neurological developmental disorder. But if it's between brain-cell developmental disorder and brain developmental disorder, I would have to go with brain developmental disorder. ATC^{. Talk} 10:38, 4 May 2009 (UTC)

Why is "brain-cell development disorder" worse than "brain development disorder"? It's more accurate, surely. Is it the length? I don't see what advantage the other suggestions have over "neurodevelopmental disorder", which is the technical term; it is no harder for non-experts to understand than "neurological brain developmental disorder". Anyway, let's see what other editors think. Eubulides (talk) 16:08, 4 May 2009 (UTC)

I really don't like "brain-cell development disorder". This implies the individual brain cells developed wrongly. The Pathophysiology section points out that although there might be problems right down at the cellular level, we are not really sure what scale (cell, network, mind) autism goes wrong. I have no problem with "neurodevelopmental disorder" myself, but I'm over-exposed to such terms compared to the "general reader". I understand the caution against using such a long erudite word in the lead sentence. A quick search of the news.bbc.co.uk site shows they aren't afraid to use "neurodevelopmental" but more often use "brain development". Colin°^Talk 17:41, 4 May 2009 (UTC)

Yes, I prefer "brain development" as well, since it might be a question of connectivity between cells, rather some problem with the structure of the cells themselves. Tim Vickers (talk) 17:55, 4 May 2009 (UTC)

Thanks for doing the BBC research and giving your opinions. Let's leave it alone, then. For what it's worth, my impression is that the most-popular theory about cellular mechanism nowadays is that it's a difference in the way brain-cell adhesion works, and that this leads to changes in the way synapses develop. See, for example, Wang et al. 2009-04-28 (PDF). This theory is summarized in the 4th bullet of Autism #Pathophysiology, but I expect it's too bleeding-edge and speculative to be mentioned in the lead. Eubulides (talk) 21:35, 4 May 2009 (UTC)

IEPs

An editor added this text today:

The Individuals with Disabilities Education Act (IDEA) was modified to include regulations for the Individualized Education Program (IEP). The IDEA requires public schools to develop and IEP for every student with a disability. A written statement for each child with a disability is developed, reviewed, and revised in accordance to IDEA regulations. The statement must include the child’s present levels of academic and functional goals, measureable goals, a description of short-term objectives, a description of the special education and related services that will be made available to the child, and any appropriate accommodations that are necessary to measure the academic and functional achievement of the child. Once an IEP is developed, it is up to the teachers to implement the requirements set in the IEP. U.S. Department of Education

I've removed it for discussion. It's both too broad and too narrow: this paragraph could go on any article for a special-ed-qualifying disorder, but is also only relevant for the US. Thoughts? Maralia (talk) 23:09, 5 May 2009 (UTC)

I agree that Autism is not a good place for this text, as neither the text nor its source mentions autism. A better location would be Individualized Education Program. Much of what the text says is already covered there, I expect. Eubulides (talk) 23:30, 5 May 2009 (UTC)

Amygdala detail

An editor added the following text under a new section "Neural Detection":

Using MRI brain scans, researchers found that the area of the brain called the amygdala was, on average, 13 percent larger in young children with autism, compared with control group of children without autism. Children with autism have normal-sized brains at birth but at some point, in the latter part of the first year of life, the amygdala begins to grow in kids with autism. A normal-sized amygdala helps a person process faces and emotions, behavior commonly known as joint attention. UNC researchers conducted diagnostic assessments, in addition to the MRI scans, to monitor the children's behavior. They found toddlers with a large amygdala also had joint attention problems. Autism experts agree joint attention difficulty is a key characteristic of autism. It also is the only behavior linked to a large amygdala, according to the study. Researchers found no association between repetitive behavior or other social behaviors and a large amygdala.

I have removed it as the text was unsourced, the addition of an entire subsection is probably undue weight, and it appeared mislocated (a subsection under "Characteristics"). I see that this is briefly touched on in Causes of autism#Amygdala neurons; is further elaboration useful here? Maralia (talk) 16:35, 6 May 2009 (UTC)

The latest reliable review in this area that I know of is Amaral et al. 2008 (PMID 18258309). It notes that there are many studies of the amygdala and autism, as well as of frontal lobes and autism, cerebellum and autism, and that there's no clear and consistent pathology yet. This makes me pretty leery of citing the latest-and-greatest primary study on the amygdala. Amaral et al. mention 16 regions of the brain that have been studied, which would be a bit much to include in Autism. They do emphasize studies of the cerebellum and of the amygdala, so I changed the caption of File:Autismbrain.jpg as follows: "Autism affects the amygdala, cerebellum, and many other parts of the brain.", citing Amaral et al. Eubulides (talk) 19:47, 6 May 2009 (UTC)

Autism & Vaccines

Controversy has been adrift over whether autism is caused through vaccines or not. Many citizens may believe autism is caused by vaccinations; other citizens state that autism is not. Please put any further insights you might have-we at the UWEC are studying Autism and other issues that are related with autism, vaccines and mercury included. And there are Autism networks doing subjects on vaccines related to autism (Generation Rescue, etcetera), but the actual connections between autism and vaccines have not been proven true or false at the present. 12.227.185.235 (talk) 09:58, 16 April 2009 (UTC)

No connection has been demonstrated reliably. That is, to this point, the end of the story. What various 'citizens' think is beside the point. Sources sources sources, that is all that matters. Please also remember that this is not a forum. Dbrodbeck (talk) 11:23, 16 April 2009 (UTC)

Oh, our mistake. It is the sources that matter. Autism is our actual study, so if we find proper sources, we may use them or contact you. Thank you guys.

And we weren't trying to use the Talk:Autism as forum usage. Our apology. 12.227.185.235 (talk) 13:44, 16 April 2009 (UTC)

I would recommend you reference medical and scientific journals for your "research", rather than asking for opinions from the general public (i.e. wikipedia).

I am Offended That this vaccine therroy has made it all the way to wikipedia. Both Me And My Brother Were Vaccinated at the same time and place when we were kids as we were born within a year of each other. my brother later diagnosed with moderate autism. and i was diagnosed with aspurgers syndrome. And if anything it's genetic because my father was dyslexic. I can even dig up our of our documents to provide evidence that there is false. Ind my family is not the only one that has proven this theory wrong i know other famies that are in the same boat. Can we please omit that sentence or at least append to it saying that that her is "Highly unlikely"--Koman90 (talk) 05:16, 10 May 2009 (UTC)

Other causes in the lead

A recent edit removed the following text from the lead:

"Other proposed causes, such as childhood vaccines, are controversial,^[14] and the vaccine hypotheses lack any convincing scientific evidence and are biologically implausible."

with the comment "removed mention of vaccine as a cause, does not belong in the intro". First, this sentence talks not only about vaccines, but about other environmental causes. Second, the (unsupported) notion that vaccines cause autism is quite notable: for example, Google News reports that about 10% of the 100,000 news articles that mention autism also mention vaccination, and Google Scholar reports that about 6% of the 200,000 scholarly articles that mention autism also mention vaccination. If the relationship between vaccines and autism is that notable, it's worth mentioning in the lead, no? For now, I reverted the edit; if the wording can be improved let's discuss it here. Eubulides (talk) 19:47, 6 May 2009 (UTC)

Given the enormous coverage of this in the popular media alone, it would be an oversight not to touch upon it in the lead. Maralia (talk) 20:21, 6 May 2009 (UTC)

It depends a bit on where you live, the 'enormous coverage in the media' is likely a rather local (US) phenomenon. Fenke (talk) 21:05, 10 May 2009 (UTC)

I'd suggest

"Other proposed environmental causes, such as autoimmune disease, infections or childhood vaccines, are controversial,^[14] and the vaccine hypothesis in particular is contradicted by a large body of scientific evidence."

Less of a focus on vaccines, and that MMR hypothesis does not only "lack" evidence, it is contradicted by a growing mountain of data. Tim Vickers (talk) 21:37, 10 May 2009 (UTC)

It's a bit tricky because there are multiple vaccine hypotheses (thiomersal, MMR, vaccine overload, aluminum, etc.), the vaccine overload theory is strongly related to the autoimmune disease theory, and there is reasonable albeit not definitive evidence that a few types of prenatal infections (notably congenital rubella syndrome) can cause autism. The scientific case against MMR vaccine being a cause is quite strong, but less research has been done on thiomersal (I expect because it's no longer in most vaccines), and far less research has been on the other vaccine-related theories. How about this wording instead?

"Controversies surround other proposed environmental causes, such as heavy metals, pesticides or childhood vaccines,^[14] and the vaccine hypotheses are biologically implausible and lack any convincing scientific evidence."

Eubulides (talk) 07:39, 11 May 2009 (UTC)

I think that sentence might be better without the 'and' at the end, just start a new sentence after the ref. Fenke (talk) 09:17, 11 May 2009 (UTC)

Thanks, I changed it to a ";" (better than ".", I think, since it's closely related to the previous sentence) and installed the result. Eubulides (talk) 08:37, 14 May 2009 (UTC)

Hand and skin biting image, etc.

This edit by User:6th Happiness introduced a prominent mention of a new image Image:Dermatophagia.jpg, with caption "Self injury in the form of compulsive nail and skin biting in an adult autistic", along with the additional text "which can range from mild (such as head rubbing, and thigh slapping) to extreme manifestations (such as frequent arm biting, and violent head banging)", the latter citing Weiss 2002 (PDF). This source is an older review, by one author (who was a first-year Ph.D. student at the time), published in a lower-tier journal, namely the non-PubMed-indexed Journal on Developmental Disabilities. Surely we can do better than this source.

I attempted to substitute a better source for self-injurious behavior (SIB) in autism, namely Johnson et al. 2007 (PMID 17967920); my edit also removed the image, for reasons discussed below. Johnson et al. is much more authoritative on autism: it was published much more recently (2007), was written by the American Academy of Pediatrics' Council on Children with Disabilities, and was published in the top-tier journal Pediatrics. My attempt was reverted by User:6th Happiness with the edit summary "newer article did not list SIB examples; photo no more self-research than other photos (eg kid w cans) in article & challenges stereotype of SIB = headbanging".

That edit summary is incorrect about the newer article. Page 1194 of Johnson et al. says "Self-injurious behaviors (head banging, skin picking, eye poking, hand biting) are stereotypies that may cause bodily harm and are more common in children with severe GDD/MR (intellectual disabilities) or ASDs with comorbid GDD/MR." It goes on to say more about SIB.

My objection to Image:Dermatophagia.jpg is mainly that it is original research. It is evidently a photo of User:6th Happiness's own hand, and the edit summary comment "challenges stereotype of SIB = headbanging" indicates that the editor in question is sincerely motivated to present his personal story and opinion. However, Wikipedia is not the place for this combination of original thought and soapboxing.

My objection to the text "which can range from mild (such as head rubbing, and thigh slapping) to extreme manifestations (such as frequent arm biting, and violent head banging)" is more than just to the lower-quality source that supports it. It is also to the implication that behaviors can be categorized as "mild" or "extreme" based on their type, when it would be more accurate to say that any type of SIB can be "mild" or "extreme".

Furthermore, as Johnson et al. point out, although SIB is common in autistic individuals, GDD/MR is a more important risk factor for SIB than autism is, and Autism should not be emphasizing SIB more than reliable sources on autism do.

In addition, now that I've had time to look over the article a bit more after the change was reverted back in, there's a serious WP:WEIGHT issue. Autism is a triad of categories of symptoms: social development, communication, and repetitive behavior. This new image would be the third illustrative of repetitive behavior, arguably the least characteristic of the symptoms. And yet the article has no illustrations of social development, and at best one illustration of communication. Even before this change, the illustrations had a serious weight problem, in unduly promoting repetitive behavior over the other two legs of the triad. This new illustration makes bad matters worse. It is clearly the worst of the three images on repetitive behavior, so it should be removed on this ground alone.

Eubulides (talk) 05:54, 18 May 2009 (UTC)

Eubulides agreed. The version that was added uses a poorer source and adds original research. There are also weight issues that you raise. I would support changing the article back to the way it was. Dbrodbeck (talk) 12:27, 18 May 2009 (UTC)

"Challenge" was admittedly a poor word choice which gave an impression of intention that is inaccurate; I thought it was helpful to illustrate something other than headbanging since the public seems to assume that autism = headbanging as a SIB when this is not true (just like the public tends to assume autistics = savants.) I'm not challenging the facts/research, just presenting something other than the stereotypes common among the uneducated public.

"it would be more accurate to say that any type of SIB can be "mild" or "extreme"." I see your point and agree with editing that reflects that. I will attempt to do so in the article.

On the weight issue - I both agree and disagree. While this is another example of repetitive behaviour, but a very different kind of manifestation (eg the two of the child show non-self-harming behaviour, focus on patterns; the hand image shows repetitive SIB without a focus on pattern. I agree that variety is good, and that images of other issues in autism would be ideal to have... but how can you show a photo illustration of social communication? No matter what image you use, it will not illustrate the Autistic's experience/understanding of the scene, but rather the most-likely non-autistic viewer's interpretation of it. An illustration for the social aspects would need to be very carefully chosen, and I'm not sure a good one really can be found.

On the Worst of three - why is it "worst"? Because its graphic? That happens, that is part of many autistic's life and shouldn't be avoided in preference of less disturbing subjects imho. The other two of the kid with cans and the toys seem redundant imho, and thus one seems "worst" in that it is not adding much/anything to the article, where as the SIB photo illustrates something different.

Regarding it being my own hand- the two photos of the kid with the cans and toys is the photographers own son. If one's own photography of one's own experience with the article topic is too close to "self research", than the other two photos do not belong either. Would the image be acceptable if my mother uploaded the hand image? If so, why? (I'm not suggesting this as a work around, my mother has no interest in Wikipedia, nor would I ask her to do that if she did)

ETA: I did look at the article you ref'd and while I didn't read it I searched for key words liek 'biting' and they didn't show up. If the info is in there, I don't know why this was. While the ref I used was older, I think the list of examples is helpful. Why not ref both articles?

I'm not interested in dragging out a debate on this- majority rules here. But I did want to respond to clarify what I had attempted to express in the very limited space allowed when making a revision, and to respond to the points raised here.

