Talk:Autism spectrum/Archive 3

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ABA therapy NPOV

Saying that ABA is universally considered effective is at the very least an NPOV issue. Many prominent autistic rights' organizations and autistic bloggers have made public statements condemning the practices as abusive and denying their effectiveness as therapies.

http://autismwomensnetwork.org/my-thoughts-on-aba/ http://www.autistichoya.com/2012/09/what-they-should-be-talking-about.html http://emmashopebook.com/2012/10/10/tackling-that-troublesome-issue-of-aba-and-ethics/ http://loveexplosions.net/2013/01/30/the-cost-of-compliance-is-unreasonable/ https://unstrangemind.wordpress.com/2013/01/27/no-you-dont/ 73.41.82.251 (talk) 00:25, 7 May 2015 (UTC)

The effectiveness of therapies would fall under WP:MEDRS which none of those do. Dbrodbeck (talk) 01:08, 7 May 2015 (UTC)

What I intend to do with the article, and what new information will I add? Subtitle: Serotonin regulation I intend to add the link between low serotonin levels in the brain and the development of autism spectrum. Serotonergic system malfunction is one of the most associated causes of autism [1]. Vitamin D binds to the Vitamin D receptor which heterodimerizes to the retanoid receptor, creating the Vitamin D response (VDR) which regulates many genes including ones coding for Tryptophan hydroxylase 1 and 2 (TPH1 and TPH2) [2], which are the rate limiting enzymes responsible for converting Tryptophan into seratonin in the gut and the brain, respectively. [3]. The vitamin D response element binds sequences in the DNA that either indicate to the complex to recruit co activators thereby turning on genes or core repressors which results in turning off genes [4]. The vitamin D response turns off the enzyme TPH1 which regulates production of serotonin in the gut, and turns on TPH2 which converts tryptophan into Serotonin in the brain [5]. Without this regulation, higher than optimal levels serotonin may be produced in the gut, and lower than optimal levels may be produced in the brain. IDO, another enzyme produced in the placenta converts Tryptophan into Kynurenine which is converted to T regulatory cells. Both IDO and tryptophan are expressed in the placenta [6]. T regulatory cells are known to prevent immune cells from attacking host tissue [7]. Female mice have strong immune resonse against fetus if IDO does not exist [8]. Tryptophan is known to have a greater binding affinity to TPH1 compared to IDO, therefore low Vitamin D levels result in TPH1 being produced, and binding to tryptophan and IDO having a suppression of activity [9]. It is known that Mothers of Autism spectrum children have a greater chance of having antibodies against fetal brain proteins in their blood compared with mothers of nonautistic children [10]. Moreover, autoantibodies target the fetal brain during pregnancy [11]. Therefore, maternal blood levels of vit d are imporant for the delivery through placenta and serotonin production in the developing fetus. 2-3 sentences on your topic that will be in the final article Jump up ^ Zafeiriou, D. I.; Ververi, A; Vargiami, E (2009). "The serotonergic system: its role in pathogenesis and early developmental treatment of autism.". Curr. Neuropharmacol. 7: 150– 157. Jump up ^ Haussler, M. R.; Jurutka, P. W.; Mizwicki, M.; Norman, A. W. (2011). "Vitamin D receptor (VDR)-mediated actions of 1alpha,25(OH)(2)vitamin D(3): genomic and non-genomic mechanisms.". Best Prac. Res. Clin. Endocrinol. Metab. 25, 25: 543–559. Jump up ^ Gutknecht, L.; Kriegebaum, C.; Waider, J.; Schmitt, A.; Lesch, K. P. (2009). "Spatio-temporal expression of tryptophan hydroxylase isoforms in murine and human brain: convergent data from Tph2 knockout mice.". Eur. Neuropsychopharmacology 19: 266–282. Jump up ^ Gutknecht, L.; Kriegebaum, C.; Waider, J.; Schmitt, A.; Lesch, K. P. (2009). "Spatio-temporal expression of tryptophan hydroxylase isoforms in murine and human brain: convergent data from Tph2 knockout mice.". Eur. Neuropsychopharmacology 19: 266–282. Jump up ^ Whitfield, G. K. (2005). Nuclear Vitamin D Receptor: StructureFunction, Molecular Control of Gene Transcription, and Novel Bioactions (2nd ed. ed.). New York: Elsevier. Jump up ^ Munn, D. H.; Zhou, M.; Attwood, J. T.; Bondarev, I.; Conway, S. J.; Marshall, B.; Brown, C.; and Mellor, A. L. (1998) "Prevention of allogeneic fetal rejection by tryptophan catabolism." Science 281: 1191–1193 Jump up ^ Munn, D. H.; Zhou, M.; Attwood, J. T.; Bondarev, I.; Conway, S. J.; Marshall, B.; Brown, C.; and Mellor, A. L. (1998) "Prevention of allogeneic fetal rejection by tryptophan catabolism." Science 281: 1191–1193 Jump up ^ Munn, D. H.; Zhou, M.; Attwood, J. T.; Bondarev, I.; Conway, S. J.; Marshall, B.; Brown, C.; and Mellor, A. L. (1998) "Prevention of allogeneic fetal rejection by tryptophan catabolism." Science 281: 1191–1193 Jump up ^ Pallotta, M. T.; Orabona, C.; Volpi, C.; Vacca, C.; Belladonna, M. L.; Bianchi, R.; Servillo, G.; Brunacci, C.; Calvitti, M.; Bicciato, S.; Mazza, E. M.; Boon, L.; Grassi, F.; Fioretti, M. C.; Fallarino, F.; Puccetti, P.; and Grohmann, U. (2011) "Indoleamine 2,3-dioxygenase is a signaling protein in long-term tolerance by dendritic cells." Nat. Immunol. 12: 870–878 Jump up ^ Bauman, M. D.; Iosif, A. M.; Ashwood, P.; Braunschweig, D.; Lee, A.; Schumann, C. M.; Van de Water, J.; and Amaral, D. G. (2013) "Maternal antibodies from mothers of children with autism alter brain growth and social behavior development in the rhesus monkey." Transl. Psychiatry 3 Jump up ^ Bauman, M. D.; Iosif, A. M.; Ashwood, P.; Braunschweig, D.; Lee, A.; Schumann, C. M.; Van de Water, J.; and Amaral, D. G. (2013) "Maternal antibodies from mothers of children with autism alter brain growth and social behavior development in the rhesus monkey." Transl. Psychiatry 3 Aleksuwo (talk) 17:49, 16 October 2015 (UTC)

WikiProject Medicine - Proposed Edits

Hi all, I'm part of the WikiProject Medicine course at UCSF and have identified a few areas I'd like to work on for this page. Outline is below - looking forward to hearing everyone's input!

General changes: 1-2 more photos; Inserting references where flagged and/or deleting statements for which references cannot be found; Simplifying language (per Acrolinx report); Consistency between person-first and identity-first language (ideally would like to change all to identity-first)

Lead section: Less medical jargon while still maintaining a neutral point of view

Classification: Clarification of DSM-5 vs. DSM-4 and language no longer being a criteria (still mentioned in differentiation between autism and Asperger syndrome)

Characteristics: Will potentially remove and or streamline "Developmental Course" to take out specific prognosticating language

Associated conditions: Will be merged with "comorbid conditions"

Management: Will incorporate discussion from Talk page re: ABA therapy

Mschwarz6 (talk) 21:17, 15 November 2015 (UTC)

Peer Review

Great, thorough article that is well organized. Overall, no obvious problems jumped out, except perhaps the complicated sentences and expressions, making the information more challenging to understand to the lay person. In this regard, I know you have made substantial improvements to the original content. I liked the links under many headings to other main articles.

Some notes, section by section:

Intro: Succinct, but some information is repeated in the Classification section. I would copy this detailed information into the Classification section, and instead write something simpler here: Autism spectrum or autistic spectrum describes a range of conditions classified as neurodevelopmental disorders in the fifth revision of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5), encompassing diagnoses of autism, Asperger syndrome, pervasive developmental disorder not otherwise specified (PDD-NOS), Rett's disorder, and childhood disintegrative disorder.

Classification: Very thorough. Some sentences could use simplifying/shortening. This is the most confusing, IMO: Rather than categorizing these diagnoses, the DSM-5 has adopted a dimensional approach to diagnosing disorders that fall underneath the autism spectrum umbrella. Some have proposed that individuals on the autism spectrum may be better represented as a single diagnostic category, because they demonstrate similar types of symptoms and are better differentiated by clinical specifiers (i.e., dimensions of severity) and associated features (i.e., known genetic disorders, and intellectual disability). Here, "in turn" could be taken out (not needed): ASD, in turn, is a subset of the broader autism phenotype (BAP), which describes individuals who may not have ASD but do have autistic-like traits, such as avoiding eye contact.

Characteristics: This is an excellent section that is very easy to read.

Developmental Course: "Although autism spectrum disorders are thought to follow two possible developmental courses, most parents report that symptom onset occurred within the first year of life." - try to rewrite, maybe not start the sentence with "although". Try this?: Most parents report that symptom onset occurred within the first year of life. Autism spectrum disorders are thought to follow two possible developmental courses.... etc.

Causes: "While a specific cause or specific causes of autism spectrum disorders has yet to be found, many risk factors have been identified in the research literature that may contribute to the development of an ASD." - Just simplify to "a specific cause", don't think you need single vs plural

Genetic risk factors: "Instead, there seem to be multiple genes involved, each of which is a risk factor for part of the autism syndrome through various groups" - sentence unclear. What various groups? Maybe link to terms like "prevalence" vs "incidence", etc.

Prenatal and perinatal risk factors: Great.

Vaccine controversy: Great, slightly wordy.

Pathophysiology: minor change: "enlargement in some areas and brain reduction in others". This would make little sense to a non-medical person: "In neuroanatomical studies, when performing Theory of Mind and facial emotion response tasks, the median person on the autism spectrum exhibits less activation in the primary and secondary somato-sensory cortices than does the median member of a properly sampled control population. This discrepancy is consistent with reports of abnormal patterns of cortical thickness and grey matter volume in those regions of autistic persons' brains."

Mirror Neuron System: Maybe there are pages that could be linked to define the brain areas?

Temporal Lobe: Great.

Mitochondrial Dysfunction: Great.

Vitamin D: Great.

Diagnosis: Evidence-Based Assessment: Great as is - a comprehensive list of diagnostic tools

Comorbidity: Great.

Management: I don't know if there is a rule about using "likelier" vs "more likely", but I think more likely sounds better. I would rearrange the first sentence, so the sentence does not start with "although". "It has been argued that no single treatment is best and treatment is typically tailored to the child's needs." - this sentence is repeated twice in the paragraph, with minor variation. Remove one. Maybe change this sentence to: "OTHER Available approaches include: developmental models, structured teaching, speech and language therapy, social skills therapy, and occupational therapy." - just so ABA is not repeated again. Maybe change this to: "Applied behavioral analysis is one of the most empirically supported intervention approaches... etc", just so it does not sound like you are introducing ABA for the first time.

Epidemiology: Link to "prevalence"

History: This sounds more like "Causes", and could maybe be moved there? Or maybe preface these two interesting bits with some kind of summary statement, about why this is included.

Society and Culture: "Families who care for an autistic child face added stress from a number of different causes. One study found that half of parents who had a child with any kind of developmental disability were still caring for their child by age 50, while only 17% of parents that age would typically be caring for children." This sentence is very out of place. The information flows much better without it. However, this is a powerful statement, so just try to move it elsewhere.

