Talk:Down syndrome

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Somebody please fix and lock this because of vandalism

Ive noticed some extremely childish vandalism on the "classifications" on the right side, it says "DUHH A CHILDREN WHY DUH DOWN SYNDROM DUHHH *DROOL*." Please, lock this

I've reverted this page to undo vandilism, someone made the whole page read simply "george bush." Who ever did this needs to get a life.--Marvuglia 04:23, 5 December 2006 (UTC)

I've requested temporary semi-protection on this article. --apers0n 07:35, 5 December 2006 (UTC)

Also someone has vandalised the part on genetics

Yay!

I would just like to congradulate Ted and the contributing writers for a truly excellent article, in my very humble opionion. It is everything wikipedia should be. Good luck on getting featured!

One tiny criticism/ questio: why that first picture? I find the idea of ANY child at that age hammering a nail- seemingly alone- somewhat disturbing. In an article on a mental disability, it's even more jarring, especially since it's the first thing the reader sees. Perhaps it could be replaced with a more generic photo of a child playing or reading. Singlewordedpoem 05:50, 11 August 2006 (UTC)

How about this picture on the right? It shows most of the physical characteristics of down syndrome. --WS 20:02, 11 August 2006 (UTC)

The picture you shared seems more like a caricature. I think an actual photograph is preferable. Jeannedb 18:30, 1 December 2006 (UTC)

Some comments. The first is this is a drill, not a hammer. Second, how old do you think the child is? While not using a drill, a common Montessori work for 3-6 year olds is to hammer nails into a stump. The child in the picture seems to be older than that. It helps to develop fine motor skills -- something that many children with Down syndrome need to work on. I've seen a few children with Down syndrome use that activity and eventually master it. I believe the child in the picture is using the drill as an electric screwdriver to assemble a bookcase. Overkill on the drill, but it is certainly age-appropriate. Personally, I prefer real pictures, unless it is to help point out some physical features. The picture is the son of an early contributor, so has a Wiki-connection. Ted^Talk/_{Contributions} 20:29, 11 August 2006 (UTC)

Mia Peterson - Down syndrome advocate testifying before U.S. Senate

I personally couldn't care less about the picture - seems fine to me and I'm a pediatrician with a stake in child safety. However, the issue has been brought up several times so it is worth addressing. I have found an image of Mia Peterson, an individual with DS who is an advocate and success story. It's a little small and I could probably make it look a little nicer if I were home with photoshop. I personally don't care, but it's just another image to offer InvictaHOG 21:18, 11 August 2006 (UTC)

Good point about it coming up more than once. Other eponymous diseases use a picture of the named person (see, for example, Huntington's disease). I've not found a public domain picture yet. I prefer a more personal touch, but I'm not set against any good picture. Ted^Talk/_{Contributions} 23:15, 11 August 2006 (UTC)

You're welcome to use one of the photos of my son from my webpage.Lleshin 14:30, 18 August 2006 (UTC)lleshin

Thanks, but Wikipedia is very cautious about using pictures from websites. I cannot add the picture, since I don't have the right. It is actually very easy to add pictures -- I've done several of various diagrams and such.

1. Go to the page Special:Upload
2. Browse for the file on your computer
3. Give it a Wiki-name (lower case except for first letter and proper names)
4. Give a short description, including the source. Mine say something like "picture taken by me"
5. Licensing. This is the hard one. A separate picture from the website is much better, since it has no copyright attached to it. For those I choose GFDL (self made) or you created this yourself and release it to the public domain. Once the image is uploaded, it can be referenced in any article or talk page. Ted^Talk/_{Contributions} 15:04, 24 August 2006 (UTC)

References for the individuals and fiction sections

I think that the article needs to provide references for the individuals and fiction sections. Currently it is not possible to verify any of the information in those sections. For instance, my memory of Sound and the Fury does not include a discussion of Benjamin Compson's Down syndrome. Yes, he was portrayed as having a lower than average IQ. However, is he truly identifiable as Down syndrome? I did a search through the full text for the common synonyms for DS and for some of the physical characteristics and did not come up with any hits. If there are not sources which can cite passages which support a diagnosis of DS, we should remove them! InvictaHOG 17:31, 28 August 2006 (UTC)

I agree, to a large extent. For real individuals, the only ones we have listed have Wikipedia entries that specifically mention Down syndrome. For characteristics such as Tourette syndrome or CAIS, it is easy to sling around suspected names. I'm comfortable that we haven't done that with Down syndrome (which is more physically obvious).

For works of fiction, I think we should only include those that specifically mention Down syndrome. I spent about an hour looking around the internet concerning Compson. Many people mention Down syndrome, but I am no literary critic. I'd be willing to pare it down considerably -- including only those works that are in Wikipedia and specifically mention Down syndrome, or where we can find verifiable sources outside Wikipedia. If there is no objections, I'll do that in a day or so. Ted^Talk/_{Contributions} 03:28, 30 August 2006 (UTC)

It sounds great. Compson may well have Down syndrome - my google search only revealed one person who didn't seem to support from the primary text and just sorta assumed. The text itself doesn't say, to my memory. I will ask my wife - she's re-reading it now! InvictaHOG 09:05, 30 August 2006 (UTC)

some suggestions for edits

I've edited text where I know the answer, but had following other comments:

• in this sentence, the word "present" is used in the manner of medical jargon, and "concrete thinking" is not defined: "but generally will present with some amount of developmental disability such as a tendency toward concrete thinking or naivete"
• I'm guessing this sentence means that physical features typical of Down syndrome are found in the general population, but not as frequently? "The common physical features of Down syndrome also appear in people with a standard set of chromosomes"
• the word "excessive" implies a pathology? is the flexibility in joints and space between toes pathological, or merely unusual? "excessive flexibility in joints, congenital heart defects, excessive space between large and second toe,"
• In "Trisomy 21", 8%+88% is not 95%. I assume there's rounding error, but what are the original numbers?
• The notation like "47,XX,+21" is not explained

Simian crease - phrase usage

The phrase "simian crease" is used repeatedly in the article, although at one point the article states this phrase is no longer acceptable. Should "single palmar fold" replace "simian crease" in this article? LLP 23:31, 12 September 2006 (UTC)

The statement about the use of the word "simian" is a recent change. This is not true -- a quick Google Scholar search from 2000-2006 shows 239 hits, not all necessarily unique, and not limited to Down syndrome. In addition, simian crease is the entry name in Wikipedia. Ted^Talk/_{Contributions} 14:42, 13 September 2006 (UTC)

EastEnders/The Sun

Because of the current EastEnders storyline about Billy, Honey and their daughter Janet, who has Down syndrome, there have been a few articles in The Sun about it. I wondered if they might be of any use. Here's the links:

• Down's baby in EastEnders
• Living with Down's Syndrome (part 1)
• Living with Down's Syndrome (part 2)
• Living with Down's Syndrome (part 3)
• TV tot's parents speak out

-- AnemoneProjectors (talk) 10:01, 15 September 2006 (UTC)

"Retardation"

Perhaps this is me being oversensitive but i dont think that the sentence "There is also a small number of individuals with Down syndrome with severe to profound mental retardation." I think perhaps a less offensive word should be used so that people who have the condition dont think they're deranged or something. Discuss Ahadland 16:36, 17 September 2006 (UTC)

This issue has been extensively discussed on the mental retardation talk page. The term is latin for "delay" and has no intrinsic pejorative meaning. It has acquired pejorative connotations because insensitive and ignorant people have treated it as a pejorative. At some point the term will have become so misused as to need replacement, until the morons, cretins, and idiots (note that all threee of those terms began life as neutral medical terms as well) ruin the new term. A specific challenge for wikipedia is that the turning point does not occur simultaneously throughout the english-speaking world and apparently the term "mental retardation" has been more thoroughly abandoned in the UK than it has in the US. My own opinion is that as long as the term is widely used in both ways, sensitive intelligent people have no trouble using it in non-pejorative ways and being understood as using it that way. Why should we cater to the bigoted and ignorant? alteripse 17:11, 17 September 2006 (UTC)

Point taken, I just thought some patients with downs may have taken offence

That's like saying gay people would take offense at the mention that their sexual activity can't result in reproduction. I am wholeheartedly against editing Wikipedia to make it more politically correct than accurate. And to be frank, people with Down syndrome are "deranged" in the biological sense. I wouldn't use the term "deranged" in the article because it's unscientific, but saying anything as PC as "mentally different" (or equivalent) glosses over the fact that there's (at least sometimes) deficient neural functionality. --Davidstrauss 07:24, 21 September 2006 (UTC)

As a mother of a child with Down syndrome/Trisomy 21, the word "retardation" is not offensive when used in proper context. Very few of us parents object to its proper use. The politically correct terminology may serve in more social and editorial venues, but in a technical article, the word "retardation" seems preferable. Jeannedb 18:23, 1 December 2006 (UTC)