--6th Happiness (talk) 19:01, 18 May 2009 (UTC)

Please see #Self-injury bullet and #Hand and skin biting image below. Eubulides (talk) 20:02, 18 May 2009 (UTC)

Self-injury bullet

"while I didn't read it I searched for key words liek 'biting' and they didn't show up" Please take the time read the article, as it's quite a good one. As I wrote, you will find the word "biting" on page 1194 of the article (see the PDF copy). Look at line 10 of the left column.
"Why not ref both articles?" Because, as explained above, Weiss 2002 (PDF) is a relatively weak source. Although it is reliable, it's older (the field of autism moves fairly rapidly) and it is far less authoritative for autism than Johnson et al. 2007 (PMID 17967920). Tens of thousands of reliable sources on autism are available, and Autism clearly can't cite them all. The article should cite the best sources available on a given topic, not merely the sources that are "good enough". If Weiss 2002 were the only source available on autism and SIB, it would be OK to cite it; but we have better sources, so let's use them instead.
I see now that the text was altered to say that self-injury symptoms can vary from mild to severe. While that's true, it's also true of all symptoms of autism, and it's confusing and a bit misleading to make the point only for self-injury symptoms, as it implies to the naive reader that only self-injury symptoms can be mild or severe. For now I attempted to work around the problem by [ restoring] the older version. Let's discuss the text below and see if we can come up with something better. Here's my draft:

"Self-injury includes movements that injure or can injure the person, such as eye poking, skin picking, hand biting, and head banging.[Johnson et al. 2007, PMID 17967920]"

Eubulides (talk) 20:02, 18 May 2009 (UTC)

No further comment, so I added that. Eubulides (talk) 17:00, 19 May 2009 (UTC)

Hand and skin biting image

"public seems to assume that autism = headbanging" This is not my impression, and I don't think it is supported by reliable sources on public opinion about autism.
"While this is another example of repetitive behaviour, but a very different kind of manifestation" This behavior is very different, but it's less-associated with repetitive behavior than the other two images. The image of the child stacking the cans is by far the best image of repetitive and restrictive behavior, since it shows the behavior directly. The image of the sleeping boy with the ducks in a row is second best, since it presents a clear association between the boy and the behavior (even though we don't see the behavior directly, a naive reader can easily infer it). The image of the hand with bitten nails is by far the worst of the three, since it least-clearly shows the behavior: a casual observer of that image wouldn't know that it had anything to do with repetitive or restrictive behavior. At the top level, it's merely a picture of an oddly shaped fist, which is a completely misleading impression; and even if the picture were altered to focus on the bloody nails, it's not at all immediately clear to a naive reader that the nails result from restricted and repetitive behavior.
"how can you show a photo illustration of social communication" With pictures like the one that Autism already has of shared attention. This is the best image we have of autism symptoms, even though it's showing a negative example. (We need positive examples.)
"the two photos of the kid with the cans and toys is the photographers own son". True, but even so, that is less original research than a self-portrait, as the autistic person is not the one publishing his own photo.
"why is it "worst"? Because its graphic?" No, it's worst for the reasons described above. It is also true that it is graphic and will disturb some readers, but Wikipedia is not censored. My objection to the image is more on the basis of original research and weighting. The vast majority of autistic people do not have hands that look like that, and it's misleading to present the image in Autism, as it gives the naive reader the impression that it's typical.

Eubulides (talk) 20:02, 18 May 2009 (UTC)

Regarding the 'self portrature' issue only: I firmly disagree with you on the difference of who took the photo. If the current photos didn't exist, I could just as easily line up objects, and put my camera on a timer delay to put myself in the photo. Interpreting Wikipedia's standards in the most narrow of ways to insist that images are not self-published, is one thing. Arguing that self-published photos are OK, but only if published by certain kinds of people is privileging one voice over another. In this case, it is a voice that is most typically an outsider interpretation of the minority subject.

My interest was to improve an article through contribution. I didn't expect it to be pounced on and debated with numerous paragraphs / bullet point lists in each exchange, which I've no time for, nor interest in continuing with.

--6th Happiness (talk) 21:53, 18 May 2009 (UTC)

Anticipatory postures and deviance

A recent edit made the change "Autistic toddlers have more striking social ~~deviance~~ differences; for example, they have less eye contact and fewer anticipatory postures," (deletions ~~struck out~~, insertions italicized), with the edit summary 'restore anticipatory postures (mentioned by the source, so what makes it less important?) with a better grammatical structure; "deviance" often implies morally negative, so use "differences" instead'. There are some problems with this change:

The cited source, Volkmar et al. 2005 (PMID 15709938) uniformly uses the phrase "social deviance"; it never mentions "social differences". "Deviance" is a technical term implying violations of social norms; replacing it with "differences" loses useful and relevant information.
The cited source mentions several examples of social deviance, including "both person-to-person behaviors (anticipatory postures, turn taking, intensity of eye contact) and behaviors in which an object is the focus of joint interest (joint attentional skills such as pointing to materials, following a point of another person, or giving objects)". Also: "For example, the children with autism failed to assume anticipatory postures, reach for familiar persons, show interest in children other than peers, and engage in simple social interaction games." Also: "Items that differentiated the groups again included social activities (seeking shared enjoyment, social reciprocity, use of another person as a tool, interest in other children), and communicative tasks (attending to voice, pointing, using and understanding gesture). Two behaviors, directing attention and attention to voice, correctly identified 82% of children." Of all these, "anticipatory postures" is the one that is least likely for a naive reader to understand from the phrase alone, so that's why I removed it.
The cited source does not support the phrase "fewer anticipatory postures". Also, the word "fewer" is ambiguous; does it mean fewer types of anticipatory postures, or fewer uses of anticipatory postures? This is another reason why I removed "anticipatory postures"; it's a phrase that will be a bear to get right, and it's not worth the editing effort to salvage what is just one minor example among many.
I'd rather not do another revert right now, but the changes in the past day or so to this sentence have some problems. At least the earlier text was correct about the technical details, even if it had a grammar problem. Now the text may be grammatically correct, but its "differences" and "fewer" both incorrectly summarize the technical details; this is a change for the worse.

Eubulides (talk) 06:05, 23 May 2009 (UTC)

Since I made the change (actually two changes in one diff), I'll try to better address these issues here (space in the edit summary is quite limited). I'm happy to hear others' opinions on these, also. First, "anticipatory postures":

The reinsertion of "anticipatory postures" was simply an attempt to head off continued grammatical issues without losing information that whichever editor originally added the references from those sources felt was important enough to include. I'm not personally married to it, though perhaps if it is "least likely for a naive reader to understand from the phrase alone," what it actually needs is its own article explaining it, and wikilinked in place. As for "fewer" types or uses? Your quote of the source says "failed to assume anticipatory postures" - that seems to me to actually imply both, but at minimum would count as fewer uses, that could be easily indicated simply by inserting "uses of" after "fewer", or perhaps the source's example could be quoted directly.

As for "differences" vs. "deviance", I actually feel more strongly about this. While in technical writing (such as in a journal), "deviance" may have a technical meaning devoid of any moral weighting, in general language usage it tends to carry the same morally negative connotations as words related to it such as "devious" and "deviant" (when was last time you heard someone referred to as "deviant" without it implying something morally negative?). For a similar usage issue, consider, for example, that, technically, "abortion" simply refers to a non-birth loss of pregnancy; but general (i.e. non medical journal) use almost always refers to a spontaneous loss of pregnancy as a "miscarriage", not the technical term "spontaneous abortion", because of the moral and political baggage tied to the issue of procured abortions. "Violation", which you used in the technical definition of "deviance", can also carry a negative connotation e.g. "violate", "violent". We are supposed to paraphrase anywhere we don't use direct quotes; why should we be tied to this particular word?

Furthermore, by definition, a "deviance" is a difference; obviously, something wouldn't be a violation of social norms if it were not different from those norms! You quoted from the source above: "Items that differentiated the groups..." Is not "differentiated" a verb form of "difference"?

Bringing this together, while Wikipedia is meant to be useful to experts, it also makes a point of being aimed at a general audience. As such, I think it behooves us to avoid using terms in a technical way if those terms can easily be misinterpreted to imply something their technical usage isn't meant to imply. I personally don't see the phrase "social differences" as indicating any less variation from norms than "social deviances" implies; in other words, I don't see it losing any "useful and relevant information", only the implication that those variations are morally wrong. John Darrow (talk) 06:32, 24 May 2009 (UTC)

"without losing information that whichever editor originally added the references from those sources felt was important enough to include" As it happens I am the editor in question,[13] so I can say that the editor did not feel the information in the phrase "anticipatory postures" was that important. Anticipatory postures are just one relatively-minor example among many possibilities. They are not worth contorting the grammar over. They are certainly not worth writing another article over, just to fix this problem.
"someone referred to as "deviant" The phrase in question is not "deviant". It is "social deviance", a milder term.
"a 'deviance' is a difference" Yes, but the point is that a deviance is a certain kind of difference: it's a difference that violates social norms. Merrely calling it a "difference" loses this valuable information.
"it behooves us to avoid using terms in a technical way if those terms can easily be misinterpreted to imply something their technical usage isn't meant to imply" The text already did that, by immediately giving examples of what was meant by social deviance, such as lack of eye contact. Furthermore, the sentence is explicitly talking about the behavior of toddlers. The text cannot reasonably be interpreted to be talking about criminal behavior.

Eubulides (talk) 07:39, 24 May 2009 (UTC)

In everyday life we don't usually call avoiding eyecontact a deviant behaviour. Where "difference" carries too little meaning, "deviance" carries too much. Fenke (talk) 09:55, 24 May 2009 (UTC)

True enough. I attempted to work around this by replacing the too-little "have more striking social differences" with the stronger-but-not-too-much "differ more strikingly from social norms". The idea is to capture the technical meaning of "deviance" without using the specific word "deviance". The same edit also replaced "anticipatory postures" with "turn taking", a phrase that a naive reader is more likely to grok. Eubulides (talk) 06:41, 26 May 2009 (UTC)

Looks good.

And a thank-you for the article link on nl-wiki. Fenke (talk) 11:03, 26 May 2009 (UTC)

Food allergies

I am thinking of adding to this site. I want too add a section on food allergies that can worsen autism. Do any of you have any suggestions on some things i can add?

--Wakatoria (talk) 15:26, 10 June 2009 (UTC)

The most important thing is to find reliable sources on the topic, and to summarize them accurately. Please see WP:MEDRS for guidelines on reliable sources for medical facts and figures. It might be a good idea to discuss the sources on the talk page first, as there are a lot of conflicting sources in this area, and not all of them are reliable. Eubulides (talk) 16:51, 10 June 2009 (UTC)

Rubinstein and Moldin

The following Further reading section was recently added:

Rubenstein JLR; Moldin SO (2006). Understanding autism: from basic neuroscience to treatment. CRC Press. ISBN 0-8493-2732-6.{{cite book}}: CS1 maint: multiple names: authors list (link)

The book is an OK source, but I don't see what it brings to this article that wasn't there already (with better sources), so I removed it. Also, Google Books URLs are not reliable, so if we do cite this book we should omit that URL. Eubulides (talk) 23:02, 26 June 2009 (UTC)

Google book URLs are not reliable? I use 'em quite frequently :( I've no problem with the book being removed, I only formatted it a little differently. WLU (t) (c) Wikipedia's rules:^simple/_complex 12:55, 27 June 2009 (UTC)

Google Book URLs typically don't work for me. I often access them via a pooled IP address, and typically get a response back saying that I'm (or we're) over quota for book-reading. Another problem: they often reveal information to Google (and to others) as to who who originally read the book. There's no Wikipedia guideline on this as far as I know, but I'd stay away from them. Eubulides (talk) 18:05, 27 June 2009 (UTC)

Ah, neat - I learned something. I wonder if a gmail or other google account would help with that? There are also search options to look in full-preview books only which might help (at the expense of a much more limited set of books to view). As long as there's no wiki guidelines, I'm a happy man, I loves the google books. WLU (t) (c) Wikipedia's rules:^simple/_complex 20:30, 27 June 2009 (UTC)

Alcoholism, Drug Addiction and autism

The Epidemology subsection should include the evidence of autism runs well in families with alcoholism and drug addiction. The internet search engines have many hits on psychiatric studies on the link of alcoholic parents or relatives addicted to illegal drugs with autism. Genetic factors on the high likelihood to develop autism and alcohol abuse is startling and whether autistic children or their non-autistic relatives themselves are more prone to drug or alcohol abuse is very possible. Autistic people are said to become dependent or obsessed on a subject or thing, is this a sign of a genetic trait also associated with drug addiction and alcohol dependency? + Mike D 26 (talk) 23:19, 20 July 2009 (UTC)

Reliable sources, please? "internet search engines" don't count as reliable sources. See WP:MEDRS. Eubulides (talk) 02:08, 21 July 2009 (UTC)

AS and PDD-NOS

An editor has recently attempted three times to promote the abbreviation "AS" for Asperger syndrome in this article.[14][15][16] Unfortunately, while "AS" is a common abbreviation for "Asperger syndrome", it is also a common abbreviation for "autism spectrum"; see, for example, Davis et al. 2006 (PMID 16453070) and Davidson 2008 (doi:10.1080/14649360802382586). What reliable sources typically do is to choose an abbreviation suitable for their particular domain. Sources that are specifically about Asperger syndrome often use "AS" to mean "Asperger syndrome" (and define this abbreviation early on in the article). Sources that are about autism in general often don't do that: more commonly, they say "Asperger syndrome" or "Asperger's" or "Asperger's disorder" or something like that.

This article is about autism in general, and given that "AS" is ambiguous in practice in the autism world, the article shouldn't present "AS" as if it were generally accepted to have one particular meaning. The abbreviation "AS" is never used later in the article, so there's no need to define it in the lead. Given that Asperger syndrome isn't mentioned that often in this article, the issue of what "AS" means is not important enough to be discussed even in the body; it's simpler to remove the abbreviation entirely.

The abbreviation "PDD-NOS" is another matter. It's well standardized and is more commonly used than the phrase it abbreviates: Google Scholar reports 74 articles with "PDD-NOS" in the title, as opposed to 62 with "pervasive developmental disorder not otherwise specified". The relative popularity of "PDD-NOS" is understandable: unlike "AS", it's not ambiguous; also, it's a lot shorter than the phrase it abbreviates, whereas "AS" is not that much shorter than "Asperger's". For this reason, the recent edit that spells out "PDD-NOS" in the lead does not seem advisable; there's no pressing need to discuss both forms of the name in the lead, and the matter can be left for the body.

Given the above discussion I changed the lead to refer only to "Asperger syndrome" and to "PDD-NOS". If this can be improved further, let's discuss it here. Thanks. Eubulides (talk) 06:44, 25 July 2009 (UTC)

The first-time reader with no knowledge of autism will be confused by the term PDD-NOS. It would be better if we were to explain to readers what PDD-NOS stands for, so that they do not have to refer to another source. Consider that a person who knows nothing about autism may well go to the Autism Wikipedia article for their first exposure to an explanation. Isn't it reasonable to spell out the name of a common ASD?