Annak.med (talk) 03:42, 18 November 2015 (UTC)

Thanks so much for your review Annak.med! You picked up on a lot of areas for clarification of language that I never would have noticed. Just to summarize my response to each section and what I changed/left:

Intro: Left as is. I agree that merging the two intro sentences might be more concise, but think that might be a little less readable than two shorter sentences.

Classification: Removed "in turn," and attempted to clarify the "dimensional approach" sentences. Thanks!

Developmental Course: Switched order of phrases in first sentence.

Causes: Chose to go with "causes" rather than "cause," but agree that only one was needed!

Genetic risk factors: Attempted to clarify last sentence, and added lots of links. Thanks!

Vaccine controversy: Found one awkward/unclear phrasing ("supported by multiple lines of evidence..." and changed to "and further evidence continues to refute them")

Pathophysiology: Linked to lots of neurology jargon terms - as paraphrasing would make the reporting of the findings less accurate.

Mirror Neuron System: Linked!

Management: Oops - definitely didn't see that "likelier" before. I agree! I see many others have been editing this section as well since I last worked on it, so I tried to remove repetition/consolidate between them while preserving all of the ideas/evidence shared. I also broke up into shorter paragraphs.

Epidemiology: "Prevalence" linked!

History: I toyed around with the idea of moving this into a subheading of "Other causes proposed in history" in the Causes section, but thought this would cause more controversy/confusion and would make people more likely to think that these are still currently thought to be causes. So I left as is.

Society and Culture: Good catch! I agree it is a necessary point but breaks the flow of the paragraphs about ARM. Split up the section into "Autism Rights Movement" and "Impact on Caregivers."

--Mschwarz6 (talk) 21:30, 20 November 2015 (UTC)

Should be a list of people on the autism spectrum.Hinata Ryunosuke (talk) 02:06, 19 February 2016 (UTC)

edits re rural and interactive TV

The following was added today in this series of diffs.

moving it here for discussion and review. headers have been changed to bold to keep this in one section.

Interactive Television

Children with ASD who live in rural and poorer areas are diagnosed at a later age compared to those in urban or suburban areas. The interagency Autism Coordinating Committee (IACC) is currently trying to focus on accessing services, reducing inequities, and promoting earlier detection and intervention for individuals in rural and underserved areas.

In order to improve outcomes for children with ASD, families should be afforded equal opportunities to access high quality health care. Earlier detection and intervention should be promoted for the families in rural and underserved areas. One possible solution is using the video conferencing (VC) to aid in assessment and diagnostic procedures. It is an easier means to reach families in rural and underserved areas. The study shows excellent inter-rater agreement on diagnoses between clinicians in the VC setting and the interdisciplinary team. It suggests that VC may be a viable method to increase access to autism diagnostic services and possibly early intervention for families in rural and underserved areas.

Reese et.al. created the Integrated Systems Using Telemedicine (ISUT) Model, which links families, trained early intervention providers and educators, and university-based medical professionals. One non-randomized study reported that the ISUT Model was both well-received and cost-effective for families in rural areas requiring access to ASD diagnostic services.

There was a study comparing the clinical utility and validity between interactive VC and an in-person assessment that uses standardized ASD diagnostic tools (e.g., the Autism Diagnostic Observation Schedule-Module 1, the Autism Diagnostic Interview-Revised). The results suggested that there were no significant differences in either the diagnostic accuracy or reliability when assessment obtained in-person or remotely. Even more, parents reported equally satisfied with both of the observational conditions.

References

This gives WP:UNDUE weight to interactive TV, is sourced from primary sources and violates WP:RELTIME by talking about "current" things. Yidouwan would you please check in with your course's ambassador on these things? Thanks. Jytdog (talk) 19:12, 8 March 2016 (UTC)

content added today

content below was added in this dif, which also deleted the infobox. refs need to be fixed (pmid added), formatting, and copyediting, before this goes live

Role of Copy Number Variable Genes

Around 5-10% of autism spectrum disorders (ASDs) are observed to be the results of rare (<1%frequency) De nova or inherited copy number variations (CNVs). Genes involved with CNVs tend to be synapse-related genes that to have copy-number dosage-dependent effects on either the behavior or cognition of affected individuals. Some studies have found the number of De novo CNVs to be fivefold higher in families with an individual with an ASD when compared to those who do not

. Recent studies have identified hundreds of possible CNV regions related to ASDs. Data supports an association between rare De novo events at specific loci and the risk of ASDs. ASD has a highly heterogenic genetic background, and the majority of either common or rare CNVs do not necessarily lead to ASDs, but may increase the risk of developing one. Most likely, the clinical presentation of ASD is the result of multiple variants acting in concert.

While scientists have identified hundreds of candidate CNVs associated with ASD, CNVs with the strongest evidence associating them to ASD, have been identified, isolated and studied more vigorously. Research focuses on many De novo events, the most common of which occur at three separate loci, 7q11.23, 15q11.2-13.1, and 16p11.2.

Mutations to the 16p11.2 region of chromosome 16 are associated with hyperactivity in clinical ASD. Given that the mutation is found at a relatively high frequency, 1%, in ASD cohorts and rarely found in the siblings of ASD individuals, there is strong evidence supporting the large effect of duplications and deletions to this locus. This locus is also related to schizophrenia, bipolar disorder and obsessive-compulsive disorder (OCD).

The 7q11.33 locus, found on the long arm of chromosome seven, is associated with Williams-Beuren syndrome, which is characterized by a reciprocal deletion in this region and related to highly social personalities. The most common occurring De novo mutation to this region of the chromosome presented in ASD seems to have a very different effect than that of Williams syndrome. As opposed to deletions, the mutation involves four recurrent De novo duplications and presents as increased behavioral problems.

The de novo CNV occurring at 15q11.2-13., on chromosome 15, is the most commonly cited cytogenetic abnormality identified in idiopathic ASD. Duplications in this region are not only associated with ASD, but also with general intelligence disorders (IDs), while deletions to this region are strongly associated with schizophrenia and epilepsy. CNVs in this region, alone, have only moderate or mild effects, and it is most likely that some other genetic factors are required for this phenotype to reach ASD threshold.

References

- Jytdog (talk) 02:13, 29 March 2016 (UTC)

Merge

Merge Autism (https://en.wikipedia.org/wiki/Autism), Asperger's (https://en.wikipedia.org/wiki/Asperger_syndrome), PDD-NOS (https://en.wikipedia.org/wiki/Pervasive_developmental_disorder_not_otherwise_specified), HFA (https://en.wikipedia.org/wiki/High-functioning_autism), and whatever else there is out there into this article (https://en.wikipedia.org/wiki/Autism_spectrum) in order to keep up to date with current understanding.

Throwawaysomyipdoesntshowup (talk) 14:54, 29 June 2016 (UTC)

• Oppose, see ICD10. SandyGeorgia (Talk) 17:11, 30 June 2016 (UTC)

Ok, I will suggest this again once the ICD 11 is out of beta. I did not know it had to be in WHO's current criteria, last updated in the 90s. The other main one, the DSM V, was updated more recently, 2013, and has merged, which is why I suggested it. I am sorry for my mistake, I will wait until 2018 next time. — 

Throwawaysomyipdoesntshowup (talk) 15:15, 3 July 2016 (UTC)

See WP:WORLDVIEW-- DSM is not the only game in town :) SandyGeorgia (Talk) 11:55, 3 July 2016 (UTC)

Where did I say it was? I am not even American, and my country uses ICD 10 as a result of that. My point is that the more recently updated manual, the DSM V, has merged (2013 knowledge vs 1992 knowledge), and that the ICD 11 is going to follow that merge (which you can view by going to their beta page). If this is a problem, that is ok, I will post this suggestion again in 2018 once they follow that merge. — 

Throwawaysomyipdoesntshowup (talk) 15:14, 3 July 2016 (UTC)

References

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SSDD

User:Tilzey in this dif, and edit-warred back in, in this this dif, you added "Succinic Semialdehyde Dehydrogenase Deficiency; the first time the ref was Pearl, P. "Disorders of GABA metabolism - PubMed Health". PubMed Health..

As I noted in my edit note here after your first insertion, the first ref, and the 2nd, both note that SSDD has symptoms that are ASD-like. You added this in the Comorbidity section. Having some symptoms that ASD-like is not the same as a comorbidity. Jytdog (talk) 03:14, 10 November 2016 (UTC)

References

Social and romantic relationships for individuals with autism

Biblography

Barnhill, G. P. (2007). Outcomes in adults with Asperger syndrome. Focus on Autism and Other Developmental Disabilities, 22, 116–126.

Humphrey, N., & Symes, W. (2010). Perceptions of social support and experience of bullying among pupils with autistic spectrum disorders in mainstream secondary schools. European Journal of Special Needs Education, 25, 77–91.

Gantman, A., Kapp, S.K., Orenski, K. and others (2012) J Autism Dev Disord. 42, 1094.

Jennes-Coussens, M., Magill-Evans, J., & Koning, C. (2006). The quality of life of young men with Asperger syndrome: A brief report. Autism, 10, 511–524.

Orsmond, G. L., Krauss, M. W., & Selzter, M. M. (2004). Peer relationships and social and recreational activities among adolescents and adults with autism. Journal of Autism and Developmental Disorders, 34, 245–256.

Mehzabin, P., & Stokes, M. A. (2011). Self-assessed sexuality in young adults with high-functioning autism. Research in Autism Spectrum Disorders, 5, 614–621.

Miller, P. M., & Ingham, J. G. (1976). Friends, confidants and symptoms. Social Psychiatry, 11, 51–58.

Shattuck, P., Seltzer, M., Greenberg, M. M., Orsmond, G. I., Bolt, D., Kring, S. and others. (2007). Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 1735–1747.