I think some of this might stem from the immature taunt "retard". I think that when it is explained to children that calling someone "a retard" is offensive and wrong, they often grow up assuming incorrectly that any use of the terms "retardation" or "retarded" is offensive. --thirty-seven 21:26, 5 December 2006 (UTC)

When it comes to science, there are no offensive words. It is the scietnific word.

external link 26

This is only a small thing, but the external link 26 'a guide to parenting' (the first link of the two) comes up as 'file not found' would there be any objections if I deleted the link? I ask this because there may be a way to restore the link or perhaps if anybody knew of an alternative guide, --Mikeoman 19:43, 23 October 2006 (UTC)

Newbie here, be gentle

Hi. I am a new member, was browsing this because my child has DS. Nice job, everyone, you managed to do what many sites have not, leaving a fairly positive outlook for our kids. I made some very general edits, as follows:

Characteristics “white spots on the iris” These are known as Brushfield’s Spots. I have not yet figured out how to add the link, and recognize I cant post another webpages words directly. Here is the explanation of Brushfields spots from http://www.medterms.com/script/main/art.asp?articlekey=6570

Speckled iris. Little white spots that slightly elevated on the surface of the iris arranged in a ring concentric with the pupil. These spots occur in normal children but are far more frequent in Down's syndrome (trisomy 21). They were described in 1924 by Thomas Brushfield and are due to aggregation of a normal iris element (connective tissue). Mome23kjnc 18:59, 3 November 2006 (UTC)

Robertsonian translocation

“It is the cause of 2-3% of the observed Down syndromes”

should use people first language, “2-3% of observed cases of Down syndrome”

Prenatal screening

“suggesting a Down syndrome fetus”

again, people first language. Most of your article uses PFL, “child with DS”, this should be corrected.

Your video box showing the ultrasound refers to the fetus as an “embryo”. Looks more like a fetus to me ;)

Cognitive Development

“cognitive problems that are found among children with Down syndrome can also be found among children without Down syndrome”

could be made less wordy by saying “among typical children”.

Hope I did ok. I'm sure you will let me know if I didn't. Michelle Mome23kjnc 17:44, 3 November 2006 (UTC)

Hi Mome23kjnc, thanks for your very positive contributions to the article. To add a reference to a website, you can do this:

<ref>{{cite web |url=http://www.medterms.com/script/main/art.asp?articlekey=6570 |title=Definition of Brushfield's Spots}}</ref>

Good luck, Gwernol 18:00, 3 November 2006 (UTC)

I've added the photo of Brushfield’s Spots from the uploaded photo on the commons: Image:Brushfield.jpg --apers0n 19:11, 3 November 2006 (UTC)

Info box

Hi, I was reading the article and I realized that I didn't quite understand anything from info box. Although it says 'Classifications and external resources', links have no explanation. For example first line says "ICD-10 Q90.". Also, the Q90 link doesn't explain much. Maybe it would be better to reorganize this box and explain what these really are. Otherwise it looks confusing. Of course it may be just me :)

Vandalism fixed

Thanks to whomever fixed the vandalism on this page. It was vile.

64.241.242.18 00:20, 5 December 2006 (UTC)daltong@mindspring.com

If you are talking about the modified legend for the image, it was quite bad indeed. The article just appeared on the Main page so one would expect it to become heavily vandalised for the next 24 hours... Schutz 00:22, 5 December 2006 (UTC)

Offensive Caption on the First Picture

Hi there,

I was just reading through the article as Wikipedia is my home page and I usually take a moment to read the main article of the day and I noticed that someone had edited the caption of the first picture in the article, that of the little boy with the screwdriver, to say something incredibly offensive- along the lines of 'mental retard using power tools- bad idea'. I just though someone should know so it can be changed. Especially as it looks like the picture was donated by the parent of the child who I do not believe would appreciate the remark.

Thanks, 00:31, 5 December 2006 (UTC)Becca Martinson

Wikipedia is constantly and consistently pwned by vandalism, this page should be protected before anymore harm is done. Especially with a sensitive topic such as this one, I'm surprised it wasn't protected before being featured on the main page.

--70.49.56.83 00:51, 5 December 2006 (UTC)

Wiki has a strange policy of not protecting main page articles: vandalism just has to be reverted. Sandy (Talk) 00:53, 5 December 2006 (UTC)

I second the motion of protecting this page... KeineLust90

Vandalism reappeared... when will this be protected?

Wiki has a policy of not protecting main page articles, and admins hesitate to do it: just keep reverting. Sandy (Talk) 01:12, 5 December 2006 (UTC)

Please seeWikipedia:Don't protect Main Page featured articlesBorisblue 01:13, 5 December 2006 (UTC)

I don't agree with the policy, by the way. Getting hammered more than once a minute is STUPID. Sandy (Talk) 01:14, 5 December 2006 (UTC)

Dude, you really need to protect this page. They switched the picture of a kid with a drill into a penis... come on. OMG -- 172.151.140.66 01:15, 5 December 2006 (UTC)

I am extremely offended. OMG -- 172.132.182.10 01:23, 5 December 2006 (UTC)

This might sound heretical, but I think it should be considered-- vandalism seems to be unusually frequent and often offensive to people with this condition. Unfortunately, many people viewing the page will happen to have opened it up while one of these comments was still up and then unexpectedly run across it. Dar-Ape 01:24, 5 December 2006 (UTC)

We raised the issue on AN/I and got semi-protection, which per policy, will only be temporary. Sandy (Talk) 01:25, 5 December 2006 (UTC)

Alright. I guess the issue is settled for now. Dar-Ape 01:29, 5 December 2006 (UTC)

Not sure how long protection will stay. I asked on An/I. Sandy (Talk) 01:31, 5 December 2006 (UTC)

The mentality of the individual who perpetrated the vandalism compares VERY unfavourably with the people with Downs I have known. Awien 01:45, 5 December 2006 (UTC)

Not always, this one was gold http://en.wikipedia.org/w/index.php?title=Down_syndrome&oldid=92139457

It compares unfavorably with just about anyone's. But Wikipedians have to weigh the benefit of locking these clowns out with the risk of losing a valuable contribution from an unregistered user. There's a long and florid history of debates on this issue, and to paraphrase an oddly relevant Larry King impersonator on Saturday Night Live, both the debates and vandals will continue, no matter how many penises you stick on WP. --zenohockey 02:40, 5 December 2006 (UTC)

Lock 'em out. People can contribute to the page next week. You're not adding to knowledge about what amounts to a birth defect by entertaining troglodytes who want to amuse themselves by mocking the victims. Some pages are permanently locked because of vandalism. There's no reason why this one can't be temporarily locked.

Bob99 23:06, 5 December 2006 (UTC) (DS parent)

First picture

Section moved. Please go here for further discussion of this picture. /skagedal^... 20:23, 6 December 2006 (UTC)

Offensive picture

Can anyone remove the picture of male anatomy from the article? Jamesmack1 01:55, 5 December 2006 (UTC)

It should be gone now. --W.marsh 01:56, 5 December 2006 (UTC)

Thank you! --Jamesmack1 01:59, 5 December 2006 (UTC)

Please set protection.

I believe some time ago, the main page article was protected. Now there isn't any protection.

PLEASE consider to semi-protect the page, or it will be a long day for us. xeryus 02:08, 5 December 2006 (UTC)

A LOT of people are at work on this, and watching the articles. Rest easy, Sandy (Talk) 02:10, 5 December 2006 (UTC)

Respectfully disagree Sandy. :) I'm not targetting this at you, as I came here to muse...

If there are exceptions to every rule, then it's time to protect this article. I can't imagine being a relative of a family member with Down syndrome, perhaps looking to understand the topic better, and finding something like this. Even if it lasts for 30 seconds. A person's impression of Wikipedia, destroyed forever, to support a stubborn philosophy that says that the copy improvements that occur by being featured outweigh an absurd level of vandalism that no doubt drives away many visitors who don't really understand (I have to assume) what goes on behind the scenes to make Wikipedia. It's almost a form of wiki-selfishness when editors promulgate the "anyone can edit" party line over the ostensible mission of creating an encyclopedic user experience. Which is the higher value? Hmmm... </rhetoric> –Outriggr § 04:52, 5 December 2006 (UTC)

No argument from me, Outriggr - I don't support the policy at all (which was only recently made policy, by the way), and was just trying to reassure editors here. We put WAY too much work into every word, reference, and image on these articles at project review, peer review, and FAC to sit by and watch them torn apart during a stint on the main page, and I'm very surprised to see that TedE isn't around to care for the article. When numerous medical editors have scrutinized every word, I'm not reassured by changes made in the name of "anyone can edit". I was just telling people what the policy is, and that admins were now watching the vandalism. I actually worry more about what happens to the integrity of the text. Sandy (Talk) 10:13, 5 December 2006 (UTC)

Oops—I guess I thought your reply to Xeryus said something it didn't. I'm glad you feel the same way. I didn't realize this was a recent policy. –Outriggr § 01:41, 6 December 2006 (UTC)

Picture

Can someone please remove the huge photos of hands someone dumped in this article? Thanks —The preceding unsigned comment was added by Torus (talk • contribs) 02:12, 5 December 2006 (UTC).