Of course scholarly articles use the abbreviation: medical professionals and researchers can be expected (we hope) to know the name of the disorder they are studying, at the very least. Not so with the first-time reader with no background in understanding ASDs. Whatever404 (talk) 13:31, 25 July 2009 (UTC)

It is surely reasonable to spell out the name, which the article does. The issue is whether it's worth burdening the lead with the long phrase. Arguments for sticking with the abbreviation are (1) the condition is more commonly called "PDD-NOS", (2) the wikilink to PDD-NOS can easily satisfy the curiosity of a reader who does not know the term, and (3) the immediately neighboring text defines the term to be the condition that's diagnosed when the other two don't apply, which is pretty much equivalent to saying "Pervasive Developmental Disorders, Not Otherwise Specified". Eubulides (talk) 18:32, 25 July 2009 (UTC)

Fewer signs and symptoms

A recent edit removed the phrase "which have fewer signs and symptoms" from the end of the sentence that began "The autism spectrum disorders (ASD) also include the related conditions Asperger syndrome (AS) and PDD-NOS", with the edit summary "found nothing to that effect in the ref". The phrase "fewer signs and symptoms" was an attempt to summarize the following in the cited source (Johnson et al. 2007, PMID 17967920):

"... Hans Asperger ... described children who demonstrated symptoms similar to those of Kanner's patients, with the exception that verbal and cognitive skills were higher."
"PDD-NOS ... is ... a subthreshold diagnostic term used when a child ... does not meet full criteria for AD or AS."

In both cases the idea is that the other condition is like autism, except that the patient doesn't meet the full criteria for autism. For Asperger syndrome the patient lacks significant delay in verbal and cognitive development; for PDD-NOS there is some other way that the patient does not meet full criteria for autism. The point is important, and I attempted to summarize it better by appending the text "which may be diagnosed when a child does not meet full criteria for autism". Eubulides (talk) 07:17, 25 July 2009 (UTC)

It makes sense to describe PDD-NOS as a kind of catch-all term which can be applied to people who clearly have a PDD but who do not meet the criteria for autism or Asperger syndrome, that is the nature of the term. However, it makes less sense to describe Asperger syndrome as "not quite autism"; that is an oversimplification. There are aspects of Asperger syndrome which are not best described as "autism lite". See Diagnosis of Asperger_syndrome#Differences from high-functioning autism: the differences between HFA and Asperger syndrome are not clearly defined; more research is needed. I have attempted to differentiate PDD-NOS' status as a catch-all term from that of Asperger syndrome, which is a well-defined diagnosis. Just look at the length and breadth of the PDD-NOS and Asperger syndrome articles. Whatever404 (talk) 13:41, 25 July 2009 (UTC)

I hope our recent rewording has resolved the problems noted above. However, there seems to be some confusion in the previous comment: is Asperger's a "well-defined diagnosis" or one where the boundaries "are not clearly defined"? Anyway, there is controversy about all of the boundaries between all of these diagnoses. If anything, there is more controversy about Asperger's than about PDD-NOS, as there is significant sentiment to abolish the Asperger's diagnosis entirely (see First 2008), but there's no similar sentiment to abolish PDD-NOS. Eubulides (talk) 18:32, 25 July 2009 (UTC)

Etymology

Where does the word autism come from? Sorry if i missed it in the article but its quite long =3 70.18.233.92 (talk) 06:45, 3 August 2009 (UTC)

It's in there. Look for the word "word". Eubulides (talk) 08:24, 3 August 2009 (UTC)

Vaccine–autism theories

A recent edit made this change:

"Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination~~, and this has given rise to theories that vaccines or their preservatives cause autism. Although these theories lack convincing scientific evidence and are~~ however such a link is biologically implausible there is no scientific evidence to support any connection. Ironically, parental concern about autism has led to lower rates of childhood immunizations and higher likelihood of measles outbreaks."

This change has several problems:

It omits the popular theories that vaccines or their preservatives cause autism.
It omits the point that the coincidence in time between vaccination and preliminary diagnosis has fuelled the popular theories.
The cited source (Doja & Roberts 2006, PMID 17168158) talks about "convincing evidence", but the "convincing" was removed.
The "Ironically" is not supported by the cited sources and appears to be editorial opinion.

The theory that vaccines cause autism is quite notable. For example, a Google Scholar search for recent articles about "autism" found 30,300 citations, and for "vaccines autism" found 5,420 citations; although this is a very approximate measure, it does show that the popular theory about vaccines causing autism is quite notable, and suggests that the theory should be mentioned in Autism even if it is incorrect. Perhaps the current wording could be removed, but it's not an improvement to remove all traces of the common (if incorrect) theory that vaccines cause autism. For now, I'll revert the change. Eubulides (talk) 05:14, 13 June 2009 (UTC)

There is no link between the vaccinations and the cases of autism as mentioned here in sharp's expert's in health podcasts. Please Look at this page and listen to the podcast there have have been studies done since then that actually suggest the opposite that it actually should prevent autism and other deseiaes both mental and physical. This Vaccine Scare Has Be Going On For 20 Years Now, please invalidate this topic, as i know it is not true, me and my brother were born a little less than a year apart and we had our shots done at the same time and same place, yet he has autism and i don't please, we need to make it even more clear in the article that this myth is completely and absolutely FALSE. - Koman90 (talk) 21:30, 11 July 2009 (UTC)

The article already is pretty clear that the popular vaccination–autism theory is wrong; for example, it says "these theories lack convincing scientific evidence and are biologically implausible". If the wording can be improved while continuing to rely on reliable sources then we should do that; further suggestions are welcome. Eubulides (talk) 23:00, 11 July 2009 (UTC)

The fact that a theory lacks convincing scientific evidence doesn't necessarily mean it's wrong: there was no evidence to support Wegener's theory of continental drift when he proposed it, but he was right nevertheless.

'biologically implausible' doesn't hack it either: this is just name-calling. Since we admittedly don't know what causes autism, how we know what doesn't?

What would really dispose of this theory is to show that the correlation between vaccination and autism is zero or negative. Paul Magnussen (talk) 21:19, 24 August 2009 (UTC)

The phrases about lacking convincing scientific evidence and being biologically implausible are supported directly by the cited sources, which are reliable. Several studies have found no (or even negative) association between vaccine and autism. Eubulides (talk) 21:23, 24 August 2009 (UTC)

The fact that a theory lacks convincing scientific evidence doesn't necessarily mean it's wrong: there is no evidence to support my personal theory that continental drift is caused by attractive and repulsive interactions between the Yeti in Asia, the Loch Ness monster in Scotland and Bigfoot in America, although this theory is 'biologically implausible', I'm sure I will be proved right in time. Tim Vickers (talk) 21:58, 24 August 2009 (UTC)

Review article ?

[17] ? See WP:MEDRS, it's not clear to me this satisfies. Is this mentioned in any reputable reviews? SandyGeorgia (Talk) 22:43, 7 September 2009 (UTC)

It's an OK review, but it's not worth highlighting in Autism as it focuses narrowly on the issue of whether most children with autism are mentally retarded. A better location for that topic is the subarticle Conditions comorbid to autism spectrum disorders, which already cites the review and briefly summarizes it (much more accurately, by the way). Autism summarizes the somewhat bigger picture better and more neutrally, when it says "The fraction of autistic individuals who also meet criteria for mental retardation has been reported as anywhere from 25% to 70%, a wide variation illustrating the difficulty of assessing autistic intelligence.", citing Dawson et al. 2008 (doi:10.1016/B978-012370509-9.00152-2), a more recent source; adding older material supporting just one side of this dispute (Edelson 2006) has some obvious WP:NPOV and WP:WEIGHT issues. Eubulides (talk) 01:21, 8 September 2009 (UTC)

Hi, thanks for your explanation about deleting the 2006 Edelson review (doi:10.1177/10883576060210020301), and sorry for the delay in commmenting (computer woes). I agree that the summary of that source at Conditions comorbid to autism spectrum disorders is much better, i.e.: "A 2006 review questioned the common assumption that most children with autism are mentally retarded." But I disagree that the issue of intelligence and autism is a "narrow" one; from the literature, it seems to be a pretty important topic these days, with old assumptions about the prevalence of MR being reexamined. And of course NPOV doesn't mean citing only sources using neutral language, but rather giving due WP:WEIGHT, and in this case I don't see the problem: why not just cite the Edelson review along with a balancing source, i.e. an equally good and recent MEDRS? And if we can't find the latter, maybe we don't really have an undue weight problem. regards, Middle 8 (talk) 22:51, 11 September 2009 (UTC)

I worry that that would create a weight problem. The Wikipedia policy on neutral points of view is not about giving equal time to all sides of a controversy; it is about summarizing what reliable sources say, roughly in proportion to what they say. For the issue of IQ and autism, the Autism article already goes uncomfortably close to advocating the controversial position that the prevalence of MR with autism is considerably lower than we think, because it's based on a review (Dawson et al. 2008, doi:10.1016/B978-012370509-9.00152-2) which is fairly critical of the MR-and-autism conventional wisdom. Here's a more conventional view: "For example, among those with autistic disorder—the most severe form, involving deficits in all three core domains—IQ varies widely; it may even be normal or above average, although 30%–50% of children with autism also have severe intellectual disability." (Geschwind 2009, PMID 18984147) Like it or not, this sort of opinion is the mainstream, and if the article touts the arguments against it any more than it already does, it'll have to include a lot more of the mainstream view (as per WP:WEIGHT). I'm not sure the article (which is already bloated) can take this, but perhaps you could propose some specific wording that addresses these concerns? Eubulides (talk) 23:21, 11 September 2009 (UTC)

Hi Eubulides; you've convinced me. Thanks for finding Geschwind; unfortunately, I'm not able to retrieve the full paper, so I don't know what kind of methodology they used, or whether they just cited earlier estimates that are based on the kinds of assumptions that are now being questioned. But I agree with your opinion that, in effect, less is more (since the article is already long) and Dawson et. al. (doi:10.1016/B978-012370509-9.00152-2) suffices to explain the key issues. Adding more would be redundant: Geschwind's stated range falls within Dawson's; Edelson raises similar questions as Dawson does. I like the current wording used to summarize the latter, and agree that we can go into more depth elsewhere. regards, Middle 8 (talk) 01:38, 13 September 2009 (UTC)

AfD: Dion Betts

The article Dion Betts is being discussed for possible deletion.

I was unable to find sources indicating his notability (or that of his books), but I am by no means an expert in this area! If he is indeed notable, if his books are thought of as being significant in the field of Autism, I would be grateful if people could take part in the discussion.

I am not seeking to get this article deleted if he/his books are actually notable and significant in the field. However, if they are not significant, then the article is right to be deleted.

If you want to make your thoughts known, the AfD is at Wikipedia:Articles for deletion/Dion Betts

Thanks -- PhantomSteve (Contact Me, My Contribs) 17:39, 13 September 2009 (UTC)

Possible connection between autism and anorexia

Please visit and contribute to this section: Anorexia nervosa#Autism as a comorbid condition. Whatever404 (talk) 11:14, 25 September 2009 (UTC)

That section seems quite low-quality to me, as it promotes a primary study and I expect reviews are not kind to that theory. I suggest removing it. But this matter should be taken up on that article's talk page, not here. Eubulides (talk) 17:15, 25 September 2009 (UTC)

"Brain development disorder"

Re this, I think it's more appropriate to wikilink directly to the common term neurodevelopmental disorder rather than pipelink via "brain development disorder". Googling for "Brain development disorder" shows mostly, if not only, sites that have borrowed from Wikipedia. We shouldn't be using novel terms, even if some editors prefer them. I'll be happy to be proven wrong by being shown that most MEDRS's prefer "brain development disorder" over "neurodevelopmental disorder". (Additionally, AFAIK, it's premature to say autism is solely a disorder of development of the brain -- but in any case, we should defer to accepted nomenclature rather than invent our own.) regards, Middle 8 (talk) 21:30, 29 September 2009 (UTC)

It's certainly true that "neurodevelopmental disorder" is the more common term in specialized journals where one can expect the readership to know what those words mean, but "brain development disorder" is also used by reliable sources. For example:

"Autism is a complex brain development disorder that impairs the development of social interaction and communication skills." Honey K (2008). "Attention focuses on autism". J Clin Invest. 118 (5): 1586–7. doi:10.1172/JCI35821. PMC 2336894. PMID 18451989.

That being said, this wording issue has come up often enough that perhaps it's simpler to give up and use the harder-to-understand term, though it's better to spell it out as "disorder of neural development" the first time it's used, as that's not quite as intimidating as "neurodevelopmental disorder". Eubulides (talk) 07:22, 30 September 2009 (UTC)

Good solution to spell it out the first time in that way. Sometimes lay readers' eyes do glaze over at long, technical-sounding terms. (Again, since I'm not at all sure that "brain development disorder" is the most common term used even in those MEDRS's that are directed at a lay audience, I agree that this is a better solution.) thanks, Middle 8 (talk) 13:03, 30 September 2009 (UTC)

Ketogenic diet

A recent series of edits added the following material to Autism #Management:

"Preliminary data from a study using The ketogenic Diet revealed a 60% improvement in children with autistic behaviour, in accordance with the Childhood Autism Rating Scale, without the risk of serious side effects (Evangeliou, A., Vlachonikolis, I., Mihailidou, H., Spilioti, M., Skarpalezou, A., Makaronas, N., Prokopiou, A., Christodoulou, P., Liapi-Adamidou, G., Helidonis, E., Sbyrakis, S., Smeitink, J., 2003) ‘Application of a Ketogenic Diet in Children with Autistic Behavior: Pilot Study, Journal of Child Neurology, vol. 18, pp.113-118). Although it is not fully understood why this scientific diet reduces autistic behaviours in children with autism who do not have epilepsy, there are two theories why this works. The ketogenic diet has been shown induce ketosis, by increasing the number of ketones that are made in the body. The first theory is that it influences glucose oxidation, and the second theory is that it significantly alters and normalises cortisol levels. In the fasted state, cortisol increases and maintains normal concentrations of glucose in blood. The ketogenic Diet is currently an established effective treatment for childhood epilepsy, (Kossoff Eric H.; Freeman John M.; Vining Eileen P.G.; Pyzik Paula L.; Ye Xiaobu; Goodman Steven N. A blinded, crossover study of the efficacy of the ketogenic diet, Epilepsia 2009 Volume: 50 Issue: 2 pages 322-325)."