Vivienfoster (talk) 22:38, 28 February 2017 (UTC)

No mention of Maternal Immune Activation as a risk factor

Seems strange not to mention Maternal Immune Activation as a risk factor as there is a lot of literature on this, eg refs in Maternal Immune Activation and Autism Spectrum Disorder: Interleukin-6 Signaling as a Key Mechanistic Pathway ? - Rod57 (talk) 14:23, 23 March 2017 (UTC)

The infinity symbol in question, its relevance

Do we have a better reference for the claim that this symbol should be used? The current source seems to be just a blog which is questionable as to the level of reliability. Even if that is okay, the source itself shows the rainbow infinity symbol as one of a dozen symbols that people came up with after the author asked people to submit the ideas. This particular symbol was liked by a few people. Is that good enough to be used as the lede photo in the info box? Z22 (talk) 14:00, 1 April 2017 (UTC)

Yeah, that's not just poorly sourced; that is exceptionally poorly sourced. I have removed it from both this article and that on Neurodiversity. "Joanne Lara, Bev Leroux, and April Dawn Griffin like this symbol" would not be a reason to include it even if the source was unquestionably reliable, which it unquestionably isn't. TimothyJosephWood 14:38, 1 April 2017 (UTC)

The same symbol is still being used in Autism_spectrum#Society_and_culture, Autism#Society_and_culture, and Template:Autism-stub. I don't think it is good to be on those pages. Z22 (talk) 23:39, 1 April 2017 (UTC)

Cleaned. I suspect that someone is trying to use Wikipedia to make this a "thing". TimothyJosephWood 02:20, 2 April 2017 (UTC)

References

• Gillott, A., Furniss, F., & Walter, A. (2001). Anxiety in high-functioning children with autism. Autism, 5(3), 277-286. doi:10.1177/1362361301005003005
• Miller, L. E., Burke, J. D., Troyb, E., Knoch, K., Herlihy, L. E., & Fein, D. A. (2017). Preschool predictors of school-age academic achievement in autism spectrum disorder. The Clinical Neuropsychologist, 31(2), 382-403. doi:10.1080/13854046.2016.1225665
• Patterson, D. (2017). A comparative study on academic performance of students with asperger's syndrome in different classroom formats (Doctoral dissertation). Retrieved from PsycINFO Dissertation Abstracts International Section A, 77.
• Stichter, J. P., Riley-Tillman, T. C., & Jimerson, S. R. (2016). Assessing, understanding, and supporting students with autism at school: Contemporary science, practice, and policy. School Psychology Quarterly, 31(4), 443-449. doi:10.1037/spq0000184

— Preceding unsigned comment added by Knphillips (talk • contribs) 18:12, 14 August 2017 (UTC)

Autism Spectrum and the association of violence

I've heard that most studies don't support a correlation between autism and violent crimes (or was it just AS?) but on the other hand ASD is also associated with tantrums, violent outbursts and reactive aggression, and I noticed it seems a disproportionate number of recent mass shootings in the US have been committed by people diagnosed with ASD/AS. Then I found this study: http://www.sciencedirect.com/science/article/pii/S1359178914000305. Haven't read through it but seems like it might have some valid points. Any thoughts?--

Humorideas (talk) 19:55, 22 October 2015 (UTC)

I'm just a kid but we should ingore that.It's probably just a coincidence (although autism DOES have symptoms of having tantrums/violent outbursts.) (To support the point,the majority of serial killers have been white men but being a white guy doesn't make you a serial killer.)

72.69.143.35 (talk) 00:38, 8 January 2017 (UTC)

There is zero evidence that autism is associated with violence (Gupta, 2012)

I think Doctor Sanjay Gupta (2012) mentioned this before, "there is zero evidence that autism is associated with violence... however people with autism are more likely to be victims of assault, bullying and harassment", just to make this clear.

Gupta, S. (2012). What Is Asperger's Syndrome? [video] Available at: http://edition.cnn.com/videos/health/2012/12/21/exp-gupta-eitm-aspergers.cnn [Accessed 20 Oct. 2017].

62.102.148.185 (talk) 18:44, 20 October 2017 (UTC)

Sociocultural Perspective on Autism Intervention (Fong and Lee, 2017 Apr)

By Elizabeth Hughes Fong and Helen Lee.

DOI: 10.5772/65965

https://www.intechopen.com/books/autism-paradigms-recent-research-and-clinical-applications/sociocultural-perspective-on-autism-intervention

Abstract

The landscape of the population in the United States is diversifying, as are the individuals who have a diagnosis of autism spectrum disorder. Autism spectrum disorder now affects one of out every 68 children. Although the diagnostic criteria do not differ, there are differences in time of diagnosis, treatment and acceptability of the diagnosis in various cultures, which is important for clinicians to understand. One approach to autism intervention is applied behavior analysis (ABA), which seeks to intervene on socially significant behavior. In addition, to using an approach such as ABA, which emphasis social significance, individuals may also use a cultural broker. The cultural broker can help to bridge the gap between parties and promote more effective treatment experience and thus help to ensure a more culturally sensitive approach to intervention.

Keywords: autism spectrum disorder, cultural competence, applied behavior analysis, cultural broker, social validity, culture

62.102.148.185 (talk) 18:50, 20 October 2017 (UTC)

The role of culture in families' treatment decisions for Children with Autism Spectrum Disorders (Mandell and Novak M, 2005 Apr)

By David Mandell and Maytali Novak.

PMID 15977313 DOI: 10.1002/mrdd.20061

https://www.ncbi.nlm.nih.gov/pubmed/15977313

http://onlinelibrary.wiley.com/doi/10.1002/mrdd.20061/abstract

Abstract

There is little information available about how and why parents of children with autism spectrum disorders (ASD) make decisions regarding which of the many available treatments to implement with their children. Given the lack of available information regarding treatment efficacy, it is likely that parents' beliefs about child development, interpretation of the symptoms of ASD, its etiology and course, and their experiences with the health system influence treatment decisions. This article addresses these issues within the context of cultural influences. We review the small body of existing literature regarding cultural influences on decisions regarding ASD and draw implications for the study and treatment of ASD from the larger body of literature on culture and other health conditions of childhood. In addition to examining the potential for differences in clinical presentation by culture and different experiences with the healthcare system, we use Kleinman's framework of questions for understanding the role of culture in the interpretation and treatment of ASD. These questions address interpretation of symptoms and beliefs about their cause, course, and treatment. Finally, we present specific language for clinicians to use in discussion with families with different cultural beliefs about the use of less traditional treatment strategies

62.102.148.185 (talk) 19:00, 20 October 2017 (UTC)

Please read WP:MEDRS about sourcing. Best Doc James (talk · contribs · email) 19:06, 20 October 2017 (UTC)

Why? What's wrong with this source?

62.102.148.185 (talk) 19:27, 20 October 2017 (UTC)

See WP:MEDDATE for one. It is also classfied by the journal and by pubmed as a research article - a primary source. Jytdog (talk) 22:04, 20 October 2017 (UTC)

Review

This is a review thus fine to use.[1] Doc James (talk · contribs · email) 01:21, 27 December 2017 (UTC)

New section

• I beg to differ that my edit Was vandalism. giving a concise description of autism at the beginning of the article is helpful for those that Want to quickly find out What autism is.CmdrTako (talk) 11:13, 18 September 2018 (UTC)

litiralism in autism

It is often beleived by autistics that they are bad at the metaphorical use of language. They are bad only at the interpretation of metaphors, they are hyperliterial in the expression of metaphors. People they are non-flaunt in there metaphors but the intended meaning is hyperobvious. People assume that they don't mean what they said at face value because they assume that because they are non-fluent that they must be expressing themselves wrongly.

I'm not edit waring Im trying to correct the mentioned resaon for the undo.24.116.188.108 (talk) 16:06, 19 September 2018 (UTC)

Hello, I'm SD5. I wanted to let you know that I reverted one of your recent contributions —specifically this edit to Autism spectrum— because it did not appear constructive. If you would like to experiment, please use the sandbox. If you have any questions, you can ask for assistance at the Help Desk. Thanks. SD5 16:17, 19 September 2018 (UTC)

I fail to see why it's keeps being removed. Is it not good to know how to interpret autistics?24.116.188.108 (talk) 16:24, 19 September 2018 (UTC)

This new information needs to be supported by a reliable source. Willondon (talk) 16:17, 19 September 2018 (UTC)

You may want to review the policies on original research and reliable sources. The citation you're giving is not to a valid, reliable source (actually, it brings up an error, but regardless, a wikia site wouldn't pass muster), which would be needed to support your claim. PohranicniStraze (talk) 16:31, 19 September 2018 (UTC)

Thanks for not misunderstanding me, and not just ban me from the talk page so I can't discuss the issue. but I fail to see why you have a citation needed tag if you just summerily remove information that needs a source?24.116.188.108 (talk) 16:41, 19 September 2018 (UTC)

Not a problem, we were all new editors at some point! The citation needed tag is only one way to challenge a statement; depending on what is being inserted, it can be tagged or simply removed. If content is challenged and removed, then the editor who re-adds the material has the responsibility to cite their claims with a reliable source - see WP:CHALLENGE. At this point, a couple different editors have challenged and removed the material you've added, so it is up to you to find a reliable source citation. Thanks, and happy editing! PohranicniStraze (talk) 17:11, 19 September 2018 (UTC)

Stop trying to justify your editer waring with constantly changing bullshit reasons. you've been warned!TheLittleAmericanMonkey (talk) 17:45, 19 September 2018 (UTC) Just you clarify repetitively removing a submissions editing aring. Improve don't remove.107.77.233.194 (talk) 10:51, 20 September 2018 (UTC)

References

Kanner's

Would it be worth mentioning on this article (and the Autism one) that "classic autism" is also sometimes referred to as Kanner's Autism to differentiate it from other forms of autism? Iridi (talk) 22:39, 10 March 2015 (UTC)

I feel it would also be a good idea to mention other forms of treatment or helpful tools such as therapy dogs. Therapy dogs are very helpful to not only autism but to other disorders as well. (Awolf6 (talk) 16:56, 26 November 2018 (UTC)).

Temple Grandin, where are you?

I wrote this to an editor who revoked an edit of mine on this page, who has since quit as an editor, as I did several years ago, due to fractious edit warring.

Thank you TC for your polite and non-threatening note. If you are keen on Spectrum Autism, I suggest you read Temple Grandin's books, and add some of their wisdom to the Autism page. I haven't the wiki-chops to cite from paper books yet, nor quite the time to work deeply on this article. I put the reference in hoping that someone keen on the article would follow up. Sadly, wikipedia is more about edit wars and proprietary editing than pursuing knowledge. At least you were polite while reversing my edit wholesale, which I appreciate. 184.69.174.194 (talk) 04:50, 17 January 2019 (UTC)

Are you proposing some specific improvement to this article? If not, please see WP:NOTFORUM. General Ization ^Talk 04:53, 17 January 2019 (UTC)

I absolutely am. Please read her books and then bring her ideas into the article. WITH APPROPRIATE CITATIONS!! Should be easy, as she's a best selling author, diagnosed with spectrum autism. It was also a plea for people to get off their edit warring high horses, which you, thankfully, are not on one of. :) Peace. 184.69.174.194 (talk) 05:00, 17 January 2019 (UTC)

List of schools for people on the autistic spectrum

I've raised this at the Schools wikiproject also. This list could be used by readers as a resource to find an acceptable school for someone. I know that's not its purpose, but a random list that might have bad schools or be used as promotional doesn't seem appropriate, especially for this speciality. Doug Weller talk 15:02, 30 November 2017 (UTC)

Hi. IMHO, a list is a good thing, The web is about surfing for knowledge. Not for us to vette every school or link. Caveat emptor. In time, people who know the schools could comment, but I think if you don't know they are bad, leave them in, so we can work on them. WIKI stands for WorkInProgress. Well, almost... :) — Preceding unsigned comment added by 184.69.174.194 (talk) 05:03, 17 January 2019 (UTC)

Should the title be Autism spectrum disorder

As it is now mentioned in most publication and in the DSM-5, the correct title should be "Autism Spectrum Disorder". What do you think ? — Preceding unsigned comment added by Wikitavanti (talk • contribs) 21:54, 16 September 2016 (UTC)

No. The DSM is not God. In fact, it has radically changed its section on Autism with every version. But more important, we people with Autism do not have a disorder. Please read some Temple Grandin. She'll help you figure it out. — Preceding unsigned comment added by 184.69.174.194 (talk) 05:07, 17 January 2019 (UTC)

Image

Having these impediments can be discouraging for people with ASD to have simple conversations with others, make friends, have close relationships, and even keeping a job.