Looks like they already did

Great thanks

Uhhh, no it still there. 71.126.231.215 02:20, 5 December 2006 (UTC)

Thanks for the heads up! Generally, articles on the main page tend to be quite dynamic, so if you find an obvious problem like this, your best bet is probably to be bold and revert it or fix it yourself-- messages left on the talk page for this kind of thing may be outdated quickly. But again, this is just in general for extremely bad edits or obvious vandalism; there is of course no problem in posting here. Best, Dar-Ape 02:52, 5 December 2006 (UTC)

Thoroughy disappointed and appalled!

Down syndrome is a featured article; it (or a previous version of it) has been identified as one of the best articles produced by the Wikipedia community. If you can update or improve it, please do.

Is that how Wikipedia wants to be seen? Middle schoolers adding "funny" pictures to articles of a serious nature that ultimately misrepresents an entire population and demeans them? How can this be one of the best when so many people find the image so offensive? I suggest changing the picture immediately in order to save Wikipedia's reputation.

Jessyfish 04:13, 5 December 2006 (UTC)

I forgot to sign.

• What's wrong with the picture? — BRIAN0918 • 2006-12-05 04:31Z

Karyotype Image

While the idea of including a Down's Syndrome karyotype is excellent, I think the "photographic" sort, rather than the "drawn illustration" sort currently in the article, would be preferable, something similar to this:

http://www.miscarriage.com.au/images/pages/t21karyo.jpg

JDS2005 04:39, 5 December 2006 (UTC)

Protection

Seriously, can we make an exception to this policy of leaving featured articles open to unregistered editing? This is really absurd, over the past hour we've had coprophilia, racism, and a completely useless stream-of-consciousness anecdote. If people (including myself) have useful things to say, they should be willing to register to say them if an article is protected. JDS2005 05:25, 5 December 2006 (UTC)

the semi-protect will block newly registered users. I think it the account has to be four days old or so to get past the protection. Anyway, the vandalism seems to have died down. Borisblue 05:30, 5 December 2006 (UTC)

No, it seems they've switched to vandalizing the talk page itself:

http://en.wikipedia.org/w/index.php?title=Talk%3ADown_syndrome&diff=92172422&oldid=92170551

That's a problem, though, about blocking newly registered users...I see why it's necessary, but it could also cause problems...I suppose I should register already.

JDS2005 05:42, 5 December 2006 (UTC)

pictures

Section moved. Please go here for further discussion of this picture. /skagedal^... 20:23, 6 December 2006 (UTC)

Political correctness in medical terminology

Why is it the current fashion to refer to Down's syndrome as "Down syndrome"? The article claims that the former usage is "British English", but there are many Americans who still use it because it is an eponymous word taken from the name of the physician who first described it, as in "Alzheimer's disease", "Parkinson's disease", and so on. I don't quite see the reason to depart from medical terminological tradition here. Are someone's feelings being hurt, or what? Writtenright 06:56, 5 December 2006 (UTC)

I have to agree (although I don't know about the "politically correct" business -- I have never heard it called "Down Syndrome" - who calls it that? The label as "British" is absurd - unless British includes "virtually all English Speaking Americans who use the term". Where did this "Down Syndrome" syndrome come from? This article needs to be renamed.

I have no expertise in the field, but I note a Google search on "Down syndrome" returns approximately 6.7M entries, and a search on "Down's syndrome" returns 7.3M entries. I have only ever heard it called Down's syndrome, but by this crude yardstick the singular term seems fairly common too. Legis 08:48, 5 December 2006 (UTC)

My genetics lecturer at (a British) University told us that diseases named after the individual who discovered them are never referred to as "Person's syndrome", but "Person syndrome", there was one exception I can't recall at the moment, but I'm pretty sure it wasn't Down syndrome. -Obli (Talk)^? 09:42, 5 December 2006 (UTC)

It has to do with a published convention regarding eponymous titles, and neither can I remember what medical body published the guideline, but eponymous diseases are no longer stated in the possessive. It might be mentioned at WP:MEDMOS. On a personal level, I disagree, since the ICD-9 and 10 codes include the possessive eponym, but it's medical convention, not British/US. Sandy (Talk) 10:19, 5 December 2006 (UTC)

It is officially called "Down's Syndrome" - if one were too look at the Down's Syndrome Association you would see that it does not use the singular. I have a brother with down's and I am always appalled when someone is rude - to vandalise this site is just sickening. I have to say, thank you to everyone who has properly contributed to this article. Also, thanks to whoever wrote the first picture's caption for the correct usuage, i.e. not a "Down Syndrome Child" which is completely incorrect (and I might add that Extra's got this completely wrong".

one final thing, why is the first sentance now someones name? can we change this? Earthwormjim2001 16:44, 5 December 2006 (UTC)

There is some confusion here that the name has something to do with British/US english. Can someone with access to the full-text please explain the use of naming conventions with respect to eponyms ? The non-possessive form is the current convention in medical writing:

1. McKusick VA. On the naming of clinical disorders, with particular reference to eponyms. Medicine (Baltimore). 1998 Jan;77(1):1-2. PMID 9465859
2. Jacoby R, Oppenheimer C. Naming of syndromes. Lancet. 1996 Dec 14;348(9042):1662. PMID 8962012
3. Shevell M. Naming of syndromes. Lancet. 1996 Dec 14;348(9042):1662. PMID 8962011
4. Morrison P. Naming of syndromes. Lancet. 1996 Dec 14;348(9042):1662. PMID 8962010

Sandy (Talk) 16:57, 5 December 2006 (UTC)

Take a look at the list of Syndrome articles. Use of the non-possessive also appears to be a Wikipedia convention. Links such as Asperger's Syndrome and Tourette's Syndrome redirect to the singular of the name. -- BlueNight

I've known about Tourette's Syndrome for quite a while, as I was diagnosed with it a long time ago, and I have ALWAYS heard it referred to in the possessive. The disorder is referred to simply as Tourette's for short (yes, the possessive) all the time, by psychiatric professions, patients, and families. I have NEVER heard of it referred to as "Tourette Syndrome". I don't know if this is the exception Obli referred to, but it's certainly the one example I know of which contradicts this idea that the universal convention is to not use the possessive. JDS2005 03:44, 6 December 2006 (UTC)

While I fully concur that most families and professionals knowing and working with people with TS do refer to it most often as the shorthand Tourette's, the rest of your statement isn't entirely correct. Some examples: Tourette Syndrome Association (formed in the 70s), Tourette Syndrome Foundation of Canada, and the two Advances in Neurology series on Tourette Syndrome, vol 85 and vol 99.[1] Also, go to Pubmed and search on tourette - you'll see that almost every new published article refers to Tourette not Tourette's. Also, I was seriously berated by a DS group once for using the phrase "Down's". Sandy (Talk) 15:00, 6 December 2006 (UTC)

Replying to Sandy's request: I've looked at the first article in Medicine (Baltimore). Not sure how much I can reasonably cut and paste, but it's quite helpful on the subject:

The fact that an eponym is mainly a handle, in accord with the Hermogenes principle of naming, is in part the reason for use of the nonpossessive form; the "person behind the eponym" has no proprietary claim on the entity. I strongly recommend use of the nonpossessive form of eponyms and have consistently followed this practice since 1955 when I was indoctrinated in it by Dr. J. Earle Moore who edited my Heritable Disorders of Connective Tissue for serialization in the Journal of Chronic Diseases, November 1955 to May 1956, and subsequent publication as a monograph [1]. In this, Dr. Moore followed the recommendations of Morris Fishbein, long-term editor of the Journal of the American Medical Association, and his AMA Manual of Style. That and other manuals have not persisted in recommending the nonpossessive, and both practice and recommendations vary. The Council of Biology Editors manual [4] has been strongest in its position: "It is recommended that the possessive form be eliminated altogether from eponymic terms so that they can be clearly differentiated from true possessives."

Certainly it would seem unnecessary to use the possessive before a sibilant, as in Marfan syndrome, Chvostek sign, Looser zone, Laennec cirrhosis, Erdheim cystic medical necrosis, Leydig cell....

No one uses the possessive with a compound eponym, such as Lesch-Nyhan syndrome...

Why not eliminate the possessive entirely? On first use, Hodgkin disease, Huntington disease, and Wilson disease may seem to roll awkwardly off the tongue, but both the ear and the tongue, as well as the eye, become rather quickly accustomed to the nonpossessive.