This material isn't suited for this section, as the section is a very high-level description of all the hundreds of therapies (and dozens of diets) used with autism, and devoting an entire paragraph to just one of these therapies would devote undue WP:WEIGHT to the topic here. If this material belongs anywhere, a better location for it would be Ketogenic diet. If that is done, the mainstream view of the ketogenic diet's applicability to autism should be given in proportion to its weight, as per WP:NPOV. In the meantime, I moved the material here from the Autism article, so that it can be further commented upon as necessary. Eubulides (talk) 19:43, 9 October 2009 (UTC)

It is already covered in Ketogenic diet with the appropriate weight (very little). That article says "Autism, depression, migraine headaches, polycystic ovary syndrome, and type 2 diabetes mellitus have been shown to benefit in small case studies." and as one of its sources cites Hartman 2007. This review in turn cites the above paper and says "Other illnesses that have been reported in case series to benefit from the ketogenic diet are migraine headaches (Strahlman, 2006), autism (Evangeliou, et al., 2003), and depression (Murphy et al., 2004)." The lead of ketogenic diet summarised the situation by saying "The potential use of the diet as a treatment for medical conditions other than epilepsy is, as of 2008, still at the research stage.", citing PMID 18823325, which is a collaborative consensus review authored by just about every ketogenic diet research-specialist in the world. That review states "There are several uncontrolled trials and animal studies describing the potential benefits of the KD for neurologic conditions other than epilepsy and the metabolic conditions described previously. These include amyotrophic lateral sclerosis (ALS), Parkinson’s disease, Alzheimer's disease, migraine, autism, narcolepsy, brain tumors, and traumatic brain injury (Freeman et al., 2007). At this time, there is insufficient evidence to recommend the use of the KD for these conditions other than on an investigational basis." Colin°^Talk 20:19, 9 October 2009 (UTC)

I edit conflicted with Eubulides in removing the content to talk, but agree with Eubulides and Colin. SandyGeorgia (Talk) 20:24, 9 October 2009 (UTC)

Autism rate not increasing after all?

A study reported in the BBC today shows that according to the National Health Service of the UK, the rates of autism for adults and children are very similar, about 1 per 100. This means that today's autistic adults were presumably autistic all along, but not diagnosed until recently because of lack of autism awareness, and therefore that there is little or no actual rate in the increase of autism in the population. This link seems to be the original study, but I can't find any information about autism in it. I would have to assume that the news report was wrong or that not all of the study is available on the Internet. -- Soap ^Talk/_{Contributions} 13:36, 22 September 2009 (UTC)

A household survey is junk science; I suggest that unless there's a better source, this info won't be helpful. I see the info was added to the MMR vaccine controversy article, and should probably be deleted from there as well, unless more reliable and scientific sources are available. SandyGeorgia (Talk) 16:17, 22 September 2009 (UTC)

The report is here. http://www.ic.nhs.uk/webfiles/publications/mental%20health/mental%20health%20surveys/Autism_Spectrum_Disorders_in_adults_living_in_households_throughout_England_Report_from_the_Adult_Psychiatric_Morbidity_Survey_2007.pdf MrMarmite (talk)

IT is still an unscientific survey: please see this post about appropriate sourcing for medical articles. 00:11, 23 September 2009 (UTC)

I am puzzled as to why you think it's unscientific. "A survey carried out for the NHS Information Centre for health and social care by the National Centre for Social Research, the Department of Health Sciences, University of Leicester, and the Autism Research Centre, University of Cambridge". Regardless of your opinion of this, the MMR vaccine and it lack of connection with MMR was in the news, the BBC, and that in itself is worth mentioning in the article. MrMarmite (talk) 08:01, 23 September 2009 (UTC)

It isn't a voodoo poll. There is real science behind the study. However:

"Chief executive of The NHS Information Centre Tim Straughan said: "This landmark report is the first major study into the prevalence of autism spectrum disorders among adults to be carried out anywhere in the world. While the sample size was small and any conclusions need to be tempered with caution, the report suggests that, despite popular perceptions, rates of autism are not increasing, with prevalence among adults in line with that among children. It also suggests that, among adults, rates of autism remain broadly constant across age groups."

The report doesn't mention MMR -- the press-release and the British press do. Still, WP:RECENTISM suggests we should not jump to include this. We should wait for the medical literature to review this study, its methodological flaws and limitations, and place its conclusions into context. I also note that the report itself belives that:

"Perhaps most important of all is the finding that adults with ASD are socially disadvantaged, less well educationally qualified, less able intellectually and possibly under-supported by services. Much of this could be alleviated with greater involvement of existing established social, educational, welfare and health care services."

The real purpose of this report is to inform the NHS, social and educational services of the size of the problem and specific issues for them to tackle. The MMR aspect is just something thrown in to get the UK press interested. Colin°^Talk 12:42, 23 September 2009 (UTC)

I stand corrected on the voodoo poll (the BBC sure made it sound tha way !), but for the other reasons (including those listed by Colin), we shouldn't be including this until it's been properly reviewed by medical sources. SandyGeorgia (Talk) 14:38, 23 September 2009 (UTC)

NHS Choices have looked at the study and its reporting in the press; their article is a lay-friendly read. Colin°^Talk 20:38, 24 September 2009 (UTC)

Here's a link to the actual paper being discussed. I was prepared to suggest it be included but on a cursory reading, it seems a very small sample (only 72 cases identified in Phase I, 19 of whom took part of Phase II for example). http://www.ic.nhs.uk/webfiles/publications/mental%20health/mental%20health%20surveys/Autism_Spectrum_Disorders_in_adults_living_in_households_throughout_England_Report_from_the_Adult_Psychiatric_Morbidity_Survey_2007.pdf BobKawanaka 13:33, 10 October 2009 (UTC) —Preceding unsigned comment added by BobKawanaka (talk • contribs)

Math?

I believe folks are misguided here, taking the reciprocal of a number is not doing original research. I will defer to the majority opinion of the folks that spend so much time keeping this page reasonable ... I know that it's a lot of work as I do monitor this page's revisions everyday. Some of the other established editors should weigh in, it's perfectably reasonable and indeed desirable to equate the research to a "1 in x" number ... in fact this was implicitly done by the original study authors as they did not have exactly 10,000 subjects. The use of the word "about" in "about 1 in x" also makes this a reasonable line. Within the error bands of the particular study and in any study, it's a reasonable statement and is no way misleading. HarmonicSeries (talk) 02:17, 10 October 2009 (UTC)

A few points. First, the source (Newschaffer et al. 2007, PMID 17367287) is not a single study: it is a review of many studies, whose results did not agree. Second, "about 6 per 1,000 people" paraphrases the source's "close to 60 per 10,000" exactly, whereas the proposed "1 per 166" gives a connotation of precision that is not at all present in the source (and changing it to "1 per 170" or "1 per 200" would introduce further error into the number). Third, the source consistently uses "per 10,000" figures for its estimates: the advantage of this kind of presentation is that it's much cleaner to give numbers like "10–20 per 10,000" than to give numbers like "1 per 500–1,000", and it's easier to compare "37 per 10,000" to "20 per 10,000" than it is to compare "1 per 270" to "1 per 500". Autism took the liberty of using "per 1,000" statistics rather than the source's "per 10,000" statistics: this preserves the abovementioned advantages while making the numbers a bit easier for the general reader to follow. Eubulides (talk) 05:20, 10 October 2009 (UTC)

Well, it's 1 in 166.66...66, so it should round up to 1 in 167. ~~However, I actually prefer this over other ratios, because I find it easier to compare, although~~ I think a percentage would be optimal. My high school consists of about 100 students, so when I look at non-congenital mental disorders (so this wouldn't be a great example for autism, but for depression, personality disorders, schizophrenia, etc. it should be okay), this gives me an idea of about how many of the students in my school would have a certain disorder (at any time during their life or currently, depending on the situation). A 0.6% chance of having a child with autism (although this figure probably doesn't represent me) tells me a lot more than 60 of 10,000 or 6 of 1,000. A percentage would also be more consistent with most of Wikipedia's other articles on mental disorders, and is probably the easiest to manipulate to accommodate other denominators. MichaelExe (talk) 17:46, 10 October 2009 (UTC)

It's not just a matter of the math; it's a matter of what the sources support, as explained by Eubulides. In a high school population, 6 per 1,000 is as easy to sort as 1 in whatever. SandyGeorgia (Talk) 17:54, 10 October 2009 (UTC)

1 out of 167, 60 out of 10,000 and 6 out of 1,000, and 0.6% are all the same. If you went to the author(s) of the source we used, they wouldn't tell you otherwise. Imo, 0.6% looks the best, 6 out of 1,000, second, 1 out of 167, third, and 60 out of 10,000 (the actual ratio), last. I do agree with Eubulides that 1 of 167 is not the proper use of significant numbers (which is basically what was said).

Percentages are much more consistent within Wikipedia's mental disorder articles, so I support their use above any other ratio. MichaelExe (talk) 18:25, 10 October 2009 (UTC)

Percentages are not more common among medical featured articles. SandyGeorgia (Talk) 18:27, 10 October 2009 (UTC)

Maybe not (I don't feel like checking through them all), but autism is in the "WHO ICD-10 mental and behavioral disorders (F · 290–319)" category, which consists predominantly of mental (and emotional) disorders that also use percentages. The other diagnoses in "Pervasive developmental disorders and autism spectrum" use either no percentages, out of 1,000s or ratios (PDD-NOS, Childhood disintegrative disorder), percentages, out of 1000s and X:1 ratios (Asperger syndrome, which I'll assume takes its numbers from the sources), or percentages and a "one in every 12,500" (Rett syndrome).

Tbh, the percentages (0.6%) and the exact numbers from the source (60 of 10,000) are the most appropriate. I still prefer percentages, though. MichaelExe (talk) 18:52, 10 October 2009 (UTC)

I'm sure we had a discussion on presenting numbers before, but don't have the time to dig it out. There's lots of research on ways of presenting the same number but leaving the reader with different impressions or confusing the reader. As noted, the 166 looks like three significant figures of precision whereas 60 is just one. Percentages aren't as easy as you think. The problem with numbers like 0.6% is that a surprising number of people can't read that properly and interpret as 60%. This is why newsreaders say "Interest rates went up by a half of one percent" rather than "went up by a half percent". I've frequently heard TV presenters say a 40% figure is 10% higher than a 30% figure (and not "10 percentage points higher", which is a fairly abstract concept). One advantage of per 1,000 or per 10,000 is that no fractions are required for rare conditions. BTW, my high school had nearly 1,000 students so everyone's personal-comparison-group will be different. Colin°^Talk 19:10, 10 October 2009 (UTC)

But newsreaders don't say "Interest rates went up by five per mille/thousand". One percent vs. a percent doesn't change how you would write it at all. It's still 1%, albeit one is clearer. Also, saying 40% is 10% higher than 30% seems fine to me, because you're still using the same denominator (100). It's like saying 3/5 is 1/5 higher than 2/5. If one didn't intend it to be taken this way, they would say 40% is 1,333% of 30%. When comparing marks on tests, no one says percentage points. Multiplying percentages wouldn't be any harder than multiplying 1 of 1,000s, either.

Also, I went through the featured diseases and disorders under 'Health and medicine", and about half of them only use percentages, a quarter use X of 1,000s as the main prevalence rate AND percentages for other rates, and the other quarter only X of Ys.

I guess the most appropriate policy would be to take the numbers straight from the sources. I wouldn't call it the best policy, however, because you end up with several different denominators. This article primarily uses X of 1,000 ratios, but it also has X:1 ratios, and percentages.

Either way, wouldn't it be better to have the autism rates (and the autism spectrum disorder rates) in the heading instead of the ASD rates to distinguish autism from Asperger syndrome and PDD-NOS? MichaelExe (talk) 20:02, 10 October 2009 (UTC)

Financial reports may well talk about a change in "basis points", which is a "per 10,000" figure. Have a look at Percentage point and Basis point, which are both terms used to express absolute differences. People read the "%" as a unit like "ml" or "km" and think that because 40ml is 10ml higher than 30ml then you can also say (without causing confusion) that 40% is 10% higher than 30%. The ambiguity is what is the "10% higher" referring to? That 40 is a bigger number than 30 (it's actually 33% higher)? Or that the difference between 40% and 30% is 10% of the original population being referred to (hence 10% more of the original population). "10ml higher" is an absolute statement but "10% higher" is a relative statement, and what it is relative to isn't always clear. Anyway, this just proves my argument that percentages often cause confusion. Colin°^Talk 07:16, 11 October 2009 (UTC)

(outdent)

The topic of which style to use ("N%" or "N per 1,000" or "N per 10,000" or "1 per N" etc.) has been discussed before at quite some length. See, for example, Talk:Tourette syndrome/Archive 5 #Percentages vs per XXXX in epidemiology and the adjacent (long) threads. Those threads agree with you that the style used within an article should be consistent, even if the sources' styles differ. My take from that discussion is that the "1 per N" method is OK if there's only one number to report, but works poorly if several prevalences are discussed because they are hard to compare. And the choice between "N%" or "N per 1,000" or "N per 10,000" should typically be made to keep N relatively small but usually above 1; that also makes it easier to compare. That is, for comparing rare conditions, "N per 10,000" is better; for comparing quite-common conditions, "N%" is better. With Tourette syndrome #Epidemiology we went with per-1,000, as that made the numbers work out best for comparing prevalence rates in this not-rare-but-not-that-common condition. Autism's prevalence is in the same ballpark as Tourette syndrome's, so per-1,000 seems appropriate here too.
Autism uses per-1,000 figures uniformly for overall prevalence rates. It uses % only when reporting other things, e.g., the percentage of children with ASD that injure themselves. But that's OK: the latter figure is measuring a much different thing, and it's appropriate to use % there because it's a much higher number (30%).
"wouldn't it be better to have the autism rates (and the autism spectrum disorder rates) in the heading instead of the ASD rates" Yes, that would make sense. How about the following change to the lead? " The prevalence of ASD is about 6 per 1,000 people, with about four times as many males as females; the prevalence of autism alone is about 1–2 per 1,000."

Eubulides (talk) 20:42, 10 October 2009 (UTC)

Perfect. =D MichaelExe (talk) 04:31, 11 October 2009 (UTC)

OK, thanks, I made a change; I reworded it for brevity, to remove the "alone", before installing it. Eubulides (talk) 04:53, 11 October 2009 (UTC)

Glad this is resolved. I can't believe I posted my query to the medicine project three years ago! Been here too long. Colin°^Talk 07:16, 11 October 2009 (UTC)

no "Criticism" section?