How does this illustrate the condition in question? Doc James (talk · contribs · email) 01:31, 3 March 2018 (UTC)

Frankly, it doesn't. It's just a random picture of a (supposedly, we only have the source's word for it) autistic child. It's not a bad picture, in the purely aesthetic sense, but it doesn't belong here.Sumanuil (talk) 19:02, 3 March 2018 (UTC)

Please, if you don't know, don't pontificate. I have autism, and so does my son. Diagnosed, etc. This photograph is perfectly expressive of an autistic person. If you are autistic, you'll get it instantly. To say "it doesn't belong here" is to silence autistics. And who are you to do that? This is not about "aesthetics", it is about illustrating autism. Great picture, please keep it in. Thanks. 184.69.174.194 (talk) 04:55, 17 January 2019 (UTC)

Rubbish, it's a rather stereotypical image, child focused which helps reinforce the idea that Autism is a childhood thing. I don't think it expresses much more than a rather outdated representation of what autism is. Saying a picture is unrepresentative is not "silencing autistics" it is merely expressing an opinion of whether the image is suitable.Lacunae (talk) 22:21, 22 February 2019 (UTC)

@Lacunae: What do you think of these possible alternatives?

1 Identified as an adult man with autism

2 A comedy troupe the members of which have Aspergers—best group shot I could find where everyone is known to have autism.

3 Instance of stimming

4 There are lots of nice images on commons of athletes and activists with autism, but I think it would be a bit odd to single out one known individual for the lead image

Cheers, gnu57 00:22, 23 February 2019 (UTC)

Merger with Autism

As the terms Autism and Autism spectrum are increasingly used in reference to the same condition, I recommend a merger of both articles. ADeviloper (talk) 16:18, 8 February 2015 (UTC)

the autism article is about the obsolete autism disorder. I should be moved to autism disorder107.77.233.194 (talk) 11:00, 20 September 2018 (UTC)

I looked in the archive and saw that this was briefly discussed back in 2011, here. It was also discussed briefly in the autism article back in 2008 here. ADeviloper has also currently proposed this at the Autism article here. I am going to propose that formally by tagging the articles. I will direct discussion to this thread.

My reasoning (and I may be wrong) is that ASD is the broad diagnosis in DSM V, and autism is one classification within that, and much of the content in autism is about the spectrum. It seems to me that much of the content from autism should be merged here, and this article should have WP:SUMMARY sections from each of autism, asperger's, and the other classifications, to knit the related articles together.

In any case, I don't see that this has ever been thoroughly discussed and it perhaps should be. I do acknowledge that Autism is a featured article and that editors like SandyGeorgia have worked heroically to keep it that way. Nonetheless, this seems ripe for discussion. Tagging now. Jytdog (talk) 17:05, 8 February 2015 (UTC)

• Oppose. As clearly explained at the autism article, the Featured article refers to classic autism, not the full spectrum (which includes other conditions). Articles on both are necessary, they are separate concepts, the autism article is about classic autism, and in any case, a Featured article -- vetted by a community process -- is not going to be merged away via a merge request. SandyGeorgia (Talk) 22:44, 8 February 2015 (UTC)

hey sandy. i know you are very very close to the Autism article (and it has been a great accomplishment to get it there and even a greater one to keep it there). Can you see that there is a bunch of content in the autism article that is really about ASD? In my view, there is a bunch. Jytdog (talk) 23:43, 8 February 2015 (UTC)

If you give me samples of any text at autism that doesn't apply to classic autism, we can discuss moving it to autism spectrum, but we can't merge away a featured article, particularly when the two terms are notable and worthy of their own articles. PS, I think this discussion is on the wrong page. Autism is an FA-- a discussion of doing away with a featured article belongs on its page. SandyGeorgia (Talk) 00:40, 9 February 2015 (UTC)

sorry i am being unclear. i never meant to merge the whole thing - just the general parts. But that is only if folks agree that this article should be the top article in the suite. I think that is where the field is -- ASD is the top, and autism is one category within that. am i wrong? if you don't agree with that there is no point in continuing (I am sure you and others who regularly work here know the literature better than i) Jytdog (talk) 01:08, 9 February 2015 (UTC)

but to answer your question, when i read the Causes section, and the Mechanism section, of the autism article, i see nothing there specific to the autistic classification per se.... Jytdog (talk) 01:12, 9 February 2015 (UTC)

OK, so I'm still not clear on what you are proposing, or that you are understanding the consequences and process. I have no idea what you mean by "top article" ... ?? What has happened here is that this article is junk because no one cares, while autism is in good shape because it is watched because it is featured, comprehensive, and vetted. This article has been junked up (here is what it looked like when Eubulides-- who authored the entire autism suite-- last edited it.) Our article naming convention has nothing to do with a "top" article ... so I'm lost on what you mean by that ... We have two separate topics that meet notability, and one of them is in good shape, comprehensive, well written because it is featured, while the other is the usual Wikipedia garbage dump, deteriorated from when Eubulides maintained the entire suite. Perhaps we aren't following what each other is saying.

To merge away a Featured article means to defeature it. (There have been three such cases in the history of Featured articles.) Yes, autism is one kind of ASD; if you are saying that autism is a content fork from ASD, and that content is in the wrong article, then we have to go to FAR and propose delisting autism as a featured article. Then you move good content from a featured article into this crap article, and we end up with one large bad article. Just to be sure you understand the process ... by merging content to here, you don't end up with a featured article ... you lose a featured article, and then folks unwatch, and then we get even more deterioration.

I don't know the literature better than you, because you have better journal access than I do. The autism article was written about classic autism by Eubulides; in the older versions of this article, it was only about the spectrum (who knows what all garbage is in here now since Eubulides left). The article organization once worked; if you are saying it no longer does, then we lose the Featured article. One less article for me to watch over is OK with me :) :) But it was my understanding then that nothing in the autism article was not about classic autism. SandyGeorgia (Talk) 01:32, 9 February 2015 (UTC)

I am letting this go. Thanks for talking! Jytdog (talk) 02:11, 9 February 2015 (UTC)

• Oppose ASD is a broader category while autism is more specific. Doc James (talk · contribs · email) 11:30, 9 February 2015 (UTC)
• Oppose per SandyGerogia and Doc James. Dbrodbeck (talk) 12:09, 9 February 2015 (UTC)
• Oppose per Doc James. -- ATOMSORSYSTEMS ^(TALK) 01:24, 11 February 2015 (UTC)
• Oppose - while related, there's a clear medical distinction in scope between the 2 concepts Seppi333 (Insert 2¢ | Maintained) 10:33, 20 February 2015 (UTC)
• Oppose; like others said, classic autism is a distinct condition on the spectrum. However, I would recommend renaming the other article to Classic Autism as laymen may easily confuse the two - and it seems even professionals sometimes use 'autism' to reference the entire ASD.--Humorideas (talk) 19:49, 22 October 2015 (UTC)
• Don't Oppose. None of you people seem to have autism. Be careful then, of your opinions, which are ultimately lacking insight. The understanding of autism is changing, and much of the information in the "Autism Classic" article should be just put into the history section of a merged article. The DSM rewrites autism every addition, do we get a new article each time? Why is the article so focussed on the DSM? Are we advertising for the psychiatry profession, or a wiki? 184.69.174.194 (talk) 12:39, 3 January 2019 (UTC)
• Merge. Autism references both the DSM-5 and DSM-IV multiple times in its content, which makes the article inconsistent, since it is recognizing the DSM-5 while not adhering to its recommendation for terminology of the subject. Also, Autism spectrum references Autism sections as the main article for certain subjects. For example, Autism spectrum#Pathophysiology links to Autism#Mechanism, which in turn links to Mechanism of autism, which, while referencing sources that refer to the subject in question as autism spectrum disorder, still refers to it as autism in its body. Furthermore, the entire Autism spectrum#Autism rights movement section is identical in both articles. Most, if not all, of the more recent references in both articles refer to the subject as autism spectrum disorder as opposed to autism, if not in the title, then in the abstract. From what I've seen, "classic autism," as it has been referred to here, is just an older, potentially outdated concept that should be included in a History section here. 13thehappykid. 03:12, 18 June 2019 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 28 August 2019 and 6 December 2019. Further details are available on the course page. Student editor(s): Jaselleee. Peer reviewers: Andrianicole1.

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Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 3 March 2020 and 28 March 2020. Further details are available on the course page. Student editor(s): Rluna2020. Peer reviewers: Dsalvarez.

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Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 13 April 2020 and 8 May 2020. Further details are available on the course page. Student editor(s): Anwer2007. Peer reviewers: Zachthompson45.

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Identity-first vs. Person-first language

There is an ongoing discussion about person-first vs. identity-first language at the Autism article talk page. Interested editors are invited to participate. --Wikiman2718 (talk) 13:07, 1 August 2019 (UTC)

(duplicate) Merger proposal

This talk is related to Talk:Autism_spectrum#Merger_with_Autism.

I propose to merge Autism into Autism spectrum, because Autism and Autism Spectrum Disorder refer to the same thing, just that the former is the older version, and the latter is the latest version. See below.

I am able to state that:

1. According to https://www.webmd.com/brain/autism/understanding-autism-basics#1, it was previously called Autism, but it is currently called Autism Spectrum Disorder.
2. According to https://www.autismspeaks.org/what-autism, Autism is also known as Autism Spectrum Disorder. They are used interchangeably and refers to the same thing. Also, there are many sub-types of Autism, because it refers to a broad range of conditions. Also, Autism is a Spectrum disorder (which is why it is used interchangeably with ASD).
3. According to https://www.medicalnewstoday.com/articles/323758.php, ASD is an umbrella term, in it includes Asperger syndrome.

BG5115 (talk) 04:34, 3 May 2019 (UTC)

Autism is a severe form within the Autism spectrum So no need to merge. Doc James (talk · contribs · email) 14:44, 1 August 2019 (UTC)

Ignorant caption

Stacking objects during doesnt neecessarily indicate autism. Such astonishing lack of experience. — Preceding unsigned comment added by 31.48.49.11 (talk) 21:29, 12 September 2019 (UTC)

Text

User:Osterluzei not sure why the heading "overdiagnosis". The frequency of the condition is under epidemiology. Doc James (talk · contribs · email) 02:01, 31 December 2019 (UTC)

Overdiagnosis in children and adults

According to a CDC study relying on data from the Autism and Developmental Disabilities Monitoring (ADDM) Network, ASD prevalence was approximately 4% higher based on the historical DSM-IV-TR case definition compared with the new DSM-5 case definition from 2013. Relatively mild forms of autism, such as Aspergers as well as other developmental disorders were included in the recent DSM-5 diagnostic criteria. Another observational survey concluded that ASD prevalence was constant between 2014 and 2016 but twice the rate compared to the time period between 2011 and 2014 (1.25 vs. 2.47%). In the U.S, the rates for diagnosed ASD have been steadily increasing since 2000 when records on its epidemiology were first created. Similar prevalences were noted in other industrialized countries during the same time periods.