- from McKusick VA. On the naming of clinical disorders, with particular reference to eponyms. Medicine (Baltimore). 1998 Jan;77(1):1-2. PMID 9465859

With the variety of sources mentioned here, the non-possessive sounds well recommended. –Outriggr § 04:25, 6 December 2006 (UTC)

Thanks for doing the work, Outriggr. Sandy (Talk) 15:00, 6 December 2006 (UTC)

I suspect the exception mentioned previously is Lou Gehrig's disease (ALS). In this case, Lou Gehrig had the disease, so the possessive is appropriate. Also, the way Google works, the first entries for "Down's syndrome" are actually "Down syndrome". They automatically consider possessives. Look at the national societies that are "Down's syndrome" and those that are "Down syndrome". The former are nearly entirely UK, India, and maybe a couple others. The latter are US, Canada, Australia, New Zealand, etc. Genetics411 22:22, 6 December 2006 (UTC)

For what it's worth? Most parents of kids with DS prefer People First Language and prefer Down syndrome to "Down's syndrome". Dr Down did not have DS. It is a bone of contention for some of us to hear our children referred to as "Down's kids, Downies, Downsies," etc. Someone asked if we were trying to be too politically correct. Perhaps so, but as other words have evolved to mean things less than polite, so has "Downs kids". My daughter is a child first, DS is but a little spect of who she is. Thanks for really thinking hard about this, it really IS important. Mome23kjnc 22:39, 11 January 2007 (UTC)

Strengths?

Surprised that there is no mention of people with Down syndrome, in general, having friendly and warm personalities. This isn't the best source in the world, but could be a start: mentalhelp.net/poc/view_doc.php?type=doc&id=10332&cn=208

"Just like mental retardation in general, Down syndrome is associated with a broad spectrum of intellectual and adaptive functioning. Each Down case is unique. Some individuals function quite well and demonstrate relatively good social skills, while others face profound challenges in social and intellectual situations. The Down population has a widespread reputation for possessing friendly and loving temperaments. They often express affection openly and are very endearing to other people."

I'd like to see this mentioned not just because it's (evidently) true, but because it's harmful to people with Down syndrome (and indeed any neurological atypicality) to focus excessively on those differences that are maladaptive. Being friendly and warm isn't just "naivete" -- see The Onion for a satire on that sort of thinking. regards, Jim Butler^(talk) 07:10, 5 December 2006 (UTC)

I assume it's not mentioned because, while many people with Down's Syndrome may be "warm and friendly", the characteristic of being "warm and friendly" is a characteristic of humans (and many other animals, for that matter), rather than a characteristic that is in any way specific to Down's Syndrome. Hence, it has no real relevance to an encyclopedia article describing the syndrome. JDS2005 07:15, 5 December 2006 (UTC)

So the source I just cited is simply wrong? Jim Butler^(talk) 07:19, 5 December 2006 (UTC)

I'm not saying it's WRONG, I'm just saying that it's not really relevant for an encyclopedia article about the syndrome. It's certainly nice that a lot of people with Down's Syndrome are happy and well adjusted, but a friendly smile doesn't come from a third Chromosome 21, which is the subject of this article. It would be an appropriate subject for a non-encyclopedia article, something like "Living with Down's Syndrome" or that sort of thing.

Now if you had a source that said "Down's Syndrome causes warmth and friendliness," (even better if it had a well-described mechanism), it would be an entirely different situation. JDS2005 07:34 5 December 2006 (UTC)

Cause isn't the issue, correlation is; and no proposed mechanism is necessary if it's an observable phenomenon. Genes certainly do correlate with temperament in other genetic syndromes such as Williams ("overly friendly personality")[2] and Angelman (aka "happy puppet syndrome")[3]. I don't know enough about Down to know whether any supposed temperamental difference is really intersubjectively verifiable. Maybe it's just one of those things where people are projecting based on Down kids' facial morphology appearing more "baby-face"-like. Jim Butler^(talk) 07:48, 5 December 2006 (UTC)

Here's a study suggesting a behavioral phenotype[4] -- more along the lines of "less disruptive" than "warm", though. Jim Butler^(talk) 07:51, 5 December 2006 (UTC)

I wasn't saying that mechanism is NECESSARY, I was just saying that it would be better. However, the first article you linked didn't really suggest any correlation at all, but merely a popular notion associating "warmth and friendliness" with Down's Syndrome. While it certainly may be true that any number of people with Down's Syndrome are warm and friendly, it's not relevant for an encyclopedia article until there is scholarly work demonstrating that correlation. While that study you linked isn't the same as "warmth and friendliness", it's exactly the sort of thing that SHOULD go in an encyclopedia article, possibly not as hard fact (one single study is never conclusive proof of anything), but definitely as legitimate evidence that should be presented to readers. JDS2005 08:05, 5 December 2006 (UTC)

I oppose the introduction of anecdote to an article which has been carefully reviewed by medical authors for accuracy: if you can find a PMID source which references that as peer reviewed *fact* enjoying widespread medical consensus, then it should be introduced. Please see WP:MEDMOS; mentalhelp.net isn't the highest quality source, and that is anecdote which, to my knowledge, is unfounded. I also agree that it's not relevant to an encyclopedic article, unless there is solid peer-reviewed and published medical evidence which enjoys widespread medical consensus (to my knowledge, that anecodate doesn't). Sandy (Talk) 10:25, 5 December 2006 (UTC)

Under NPOV, a scientific view doesn't have to represent widespread consensus in order to be included; it simply has to be a sig POV and not a tiny minority one. Such views wouldn't be presented as "fact", but simply as what they are: conclusions some scientists have drawn based on their examination of evidence. Here's an example[5] of such a peer-reviewed sec source regarding Down and personality. The picture appears to be more complicated than the "warm" stereotype, but as the abstract says: "Young children with Down syndrome show a general profile of delays in the development of instrumental thinking coupled with emerging relative strengths in social-emotional functioning." They use the latter to compensate for the former. --Jim Butler^(talk) 02:32, 6 December 2006 (UTC)

Have you read the full text of that study, including methodology and discussion? Do you know the sample and methodology? Do you know the study shortcomings and limitations? Was it a controlled study on a large sample, or a case study, for example? Do you know how broadly the results can be interpreted? Without reading the full study, and putting it into the context of supporting or refuting studies, it's hard to know how to interpret or what context to give to the abstract. You can find a study on PubMed that says just about anything - the question is context, and how to present the results accurately and responsibly. That abstract doesn't give me enough to be able to say anything that I can be sure is accurate. Sandy (Talk) 03:05, 6 December 2006 (UTC)

Sandy, I don't know how controversial the idea of a behavioral phenotype in Down is, or what the parameters of the putative phenotype are. The issue does appear to be at least of historical interest, and a matter of some debate in the literature today. Dr Down himself suggested that a behavioral phenotype existed, and included exceptional humor and amiability[6], though not all of his ideas bore out:

• "The first use of such a concept was by Langdon Down in his original description of individuals with Down syndrome. He described a characteristic profile of personality traits. These included strong powers of imitation, a lively sense of humour and the ridiculous, obstinacy and amiability. His proposal has received substantial criticism over the years, not least because of the wide variability in personality profiles witnessed in people who have Down syndrome, just as in the general population. But recent research has supported the notion that there is a greater similarity personality and temperament-wise between people with Down syndrome than would be expected by chance."

Here's a reference[7] challenging the happy/placid stereotype:

• "The stereotype of people with DS as happy, placid individuals with a gift for mimicry is not borne out by recent behavioural research. "Stubbornness" and obsessional features seem to be over-represented, and many people with DS react adversely in situations involving conflict."

Regarding the review I mentioned above (by D. Fidler), I haven't read the original, but here's a PDF link to a book chapter[8] by the same author covering the same territory. That reference says:

• "It is argued here that some aspects of the Down syndrome behavioral phenotype are already emerging in infants and toddlers, including emerging relative strengths in some aspects of visual processing, receptive language and nonverbal social functioning, and relative weaknesses in gross motor skills and expressive language skills."

Given the above, it may be reasonable to say something along the lines of what Down originally thought about a behavioral phenotype in Down, and then cite more current research/opinion. Editors more familiar with the subject should have an idea as to where Fidler's view (and that of Collacott et al. cited above[9]) falls relative to other sci views. thx, Jim Butler^(talk) 08:04, 6 December 2006 (UTC)

I would be in favor of someone who knows the field well writing up a summary of the issue, but I wouldn't support one of us who isn't very well versed in DS adding something without 1) having read the full text of the studies, and 2) putting it into the broader context of refuting and supporting studies, strength of each study, and medical consensus. I agree that a DS-knowledgeable editor should be able to write something based on the sources listed above, but let's be sure it's an accurate reflection of all published literature, and not based on the abstracts we're able to come up with - I don't even know what is viewed as the best Review article in the field, as I do know, for instance, with TS. I urge that we add something after someone knowledgeable shows up to help, and I just don't know what became of TedE, who mostly authored the FA of this article. Sandy (Talk) 15:08, 6 December 2006 (UTC)

I think that's a good ending point, Sandy, but too stringent for a starting point. I appreciate the high standards you advocate, but they go beyond WP:BOLD, WP:NPOV and WP:VER. We don't want to let the perfect be the enemy of the good. If everyone were as cautious as you advocate, then stuff wouldn't get added to articles at all. There are plenty of scientific questions where widespread consensus doesn't exist, and fields where there is no single "best" review article.