I'm very surprised that there is no Criticism section in this article, that explains that autism is not even a real condition, but is in fact a completely overdiagnosed fake illness that has only become popular in recent years. —Preceding unsigned comment added by 171.64.75.60 (talk) 23:11, 17 September 2009 (UTC)

As per WP:V we'd need reliable sources to support the claim that autism is a fake illnesses. As far as I know, there are no such sources: the rumor that autism is a fake is just a rumor, and not a notable one at that. Eubulides (talk) 23:49, 17 September 2009 (UTC)

Sorry Eubulides, I know this isn't an off-topic forum, but this kid is nuts. He's just not cut out to be here editing Wikipedia. To me, it seems he may have a biased viewpoint (that's okay to have, but not on Wikipedia it is). A more proper way he should've worded it was that the criticism section "explains the controversy over whether or not autism is fake" or something along those lines. Also, if people think autism is fake, than why do people use that mentality as an excuse to demonize people struggling with a real condition. Autism is nothing to laugh at, whether it is thought of as fake or not, and whether people with it are proud of it or not...No matter how proud you are of it, you'll sometimes still want to be link everyone else.

This kid also has to understand that people make the same claims every day, each time it happens, possibly millions of children with ASD are discouraged or offended. If anyone tries to bring any opposition to it, he/she is further attacked e.g. with some stupid fake name like "ass burgers". Insults to people have hit a new low with this type of stuff...it's bad enough that some, if not most, conservatives are hated just for their viewpoints.

I'm not being biased, I am just being a self-advocate for myself and other kids and adults.72.92.216.214 (talk) 00:14, 14 October 2009 (UTC)

While most of us do not agree with his views (I don't), that does not give you the right to call him "nuts" or to limit his ability to contribute to Wikipedia. Wikipedia supports equality and punishes personal attacks. A better argument against his claims would be that he hasn't offered any reliable or verifiable sources for them. We have no reason to believe him because of this. MichaelExe (talk) 01:00, 14 October 2009 (UTC)

Unsourced and incorrect info added, and useful info removed

A recent series of edits to the lead had several problems:

It inserted a claim about "difficulties with play and leisure activities" that is not supported by the cited source (DSM-IV-TR-299.00).
It added a claim that childhood disintegrative disorder and Rett syndrome are ASDs. The cited source says they're not.
It removed the text distinguishing autism from Asperger syndrome; that's a useful distinction to have in the lead.
It also removed text containing the useful distinction between PDD-NOS and the other two ASDs.

For now I reverted the edits. Eubulides (talk) 02:08, 10 September 2009 (UTC)

It also made the lead more confusing than need be: the link to autism spectrum disorders sufficed. SandyGeorgia (Talk) 02:13, 10 September 2009 (UTC)

The statement highlighting researcher Dr. Paul A. Offit with a reference to his background and article on vaccines and autism was removed by Eubulides (talk), stating it lacked a proper reference. This removal of text is problematic since it should be noted that Offit is a co-inventor of the rotavirus vaccine, as this is not widely known by the non-medical community. The reference removed by Eubulides was to an article Offit coauthored with J. S. Gerber in 2009. The wikipedia article on the Thiomersal controversy also cites Offit's work supporting arguments of the safety of thiomersal. User:Revelle07:Revelle07 (Revelle) —Preceding unsigned comment added by Revelle07 (talk • contribs) 18:31, 23 October 2009 (UTC)

Please see #Paul Offit and rotavirus vaccine below. Eubulides (talk) 18:58, 23 October 2009 (UTC)

The XMRV Retrovirus may be the Cause of Autism in Many Cases

Hi folks, just in case you have not heard yet, this news is hot of the press, and not yet peer reviewed, but nevertheless reliable:

40% of Autism patients thus far tested are positive for XMRV

This research comes from the Whittemore Peterson Institute, which recently published a study showing XMRV (xenotropic murine leukemia virus-related virus) was found in 67% of chronic fatigue syndrome patients (and later updated to 95%). This XMRV news has set the world of chronic fatigue syndrome research alight.

It now may pan out that XMRV could be a major causal factor in autistic spectrum disorders too.

XMRV is only the 4th human retrovirus discovered, HIV being the 3rd. XMRV was first discovered a few years back, but with little media publicity at that time, except in the world of virology, where there was already the expectation that XMRV would be a huge thing in human disease.

For more info, search Google on: XMRV chronic fatigue syndrome

Anyway, I just popped over form the chronic fatigue syndrome Wiki article to tell you this. Hope it is useful. --Drgao (talk) 03:34, 8 November 2009 (UTC)

Thanks for the info. Please see WP:MEDRS; the Huffington Post is not a reliable medical source, and primary sources (single studies) aren't useful for this until they are published in secondary reviews. I hope that sort of sourcing isn't being used in the Chronic fatigue syndrome article. SandyGeorgia (Talk) 03:40, 8 November 2009 (UTC)

No, of course that is not to suggest you include that source or story yet in your excellent article, but just for your own info. No doubt the data will be published in an appropriate peer reviewed journal in the future. --Drgao (talk) 04:05, 8 November 2009 (UTC)

I don't know of any scholarly review of this work. An article by Denise Grady in the October 12 New York Times[18] makes it pretty clear that this stuff is still in the very early stages for chronic fatigue syndrome (where it's been studied more) and that considerable skepticism is being expressed about it. Needless to say it is being checked out, as it should be: if it does pan out it would be great news for CFS sufferers. The status for autism is even more speculative, I'm afraid: zero studies have been published. Eubulides (talk) 06:08, 8 November 2009 (UTC)

Before you can interpret the skepticism, however, you ought to familiarise yourself with the nature of its source. In the case of CFS research, a huge divide exists between the psychiatric camp, many of whom who believe the CFS is an illness feigned by patients, that, in effect, CFS is "All in the Mind", and the biological camp, who believe that CFS has a physical cause, such as genetics, viruses, toxins, and so forth. In terms of the major authorities such as the CDC, NIH, the psychiatric camp rule the roost. Thus any emerging evidence that may indicate a physical cause for CFS is automatically criticised by the psychiatric camp, as it contradicts what they are saying.

This very unfortunate real world political situation lies at the heart of the edit warring that goes on in the CFS Wiki too. A recent comment by SandyGeorgia on the CFS discussion page, namely "I advocate a rewrite of the article, basing it on secondary reviews, giving due weight to those reviews and eliminating undue issues from primary sources...." is technically correct, one cannot argue with the advice. However, in practice, because of the underlying politics of CFS research itself (which is a whole can of worms), the sources SandyGeorgia advocates using are those same sources that blindly support the psychiatric view of CFS. Many CFS patient groups are vociferous in their condemnation of the psychiatric view. --Drgao (talk) 23:44, 8 November 2009 (UTC)

Wikipedia is not the place to write the great wrongs of the world. If the writings of experts tends towards one viewpoint, then so must Wikipedia. We have policies on this kind of thing. Colin°^Talk 23:57, 8 November 2009 (UTC)

We are not talking about being Don Quixote, but rather being informed on the subject. If you don't know about the science, the history and the politics, you are probably not going write a good article. I am concerned with accuracy. --Drgao (talk) 00:33, 9 November 2009 (UTC)

Drgao, please see WP:SOAP; this issue if of no relevance at Talk:Autism, but you may wish to pursue it at Talk:Chronic fatigue syndrome. SandyGeorgia (Talk) 00:36, 9 November 2009 (UTC)

Stimming

A recent edit took the following text:

"who may be silent, mentally disabled, and locked into hand flapping and rocking"

and wikilinked "hand flapping and rocking" to the Stimming article. However, the cited source (Happé 1999, PDF), does not say that hand flapping and rocking is stimming, and as the Stimming article makes clear, it is only a hypothesis that hand flapping and rocking is stimming. I therefore reverted the change as being unsupported. Eubulides (talk) 21:49, 24 November 2009 (UTC)

Paul Offit and rotavirus vaccine

The statement highlighting researcher Dr. Paul A. Offit with a reference to his background and article on vaccines and autism was removed by Eubulides (talk), stating it lacked a proper reference. This removal of text is problematic since it should be noted that Offit is a co-inventor of the rotavirus vaccine, as this is not widely known by the non-medical community. The reference removed by Eubulides was to an article Offit coauthored with J. S. Gerber in 2009. User:Revelle07:Revelle07 (Revelle). Meaningless statement "biologically implausable" was removed as this is misleading and wrong. The research cited shows simply a lack of convincing scientific evidence, and moreover makes no reference to conclusive evidence 'provoking disbelief' in any and all connections between autism and vaccines. comment added by Revelle07

This now disprven-hypothesis is discussed in detail at the Thiomersal controversy and MMR vaccine controversy articles. This article presents a summary of these articles, which should not give undue weight to the fringe viewpoints of Greer et. al. Instead this article should present the scientific consensus on the question, which is that this idea was proposed, tested and now disproved. However, it could mention the data falsification and financial links to personal injury lawyers that appear to have surrounded some of the proponents of this hypothesis, but I'd leave that decision to other editors. Tim Vickers (talk) 18:12, 23 October 2009 (UTC)

This is an article about autism, not about rotavirus or rotavirus vaccine. The article should not note the background of the reliable sources in the article text, in an attempt to impeach them; that would be biased coverage and would violate Wikipedia's policy on neutrality.
The statement "biologically implausible" is well-supported by the cited source, Gerber & Offit 2009 (PMID 19128068), which says that the vaccine overload and the the thiomersal theories are both "biologically implausible".

Eubulides (talk) 18:58, 23 October 2009 (UTC)

Your use of wikipedia policy is incorrect and disingenuous: the paragraph is discussing vaccines and autism and was edited to include a named reference to Offit's work which includes connections between autism and vaccines, as well as thiomersal, supporting the safety of vaccines. You claim (or question) that this is an attempt to impeach Offit when it is merely stating his relevant background to the topic with which the non-medical community clearly is not familiar. The fact that Offit is in the vaccine industry as a researcher obviously must be noted to the unbiased reader of wikipedia. Right? Or is there something wrong with noting that Offit is an inventor of vaccines? I would think that this would make Offit very reputable in the discussion of vaccine safety. To be neutral, means neither favor nor disfavor the research cited. There was no attempt at an ad-hominem compliment or attack of Offit or any researcher, simply a relevant statement of facts to the unbiased analyst of this article.

Your edits are clearly favoring the support of the arguments and this violates neutrality.
It would be appropriate to remove the whole statement and leave them in a separate article on Autism Controversies where they belong. —Preceding unsigned comment added by Revelle07 (talk • contribs) 19:23, 23 October 2009 (UTC)

I fail to see how one particular researcher's views are so notable and important as to require highlighting him by name. Why is this? We could probably best resolve this dispute by citing several of the many review articles by different authors on this topic eg PMID 17168158 PMID 17928818 or PMID 1476124. Tim Vickers (talk) 19:31, 23 October 2009 (UTC)

That's already done; the statement in question is supported by four refereed biomedical journal articles: Doja & Roberts 2006 (PMID 17168158), Gerber & Offit 2009 (PMID 19128068), Gross 2009 (PMID 19478850), and Paul 2009 (PMID 19363650). There is no controversy among reliable sources about the implausibility of a vaccine–autism link. Autism currently has (by my count) 180 sources with at least 375 distinct authors (many authors are not listed in the article to save space, and are noted only with an "et al."). Singling out one of these authors in the lead is clearly a violation of Wikipedia's WP:WEIGHT policy. There is a wikilink from the References section to the Paul Offit article (just as there is for other authors who have their own Wikipedia article); that is enough for readers who want to know more about Offit's bona fides. Eubulides (talk) 19:49, 23 October 2009 (UTC)

OK, that seems very sensible. Tim Vickers (talk) 19:54, 23 October 2009 (UTC)

I understand your concern and you make a very good point. However, in research science it is common that potential or perceived conflicts of interest are noted (and therefore notable), particularly when the researcher(s) appear in several areas relevant to the overall discussion and is used as a key source in the citations and citations within. Such is the case here where the same researcher is noted in discussions about thiomersal, MMR, and vaccines connection to autism. That does not mean that the researcher's opinion is innately biased, but it is important to at least note. In the same way it would be wrong to use a citation supporting flippant claims of vaccine's dangers from a source who is taking part in a lawsuit against pharmaceutical companies. We need to show both sides of the issue.--Revelle07 (talk) 19:55, 23 October 2009 (UTC)

For that reason, I really fail to see why this information is not useful to cite here. Of course, like I said, it could deserve a separate treatment elsewhere. The fact that you repeatably remove Offit's name gives the appearance that you take a personal interest in this. I hope this was not the case here. Someone even edited my discussion comments earlier which is unprecedented, outside of blatant warring-type edits in which case please delete anything that sounds like banter. I hope you will not censor open discussions like this.--Revelle07 (talk) 19:55, 23 October 2009 (UTC)

Not a personal interest in one researcher, just no reason to mention one author out of several. You've provided no reason to single out Offit here, it isn't as if he's the only author of the article cited, or that this article is the only source for the statement in question. In fact, he's one author out of six, but if you're worried about any possible bias we could add another few reviews on the same topic, saying exactly the same thing. Tim Vickers (talk) 20:02, 23 October 2009 (UTC)

I did move the comments, but I didn't change them. They were in an old talk thread that had nothing to do with Offit or rotavirus; in such cases it's better to start a new thread so that other editors can more easily see what's going on and join the discussion. Apologies if this appeared to be censorship; that certainly wasn't the intent. Autism already has a lot of citations on this subject, but if people think it'd help to also cite DeStefano 2007 (PMID 17928818) that'd be fine. (I assume "PMID 1476124" is a typo.) Eubulides (talk) 20:14, 23 October 2009 (UTC)

Sorry, I meant PMID 14761240 Tim Vickers (talk) 20:18, 23 October 2009 (UTC)

The lead of the article is meant to summarise the article. It is no place to discuss the career of one of the authors of our sources. This is an article on autism, not Offit. Even Kanner, Asperger and Baron-Cohen aren't important enough to get mentioned in the lead, despite being well known figures in the field. Colin°^Talk 20:30, 23 October 2009 (UTC)

Editors here may find this review of Offit's Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure to provide a useful perspective.LeadSongDog come howl 20:10, 30 November 2009 (UTC)

Cutting edge research

(Moving this from my talk page as it's about the Autism article.) Eubulides (talk) 21:43, 16 December 2009 (UTC)

Hi,

I edited the autism page with some comments that are from cutting edge researchers, but, as far as I know, unpublished research, at least, I have not seen it published.

While I respect the need to not put junk in Wikipedia, the comments edited were out of date and somewhat general in themselves. Also, the links used for support of the edited comments were not fully accessible, in that they lead to science journal articles, (generally good) but do not allow non-subscribers to view more than abstracts of those articles,(bad) and the abstracts do not directly support the comments that cite them.