Validity of ASD

@Doc James: the "ASD Validity" paper which I cited (doi:10.1007/s40489-016-0085-x) isn't published in a PubMed-indexed journal, but PubMed-indexed journals have paid attention to it. (It is also worth noting that it is a peer-reviewed journal published by a respected publisher, and one of the coauthors is rather notable.) See this back-and-forth of editorials in the PubMed-indexed journal Autism Research – PMID 28130875, PMID 28714261, PMID 28714260. Müller and Amaral agree that much of what Waterhouse et al. are saying about the validity of ASD is fundamentally true (and indeed, even widely accepted among researchers in the field)– but they disagree with the idea that the concept of ASD should therefore be abandoned as a basis for further research (or at least, they argue that doing so is premature.) See also this paper (from a PubMed-indexed journal) by one of the coauthors of the first paper which makes many of the same arguments – PMID 25465942. I don't see why some discussion of the validity of the disorder should not exist in the article. Since ASD is a DSM-5 diagnosis, the same (very widely-held) doubts about the validity of DSM-5 diagnoses in general apply to it, but it may well be that some DSM-5 diagnoses have greater validity problems than others, and ASD may fall into that category. (I agree that my original contribution was somewhat one-sided, in that I cited researchers and clinicians who are sceptical of ASD validity without including those who are sceptical-of-that-scepticism, but surely the solution to that is to add some representation of that later viewpoint, such as the Müller and Amaral editorials, rather than ignoring the issue entirely). SJK (talk) 02:23, 16 November 2019 (UTC)

We could write something in the "Society and culture" section. Definitely does not belong in the lead.[2]

There are reviews on the topic in major journals that are pubmed indexed.[3] Doc James (talk · contribs · email) 05:55, 16 November 2019 (UTC)

@Doc James: I'm confused by your statement that it "does not belong in the lead", when I never put it in the lede – I put it at the end of the "Classification" section. I also don't understand how a debate about biological validity and construct validity is a debate about "society and culture" – biological validity and construct validity are not about "society and culture", they are about nosology, and hence belong in the section that discusses that ("Classification"). I'm also not sure why you think PMID 28275086 is on the same topic, given that article never even mentions the issues of biological validity and construct validity. That article is primarily about ethics, which is a rather different topic from validity. SJK (talk) 08:21, 16 November 2019 (UTC)

Yes apologies, you placed it under "classification" were in my opinion it does not belong either. Doc James (talk · contribs · email) 08:25, 16 November 2019 (UTC)

@Doc James: Why doesn't it belong under "Classification"? My argument is that the construct validity and biological validity of a diagnosis are fundamentally questions of nosology and hence belong under "Classification". If you think my argument is wrong, why is it wrong? What is your counterargument? SJK (talk) 09:06, 16 November 2019 (UTC)

The sources are insufficient. We need evidence that these are major positions. Doc James (talk · contribs · email) 09:35, 16 November 2019 (UTC)

We need metaanylyses or other similar sources that pass WP:MEDRS. A single paper doesn't cut it. -- BullRangifer (talk) 04:46, 31 December 2019 (UTC)

Text

"Sometimes it is considered a mental disorder if it impacts on function, but as a spectrum; for certain people (such as those with Asperger's Syndrome, which is on the spectrum), functioning is easier (hence in this case, it classes as a developmental disorder); in which Asperger's Syndrome/High-functioning autism and "intellectual disability with autistic features" and low-functioning autism are drawn parallel as different ends of the spectrum in relation to intelligence."

We need better sources. Doc James (talk · contribs · email) 04:47, 9 January 2020 (UTC)

"For some people on the spectrum, stereotyped expectations in relation to behaviors can also be a source of stigma, or personal trauma and in the past, due to dated research, autistic people have been misunderstood and institutionalised. "

We need better sources. Doc James (talk · contribs · email) 04:47, 9 January 2020 (UTC)

"The National Autistic Society also does not consider autism a mental illness."

Source is good but what text in the source supports this? Doc James (talk · contribs · email) 04:47, 9 January 2020 (UTC)

References

Biomarker identification

The following text describing a peer-reviewed, well sourced study was removed from the article without explanation, which I have restored. If you have a legitimate reason for removing this text explain here:

 Efforts to discover potential biomarker screening assessments had been stymied because of the heterogenetic nature of ASD symptoms and the polygenomic nature of its causes. In 2018, a technique was discovered that can use saliva samples to screen for ASD using an approach that integrates genetic, epigenetic, and metagenomic methods. By using many samples of pooled microbial RNA concentrations from saliva, researchers were able to use machine learning to train an algorithm for an effective predictive model that accurately discriminates children with ASD from those with DD or TD. The researchers who discovered the technique said, "This non-invasive test could augment the accuracy of current ASD assessment, as an adjunctive tool for children with positive MCHAT screening, or an objective aid in ASD diagnosis." As of 2019 further refinement of the model is being pursued to account for variations in microbial RNA among various diets and geographic locations.

Sparkie82 (t•c) 17:17, 1 January 2020 (UTC)

User:Sparkie82 I see a number of comments. One version had a predatory journal. Some of this text could go in a research section I guess.

Were does this ref talk about biomakers https://www.cdc.gov/media/releases/2016/p0331-children-autism.html Doc James (talk · contribs · email) 08:33, 2 January 2020 (UTC)

How about a subsection under Diagnosis titled, "Ongoing research"? I understand your concern with this claim -- it is quite extraordinary and should probably be segregated in this article until other researchers have replicated the findings. Sparkie82 (t•c) 22:26, 6 January 2020 (UTC)

Hearing no objections, I did it. (I bundled the cites - can clean up later) Sparkie82 (t•c) 01:49, 20 January 2020 (UTC)

Text 2

This ref which is good is used to try to support "There has been ongoing research to identify biomarkers for ASD but efforts to discover potential biomarker screening assessments have been stymied because of the heterogenetic nature of ASD symptoms and the polygenomic nature of its causes. In 2018, a technique was discovered that can use saliva samples to screen for ASD using an approach that integrates genetic, epigenetic, and metagenomic methods. By using many samples of pooled microbial RNA concentrations from saliva, researchers were able to use machine learning to train an algorithm for an effective predictive model that accurately discriminates children with ASD from those with DD or TD."

https://www.cdc.gov/ncbddd/autism/screening.html

It however does not Doc James (talk · contribs · email) 21:14, 20 January 2020 (UTC)

Okay, I removed the ref. Sparkie82 (t•c) 00:51, 28 January 2020 (UTC)

Text again

There has been ongoing research to identify biomarkers for ASD but efforts to discover potential biomarker screening assessments have been stymied because of the heterogenetic nature of ASD symptoms and the polygenomic nature of its causes. In 2018, a technique was discovered that can use saliva samples to screen for ASD using an approach that integrates genetic, epigenetic, and metagenomic methods. By using many samples of pooled microbial RNA concentrations from saliva, researchers were able to use machine learning to train an algorithm for an effective predictive model that accurately discriminates children with ASD from those with DD or TD. The researchers who discovered the technique said, "This non-invasive test could augment the accuracy of current ASD assessment, as an adjunctive tool for children with positive MCHAT screening, or an objective aid in ASD diagnosis." This sources fail WP:MEDRS. Doc James (talk · contribs · email) 08:52, 28 January 2020 (UTC)

The sources are fine. Sparkie82 (t•c) 04:59, 29 January 2020 (UTC)

A bunch of primary sources and popular press? The CDC was a great source but did not support the content in question. Doc James (talk · contribs · email) 07:43, 29 January 2020 (UTC)

References

WikiProject Medicine - Proposed Student Workplan

Hello everyone! I’m taking the WikiProject Medicine elective course at UCSF and have identified 4 sections in this article that I would like to improve over the next 3 weeks. This is my workplan and timeline:

Weeks 1-2: 1. Signs and symptoms- Currently, every symptom domain paragraph is dense and missing several common and important ASD symptoms in children. My goal is to make this section easier for a parent/teacher audience to read by: a) Simplifying language b) Dividing each category into subdomains of symptoms. For example: Subdivide behavioral symptoms into 2 subdomains: Restricted/Repetitive Behaviors and Other; Subdivide communication into Receptive and Expressive; Social skills- children and adults c) Describe how symptoms differ in girls vs boys d) Replace “Developmental course” section with a Timeline of symptom onset. I will review the wikipedia image posting guidelines, and possibly add an image to describe timeline.

2. Diagnosis a) Update “Evidence-based assessment” with latest diagnostic tools and guidelines b) Describe other important parts of ASD comprehensive evaluation (e.g . speech/language assessment)

Week 3: Epidemiology a) Update data on current prevalence according to the latest CDC reports

Week 4: Management a) Add “Treatment modalities” to describe the 3 management strategies: –Behavioral interventions –Medications/psychopharmacologic –Alternative therapies b) Complete peer review

If time allows, I will update the "Caregivers" section to include latest info on caregiver stress, and/or “Prescription medication” section in the main Autism therapies article linked to this page. Let me know if you have any ideas or suggestions! — Preceding unsigned comment added by Rluna2020 (talk • contribs) 16:32, 6 March 2020 (UTC) Rluna2020 (talk) 16:55, 6 March 2020 (UTC)

Peer Review

Great job on the edits so far! Strong work! Here is some of my feedback:

Suggestions for lead paragraph:

• "Risk factors include having an older parent, a family history of autism, and certain genetic conditions" Is there a specific age of the parent above where risk increases? (ie parents older than 50 years old)?
• "The DSM-5 redefined the autism spectrum disorders to encompass the previous diagnoses of autism, Asperger syndrome, pervasive developmental disorder not otherwise specified (PDD-NOS), and childhood disintegrative disorder." Might be good to give a time frame for when this shift happened (ie in 2010, autism spectrum disorders were re-classified to encompass...)
• "The term "spectrum" can refer to the range..." I think this sentence can be fixed as it's quite long and "look after themselves" is a little vague. How about this: The term "spectrum" can refer to the range of symptoms and their severity, which is why some experts favor distinguishing people with Autism based on how it affects their daily lives.

Suggestions for Signs and Symptoms paragraph:

• I think the initial parts about Savant syndrome and Self Injurious Behavior would fit better in the "Comorbidity" section.
• I would suggest after the first 2 sentences in this paragraph, you can jump to Developmental Course because the paragraph about Asperger and PDD-NOS seems to be covered in the last paragraph of Classification
• Great examples of the social skills. I would probably change the formatting from "Lack of mutual sharing of interests: many children with autism prefer not to play or interact with others" to two sentences: Lack of mutual sharing of interests. For example, many children with....
• "People with autism spectrum usually display odd nonverbal behaviors." Maybe instead of 'odd' use 'different' or 'atypical'? I suppose you should use language as close to DSM as possible but avoid jargon or words that could be read as adding value/judgment.

Going back to your workplan: I didn't see a lot of distinction in symptoms between girls/boys so maybe you're still working on that!

Overall: Great job using shorter sentences. I like how overall the sections you edited are meant for a medical professional but it's still easy to read and understand. Keep it up! — Preceding unsigned comment added by Dsalvarez (talk • contribs) 01:57, 23 March 2020 (UTC)

WikiMed Response to Peer Review- Spring 2020

Hello, Wikipedia! I will be responding to my peer review by User:Dsalvarez. Thank you so much for your excellent review of my article! I appreciate all your suggestions to improve the lead paragraph. Although it was not part of my original plan for this course, I took into account your observations as a reader and edited some portions of the lead paragraph regarding the updated diagnostic term “Autism Spectrum.” I reviewed the new DSM and specified the timepoint in which the name of the diagnostic term occurred. I also appreciate you pointing out that some parts of lead sentences like “look after themselves" were vague as this helped me realize that they were lacking reliable citations. I responded to your feedback by improving the final sentences of the lead paragraph and by adding reliable references.