I'm not suggesting putting in my original miconception of Down people having a particular tendency to warmth and friendliness, but rather the stuff I dug up about some scientists believing that a particular behavioral phenotype exists, and what its parameters may be. This can be added without misrepresenting it as consensus. There's enough there to provide a good starting point for more knowledgeable editors to build on and contextualize, and add any opposing POV's. I agree with User JDS2005 that V RS material ought to go in articles, because by putting it there, it will not only inform readers, but attract productive edits. best regards, Jim Butler^(talk) 02:31, 11 December 2006 (UTC)

If you, me, someone hasn't read the full study, and other refuting or validating studies, and can't put the info in the broader context, how do you assess whether you are giving undue weight? Sandy (Talk) 02:44, 11 December 2006 (UTC)

:::::::It depends on the issue, the evidence and how editors frame it. Saying some scientists are studying the existence of a phenomenon and that it remains controversial isn't undue weight unless the idea that that thing exists is a tiny minority view, which the Pubmed stuff above plainly isn't. Jim Butler^(talk) 03:03, 11 December 2006 (UTC)

Agree with Sandy. Popular (mis)conceptions should not be included, unless they are backed up by hard evidence. It might seem a nice thing to say, but doesn't help the parent of a "difficult" child if everyone expects them to be angels. Colin Harkness°^Talk 12:04, 5 December 2006 (UTC)

I think that while many kids with DS are very "sweet and loving", so too are most young kids in general. However, anyone who has ever gotten to know a youngster with DS will know that they are just like other kids, they have tantrums, they can be moody, stubborn seems to come in triplicate, and generally they are just like us. The problem with labeling any group of people anything from "sweet and loving" to "angry and violent" is that we are buying into presumptions, rather than seeing the individual as just that...individual. I would prefer that people who meet my daughter have no preconceptions about who she is based on what they think they know about DS. Allowing her own personality to speak for itself is the safest bet. Sure, she may be sweet and gentle sometimes, (she is) but she has moments just like anyone else when she is no fun to be around, demanding, sullen, or irritated....shes human. I like to remind people that labeling kids with DS as "lovable oafs" is no different than proclaiming all people of color as athleticly gifted. It is a generalization, when what all we human beings want is to be seen as the individuals that we are. Mome23kjnc 23:00, 11 January 2007 (UTC)

Good job!

You wrote a GREAT article! Good job!!! You are great! We are so proud of you. GOOD JOB! —The preceding unsigned comment was added by 216.235.37.237 (talk) 09:59, 5 December 2006 (UTC).

Vandalism

Hello Can someone remove the AIDS banner sitting at the top of the page? I do not know how to Thx 220.240.55.95 11:28, 5 December 2006 (UTC)

Increased incidence of further children with DS

Hi

As a parent of a young boy with DS, I'm surprised there isn't any content around the statistics (oft quoted) that the incidence of conceiving a child DS for parents who already have one child with DS is approximately 1% irrespective of maternal age indicators (e.g. see http://www.hon.ch/Dossier/MotherChild/birth_disorders/down_syndrome.html). Now, this may be just heresay on the part of genetic counsellors, but it was certainly presented to my wife and I as fact when we were considering having an additional child.

Has this been an issue discussed and now ingored, or is it factually disputed?

Matt Larkim 11:47, 5 December 2006 (UTC)

That article's statement looks wrong, possibly due to simplifying things. How can they say:

The probability that another child with Down syndrome will be born in a subsequent pregnancy is about 1 percent, regardless of maternal age.

if the risk is > 1% for anyone over 40. If there is any truth in this, then surely it would be "no less than 1 percent". Colin Harkness°^Talk 12:12, 5 December 2006 (UTC)

Indeed; if we take the case of a 45 years old mother, it is hard to imagine that the incidence would actually decrease from 5% to 1% just because she has already had a child with DS. However, if we are talking about a mother for which the age indicates a risk below 1%, I would not be surprised if the fact that she has already had a child with DS would increase this risk to 1%. In both cases, a good reference would be required to clarify this and add it to the article. Schutz 12:18, 5 December 2006 (UTC)

Agreed, which is actually what I was reading to try to understand from the article. Unfortunately I am parent and not a geneticist (sp?) so I don't know where to start to find the information. It raises all sorts of questions about statements which purport to say "DS is a random occurrence" when there is this claimed pre-disposition once a child has been conceived with DS. I agree about the statistical analysis above (Colin), but the same phrase is used elsewhere on generally reputable sites (e.g. http://www.nichd.nih.gov/publications/pubs/downsyndrome.cfm) so whilst it seems illogical there is also the possibility that the statistic is right at the 1% figure for all. Larkim 12:36, 5 December 2006 (UTC)

A quick Google for "another child with Down Syndrome" brings up some pages (not necessary good enough to be sources) that indicate that the 1% is on top of any age-related-risk. Also, the "translocation" form may greatly increase the risk of another child, making genetic councelling vital. Colin Harkness°^Talk 14:13, 5 December 2006 (UTC)

The recurrent risk for trisomy 21 is 1% until age 35. ("AAP issues guidelines on health supervision for children with Down syndrome - Committee on Genetics of the American Academy of Pediatrics", American Family Physician, Sept 1, 1994 -- there is probably a primary source somewhere). —The preceding unsigned comment was added by Genetics411 (talk • contribs) 21:00, 5 December 2006 (UTC).

OK, I'm convinced by the discussion here - can I suggest someone adds to the text. I think it is a really interesting aspect of DS that on one hand the incidence is apparently random, but that any parental combination that has produced one Trisomy 21 DS baby then has a significantly increased risk of producing a second (indicating that there must be some environmental or "biological" predisposition of some parents to have children with Trisomy 21). Larkim 08:43, 6 December 2006 (UTC)

I suggest we find a primary source before adding this in, especially given the disagreement of secondary sources implied by Genetics411. Samsara (talk • contribs) 09:24, 6 December 2006 (UTC)

u all are being racist

how does the picture drill.jpg shows that the child is having Down syndrome? u making him look bad on the internet he can sue u165.21.155.13 12:15, 5 December 2006 (UTC)

Errr... Racist? How? He clearly has Down Syndrome, and it doesn't make him look bad. Plus, his parent was the one who uploaded the photo. Sarg 12:59, 5 December 2006 (UTC)

• This is User:Excalibur's son. He put the picture there and helped write the article. Please calm down. --Bridgecross 14:50, 5 December 2006 (UTC)

Neither Down's Syndrome, nor the use of power tools, are a race, so the accusation of racism is completely nonsensical. JDS2005 03:46, 6 December 2006 (UTC)

To me it likes the kid is holding the drill unsafely, regardless of down syndrome. His hand is too close to the chuck as is his face. His hair could get cautght, or a splinter could go into his eye. —The preceding unsigned comment was added by 195.137.231.43 (talk) 09:53, 7 December 2006 (UTC).

---

About : Expand medical section see: http://AtlasGeneticsOncology.org/Educ/PolyTri21Eng.html (or maybe to be included at "Down syndrome Classifications and external resources" with OMIM ?
To show that mentally handicapped persons can be artists, you can use if you wish the image (or part of it)from : http://atlasgeneticsoncology.org/Educ/Images/FriendsEng.gif, provided that you cite the source (Courtesy Atlas of Genetics and Cytogenetics in Oncology and Haematology. http://AtlasGeneticsOncology.org)e.g.File:FriendTri21Paint.gif

Why would we want to show that mentally handicapped people can be artists? No part of the article suggests that mentally handicapped people can't be artists. JDS2005 03:49, 6 December 2005 (UTC)

---

About : "Expand medical section"

About : "Expand medical section" you can see at: http://AtlasGeneticsOncology.org/Educ/PolyTri21Eng.html Jlhuret 12:59, 5 December 2006 (UTC)

Photograph

File:Drill.jpg

What's with the drill?--Greasysteve13 13:48, 5 December 2006 (UTC)

History

This large block of poorly referenced text was added: what should we do with it?--Steven Fruitsmaak (Reply) 14:11, 5 December 2006 (UTC)

John Langdon Down was ambivalent about Darwinism and uncomfortable that it was being used by some to justify racial discrimination. Langdon Down was himself of the opinion that the human race was universal and he stated that "these examples of the results of degeneracy among mankind appear to me to furnish some arguments in favour of the unity of the human species."