The information I am getting is probably top of the line, cutting edge stuff, that, unlike some things published in Wikipedia, should not be denied the readers just because it's not yet out in the literature yet. Why hobble Wikipedia and it's readers? —Preceding unsigned comment added by 76.232.9.94 (talk) 20:55, 16 December 2009 (UTC)

Unfortunately Wikipedia cannot accept cutting edge, unpublished research; we need reliable published sources to support claims in an encyclopedia. (See the verifiability policy.) It's standard practice on Wikipedia to cite the contents of science journal articles, even when they (unfortunately) are not freely readable. Review articles are best, and for autism there are plenty of recent reviews, so there should not be a problem finding good sources. Please see Wikipedia:Reliable sources (medicine-related articles) for the sort of sources we are looking for here. Eubulides (talk) 21:02, 16 December 2009 (UTC)

There are several things you should know if you don't already: First, there is a tremendous amount of research going on in autism, neurology, and immunology. Comments such as "such and such has not been found" are easily made obsolete by the new research. Also, not all findings are published. The findings I reported were made by the leader of a major reserch study, in a formal presentation to study participants. But, the change to comments was not on some currently controversial topic either. I am not sure which change you are responding to, but if you actually followed research, even published research, in this area you would know that biomarkers for subsets of autistics have been found. Not all the biomarkers I mentioned, but enough to show that the stuff I edited was obsolete. —Preceding unsigned comment added by 76.232.9.94 (talk) 21:18, 16 December 2009 (UTC)

I agree that there's a tremendous amount of research. However, I'm afraid that many of the genetic findings are controversial within the research community as a whole, and in the past a lot of them haven't panned out. (Some of the biomarkers are obviously bogus; some haven't been confirmed, etc.) An encyclopedia article cannot appear to endorse a theory or proposal that has never been published or peer-reviewed, even if the theory is correct; this is a core policy of Wikipedia. The text that's currently in Autism, "Research into causes has been hampered by the inability to identify biologically meaningful subpopulations", is supported by a high-quality 2008 review (Altevogt et al. 2008, PMID 18519493; this is freely readable), and this text is still accurate today, as there is no consensus in the wider research community about what these subpopulations are. The Autism paragraph goes on to say that there is a proposal to classify autism using genetic subpopulations, and gives a specific example of one of these proposed subpopulations, so it's not like the article is ignoring the issue. I'm not saying the article can't be improved: far from it! but improvements must be supported by reliable biomedical sources. Eubulides (talk) 21:43, 16 December 2009 (UTC)

The phrase you reverted to by removing my edit is really misleading. "Research into causes has been hampered by the inability to identify biologically meaningful subpopulations". Volumetric MRI is finding subpopulations of autistics with abnormally large brains, (that was already in the article) but also some with abnormally small brains, (and increased IL10 in the blood) along with brain autoantibodies not found, or in some casex, almost never found, in typically developing children. You are really doing a disservice to readers by keeping this stuff out, especially since you leave in the "no biologically meaningful subpopulations" comment, which is kind of ambiguous when you think of it, because what does "biologically meaningful" mean exactly? I guess I can not stop you but if you actually want to generate good content, you should go to PubMed and look at the latest research and then think about the old phrasing and how it can be made better. We had a similar discussion when I was trying to edit a section about brain autoantibodies in the "Causes of Autism" article some time back, and showed you that the same authors who you relied on to keep reverting my edits had actually found brain autoantibodies in autistics since they published the article that you used as a citation to challenge my changes. It seemed like a huge waste of time frankly, but finally, you let the obvious and non-controversial changes I had made remain. —Preceding unsigned comment added by 76.232.9.94 (talk) 22:08, 16 December 2009 (UTC)

If you'll recall from the discussion about that earlier change to Causes of autism, the wording you originally installed was not "obvious and non-controversial"; on the contrary, it contained claims like "many researchers report abnormalities of some type of immune function to be far more prevalent in autistics than controls" that presented a one-sided view of a controversial topic, claims that were not supported by a reliable source. After some back and forth, I did the legwork to come up with a reliable review in this area, Stigler et al. 2009 (doi:10.1016/j.rasd.2009.01.007), and as a result a better text was drafted with much better-supported wording such as "Results from immune studies have been contradictory", wording that was eventually installed. No doubt a similar process could occur here, but the first step is to find a reliable medical source: we simply cannot put stuff into a Wikipedia article based on an anonymous editor's recollection of an unpublished presentation.
One part of the change you just now installed into Autism has been kept, in a reworded form, as the text no longer claims that all autistic children have faster-than-usual brain growth just after birth. (There is a pattern of faster-than-usual growth, but it's not known whether this is universal; note that this is different from the issue of brain size.) The parts that were not kept, because we don't have reliable sources, are:

Reduced blood levels of melatonin is a notable neurotransmitter abnormality in autism.
The claim that we are now able to identify biologically meaningful subpopulations of autism.
The following text:

"However, recent research has indicated many distinct biomarkers for autism not found in healthy control subjects, including greater brain volume, lesser brain volume, abnormal brain response to stimuli, abnormal cytokine profiles, and abnormal brain autoantibodies in subsets of autistics."

The issues of greater brain volume, abnormal brain response to stimuli, abnormal brain autoantibodies are already covered by the article, in the Other symptoms and Pathophysiology sections, and it's not clear why they need to be repeated. The issues of melatonin and cytokine profiles would also be good to cover, along with lots of other biomarker hypotheses being investigated (such as oxidative stress, glutamate, GABA, dopamine, lymphocytes, etc). But this is not something that a Wikipedia editor should research! We should be relying on reliable sources on this topic, such as we found for Causes of autism.

Eubulides (talk) 00:45, 17 December 2009 (UTC)

A paper on reduced melatonin in blood of some autistics was published by Thomas Bergeron of the Pasteur Institute. It's on Pubmed. As to the increased brain volume, I am only saying that it's not good writing to mention increased brain volume as though this is a universal finding when some researchers doing volumetric MRI, while confirming increased brain volume in some autistics, have found decreased brain volume in others. Well, I am sorry if I got snippy but I feel very strongly that parents of autistics should understand there ARE findings of biologically meaningful subpopulations. If enough of them come to understand that, It think they will make specific demands of the political/research funding process, demands that can only help, ie, find out why some brains are small, some big. But besides the importance to the parents and society, I just don't think the article as now written is accurate, as in the my last disputed edit, because the research has made this statement, made only a year ago now pretty clearly obsolete. I guess you could say it's partly a matter of semantics, maybe the authors of that review would say, "biologically relevant" does not apply to findings of different brain size, if you can't tell us what is means, but I think most people would not agree with that as written. Again, at the very least it's misleading. A very large number of researchers are talking now about the heterogeneity of autism, in other words, they already believe very strongly that the etiologies are different in different autistics because they find abnormalities in some but not all. Brain size just happens to be one of those things that jump out at you, at least to most people, that it's at least very likely, when the brain sizes of autistics are found outside the norms, that this is "biologically meaningful" Well, I've got no more time for it, but this autism article is just plain terrible as written, it's so misleading in so many ways, so out of line with current research, that it should not even be in the dictionary, it's doing more harm than good. At the very least, it should contain dozens of caveats, ("brain size is increased in SOME autistics" is just one example. I'm not going to fight it all out, but the readers are really getting a bad deal here. —Preceding unsigned comment added by 76.232.9.94 (talk) 06:40, 17 December 2009 (UTC)

And, not to beat it to death, but to me, the sense of the article from which the quote came puts it in a different light altogether. Here is the entire paragraph, and, by the way, the review article does not really seem to be a literature-wide review of published studies, it's more the notes of a symposium held by this organization. But, anyway, here is the quote:

"The diversity of symptoms and symptom clusters attributed to autism emphasizes that there is not just 1 type of autism but rather a collection of different variants, each with its own set of characteristics and, presumably, etiologies. The inability to identify and stratify biologically meaningful subpopulations has limited research into the causes of autism. Thus, several workshop participants highlighted the need to develop autism phenotypes that may be used to identify clinically meaningful subtypes, looking at onset, clinical presentations, the associated symptoms, and the clinical course. Participants identified several potential strategies that could be used to investigate potential subtypes, including but not limited to analysis of genetic data, analysis of biological samples (eg, blood, urine), metabolic profiling, and stratification and analysis on the basis of comorbidities. ""

To me, the entire paragraph, showing as it does the widespread belief of many different etiologies for the condition, and the subsequent findings of very clear abnormalities in some subsets of autistics, turns the quote made from the article completely on it's head. However it's to be done, I think this should be incorporated in the article, so that at the least people know the thinking of a large number of researchers. —Preceding unsigned comment added by 76.232.9.94 (talk) 06:59, 17 December 2009 (UTC)

And, last point, the rewording in Causes of Autism to "Results from immune studies have been contradictory" is terribly misleading. I can give you many studies showing immune system abnormalities that have not been refuted at all. Not in peer reviewed journals, not in any journals covered by PubMed at all. So really, there was nothing controversial about the statement of immune system abnormalities in some autistics. If someone disputes the findings of immune system abnormalities, and get's their dispute published, then there will be controversy, and, unlike the immune system studies, you have that with the identical twin studies which are quoted without any caveats, even though peer-reviewed journals have had articles disputing the meaning of the high identical twin concordance rate, ie, that in utero effects may explain a lot of it, rather than purely genetics. —Preceding unsigned comment added by 76.232.9.94 (talk) 07:12, 17 December 2009 (UTC)

The wording in Causes of autism should be discussed in Talk:Causes of autism.
I'm aware of the Institut Pasteur paper on melatonin and ASD (Melke et al. 2008, PMID 17505466), and it's very interesting work that is part of an active research area, but it is a primary source and we need reliable reviews to cover research like this (see WP:MEDRS). Bourgeron's own 2009 review of the area (PMID 19545994) says only "other modulators such as serotonin and/or melatonin may play crucial roles in the onset and severity of ASD" which isn't much to go on vis a vis melatonin. Melke's own review has not, as far as I know, been published yet, so we can't cite it; and at any rate it'd be better to use someone else's review of the work of the Melke–Bourgeron–etc group. (The most recent high-quality review of autism that I know of, Levy et al. 2009 (PMID 19819542), does not mention melatonin at all, which suggests that melatonin's significance may not seem as important to researchers outside that group.)
I am unfamiliar with reviews covering the topic of decreased brain volume associated with autism; the reviews I've seen (e.g., Casanova 2007, PMID 17919128) talk only about increased brain volume. If you could mention some sources that would be helpful.
The heterogeneity of autism is discussed in Autism, which contains statements such as "there is increasing suspicion that autism is instead a complex disorder whose core aspects have distinct causes that often co-occur" and "autism does not have a clear unifying mechanism at either the molecular, cellular, or systems level; it is not known whether autism is a few disorders caused by mutations converging on a few common molecular pathways, or is (like intellectual disability) a large set of disorders with diverse mechanisms". As far as I can see, this pretty much covers everything that's in that symposium quote about causes, though no doubt it could be worded better.
The key notion here is still sources. We need good sources to make claims about biomarkers or melatonin or whatever. Autism has lots of primary sources, covering all sorts of things (melatonin is just one small corner); we can't go picking and choosing among the 20,000 or so primary studies that have been published on the subject, and we have to rely on recent reliable reviews to help us report what's significant and skip what's not.

Eubulides (talk) 08:00, 17 December 2009 (UTC)

Although the link you've given me says review articles in medical journals are considered very good sources, it does not seem to forbid citations to primary research published in medical journals, and in fact, you find those citations all over wikipedia. And yet, you've taken away the mention of the low melatonin findings of the folks at Pasteur, even though you know about them yourself. Does that make sense? I am not saying they found something of great importance, but it is something that has not been refuted, so it seems to me it should be in the article. Really, the decision what to put in there, and what to take out, seems quite arbitrary on your part. Recent findings no good, only reviews good? That ensures the article will not be up to date, in other words ensuring it will be inadequate. And you say we should use "recent" reviews, but you have citations to reviews from 2007. A very long time ago. With several papers on abnormalities in autistics nervous, immune and metabolic systems, and therefore possible etiology, coming out every week at this point in time, a review from 2007 is probably about 1,000 peer-reviewed papers behind the state of research. Instead of debating your application of policy, which I really think is biased towards removing solid information, I will point out just one of the many flaws in the article: First, inadequate emphasis on the heterogeneity of autism, for example, difference between an autistic who is clearly intellectually above average and one who is clearly mentally retarded. I am not saying the article does not mention this, but it's all so poorly written that it gets lost. The stilted over-use of jargon is most of the problem there. Well, I really don't have time for this. I think you are probably doing more to ensure the public is uninformed or misinformed on this topic than all but some small number of out and out charlatans and crackpots. You keep out solid new information, while keeping in old statements proven false. This is exactly what you did before in regards to auto-antibodies, insisting on keeping in a quote that said there were no definite findings of abnormal autoantibodies, from an article by the folks at UC Davis Med School, when the up to date information showed those same people had since discovered and published findings of autoantibody abnormalities. Please reconsider the way your are applying the policy. At the least, findings from Institut Pasteur could be mentioned as, "one group at the Pasteur Institute published findings of abnormally low levels of melatonin". That is an objective fact, and everyone has been warned it's not necessarily universally accepted by the "one group" wording. Using that wording, a lot of stuff could go in without being misleading. Well, that's all I've got, but I will tell you, you are missing a huge amount of good information from me that could be attributed to "unpublished studies" or such. —Preceding unsigned comment added by 76.232.9.94 (talk) 13:55, 17 December 2009 (UTC)

I surely do not want to open up a can of worms but I do find that the page could do with more, let's call it "less confirmed" or "less rigorous" research. Calling it "cutting edge" or "new" imparts a misleading sense of it being better/more modern than what's gone before. Calling it fringe is unfair in the sense that something that is fringe, with NO published research shouldn't be included in this category. I don't contend it's an easy line to walk, keeping the page from being cluttered with secretin, dolphin play, music therapy but at the same time, more information on newer published research is valuable. People can make their own decisions on the value/investigate further. The advantage wikipedia has over a print encyclopedia is the ability to integrate new information very quickly. I think there can be a strongly worded header that what follows are new directions that while published, are not confirmed yet by the larger scientific community. If a study is particularly poor with say 6 patients, with a biased selection criteria and written in an off-axis journal, I have no problem with leaving that off the page because it's of little value. But I do think there are some other areas that can be covered that aren't being covered. HarmonicSeries (talk) 14:23, 17 December 2009 (UTC)