In terms of the signs and symptoms section, I disagree that self-injurious behaviors (SIB) and savant syndrome should be included the comorbidity section. Although it can be common in people with ASD and other neurodevelopmental disorders, Savant syndrome is not recognized as a psychiatric disorder within the DSM-5. SIB is a common behavioral manifestation seen in ASD and other disorders, but it is also not a diagnosis in and of itself. Unfortunately, I did not have enough time during the course to elaborate the developmental course section and to describe differences in symptoms between boys and girls, but I hope to be able to make these edits in the future as I complete my school's Deep Explore project. Finally, thank you for your suggestion to change the word “odd” to “atypical” in the social skills section. I had debated changing this word for a long time, so I really appreciate your final input! Once again, thank you for your excellent review of my work.Rluna2020 (talk) 00:51, 27 March 2020 (UTC)

WikiProject Medicine UCF College of Medicine Spring 2020 - Workplan

Dear WikiMedicine community, I am a third year medical student at UCF College of Medicine involved with WikiProject Medicine Spring 2020. Following is my workplan for improving the Autism spectrum page:

Overall: simplify some jargon e.g. change hyper- or hyposensitivity to increased or decreased sensitivity; add illustrations as needed

Introduction: add a figure to illustrate developmental disorders under the umbrella of autism spectrum disorder; add that Rett is almost exclusively in girls

Classification: add links to childhood disintegrative disorder, and PDD-NOS; add a figure to clarify the relationship between and overlap of features of Autism disorder, Asperger, and PDD-NOS.

Signs and symptoms: briefly elaborate on reason for self-injurious behavior in autistic children; move last line in third paragraph to Introduction or Classification section. Add a sentence on childhood disintegrative disorder.

Developmental course: add that childhood disintegrative disorder is characterized by regression

Pathophysiology: create a separate page for pathophysiology with the latest hypothesis for risk factors and pathogenesis of autism based on systematic reviews; explain 'confounding by indication' for the lay person

Causes: add a line about genetic and environmental interaction

Diagnosis: add a paragraph on screening recommendations and tools; add a paragraph on misdiagnosis; add most sensitive diagnostic test per Cochrane review

Treatment: Expand on 'main goals of treatment'; add subsection on prognosis

History: Mention Leo Kanner as first person to classify autism as a neurodevelopmental disorder present at birth and to reject the 'refrigerator mother' theory; ASD established as unique diagnosis from schizophrenia in 1980

Autism in Popular Culture: consider adding this subsection under Society and Culture; status TBD Anwer2007 (talk) 16:36, 16 April 2020 (UTC)

WikiProject Medicine UCF COM 2020 Peer Review

This project demonstrates great work so far. I am especially impressed with the new images that are very clear and properly placed in this article. They provide a great touch to help visual learners understand the pathophysiology and diagnostic considerations of ASD. Great job! For the rest of the review, I will break down each section you have listed and provide comments.

Overall: As mentioned above, the new images and illustrations are stellar! Great job with those. As far as the rewording of jargon, I feel that many of the sections that you worked on were pretty science-intense subjects, which made it difficult to eliminate jargon. It may be worth it to take one pass through each section and see if there is any ability to eliminate medical and scientific jargon when possible. That being said, many sections need it to properly explain the processes.

Introduction: Figure looks great. I did not see the addition of Rett syndrome being almost exclusively seen in girls though.

Classification: Great job adding these hyperlinks. The ability to move to different wikipedia pages this way is very helpful to allow users to pinpoint specific knowledge that they are looking for.

Signs and symptoms: I think this paragraph was a good addition. Self injurious behavior is one of the more concerning things about patients with ASD, especially for parents of patients that might be viewing this article. I think adding this section was a good idea. It is well written as well and provides good information. My one suggestion would be to possible add one sentence before the theories explanation about what self injurious behavior represents. I know that it may seem self explanatory, but it may be helpful to mention what this means for completions sake.

Developmental course: I didn't find the addition about disintegrative disorder. I think it could still be helpful to add though.

Pathophysiology: It looks that you have spent the most time on this section, and it shows. You have some great sources on the pathophysiology of ASD and I think that the information added appropriately expresses the current scientific consensus on ASD at this time. The information goes well in this location and helps elevate the article to better explain the science behind ASD. The additions in the this section however probably have the most jargon, based on their basis in scientific and neurology research. I loved the portion you edited under the genetics section. I think it is very clear and well written. The sections titled brain connectivity, neuropathology, and gut-immune-brain axis all may be difficult to understand. I say this with the understanding that many of the terms are difficult to substitute with less jargon-like terms, but I would try and pass through it and see if there are any ways to do so. This could make the article more readable and continue to elevate it.

Causes: I think that this section explains how genetics play a role in ASD very well. The link between nature vs nuture that you mentioned in your workplan could be teased out more. I think adding a sentence or two about the interactions between genetic and environmental factors would be a good addition.

Diagnosis: Great addition. I feel like this topic is one that will be so helpful for people that are coming onto wikipedia to look up ASD. I think this section is well written and clearly is exhaustive in the diagnosis and screening criteria for ASD. Adding the misdiagnosis section is great as well. Well done!

Treatment: Your edition here fit well. I believe that this section is well worded and does not need any additional edits, especially since there is another wikipedia article specifically dedicated to autism therapy

History: This was a good addition and written well.

Autism in Popular Culture: I noticed that you did not add this section. I think it could still be interesting if you have the time and would like to add it, though not necessarily needed.

You have done a great job with this article. It was a big undertaking as an extensive subject with a large amount of research that can be added and I feel that you have elevated the article with your edits. Thank you for your hardwork!

Zachthompson45 (talk) 16:37, 6 May 2020 (UTC)

"The Autism Spectrum" or "Autism Spectrum"?

The lead sentence currently says "Autism Spectrum, also known as Autism Spectrum Disorder...". It reads weirdly - you'd expect to see "The Autism Spectrum" instead. What is the right way to phrase this sentence? Mount2010 (talk) 19:39, 13 March 2020 (UTC)

You're right. Fixed it. Paradoctor (talk) 20:04, 13 March 2020 (UTC)

@Doc James: special:diff/945460641? Paradoctor (talk) 04:55, 14 March 2020 (UTC)

First we do not write each word with a capital letter. And second yes "Autism spectrum" is fine. One does not need a "The" Doc James (talk · contribs · email) 05:18, 14 March 2020 (UTC)

Mount2010 has a point. Cf. electromagnetic spectrum. Or would you remove the definite article there, too? English grammar seems to demand it. Paradoctor (talk) 06:06, 14 March 2020 (UTC)

P.S.: @Doc James: Please note that the reverted edit did not use caps. Paradoctor (talk) 07:17, 14 March 2020 (UTC)

Is there any rationale for using "Autism spectrum" over "The Autism spectrum"? I'd like to see your reasoning, preferably backed by something reliable. For pages like Asperger Syndrome, I can see the reasoning for the lack of a definite article, but in this situation, the lack of a definite article sounds weird. Mount2010 (talk) 10:48, 8 May 2020 (UTC)

Autism and the medication Suramin

Has the argument been made about the pros and cons of including information regarding the efficacy (or inefficacy) of treatment with Suramin. Small scale study showed 10 males living with ASD underwent intravenous infusion of suramin (20 mg/kg) (vs. saline) and their ADOS-2 comparison scores improved by -1.6 ± 0.55 points. Also note, no serious adverse events. https://www.ncbi.nlm.nih.gov/pubmed/28695149 Evangelos Giakoumatos (talk) 18:39, 6 May 2020 (UTC)

I'd like to start off by saying I'm not a doctor, nor am I a scientist or even trained in the scientific method; I'm simply an autistic person. I don't think that study should be mentioned at all. It's far too small of a sample size to be worthwhile, especially since the test subjects were all AMAB children. In addition, ADOS diagnosis seems questionable at best, and a ploy to make money at worst. In addition, the "results" section feels almost as if it were written by an ABA practitioner, "Secondary outcomes also showed improvements in language, social interaction, and decreased restricted or repetitive behaviors". Further reading on the scale of the study reveals huge issues: "Ten male subjects with ASD, ages 5-14 years, were matched by age, IQ, and autism severity into five pairs[...]". This means that there were five groups, each with a sample size of two: with one receiving a placebo. Again, I am untrained, but this seems more than a little flawed. 3nk1namshub (talk) 05:11, 29 June 2020 (UTC)

ABA mentions should be removed

Applied behavioral analysis (ABA) is abhorrent, and many Autism rights organizations reject it as pseudo-scientific torture. ABA is used to remove the external "signs" of Autism, such as stimming, lack of eye contact, and lack of verbal language. ABA only "works" if your outcome only cares about whether someone acts "normal", regardless of their wellbeing (and even then, it almost never works).

I think any "therapy" that has many of its former patients calling it torture should be looked at very, very closely. In fact, I would consider any "training" that uses physical and verbal abuse to force a person to stop doing harmless things they like as torture, although I am not an expert on torture. Do we abuse drug addicts for using drugs? Do we scream at depressed people for not getting out of bed? Of course not. I see no reason for the glorification of a "therapy" that does that to Autistic children, whose behaviors are not harmful, nor an illness.

https://www.spectrumnews.org/features/deep-dive/controversy-autisms-common-therapy/ https://autisticadvocacy.org/tag/aba/ https://autisticuk.org/does-aba-harm-autistic-people/

At the very least, I feel that the mentions of ABA are biased. They are given lots of attention, while criticism is given almost none. As criticism of ABA is widespread, especially from people who have undergone ABA, it should not be presented as anything other than a highly controversial topic. For instance, the term TERF is considered by a small minority to be considered a slur, yet the Wiki article for it gives prominent space for discussion of whether or not it is a slur. Meanwhile, ABA is incredibly controversial, and criticism of it is nowhere near the opposition on the TERF page. 3nk1namshub (talk) 06:04, 29 June 2020 (UTC)

UNDUE term in infobox

Why is the infobox giving WP:UNDUE weight to a 2009 opinion by Baron-Cohen? "Autism spectrum condition" has been mentioned in 8 reviews in the last five years;[4] conversely, "autism spectrum disorder" has been mentioned in 1,963 reviews in the last five years.[5] It would be fine to mention this alternate term in Societal and cultural aspects of autism, but this article has it prominently placed in the infobox. SandyGeorgia (Talk) 14:28, 25 July 2020 (UTC)

Now someone added "Autistic Spectral Disorders" to the infobox, a term which only has 11 hits on google scholar since 2016. I'd be for removing both of these terms because of their undue weight.--Megaman en m (talk) 09:24, 3 August 2020 (UTC)

I see 'autism spectrum condition' on the NHS 'What is autism?' page, which I think is pretty mainstream, maybe 'autistic spectrum condition' is going overboard though. Adlihtam (talk) 19:27, 8 August 2020 (UTC)

Special education classes

I don’t understand this revert. How is it bad to be not specific to one country? Isn’t the whole point of articles is to globalize the point of view? I certainly think low functioning autistic can benefit from a separate classroom. A higher functioning autistic can benefit from resource room. Zoe1013 (talk) 20:09, 16 August 2020 (UTC)

It is bad to not globalize, and the edit didn't reflect globalization (not every country has the advantages of higher income countries, with separate classrooms). Also, we need to reflect WP:MEDRS sources, not add opinions. Which MEDRS source are you citing? SandyGeorgia (Talk) 20:49, 16 August 2020 (UTC)

Disabled kids in poor, rural areas of developing countries are excluded from school. Intensive, sustained special education programs doesn’t exist for these kids. Perhaps the article should not mention special education programs either. Higher income countries can afford special education programs while poor, rural areas of developing countries cannot. Zoe1013 (talk) 06:37, 17 August 2020 (UTC)

Agreed, but this is material for a sub-article (which might already exist in some form on Wikipedia). I suggest poking around the 'pedia to see if there is an existing article related to autism and education programs, which should be written from a global perspective (not just US/UK, for example). And then, you should find high-quality, non-advocacy sources for adding text. You can't just add text to the wrong article without sourcing it :) I will poke around to see if I can determine if an article exists already and get back to you; since I am busy, it would help for you to do same. SandyGeorgia (Talk) 13:15, 17 August 2020 (UTC)

I'm back. There are, unfortunately, a jumble of different templates in the autism area, but best I can tell, there is no sub-article for educational issues. I can only find Treatment and Education of Autistic and Related Communication Handicapped Children. We would expect to find a link to a main article on education at Autism#Education if it existed. You can see that the text there, which uses only high-quality MEDRS-compliant sources, is considerably outdated as no one has kept autism up to date since it became a featured article. WhatamIdoing has several times raised the issue of these kinds of topics in medical content, and might suggest what the article should be named, or where this kind of content should go. If you can find high-quality, MEDRS-compliant sources, adding a sentence or two to autism could also work. I suggest, though, that you become very familiar with what is already stated at Autism#Education, to make sure the text you contemplate is supported by the underlying literature. This search gives you a starting place. SandyGeorgia (Talk) 13:30, 17 August 2020 (UTC)

My impression is that the Self-contained classroom is not an unusual approach for urban kids in middle-income countries. Entirely separate special schools are more common in some countries, especially for kids who have significant disabilities or who benefit from situations that most schools can't provide (e.g., other Deaf kids to sign with). I believe that Resource rooms are ubiquitous in the US, but I don't know how common they are elsewhere, or what they might be called in other countries.