Professor O'Connor Ward states in his book 'Dr John Langdon Down And Normansfield' (updated and reprinted 2006) that:

"After his initial identification of the specific picture of the Mongolian Idiot, Langdon Down moved away from the concept of facial and other characteristics of other races representing evidence of degenerative genetic inheritance, leading to physical characteristics appropriate to another racial stock. Speaking in a discussion on a paper by B.W. Richardson in 1867 on 'Physical Disease from Mental Strain', Langdon Down said that he had abandoned his belief in phrenology after 10 years of study. He had turned his back on the view that a person's character and intelligence could be deduced from the outer appearance and shape of the skull.

They could estimate quantity of the brain, but owing to not being able to ascertain the quality on the failure of phrenology, which had received due attention from those who paid great attention to psychiatric subjects and had been tried and found wanting."

When Langdon Down was invited to write for the section on idiocy in Quain's Dictionary of Medicine in 1882, he made no mention of racial characteristics as being important in the diagnosis. His Mongolian group were simply listed as strumous. He had, for practical purposes, abandoned the ethnic concept. The dictionary appeared again in 1894 and once more Langdon Down wrote the section on idiocy. He again left the ethnic concept in abeyance.' Citation: Stuart Mills, Information Officer, http://www.downs-syndrome.org.uk/ —The preceding unsigned comment was added by Stevenfruitsmaak (talk • contribs) 14:11, 5 December 2006 (UTC).

Referencing something to a support organization website isn't good enough for best reliable sources per WP:MEDMOS: unless someone has the book and can properly write and cite the text, I'd remove it from the article until someone who has the book can do so. Parts of it seem off-topic for this article, as well. Sandy (Talk) 15:50, 5 December 2006 (UTC)

No one objected, it was never better source, so I deleted it. If anyone is extremely attached to that text, perhaps it can be incorporated at History of Down syndrome. Sandy (Talk) 04:24, 10 December 2006 (UTC)

Sorry, but I am confused as to why this section that I added was removed? I have cited Stuart Mills the Information Manager at the Downs Syndrome Society and the book that he referenced. I felt it was important for readers to realise that Dr Down went back on his original slightly racist assertions of Mongols as being genetic throwbacks. User:jdavies555 20 December 2006

Down Syndrome and employment

Something on vocational opportunities would be good.Anthony717 14:37, 5 December 2006 (UTC)

POV

Can someone knowledgeable about Down syndrome pls check this edit vis-a-vis POV and original research? Sandy (Talk) 16:02, 5 December 2006 (UTC)

Looks like some things have been formulated more positive, but the results still seems quite neutral to me.--Steven Fruitsmaak (Reply) 16:55, 5 December 2006 (UTC)

I'm not entirely comfortable with the changes made there. The changes seem to suggest that impairment is not the norm among people with Down's Syndrome, and mention of speech impairment is outright deleted without explanation. JDS2005 03:52, 6 December 2006 (UTC)

Concur with JDS - It seemed an overly optimistic version to me. Sandy (Talk) 15:10, 6 December 2006 (UTC)

I think other than the deletion of the speech matters, it is fine. Generally speaking, people with DS born these days are doing better in life than their older counterparts. Given the better medical care, schooling, social oppostunities, etc, that makes perfect sense. As an example, my daughter is 8, is in a regular 2nd grade classroom where she does just fine, with minor accomadations. She is a Girl Scout, plays on regular teams for sports, reads at age level, has very good friends, and is generally a pretty typical kid. She is not different from many kids with DS out there. It is just that the old myths about DS are hard to break. Many many people with DS are out in the world, doing well, working, driving, marrying, going to college. Of course, there is a huge variability across the spectrum, just as in typical children. But more often than not these days, optimistic fits just fine. Mome23kjnc 00:06, 12 January 2007 (UTC)

Chimps

I converted this inserted external jump to a PMID ref, but someone needs to check the accuracy, as there is no abstract. The part about mice is unreferenced.

The effects of the extra copy vary greatly among individuals, depending on the extent of the extra copy, genetic background, environmental factors, and random chance. Down syndrome occurs in all human populations, and analogous effects have been found in other species such as chimpanzees and mice.

Sandy (Talk) 16:08, 5 December 2006 (UTC)

External jumps in Genetic research section

The external jumps in this text need to removed and converted to references or wikilinks, but with the convoluted parentheses, I'm not sure how to re-write it:

Recent use of transgenic mice to study specific genes in the Down syndrome critical region has yielded some results. APP (Online Mendelian Inheritance in Man (OMIM): 104760, located at 21q21) is an Amyloid beta A4 precursor protein. It is suspected to have a major role in cognitive difficulties. Another gene, ETS2 (Online Mendelian Inheritance in Man (OMIM): 164740, located at 21q22.3) is Avian Erythroblastosis Virus E26 Oncogene Homolog 2. Researchers have "demonstrated that overexpression of ETS2 results in apoptosis.

Sandy (Talk) 16:28, 5 December 2006 (UTC)

I'd just convert them to notes, i.e.:

Recent use of transgenic mice to study specific genes in the Down syndrome critical region has yielded some results. APP is an Amyloid beta A4 precursor protein. It is suspected to have a major role in cognitive difficulties. Another gene, ETS2 is Avian Erythroblastosis Virus E26 Oncogene Homolog 2. Researchers have "demonstrated that overexpression of ETS2 results in apoptosis.

Do you think this would cause much of a mix-up? Fvasconcellos 16:59, 5 December 2006 (UTC)

That looks good to me, but I don't know the territory well. Go ahead, if you're confident, but websites should include last access dates. Sandy (Talk) 19:15, 5 December 2006 (UTC)

I'll go ahead then. The paragraph itself still reads a bit awkwardly, but I'm not sure what to do with it. Fvasconcellos 19:30, 5 December 2006 (UTC)

why is he using a drill

why is the Subject using a drill? Is this in any way relevant? —The preceding unsigned comment was added by Sidecrab (talk • contribs) 16:43, 5 December 2006 (UTC).

• He's using an electric drill so he can put the bookcase together, that's why. --Elkman - (Elkspeak) 16:46, 5 December 2006 (UTC)
  • There must be a barnstar for that :-)) Sandy (Talk) 16:48, 5 December 2006 (UTC)

I second sidecrab.martianlostinspace 18:57, 5 December 2006 (UTC)

Please go here for further discussion of this picture. /skagedal^... 20:23, 6 December 2006 (UTC)

Name

I have never ever heard it referred to as "Down Syndrome", it's always "Down's Syndrome" or "Downs Syndrome". I take this to be an Americanism

It is not - see Lancet publications discussed above. (Lancet is British.) Sandy (Talk) 16:58, 5 December 2006 (UTC)

Locked

Where is the topic on this being locked in here? I thought that main page articles where not supposed to be locked except for a short period, and where they where locked, a notice was to be put onto the talk page. This has now been locked for about 30 minutes. I know that there has been heavy vandalism, but mostly it has be reverted quite quickly. Please can this lock now be removed.

thanks *Drem* (from 212.85.28.67 17:13, 5 December 2006 (UTC))

edit

For reference, Semi-protection should not be used:

• To prevent vandalism on the day's Featured Article. Semi-protection for a very brief period is acceptable to remove excessive vandalism from the page, or to combat an unusually high level of vandalism from multiple IPs or accounts. For a rationale of this, see Wikipedia:Don't protect Main Page featured articles. Other pages linked from the Main Page may be protected if under attack, though more leeway should be given with these than with most articles.

Citations

I started working on some of the citations (I was traveling when this article came up on WP:FAC, or I would have raised these items there), but this work is probably better left for after the article is off the main page. Many of the journal articles don't include PMIDs (I added some). Several of the footnotes are just blue links which need to be expanded. And all too many statements are referenced to support organizations or other non-medical sources, and need close examination or better (medical, peer-reviewed) sources. Sandy (Talk) 18:10, 5 December 2006 (UTC)

Using the drill

I am going to remove the phrase "Using an electric drill" because it's junk. Any objections, please say why. Also provide citations. 86.135.97.73 18:12, 5 December 2006 (UTC)

Go further: Remove the entire picture. It's far too random an example, and vague. That's like saying Person with a stammer getting on a bus..

The links beneath it also appear pointless.martianlostinspace 18:56, 5 December 2006 (UTC)

I disagree on all counts (see many discussions above), and the links below it are per WP:MEDMOS and the standard infobox. Sandy (Talk) 18:58, 5 December 2006 (UTC)

When this got its featured star on 13th September, the text said "Child with Down syndrome". Every change to the text since then (ignoring vandalism) has been by anonymous editors. I agree with the idea of dropping the "using an electric drill" since (a) it is incidental and (b) he is using a screwdriver bit in the drill, so it is actually being used as a screwdriver – this is a distraction from the point. An alternative to the as-featured text would be "A child with Down syndrome" (Note the lower-case "s"). —The preceding unsigned comment was added by Colin Harkness (talk • contribs) 20:20, 5 December 2006 (UTC).