Please see WP:MEDRS, WP:UNDUE and WP:RECENTISM; Wikipedia is not the place for publishing original research or "less confirmed" or "less rigorous" research, nor the place for "integrat[ing] new information very quickly" if that info is "Recentism" (Wiki is not a newspaper), and a feautued medical article is based on giving due weight to published secondary reviews. When research is confirmed and finds its way into secondary reviews, it can be included on Wiki; what other Wiki articles (that are not featured and haven't been rigorously reviewed) do or don't do isn't relevant. Please see WP:OTHERSTUFFEXISTS. Unless the original poster has strong sources supporting proposed content, this talk page shouldn't be used as a WP:SOAPBOX. Causes can be explored in the Causes sub-article. SandyGeorgia (Talk) 14:38, 17 December 2009 (UTC)

Just to be clear, I am not proposing that all new stuff be let in, rather that old stuff that is clearly out of date should be taken out when it can be shown to be out of date, and that new stuff should be let in under less strict criteria than Eubulides is using. The out of date stuff I am referring to were things like the "no autoantibodies found in autism" which was clearly untrue at the time I got in a dispute over it. Or the findings on low melatonin, which Eubulides kept out because he said it had not been in a literature review. Although there is a guideline stating that review articles are the preferred source of medical information, I have seen nothing prohibiting citation of any journal article reporting a study's findings, and it seems to me that excluding all study findings on the basis they are not included in review articles is really a bad idea in a field as active as autism. As I pointed out above, review articles from 2007 are about 1,000 papers behind the latest research. I hope people will reconsider their application of rules which require judgment calls, as this one does. I am not on a soapbox except to get accurate information out, which means removing old no longer accurate statments. If I went too far with reporting unpublished information, sorry about but as for mentioning research without citations for everything, the fact is the article does that repeatedly as it stands, and the editor knew about the finding of low melatonin independently, so, why remove it, unless you are going to remove all uncited claims, even when you know they are true? Could be done but seems very silly. —Preceding unsigned comment added by 76.232.9.94 (talk) 15:35, 17 December 2009 (UTC)

Please sign your entries by typing four tildes (~~~~) after your posts. Adding every bit of recent published info from primary sources would amount to WP:UNDUE and WP:RECENTISM; I concur with Eubulides. SandyGeorgia (Talk) 15:40, 17 December 2009 (UTC)

I went to the links you gave on recentism and undue and I do not agree with your statement. I do not agree that citations to articles in peer-reviewed science journals should be disallowed under the rules as given. Is that what you are claiming? Please clarify. I see countless such citations in Wikipedia.76.232.9.94 (talk) 15:55, 17 December 2009 (UTC)

I think that constructive comments are trying to be made here. There is nothing in wiki guidance that says new peer-reviewed research can not be included without first being reconfirmed by later studies. None of what has been said here is inconsistent with WP:UNDUE and WP:RECENTISM either. More collaboration among editors is surely a good thing. HarmonicSeries (talk) 15:57, 17 December 2009 (UTC)

Once again, please see WP:OTHERSTUFFEXISTS and WP:MEDRS; what may or may not be in any other Wiki article (on the website "anyone can edit") isn't relevant to a thoroughly reviewed and vetted featured article. Imagine if we included every piece of primary research in every article: the article would become a lengthy, unreliable, example of newspaper recentism. Due weight is given to high-quality sources and research over unvetted Recentism. It might be helpful to reread Eubulides response above, which does focus the discussion on sources as they are applied on Wiki. SandyGeorgia (Talk) 16:14, 17 December 2009 (UTC)

It is not helpful to continually suggest that the addition of anything new is recentism or the tip of the iceberg to a horrible page. Your opinion is that the hurdle for inclusion is very high. Other editors have a different but equally valid opinion that the hurdle could be lower and still consistent with wiki guidance and those editors believe that a better page would result. You do not believe that. We understand that. HarmonicSeries (talk) 16:23, 17 December 2009 (UTC)

I agree that constructive comments are being made here; the article has already been improved a bit as a result, and I hope for more improvements. Still, we have to remember that the article is already full already, and it does not contain nearly enough room to talk about all the lines of research into causes, pathophysiology, treatment, etc. If we're going to talk about melatonin, how can we justify excluding naltrexone, carnitine, acetylcholinesterase inhibitors, oxytocin, tetrahydrobiopterin, alpha-2 adrenergic agonists, tetrahydrobiopterin, music therapy, hyperbaric oxygen, etc., etc.? All these treatments have their adherents and have some promising evidence published as primary studies and I wouldn't call any of them purely WP:FRINGE; but none are mainstream by any reasonable measure. There simply isn't space here to talk about them all; the article's already too big and really needs to be put on a diet (it takes more than 30 seconds for me to load it!). I suggest discussing more-cutting-edge therapies in Autism therapies, which has more room for it. And, above all, we need good sources. Primary studies are not good sources for autism: as I've said before, there are tens of thousands of published and peer-reviewed autism papers, and we should not be placed into the position of deciding which 1% to cite and which 99% to omit. That's the job of qualified expert medical reviewers. This field has no shortage of high-quality reviews! We should be using them, not redoing them. Eubulides (talk) 18:17, 17 December 2009 (UTC)

Just like to add my voice to support Eubulides and SandyGeorgia wrt the importance of using reviews. As Eubulides points out, we have no shortage of them in this important topic area and his primary studies point about "deciding which 1% to cite and which 99% to omit" should probably be framed as a banner in WP:MEDRS. It is healthy to point out when some of our sources are getting out-of-date, note which facts may now be questioned and to discuss potential facts for inclusion. But we must be patient when it comes to writing encyclopaedic material. If editors are frustrated that what they regard as important and significant research isn't being covered by recent medical reviews, it is not Wikipedia's job to right that wrong. As Eubulides says, adding new material to daughter articles may be easier as they have more room. Then the facts can bubble up and be condensed for this parent article. Colin°^Talk 20:01, 17 December 2009 (UTC)

I want to be clear, I only mentioned a low level of melatonin because a high level of seratonin is mentioned in the article, and melatonin is synthesized from seratonin in the body. So, it seemed logical to mention this in that context, not as a therapy of some sort. The low melatonin and high seratonin may be related, in that if less serotoin is coverted into melatonin there will be exactly the situation that is widely report, high serotonin, low melatonin. Got to go now, but please someone explain to me why research papers in peer-reviewed articles, especially the findings of a researcher at the Pasteur Institute, are not good enough. I just can not see this. —Preceding unsigned comment added by 76.232.9.94 (talk) 00:42, 18 December 2009 (UTC)

It's hard to know what else to offer you, when Colin, Eubulides and I have all explained in several ways and several times: I'm at a loss for what else we can add to help you understand. SandyGeorgia (Talk) 01:24, 18 December 2009 (UTC)

Well, I will respond in what I hope is a constructive way. I think primary research papers are kind of open to abuse, because someone may have a minority viewpoint they want to push, but I think this should not mean all primary research is banned. For one thing, I think the problem of "deciding which 1% to include and 99% to omit" is the traditional job of an editor. But, if you don't have that paradigm, then at the least, under the theory of user-contribted content, shouldn't it be the case that studies are not deleted if they are at least cited to peer-reviewed articles? Because, to at least some extent, deletions are being made, at least as I understand it, in other words, someone is making these decisions on a case by case basis. Even the concept of only using "review" articles is a bit circular, after all, the reviewe are made of the original papers by searching pubmed.gov.

In my view, the true task, which requires substantial understanding of the underlying content, is to first separate wheat from chaff, then separate high-quality wheat from low-quality wheat. Not to beat the melatonin thing to death, but if you look at the most respected and cited institutions, people, and journals I think you will find Pasteur Institute is near the top. Now, that would not mean much, if for example the paper was on say one "autistic" patient with some extremely rare genetic defect that probably had no implications for most other austistics. Not meaningful. But if you've got a finding of low melatonin in a very large percentage of the autistic population, then at the very least, parents who want to give their autistics kids melatonin, not for autism, but just to make them sleep, (half the kids have sleep problems according to another part of the same article)would have some indication it's likely, in most cases, to only be bringing them back to a typically developing child's level. In other words, with just a little background in the subject, the melatonin information becomes of much greater interest to the laymen/parent readers of the article than many other biomarker findings. So, my conclusion is, it's just not possible to edit effectively without all the background. Perhaps my change to include the melatonin findings did not explain enough background. My fault for that. —Preceding unsigned comment added by 76.232.9.94 (talk) 03:06, 18 December 2009 (UTC)

We're not saying primary research is bad source material in general but it is bad for Wikipedia. This is wholly due to our "anyone can edit" (anonymously) policy. If Wikipedia's Autism article was written by a single or group of well-regarded experts, then I'm sure they would cite primary research papers much as they do in review articles. The job of deciding whether a primary study was done (a) by a well regarded group (b) to a good scientific standard (c) is actually clinically relevant or just a stepping stone for further study and (d) is notable when compared to all the other research ... is something that requires an expert opinion. Wikipedia doesn't trust its editors to be experts even if they are, so we need instead to cite experts' literature reviews. And if we cite their material in high-quality journals, we can be sure those experts have been vetted and their material checked. Our policies do limit at times what Wikipedia can say or how up-to-date is can be. But if you are prepared to work within those restrictions, then some pretty decent content can be produced.

Wrt melatonin, we can only indicate that this might be useful to some children if we can cite reviews or clinical guidelines that make such a recommendation. Just because melatonin levels are low in some children doesn't automatically mean that orally consuming the stuff will help or be safe. Colin°^Talk 09:20, 18 December 2009 (UTC)

Also please see #Levy et al. below. Eubulides (talk) 00:02, 19 December 2009 (UTC)

Levy et al.

I went through Levy et al. 2009 (PMID 19819542), a fine review of autism published last month in The Lancet, and used it to update and modernize the article a bit. Among other things, this change introduces a brief discussion of melatonin-related issues, as follows:

"The relationship of neurochemicals to autism is not well understood; several have been investigated, with the most evidence for the role of serotonin and of genetic differences in its transport."

This is as close as Levy et al. get to talking about melatonin. I hope it addresses part of the comments above, at least the parts about being based on older reviews and on ignoring the possible role of melatonin in autism pathophysiology.

Some responses to previous comments:

"shouldn't it be the case that studies are not deleted if they are at least cited to peer-reviewed articles" No, because there are 20,000 peer-reviewed articles on autism, and the article cannot possibly contain material that cites them all. In an area where little work is done, and where no reviews are available, it may be necessary to cite a primary study with all due caution. But in autism there are reviews galore, and there is no reason for us to be citing primary studies ourselves. We should rely on reviews.
"Even the concept of only using "review" articles is a bit circular" No, because the reviews are written by acknowledged experts in the field, and are themselves peer-reviewed. In contrast, Wikipedia editors are anonymous, with no known qualifications. The only quality control we have, really, is our sources. If we refuse to rely on reviews, we'll have an article in which editors are free to promote all the latest fads: not just melatonin, but also hyperbaric oxygen and the rest. And there simply is not enough space in this article for all that stuff.
"if you look at the most respected and cited institutions, people, and journals I think you will find Pasteur Institute is near the top" Yes, they're quite well-respected, but it's just one research group at one place. It's standard practice in science for people to replicate promising results before relying on them; in medicine, the results need to be not only replicated, but its effectiveness and safety have to be tested clinically. Besides, even if we limited ourselves to "top" institutions, that would cut the number of primary studies that we could cite down only to 5,000 or 10,000, hardly enough to help us decide which of those studies to cite.
"parents who want to give their autistics kids melatonin, not for autism, but just to make them sleep, (half the kids have sleep problems according to another part of the same article)would have some indication it's likely, in most cases, to only be bringing them back to a typically developing child's level" This is exactly the sort of original research that Wikipedia articles cannot do. They can't even imply this sort of thing, not without a reliable source. See Wikipedia:No original research.

Eubulides (talk) 00:02, 19 December 2009 (UTC)

I have to ask, do you see 20,000 citations? If not, then maybe it's not a big problem. Obviously we've beat this to death but I would ask, what are the rules for removing other people's edits exactly? —Preceding unsigned comment added by 76.232.9.94 (talk) 03:30, 19 December 2009 (UTC)

We could easily see thousands of citations if every citation ever added to Autism had to be kept. Perhaps you're thinking about the Wikipedia:Consensus rule? Eubulides (talk) 03:38, 19 December 2009 (UTC)

I don't know the Wikipedia consense rule, I am asking. Though I've seen the rule favoring review articles, I've seen nothing forbidding citations to original research articles in journals, and in fact, I see those kinds of citations all over Wikipedia, countless times. So, what are the rules? —Preceding unsigned comment added by 76.232.9.94 (talk) 06:30, 19 December 2009 (UTC)

I do want to point out one thing: the claim made here, "primary sources can not be used" is false according to the link given above. In fact, the link gives extensive guidance on how primary sources may be used. Since the information in the link seems to be routinely misrepresented, I will go and get the relevant sections from the link. —Preceding unsigned comment added by 76.232.9.94 (talk) 06:46, 19 December 2009 (UTC)

So, here is one relevant section from the guidlines on medical articles "Reliable primary sources can add greatly to an article, but must be used with care because of the potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors, or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources, as defined above".

In other words, you can use a primary source but not as though it was a review article secondary source. But you can use it to say "Dr. Bourgeron found abnormally low melatonin in the blood of 55% of autistics". This is citing the source as a primary source, perfectly allowed under this section, particularly if it is not presented as a consensus belief among researchers, or given undue weight in some other way. I am upset that I was told primary sourced are diallowed when that does not seem to be the rule at all. Please someone, tell me the basis for the statement primary sources are not allowed? 76.232.9.94 (talk) 06:53, 19 December 2009 (UTC)

I am quoting another section of the rules on primary sources which clearly shows they are not forbidden if presented properly:

"Individual primary sources should not be cited or juxtaposed so as to "debunk" or contradict the conclusions of reliable secondary sources, unless the primary source itself directly makes such a claim (see Wikipedia:No original synthesis that advances a position). Controversies or areas of uncertainty in medicine should be illustrated with reliable secondary sources describing the varying viewpoints. The use and presentation of primary sources should also respect Wikipedia's policies on undue weight; that is, primary sources favoring a minority opinion should not be aggregated or presented devoid of context in such a way as to undermine proportionate representation of expert opinion in a field.

If an important scientific result is so new that no reliable reviews have been published on it, it may be helpful to cite the primary source that reported the result. Although popular-press news articles and press releases often tout the latest phase II clinical trial, such trials are rarely important enough to mention in an encyclopedia. Any such results should be described as being from a single study, for example:

"A 2009 U.S. study found the average age of formal autism spectrum diagnosis was 5.7 years." (citing PMID 19318992) After enough time has passed for a review to be published in the area, the review should be cited in preference to the primary study. If no review is published in a reasonable amount of time, the primary source should be removed as not reporting an important result. When in doubt, omit mention of the primary study, as per WP:RECENTISM.