Looking at the article, I don't think that I'd mention a resource room in that sentence, because it's not really an "intensive" therapy (by itself). If someone wanted to find a few good sources (books, probably) and re-write the section, then one way to re-organize it would be to separate medical- vs school- vs home-based management approaches. WhatamIdoing (talk) 15:45, 17 August 2020 (UTC)

The signs and symptoms section is a little confusing

There are parts in that section where it uses language that seems a little unclear.

I think we should try fixing it all up and make it more clear and straightforward. CycoMa (talk) 23:28, 19 February 2021 (UTC)

I’m gob try to make the symptoms section more organized and clear. CycoMa (talk) 22:03, 21 February 2021 (UTC)

I think social and communication skills should be a single section. With making subsections for social and communication. CycoMa (talk) 22:11, 21 February 2021 (UTC)

I’m trying my best to make the section more organizan and easy to read but, this topic in particular is not something I’m a expert in.

So do forgive some actions of mine. CycoMa (talk) 00:06, 23 February 2021 (UTC)

Used to be different disorders

I don’t know if I misread something but the history section doesn’t mention the fact that Autism, Aspergers, and other disorders under the ASD spectrum used to be classified as separate disorders.

I do believe it should be mentioned in the history section. CycoMa (talk) 21:47, 4 March 2021 (UTC)

Multiple Errors In The Page That Need Fixing

Asperger's is no longer a diagnosis! There is now, as I understand it, a 3 level system to classify Autism. I have never heard of the terms "PDD-NOS" nor "childhood disintegrative disorder". Also, this uses the terms "mild" and "severe", which is controversial, as it is believed by some that Autism is a "dif-ability" rather than a disability. Like in the "autism rights movements" section. However it still uses those terms in the introduction. I tried editing the page once, but someone removed my changes saying I shouldn't remove something without saying a reason. But I did! I said "outdated information removed". Is that too short or not specific or what? I undid the edit, but they kept re-doing it. So now I have written this in the talk page. I hope you read and fix this. Read the "Outdated terminology/taxonomy" talk section. I did not write it, but I think it is relevant. 49.195.191.224 (talk) 04:44, 19 April 2021 (UTC)

Symptoms in infobox

For the symptoms in the infobox template, I wanted to add before communication "verbal and nonverbal communication", and change "problems with" to "impairments in." ATC ^{. Talk} 20:47, 28 September 2021 (UTC)

The Neurodiversity movement

I think its current position in Society and culture is good, but I feel like the topic is too "advanced" for the introduction, as most people looking for information in this section just want a basic overview of the autism spectrum. I just need to know if getting rid of its presence in the introduction is a good idea, Thanks -Themitochondriaisthepowerhouseofthecell (talk) 15:49, 19 October 2021 (UTC)

I think that it is important to be kept, as I think it gives a general understanding of how autism is being viewed in society as well as current activist initiatives in modern ASD communities, I also don't think neurodiversity is that "advanced" of a concept as it is relatively popular in autism advocacy and highlights the modern debate regarding how we should view autism in our current society both by autistic movements and advocacy movements. Which is very important to our modern perceptions to how we view autism in general. - AverageWikiEditingEnjoyer (talk) 09:53, 21 October 2021 (UTC)

Merge with Regressive autism

I propose to merge Regressive autism into Autism spectrum. RA is in essence a 'subcategory' of Autism spectrum, and is in fact already touched on in the article: Autism spectrum#Developmental course. Most of the content in the RA article is already at least partly described here, and the rest is about topics that would be appropriate to include. Further, the RA article would require significant replication of this article in order to give a full description of it. The overlap is significant and a reader would be more usefully served to have it all in one place. Both articles are also well within readable prose size, so that isn't a limitation. Note: the regressive Autism article is not about Childhood disintegrative disorder, which is in kids between 3 and 4 years of age. Please ping me if you want me to respond quickly, otherwise I'll probably be back within a few weeks. --Xurizuri (talk) 08:31, 28 October 2021 (UTC)

Under the assumption of consensus that silence implies, I'm going to merge the articles. Silence is the weakest form of consensus so feel free to undo it or say here that you disagree. — Preceding unsigned comment added by Xurizuri (talk • contribs) 02:51, 27 November 2021 (UTC)

merge done (other than clean up) --Xurizuri (talk) 03:38, 27 November 2021 (UTC)

Discussion at WikiProject Autism

Please see the discussion at WikiProject Autism. --Xurizuri (talk) 03:23, 5 February 2022 (UTC)

Request for comment

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section.

Do other autism-related articles (Asperger syndrome, PDD-NOS, autism, possibly others) need to be merged into this one? I dream of horses (Contribs) (Talk) 18:57, 26 February 2022 (UTC)

Oppose merge: Thank you for the RfC. Per all of my replies to the depressing request and discussion above, no they shouldn't and it would be disruptive editing against WP:MEDRS if anyone would. I also recommend reading this comment by SandyGeorgia: [6] Wretchskull (talk) 18:58, 26 February 2022 (UTC)

SandyGeorgia's very neutrally-worded comment (along with subsequent ones on the talk page) basically just say that they're disappointed that the autism articles have reduced in quality over time, despite their significant contributions to it, and that they are choosing not to indicate a preference in this issue. Could you elaborate on how that demonstrates that this merge shouldn't happen or that this is disruptive? (note for other editors, avoid pinging SandyGeorgia per the comment, which indicates that they don't want to be dragged into this). --Xurizuri (talk) 03:50, 27 February 2022 (UTC)

I also oppose a merge, and agree wholeheartedly with Wretchskull on this topic as I don't think the burden of proof has been to combine those articles together at the present time. --Historyday01 (talk) 18:59, 26 February 2022 (UTC) I support fixing up the autism-related articles, but only merging autism with this article, but not the others, as Averixus stated.Historyday01 (talk) 04:06, 6 March 2022 (UTC)

• Note: https://pubmed.ncbi.nlm.nih.gov/30043350/ may be of interest. — Berrely • ^Talk∕_Contribs 19:09, 26 February 2022 (UTC)

I support merging autism, but not Asperger syndrome or PDD-NOS. Autism is now used as a general umbrella term to refer to the autistic spectrum (as show by the many sources Oolong gave above, and also some of the sources Wretchskull provided). Asperger syndrome and PDD-NOS are historic diagnoses so should still have their own articles describing them as such. Similarly, the historic diagnosis of classic autism or low-functioning autism will still have its own article.

The articles that need merging are autism and autism spectrum, because the two terms are used synonymously and much of the content of the two pages overlaps. Maintaining them as separate gives a confusing and inaccurate impression that they are distinct diagnostic categories or are treated separately by scientists, which is not the case (again, as shown by the many sources above). Averixus (talk) 19:10, 26 February 2022 (UTC)

Per my contribution above, there are issues across multiple articles in this topic area. I'm not convinced yet on which articles should be merged, but I am convinced that a wider cleanup is needed across multiple autism related article pages. Sideswipe9th (talk) 19:17, 26 February 2022 (UTC)

I completely agree with this, a larger cleanup is needed. Averixus (talk) 19:21, 26 February 2022 (UTC)

Well said. I think the one other article we need to bring into the mix is the one currently titled low-functioning autism; parts of autism should probably be merged into this, rather than autism spectrum, and it should probably have the title changed (I'd suggest classic autism or Kanner autism). If the other pages were to be merged anywhere, it would make more sense for it to be into History of autism rather than the main autism spectrum page. Either way, as you say, there's a heck of a lot of cleaning up to do, even if a lot of it is just putting things into the past tense. I proposed merging those two articles as an obvious first step towards bringing Wikipedia's autism content up to date, and the furious response I received makes me less optimistic that the wider project is feasible. Still, who knows? --Oolong (talk) 14:02, 27 February 2022 (UTC)

I'm gonna just let my stream of consciousness write this comment. The status of Asperger's is a very polarizing one; while it has definitely been removed as a diagnosis, some-- no, many-- academics still cite it as a separate type of autism. We can go with either merging it to a subsection here saying how Asperger's blablabla but the validity of it remains debated... or keep the whole article but heavily highlight the recent changes and controversy, perhaps dedicate an entire lead paragraph to this. There's a whole cloud of thoughts within my head but I think I'm making my point here. My point is, there's no advantages or disadvantages regardless of what we decide, and considering it will be a waste of time and decade in editing effort, and that it is much easier to just improve the Asperger article, I think I shall oppose merge, with disclaimer that I'm barely a med rookie. PDDNOS, I believe, has no same amount of controversy as Asp., so I don't think it needs to be merged too. I do agree with Sideswipe, autism is a pretty useless article and relevant info can be merged to the spectrum. GeraldWL 19:22, 26 February 2022 (UTC)

Even if it weren't used by scholars, Asperger's is still an important part of some adults' identity and self-conception. We should probably keep a separate article on it, and just be clear that it was removed from the DSM. WhatamIdoing (talk) 02:54, 2 March 2022 (UTC)

I strongly support merging the articles, noting that certain articles should remain in a reduced form. In particular, classic autism (which I'm using to refer to autism as it was recognised pre-ASD) and Asperger do still deserve a separate article, but mostly in a historical and social context and to demonstrate evidence that they may or may not be a distinct disorder/identity. They should not be treated as a disorder/identity in their own right, because they aren't officially recognised as such. --Xurizuri (talk) 03:37, 27 February 2022 (UTC)

subpoint on further reflection - I'm unsure what direction to start from. We could start with the biggest, central articles first, which will give us a strong base to start ordering the small articles from, and which immediately fixes the most glaring naming issue. Or we could address the spin-offs from the spin-offs first, which will give us a better idea of what content we have overall and how to structure the articles in relation to each other, and means that we more quickly address the pseudoscience and fringe views that pervade some of the autism-related articles (e.g. Epidemiology of autism#Causing factors, which I really should get around to fixing). --Xurizuri (talk) 04:00, 27 February 2022 (UTC)