OK, Colin, sounds good to me (deleting the drill part, but not the links below), since that was the FA version. Sandy (Talk) 20:33, 5 December 2006 (UTC)

May we please consent to leave the caption alone while this article is on the Main Page? The vicious vandalism it is receiving takes precedence over this minor point of contention, let's not allow this to deteriorate into a revert war... Fvasconcellos 20:46, 5 December 2006 (UTC)

Apologies. I didn't notice discussion here. I'll leave it alone.--Kchase T 20:56, 5 December 2006 (UTC)

Someone else changed the caption. - 86.135.214.219 07:26, 6 December 2006 (UTC)

Please go here for further discussion of this picture. /skagedal^... 20:23, 6 December 2006 (UTC)

Incidence

I put a cite tag on a new sentence that needs to be evaluated. Also,

The original statment in the FA version has been changed - the cited, deleted sentence bolded (by me) needs review:

Although the risk increases with maternal age, 80% of children with Down syndrome are born to women under the age of 35,[15] reflecting the overall fertility of that age group. Other than maternal age, no other risk factors are known. However, in up to 12% of trisomy 21 cases, the extra chromosome comes from the paternal gamete.[16] There does not appear to be a paternal age effect.

Margareta Mikkelsen, Hanne Poulsen, Kim G. Nielsen (2006). "Incidence, survival, and mortality in Down syndrome in Denmark". American Journal of Medical Genetics. 37 (S2): 75–78. Retrieved 2006-07-03.{{cite journal}}: CS1 maint: multiple names: authors list (link)

There seem to be problems with the citation - I found this PMID 2149979 abstract. Sandy (Talk) 19:29, 5 December 2006 (UTC)

vandalism?

On Dec. 5, 2006, the Down syndrome article was linked to the Wikipedia main page. When you click on "more" to access the rest of the article, it appears that it has been vandalised. The page that comes up has the correct title, but the only content is the message "haha...GONE!" --206.246.248.224 20:02, 5 December 2006 (UTC)

Yes, it was vandalism. This page has been getting vandalized non-stop; it always gets reverted quickly though. | AndonicO ^{Talk | Sign Here} 20:14, 5 December 2006 (UTC)

Shouldn't we have the page semi-protected, then? Honalululand 20:43, 5 December 2006 (UTC)

I have semi-protected it. The page is also currently linked from Wonkette, making fun of the vandalism. -- Infrogmation 20:54, 5 December 2006 (UTC)

Another PMID mismatch

In Genetic research section, trying to add PMIDs, can't reconcile PMID 2149984 with Zohra Rahmani, Jean-Louis Blouin, Nicole Créau-Goldberg, Paul C. Watkins, Jean-François Mattei, Marc Poissonnier, Marguerite Prieur, Zoubida Chettouh, Annie Nicole, Alain Aurias, Pierre-Marie Sinet, Jean-Maurice Delabar (2005). "Down syndrome critical region around D21S55 on proximal 21q22.3". American Journal of Medical Genetics. 37 (S2): 98–103.{{cite journal}}: CS1 maint: multiple names: authors list (link) Sandy (Talk) 21:18, 5 December 2006 (UTC)

According to the journal website, the date of publication is in fact 1990. Fvasconcellos 21:24, 5 December 2006 (UTC)

Possibly a better reference is PMID 2143053, it is a more general reference to the area. Genetics411 21:37, 5 December 2006 (UTC)

I don't know DS, so I defer to you. I'm just generally concerned about cleaning up the references, and not pleased with the amount of non-peer-reviewed sources used. Sandy (Talk) 21:41, 5 December 2006 (UTC)

First picture (boy with drill)

Ok, I don't know if this is considered OK, but I found it silly that the same issue (the first picture on the page) was discussed at three places (at least) on the same page, so I moved them all together so the discussion can be unified. I hope it's good. /skagedal^... 20:23, 6 December 2006 (UTC)

---

Original heading: First picture

I realize the first picture is GFDL and is preferable to using a fair use picture, but honestly, is that the best picture that can be used? It doesn't really identify the subject (Down syndrome) at all. --- RockMFR 01:52, 5 December 2006 (UTC)

What picture would be good to illustrate it? I think the picture of the Down syndrome karyotype will be good personallyBorisblue 02:08, 5 December 2006 (UTC)

I think these pictures on the Turkish edition are some how better than the current http://tr.wikipedia.org/wiki/Resim:Downsyndr2.jpg and http://tr.wikipedia.org/wiki/Resim:Downbaby.jpg. If no one objects, I will replace that current image with one of these images. xeryus 02:21, 5 December 2006 (UTC)

I object. The editor who brought the article to featured status has not been online today, and I don't see the need to change the picture that passed FAC without a full discussion. I don't know his reasoning for choosing the picture he chose, but I don't see any big reason to change it in a hurry, either. If others agree, it can be done later. Sandy (Talk) 02:24, 5 December 2006 (UTC)

OK then, let me correct my position on this change as a suggestion. And of course, I respect the editor. xeryus 02:30, 5 December 2006 (UTC)

Those pictures do demonstrate the condition better than the current image. I would support changing it. It's not a big deal to change a picture once it's on the main page- a lot of articles improve dramatically on their featured day. Nobody "owns" an article on wikipedia, so it's not really that big a deal: and I'm sure the original editor will be the person most pleased if an improved image is usedBorisblue 02:32, 5 December 2006 (UTC)

I didn't mean to imply the original editor "owned" the article, or that his opinion counted more than others, just that there is no hurry, and consensus should be developed to change an image. If others prefer those images, no problem from me ... Sandy (Talk) 02:53, 5 December 2006 (UTC)

I just checked, and TedE hasn't been around for a month, so I support you changing the image to your choice. I'm surprised he's not around, after he put so much into the article, but that's that. Looks like the vandalism is under control, I'm calling it a day here. Regards, Sandy (Talk) 03:16, 5 December 2006 (UTC)

I take it that there's a consensus here to change? Any objections? Borisblue 03:18, 5 December 2006 (UTC)

Wait... hold on- according to the discussion at talk:main page the copyright isn't acceptable. Is there even any evidence that these children really do have down syndrome? Borisblue 03:21, 5 December 2006 (UTC)

Well, yea, that's why I thought TedE should be consulted and there should be no hurry to change while on the main page - careful consideration goes into images during the FAC process, including examination of copyright status. I also seem to recall (but can't find messages) that people discussed showing accomplishments, rather than just a pretty image. Sandy (Talk) 10:03, 5 December 2006 (UTC)

The boy-with-drill picture has been around a long time, and debated several times. It is the son of an early editor of this article. I like it. It isn't irreplacable but I agree with Sandy that there is no rush. Colin Harkness°^Talk 12:01, 5 December 2006 (UTC)

---

Original heading: pictures

I think this article could use a couple of pictures to demonstrate the physical characteristics typical of Down syndrome. What say? - Che Nuevara 06:05, 5 December 2006 (UTC)

This would certainly improve the article, though I would understand why they would be hard to obtain or accept. There is some concern that pictures of the sufferers shouldn't be on wikipedia, as it would seem as though we were expoiting them. Even the existing pictures have met with some opposition (see Image_talk:Drill.jpg) Borisblue 06:19, 5 December 2006 (UTC)

I'd much rather see the "Drill" image replaced by an image of a person with Down's Syndrome whose face is viewed from the front, rather than the side, and hence makes the physical characteristics (widely-spaced eyes, epicanthic folds, spotted eyes, etc) more easily visible. At first glance the child in the picture does not obviously appear to have Down's Syndrome. JDS2005 6:36, 5 December 2006 (UTC)

I'm sorry they're not here to defend or explain, but I believe the original thinking was to include an image which showed accomplishment rather than physical traits. Perhaps an image showing physical traits could be included elsewhere in the article. Sandy (Talk) 10:21, 5 December 2006 (UTC)

Why would we want to show accomplishment rather than physical traits? This is an encyclopedia article about Down's Syndrome, so we should try to demonstrate "This is the syndrome", rather than "People who have the syndrome are good". This seems to be a recurring confusion. JDS2005 03:33, 6 December 2006 (UTC)

Though I think we should be sensitive to concerns about exploitation, I don't think we want to avoid being oversensitive. The condition is simply a fact, and merely depicting someone who has it should not be seen as a value judgment by Wikipedia against that person. It's not quite the same as having blue eyes, I'll grant you, but the principle is essentially the same. --Saforrest 06:57, 5 December 2006 (UTC)

So long as we do not:

(A) harm the person in the picture, or

(B) profit off of the picture because of the likeness of the person it it

there's really no ethical reason not to use such a picture.