So, this section calls for some judgment calls on how long is long enough, but what it does not say is that one review that does not mention a topic is adequate reason to delete the primary study reference. On the contrary, the relevant phrase is "If NO review is published in a reasonable amount of time". So, you've got to wait a "reasonable amount of time" at the very least, before deleting any primary source reference. In other words, the very latest journal papers can be cited as long as it is done correctly.

It seems to me you've badly misunderstood and applied these rules quoted above. The right thing to do would be to check all new postings to see if they comply with these rules given above, and only remove them if they don't, or if enough time has passed and no review articles mention them. Note to Eubulides, not if the Lancet review article fails to mention them, that is not good enough, it has to be that NO review articles mention the finding in a "reasonable amount of time". So, you had it exactly the opposite of the rule. New is not forbidden, in fact, it's implicitly protected until it's been proven to be not regarded as important by consensus, which takes time to develop.

Please don't delete my postings again under the claim that new is forbidden. I will try very hard to obey the rules as given in the section, and any others you relay to me, but you must obey them as well please. 76.232.9.94 (talk) 07:18, 19 December 2009 (UTC)

Nobody said primary sources are not allowed. What's not allowed is to use primary sources to dispute secondary sources, or to promote primary sources out of proportion to the prominence that secondary sources give them; see WP:PSTS. After this thread began I checked a recent secondary source on this topic, namely Levy et al. 2009 (PMID 19819542), published in The Lancet last month. Here's what Levy et al. says about neurochemicals in general (and this includes melatonin):

"Neurochemical investigations with animal models and empirical drug studies remain inconclusive. Serotonin and genetic differences in serotonin transport seem to have the most empirical evidence for a role in autism spectrum disorder, whereas data lending support to the roles of dopaminergic and glutaminergic systems are presently less robust, but are evolving. Study of the role of the dopaminergic and cholinergic system, oxytocin, and aminoacid neurotransmitters shows promise."

In other words, we simply don't know what roles neurochemicals play in autism: they may have causative roles in the disorder, or they may just be largely-irrelevant side effects, or they may even be artifacts of the primary studies in question. In light of this review it would be greatly misleading and a violation of WP:WEIGHT for Autism to trumpet one particular melatonin primary study over all the other work done in this area. (By the way, I urge you to read Wikipedia:Consensus, if you haven't already, and reflect about what Wikipedia:Consensus would say about this very thread.) Eubulides (talk) 07:25, 19 December 2009 (UTC)

WP:MEDRS offers guidelines that apply through the whole spectrum of medical issues, from drugs to rare diseases to common disorders to minor ailments. The sort of sources one uses for one topic will vary from those used in another. For example, an article that describes an extremely rare disease may be forced to cite a few case studies. A topic that is as well studied and as comprehensively and frequently reviewed as autism has little need to go scrabbling around in the primary research cupboard to find source material. The MEDRS example was for the situation where a major important study had just been published, and for which it would be expected for Wikipedia to have content. Material that is too new to have been reviewed yet has to be exceptionally important justify including. BTW: the editor you accuse of having "badly misunderstood and applied these rules" played a primary role in drafting those very words. Colin°^Talk 12:30, 19 December 2009 (UTC)

This is getting tiring and WP:TLDR. IP76, I agree with the suggestion that you should carefully read and understand WP:CONSENSUS, and if you disagree with WP:MEDRS, the place for that discussion is WT:MEDRS, where possibly more editors will help you understand the problems with the position you are taking here. I have seen no indication that melatonin should be included in this article, although based on the research I'm aware of, it likely does have a place in some sleep disturbance article. SandyGeorgia (Talk) 14:05, 19 December 2009 (UTC)

I agree, it is tiring. Please, can someone refer me to someone who has authority to resolve such disputes? Because I really can't see how I am wrong, I feel I've quoted the guidelines extensively and they seem to very widely support my viewpoint, regardless of who wrote them. 76.232.9.94 (talk) 14:37, 19 December 2009 (UTC)

Ok, so I read up on consensus, and still think I am not in the wrong to criticize the deletion of primary material when that primary material was presented properly. But, I also see the mention of the value of discussion. I will put out some things here for discussion as to inclusion:

1. The article's wording seems to be very unclear as to expressing the fact that there are many different causes which will lead to the diagnosis of autism. I believe this should be more clearly reworded. I say it's a "fact" because one can find countless papers indicating separate genetic abnormalities, Fragile X and much rarer problems, that have been firmly tied to autism, and yet, one can not find them in the majority of autistics. I do not believe the current wording is wrong, just confusing. I also think it should be made clear that the phenotypes vary so greatly that there is not much commonality, necessarily, between two people diagnosed as "autistic". In other words, the fact that the diagnosis is very flawed, and there is controversy over even using it, should be brought to the fore. This is not really a controversial move if you look at the literature.

2. Primary papers from Kenney Krieger, MIND, and Johns Hopkins, and for that matter, many other sources indicate autoimmune or inflammatory abnormalities in some autistics. This should be mentioned and made clear, while avoiding undue weight of course. There was a study by researchers at Johns Hopkins a few years back indicating long term inflammation in brains of autistics who had undergone regression. I believe this is kind of a landmark study in this regard, and should be mentioned with all the caveats given primary research, thought it's hard for me to believe it has not been mentioned in review articles, (don't have easy access to full articles from my home computer, get them from time to time by going to University bio library, but can't always get there)

3. The identical twin studies are almost always mentioned to show very high genetic determination in autism. I do not dispute this, but think that a careful edit should be made to indicate limitations of twin studies. For example, that most of the twins are not separated at birth, they have grown up in the same enviroments, and had the same in utero blood supply, possibly same exposure to maternal immune system, same passive immunity from the mother, etc. This need not be in great detail, but quoting "90% genetic" without explanation could be misleading.

4. Related to point 3 above, there should be more discussion of controversy over increase in rate of autism, (implying environmental cause) vs. "90% genetics" implying just the opposite. Some short indications of the difficulties, in the real world, of separating genetic from environmental factors is appropriate, again without undue weight and without too much time taken up on it. I don't think all the current wording is bad, just that it's a little bit imbalanced towards the genetics without explaining the other side.

5. I don't have information on this handy, but as far as causes are concerned, I do not believe it is wrong or misleading to research the way current studies are being done, particularly large-scale longitudinal studies, because these give implicitly an indication of what actual researchers are thinking will be productive. Obviously, this must be done carefully, but it can be done and not in any prohibited way. In any case, many people are very interested in knowing where research is going. Kids waking up and stopping me, but is there any objection to these changes generally? —Preceding unsigned comment added by 76.232.9.94 (talk) 15:37, 19 December 2009 (UTC)

Responding to your first question: there is no one person or group in charge. If you want to discuss a medical issue, with editors who are knowledgeable and have access to journal sources, then I suggest a post to the medical wikiproject. If you think our guidelines are wrong or aren't clear or helpful then Sandy's suggestion of WT:MEDRS could be used, but that page is not for discussing specific article content disputes. There are other suggestions at Wikipedia:Dispute resolution. It would really help if you could edit your posts for brevity. Also, it will help any third-parties if you could outline clearly the article text you wish to add or change and the sources you are using that back up that change. You raise lots of points. Perhaps we could deal with them one at a time. Could you start a new section with one issue. In addition to the general points you make above, could you suggest what actual changes to the text you want to see and what sources those changes might use? Colin°^Talk 15:54, 19 December 2009 (UTC)

I'd like to second Colin's suggestion to make specific proposals for changes to article text. I share 76.232.9.94's concern that the article is a bit dated and not worded as clearly as it could be, and hope that this discussion can continue to improve the article, as it has already improved it. Please bear in mind, though, that we're pretty ruthless in checking sources and making sure that the text agrees with medical consensus, not only about the topic material, but about how much weight to give each topic. Proposals that cite recent reviews are far more likely to work, but even if you can't supply sources I'm willing to go check what recent reviews say, as I have access to many (though not all) medical journals. (Please don't expect immediate turnaround on this; we're all busy.) Eubulides (talk) 18:45, 19 December 2009 (UTC)

I just wanted to say, I have not reread the entire article, but I think the latest edits are huge improvements over what was present before, it's much clearer I think and much less likely to mislead anyone. Thank you for the rewrites. 76.232.9.94 (talk) 20:05, 20 December 2009 (UTC)

^ Cite error: The named reference Sigman was invoked but never defined (see the help page).
^
Lack of support for interventions:
- Francis K (2005). "Autism interventions: a critical update" (PDF). Dev Med Child Neurol. 47 (7): 493–9. PMID 15991872.
- Rao PA, Beidel DC, Murray MJ (2008). "Social skills interventions for children with Asperger's syndrome or high-functioning autism: a review and recommendations". J Autism Dev Disord. 38 (2): 353–61. doi:10.1007/s10803-007-0402-4. PMID 17641962.{{cite journal}}: CS1 maint: multiple names: authors list (link)
- Schechtman MA (2007). "Scientifically unsupported therapies in the treatment of young children with autism spectrum disorders" (PDF). Pediatr Ann. 36 (8): 497–8, 500–2, 504–5. PMID 17849608.
^ Cite error: The named reference Aman was invoked but never defined (see the help page).
^ Cite error: The named reference Burgess was invoked but never defined (see the help page).
^ Stahmer AC, Collings NM, Palinkas LA (2005). "Early intervention practices for children with autism: descriptions from community providers". Focus Autism Other Dev Disabl. 20 (2): 66–79. PMID 16467905.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ Brown MJ, Willis T, Omalu B, Leiker R (2006). "Deaths resulting from hypocalcemia after administration of edetate disodium: 2003–2005". Pediatrics. 118 (2): e534-6. doi:10.1542/peds.2006-0858. PMID 16882789.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ Rasalam AD, Hailey H, Williams JH; et al. (2005). "Characteristics of fetal anticonvulsant syndrome associated autistic disorder". Dev Med Child Neurol. 47 (8): 551–5. PMID 16108456. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
^ http://www.autism-society.org/site/PageServer?pagename=about_home
^ http://www.cbsnews.com/stories/2008/12/01/health/main4639626.shtml Brain Waves A Key To Autism Language Woes — Chicago, December 1, 2008.
^ ^a ^b Cite error: The named reference DSM-IV-TR-299.00 was invoked but never defined (see the help page).
^ ^a ^b Cite error: The named reference Johnson was invoked but never defined (see the help page).
^ ^a ^b Cite error: The named reference Abrahams was invoked but never defined (see the help page).
^ ^a ^b Cite error: The named reference Arndt was invoked but never defined (see the help page).
^ ^a ^b ^c ^d ^e Cite error: The named reference Rutter was invoked but never defined (see the help page).
^ ^a ^b Cite error: The named reference vaccines was invoked but never defined (see the help page).
^ ^a ^b Cite error: The named reference Newschaffer was invoked but never defined (see the help page).
^ ^a ^b Cite error: The named reference CCD was invoked but never defined (see the help page).
^ ^a ^b Cite error: The named reference Howlin was invoked but never defined (see the help page).
^ ^a ^b Cite error: The named reference Silverman was invoked but never defined (see the help page).

[Sigman-1] Cite error: The named reference Sigman was invoked but never defined (see the help page).

[2] Lack of support for interventions:
Francis K (2005). "Autism interventions: a critical update" (PDF). Dev Med Child Neurol. 47 (7): 493–9. PMID 15991872.

Rao PA, Beidel DC, Murray MJ (2008). "Social skills interventions for children with Asperger's syndrome or high-functioning autism: a review and recommendations". J Autism Dev Disord. 38 (2): 353–61. doi:10.1007/s10803-007-0402-4. PMID 17641962.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Schechtman MA (2007). "Scientifically unsupported therapies in the treatment of young children with autism spectrum disorders" (PDF). Pediatr Ann. 36 (8): 497–8, 500–2, 504–5. PMID 17849608.

[3] Francis K (2005). "Autism interventions: a critical update" (PDF). Dev Med Child Neurol. 47 (7): 493–9. PMID 15991872.

[4] Rao PA, Beidel DC, Murray MJ (2008). "Social skills interventions for children with Asperger's syndrome or high-functioning autism: a review and recommendations". J Autism Dev Disord. 38 (2): 353–61. doi:10.1007/s10803-007-0402-4. PMID 17641962.{{cite journal}}: CS1 maint: multiple names: authors list (link)

[5] Schechtman MA (2007). "Scientifically unsupported therapies in the treatment of young children with autism spectrum disorders" (PDF). Pediatr Ann. 36 (8): 497–8, 500–2, 504–5. PMID 17849608.

[Aman-3] Cite error: The named reference Aman was invoked but never defined (see the help page).

[Burgess-4] Cite error: The named reference Burgess was invoked but never defined (see the help page).

[5] Stahmer AC, Collings NM, Palinkas LA (2005). "Early intervention practices for children with autism: descriptions from community providers". Focus Autism Other Dev Disabl. 20 (2): 66–79. PMID 16467905.{{cite journal}}: CS1 maint: multiple names: authors list (link)

[6] Brown MJ, Willis T, Omalu B, Leiker R (2006). "Deaths resulting from hypocalcemia after administration of edetate disodium: 2003–2005". Pediatrics. 118 (2): e534-6. doi:10.1542/peds.2006-0858. PMID 16882789.{{cite journal}}: CS1 maint: multiple names: authors list (link)

[pmid16108456-7] Rasalam AD, Hailey H, Williams JH; et al. (2005). "Characteristics of fetal anticonvulsant syndrome associated autistic disorder". Dev Med Child Neurol. 47 (8): 551–5. PMID 16108456. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

[8] ttp://www.autism-society.org/site/PageServer?pagename=about_home

[9] ttp://www.cbsnews.com/stories/2008/12/01/health/main4639626.shtml Brain Waves A Key To Autism Language Woes — Chicago, December 1, 2008.

[DSM-IV-TR-299.00-10] Cite error: The named reference DSM-IV-TR-299.00 was invoked but never defined (see the help page).

[Johnson-11] Cite error: The named reference Johnson was invoked but never defined (see the help page).

[Abrahams-12] Cite error: The named reference Abrahams was invoked but never defined (see the help page).

[Arndt-13] Cite error: The named reference Arndt was invoked but never defined (see the help page).

[Rutter-14] Cite error: The named reference Rutter was invoked but never defined (see the help page).

[vaccines-15] Cite error: The named reference vaccines was invoked but never defined (see the help page).

[Newschaffer-16] Cite error: The named reference Newschaffer was invoked but never defined (see the help page).

[CCD-17] Cite error: The named reference CCD was invoked but never defined (see the help page).

[Howlin-18] Cite error: The named reference Howlin was invoked but never defined (see the help page).

[Silverman-19] Cite error: The named reference Silverman was invoked but never defined (see the help page).

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