@Xurizuri: I wonder if the easiest way to start might be to make an outline/plan of the entire collection of autism-related articles, each with very brief summaries about the content they should contain. There's so much overlap and confusion in this whole group of pages that it's hard to start with any one task without considering all the other changes that ideally need to be made. Averixus (talk) 09:06, 27 February 2022 (UTC)

For practical purposes, whatever is decided, a series of "sandbox" articles might help. WhatamIdoing (talk) 02:55, 2 March 2022 (UTC)

Since the formal RfC has been removed (because they shouldn't be used to discuss merge proposals), I suggest we move this discussion back to the merge proposal to keep things organised. Averixus (talk) 09:17, 27 February 2022 (UTC)

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

Merge Discussion and Complications

I am creating this section to discuss potential issues, complications, and what should be done for the merging process. To start, The regressive autism section has a parent link in the Autism page. PerryPerryD 22:23, 11 March 2022 (UTC)

It seems to me that editors' dilemmas in trying to organize this topic is stymied by the fact that the whole autism/ASD thing assumes there is some kind of solid diagnostic foundation, when there isn't now and never really has been. I think maybe a way through all this is, after a very brief and cellphone-friendly lead rather than a huge run of assertions, to structure the main text of the page initially historically/chronologically. The most distinctive thing is how the professional categories have kept changing since Bleuler coined the word and Kanner described it ostensively, and the increasing tension between those foundations and how the word is used outside professional contexts. The difficulty in reference shopping in this area is that there are solid references supporting an array of contradictory definitions, both professional and public. Sledgehamming (talk) 10:00, 14 March 2022 (UTC)

Age of diagnosis section

A part of me is thinking about adding an age of diagnosis section. Because age is viewed as a big part for diagnosing people with ASD.CycoMa (talk) 19:15, 25 March 2021 (UTC)

I agree that age of diagnosis would be an appropriate section. Cliff (a/k/a "Uploadvirus") (talk) 19:46, 14 March 2022 (UTC)

Proposals for (fairly extensive) edits

As per Averixus's suggestion here, I thought it would be useful to start a list of things that need changing on the Autism spectrum page. I've had simple changes reverted that I believe should have been uncontroversial, so I thought it would be safest to share all proposed changes here for feedback, before proceeding. There is a lot wrong with the article as it stands, as a number of people have flagged up, so this is going to take a while; I've got as far as the start of the Diagnosis section in my sandbox, but I don't want to totally overwhelm this talk page so for now, I've stopped here at the end of the introductory section, when we finally get to the Table of Contents. The fact this is eight paragraphs down is indicative of some of the problems with the page. I've put each paragraph under its own header to facilitate discussion.

So far I'm only looking at what's wrong with what is on this page; I haven't made a start on enumerating what's missing. --Oolong (talk) 12:29, 1 March 2022 (UTC)

Good suggestions so far! Some thoughts...

For the "not to be confused with". This might just be something we have to accept and ignore for now, until the actual merge is finalised - because until then we are in a weird confusing situation with the two pages. I assume that actually removing the hatnote will be opposed while the other page still exists. But in the meantime I'll try changing the wording to something more neutral, like "see also".

I agree that overall the lead is too long. The excessive details about causes, diagnosis, and prevalence don't belong in the introduction. Your other ideas about phrasing and organising this section are also good. I imagine that finding sources to cite any changes will be the main obstacle to getting changes accepted. I'll try to find some good up-to-date sources soon that we can start using to make changes - but if you already have some good sources then I say just be bold and start some edits. Averixus (talk) 15:55, 1 March 2022 (UTC)

Thanks Averixus! I have to say, 'See also autism' still doesn't make sense - if that page is about a subset of what this page is about (or about an obsolete historical category) it's mentioned later on in the article anyway. I can't see a plausible rationale for keeping the hatnote at all, but maybe I'm missing something?

What I'll probably do is re-draft the lead and post it here (or in my sandbox?) for discussion, unless someone else gets to it first. Oolong (talk) 08:19, 4 March 2022 (UTC)

Oh I definitely agree, it doesn't make sense to have a hatnote there at all. But while the merge is still under discussion and not finalised, it seems strange not to acknowledge the existence of a second very similar and overlapping article. And I suspect that editors opposed to the merge will revert actual removal of the hatnote at this point. But maybe we should just try getting rid of it anyway and see if anyone objects? I guess the merge notice at the top of the page effectively functions as a hatnote for now, by letting people know the similar page exists and is under question.

Maybe the draft could go in a subpage of WP:Autism (I'm not entirely sure how to make subpages but I know they exist...). Averixus (talk) 09:40, 4 March 2022 (UTC)

Notes on existing lead

"Autistic" redirects here. Not to be confused with Autism.

It doesn't make sense to suggest that people might confuse this with autism. Either 'autism' refers to the exact same thing, or (historically, and very rarely in contemporary use) it refers to a sub-category of ASD.

The autism spectrum is an umbrella term...

This first paragraph should start by explaining what the term means in broad strokes, before introducing the other names it is known by (including 'autism') and explaining what is meant by a 'spectrum' (the existing explanation is unclear, and reads like it may have made a bit more sense before some earlier text was rewritten). As an opening paragraph, this is considerably longer than it should be. There should be a brief account of the previously separate diagnoses that were collapsed into this in DSM-5 and ICD-11, and how the new manuals divide the ASD category, but I think this warrants its own paragraph.

Symptoms can be detected before the age of two...

There was a requirement of 'onset prior to age 3 years' for a diagnosis of 'autistic disorder' in DSM-IV, but not for Autism Spectrum Disorders more broadly, and the requirement seems to be entirely absent from DSM-5. The uncited claim that 'experienced practitioners can give a reliable diagnosis' is obviously wrong in many cases.

The causes of autism spectrum conditions remain uncertain...

They really, really do, and I don't think it's helpful to have a substantial paragraph on this before we get to the Contents table. This should be fully dealt with in the separate section below; a single sentence in the introductory sentence would be sufficient.

Diagnosis is based on observation of behavior and development...

Is this the right place for this? It's quite detailed when it comes to childhood diagnoses, and I'm fairly sure many of those details will vary from country to country, which is not made clear here.

Autistic spectrum disorder is considered a lifelong condition...

This paragraph relatively solid, although again I'm not sure this level of detail belongs in the opening section. If we're talking about cures, it's probably worth mentioning that as far as the best evidence we have goes, most autistic people don't want one; or, given that this question hasn't been researched as much as it should be, at least that many autistic people have said they wouldn't want to be cured. I don't think the sentence on research that has 'pointed to the reversibility of phenotypes' belongs here; this is a very strong claim, and would require strong evidence.

The reported prevalence of ASD worldwide is variable...

This should be dealt with in a section on prevalence, and expand considerably on the fact that 'Apparent increases in the prevalence of ASD have been attributed to changes in reporting practices': there is an important and dangerous misconception that actual prevalence has skyrocketed, and it deserves to be addressed seriously.

Advocacy groups have emerged, some as part of the autism rights movement...

A bit odd to mention the autism rights movement (autistic rights movement) but not the huge charities set up by parents, given that the rest of the paragraph is talking at least as much about the big charities. A casual reader might get the very wrong idea that parts of the autistic rights movement promote drug treatment, biogenetic research, behavioural therapy, and 'beliefs about envirotoxins', when these are all things that have been largely opposed (or at least selectively resisted) by autistic-led organisations. I'm amused by how obviously this sentence was written by someone with an axe to grind: "Critics, including those on the spectrum, have bemoaned the entrenchment of some groups' opinions". Also, that Washington Post article is really misleading. Someone ought to take a careful look at the other links too, at some point.

Proposed replacement lead

I propose the following as a new lead section, replacing everything before the table of contents. There might be stuff in the paragraphs this would mean removing that should be relocated elsewhere, and we might want some references out of it, but I don't think any of that needs to come before the ToC: as per Wikipedia:Manual of Style/Lead section, this bit should be concise. Does anyone disagree?

If anything else ought to go in here, I would suggest it should be something about autistic community and the neurodiversity movement: something to give people a sense for the fact that autism is not just a medical label. --Oolong (talk) 14:54, 10 March 2022 (UTC)

This is a great start, already a big improvement on the current lead. I have a few ideas for changes but not sure what the protocol is - should I edit this draft directly, or add a new section for my proposed version? Averixus (talk) 17:18, 10 March 2022 (UTC)

I agree that it's an improvement but I have one concern. Per WP:LEADFOLLOWSBODY is this not going about the content backwards? That is writing a lead and changing the body later to match it. Surely we should be fixing the body first, and then once it's clear what content is there we can more accurately rewrite the lead to match the new body text. Sideswipe9th (talk) 20:09, 10 March 2022 (UTC)

Thank you both! Averixus feel free to make edits directly, but if they're substantial or you think they might be controversial, it might be best to paste them separately? Also, see below...

Sideswipe9th thanks for bringing my attention to that - I've read some of the guidelines on lead sections, but I'd missed that particular bit of advice. My thinking was that the lead as it stands is kind of a disaster, and the most important part of the article, but I can see the reasoning for fixing that up last. This will take some thought.

There's perhaps a bit of a tension here between 'summarize the most important points, including any prominent controversies' and 'a lead section should contain no more than four well-composed paragraphs' and 'making the lead section accessible to as broad an audience as possible'! Depending on what we consider 'the most important points', it is likely to require intensive condensing to pull this off, given what a huge topic this is; I've only tried to summarise the absolutely central points so far, which is how I kept it down to three paragraphs. As with most of the rest of the article, the current lead tries to cover way too much, in too much depth, while missing out a huge amount of important stuff. Either way, I guess we'll probably need a fourth paragraph if we hope to summarise the article even in the broadest possible strokes.

As previously mentioned, I've made a start on assessing/critiquing the rest of the article in my sandbox, but alongside this I'm wondering if we should be pulling together a rough sketch of what it should include. I think there are some major omissions, as well as substantial structural problems. A lot of the detail should, I think, not be covered here, but only in separate articles prominently linked from here, several of which already exist; the alternative is an unmaintainable behemoth that very few people will read anyway, where key aspects of the experience of autism are either crowded out by technical detail or left out entirely. --Oolong (talk) 14:03, 11 March 2022 (UTC)

@Sideswipe9th and @Averixus, I went ahead and pasted in my replacement lead. I'm reasonably confident it's a substantial improvement; the previous one was bad: nowhere near meeting Wikipedia guidelines for what a lead should look like, 2-3 times too long and badly outdated. I don't know if this was rash, but we're months away from making the rest of the entry adequate, so I don't think it made sense to leave the previous mess in place until everything else was fixed.

I reverted a couple of attempts yesterday (by someone with no account) to do a search-and-replace to remove all mention of 'disorder'; their approach was obviously wrong, but they did kind of have a point. The previous lead was offensive both in terms of some of the language used, and the poor quality of its construction. I think the new version gives us a decent starting point.

Any thoughts? Oolong (talk) 13:22, 14 April 2022 (UTC)

In case we need to refer back to what was removed for this, here's a permanent link to the previous version: https://en.wikipedia.org/w/index.php?title=Autism_spectrum&oldid=1082680730 Oolong (talk) 13:31, 14 April 2022 (UTC)

I've been too busy to really keep track or contribute for a while, but I agree the new head is definitely an improvement over the old one. And we can keep chipping away making it - and the rest of the article - lots better. Averixus (talk) 12:17, 15 April 2022 (UTC)