Also, Safforest, when you say "I don't think we want to avoid being oversensitive", don't you mean you DO think we want to avoid being oversensitive? Otherwise your argument doesn't make much sense.JDS2005 07:07, 5 December 2006 (UTC)

Right, one too many negations there. The issue with your points A and B is that the photo licensing Wikipedia prefers -- "free" photos in the sense of GFDL or certain kinds of CC licences -- do not come with the strings you'd like to see attached. Because Wikipedia content can be resyndicated anywhere, there's no guarantee that a "free" picture wouldn't some day be used for profit, or be used in a way damaging to the dignity of the original subject. That's the risk we take with every submitted photo. --Saforrest 08:44, 5 December 2006 (UTC)

I'm not exactly talking about legalities here...in fact, I'm not paying any attention to what other people do with the photos in resyndication. I'm just saying there should be no ethical concerns about exploitation so long as WIKIPEDIA does not harm or profit off of the people in the photo. What people do with it afterwards, outside of Wikipedia, is not our concern. JDS2005 03:37, 6 December 2006 (UTC)

A reading of the talk page and archives seems to indicate there have been at least a half-dozen editors with children who have DS. Any one of those could have uploaded a picture. Why do you suppose they haven't? Given the abuse the article has taken over the past several days, I can see why. The picture has been criticized for several months, and yet noone has uploaded a picture of their child. Under those conditions, I'd be very hesitant to use a random picture. Genetics411 05:38, 8 December 2006 (UTC)

You might notice above that Dr. Leshin (a pediatrician who happens to have a son with Down syndrome) offered photos of his own son for this page. You're welcome to use one of the photos of my son from my webpage.Lleshin 14:30, 18 August 2006 (UTC)lleshin <--- That appears in the discussion towards the top of this page. Perhaps he should be taken up on his offer. His web site is http://www.ds-health.com/ Jeannedb 14:00, 8 December 2006 (UTC)

---

Original heading: First picture

What does a boy with a drill have to do with Down syndrome? Maybe a photo representing the syndrome would be better.NapoleonAlanparte 22:30, 5 December 2006 (UTC)

Please scan the talk page - it's been discussed here a bunch. Sandy (Talk) 22:31, 5 December 2006 (UTC)

Now that this is off the main page, I've found a few possibilities for new pictures. This category of a wee babe is all free enough for us to use. Similarly, this photo is licensed so that it only requires attribution. This photo of the same girl is probably the best I've found because the distinctive features of someone with Downs are clear and she is old enough that she doesn't look like just a baby with a chubby face (which is what some Downs babies look like to me). Your thoughts?--Kchase T 02:29, 6 December 2006 (UTC)

That third link, labelled "Esther", is perfect. It's exactly the sort of thing I called for yesterday. I nominate that one for the first image on the page. JDS2005 04:03, 6 December 2006 (UTC)

I'm glad you're looking for an improved picture, but I'm not enthralled with the photographic quality on either of those. Sandy (Talk) 15:13, 6 December 2006 (UTC)

then put the drill picture further down the page 86.135.214.219 10:54, 6 December 2006 (UTC)

In general, Flickr images can't be used. There is a copyright notice on each page. I don't think it would fall under fair use, and pictures of children may run into other problems without the permission of the parents. While some parents may be flattered to have a picture of their child at the top of the article, others would not be. Genetics411 19:36, 6 December 2006 (UTC)

As Skagedal mentions below, the images I've found can be used. Flickr has lots of images, some of which are fully copyrighted, others of which have non-free Creative Commons licenses, and a few, like the above, that have CC licenses that are free enough for use here. As to the point about parents, I'd be happy to email the poster myself if we get consensus for a particular image.--Kchase T 21:52, 6 December 2006 (UTC)

---

My opinion: There are some things I like about the current picture. First, I like that the boy is doing something, in this case using a drill. Second, I like the Wikipediaconnection, that it is the son of an early editor of this article. That also has the advantage that there are no copyright or ethical problems. But there is a strong argument for changing it: it doesn't illustrate the topic very well. The facial features of Down syndrome that are so distinguishing do not show very well. A face shot taken from the front would be preferrable, in my opinion. So, to consider the alternatives:

• Downsyndr2.jpg from Turkish wp - nice, but has copyright problems
• Downbaby.jpg from Turkish wp - nice, but has copyright problems.
• Esther from Flickr - very nice, imo! And to adress the copyright concern that Genetics411 has, the picture is marked by the author as CC-BY-2.0.
• Esther again, black & white - also very nice, same girl as above, also CC-BY-2.0. IMO not as good as the above, photo quality wise, but also nice.

I agree with some wikipedians above that there is no rush to replace the drill picture, but how about contacting the author of the Esther photos, hear how s/he feels about it illustrating the wp article? /skagedal^... 20:23, 6 December 2006 (UTC)

• Oh, i forgot one alternative: Trisomy21_Mia.jpg, Mia Peterson, copyright: PD. Not an excellent picture though, IMHO. /skagedal^... 20:34, 6 December 2006 (UTC)

I understand the concern about the current image, but I don't feel any of these are good enough. Sandy (Talk) 21:54, 6 December 2006 (UTC)

As the photographer and father of the boy, can I make a few points here? People with DS come in all shapes, colours, sizes, and have a wide range of features. To choose a picture that conforms to a stereotype - for example a short overweight person with a protruding tongue, would be grossy offensive to the very many people with DS who are attractive and look pretty much like everyone else. yes, you can go for a front face shot as opposed to a profile - it doesnt really make much difference. the fact that the boy is doing something - in this case helping with some DIY - is important because people with DS do pretty much everything that you can do - the old "cabbage" stereotype needs to be vigorously challenged. I'm happy to provide a few more pictures if you like, but they wont solve anything - Maybe we should have a whole gallery, but then those exist elswehere - see for example [10] Excalibur

Because we apparently aren't supposed to change the picture without discussing it, which nobody seems to want to even approach, I have edited the caption to read "This child loves to use screwdrivers!" The child in the picture may or may not have downs, we don't know. This also may or may not be a picture from the original creator of the article, a rumour that appears to have appeared as fact without validation from thin air. As such, the caption has been edited to signify that all we can tell is that the child in the picture is enjoying the use of the power tool. Let's focus on what is definite, not rumours or hearsay of somebody claiming to be the father. Truth, my fellow Wikipedians, shall always prevail. Txtimetraveler 03:03, 26 December 2006 (UTC)

Is there even any evidence that these children really do have down syndrome? Borisblue

A reading of the talk page and archives seems to indicate there have been at least a half-dozen editors with children who have DS. Any one of those could have uploaded a picture. Why do you suppose they haven't? Given the abuse the article has taken over the past several days, I can see why. The picture has been criticized for several months, and yet noone has uploaded a picture of their child.

The second picture is my daughter, Ciarra, at age 6. She indeed does have DS. There is so much hoopla regarding this picture of the little boy with the drill, which I do not understand. He is likely 8 or 9 yrs old, and like any little boy is learning to use simple tools and help his Dad. I do not get the big deal here. On the other hand, it is true that small minded people seem to target kids with DS by manipulating pictures, etc. It is ridiculous, and unfair, but it happens far more than you realize. I would not be adverse to offering another photo of my daughter, showing facial features, if you think it would help the article. http://img.photobucket.com/albums/v602/ciarrasmom/CafePress/CiarraRedCoat.jpg or http://img.photobucket.com/albums/v602/ciarrasmom/CafePress/Cbestbigger.jpg are fairly decent. Im pretty new to this, so maybe someone can add one if they think it works? My vote would be to keep the one of the little boy with the drill, too, as it does show him being a normal little kid. Sorry that was me Mome23kjnc 00:21, 12 January 2007 (UTC)

stop silly edit war

warring over picture caption "Child with Down syndrome using an electric drill" to "8 years old child with Down syndrome using an electric drill to make a bookshelf for his dad 40th birthday present" the age and the father's age is not relevant. IT's distracting cut it out. I'm sprotecting the page as the warrior is IP jumping and don't want to throw some more rangeblocks. -- Drini 05:45, 7 December 2006 (UTC)

can someone please revert?

someone keeps deleting the article in favor of a random reference to free willy.

unfortunate. —The preceding unsigned comment was added by 68.14.222.241 (talk) 18:02, 8 December 2006 (UTC).

Unsourced addition to lead

I've removed this addition to the talk page because 1) it is unsourced, and 2) it was added to the WP:LEAD, which should be a summary of the article, not introducing material not already discussed in the article. If the information can be sourced, it will need to be added to the appropriate section(s) in the article.

Health benefits of Down syndrome include reduced incidence of many common cancers. Fertility rates appear to be very low, with only three recorded instances of males with Down syndrome fathering children.

Sandy (Talk) 15:12, 9 December 2006 (UTC)

Can Borisblue 06:19, 5 December 2006 please stop talking about folk "suffering" from DS? You dont suffer from DS, its not an illness - you just have it! Excalibur

It's a British thing: I too, wish they didn't use that particular POV language, and am constantly removing it from articles. Excalibur, can you please source the text above? Sandy (Talk) 15:35, 9 December 2006 (UTC)

OK I'll try to track them both down - the third known case of paternity was only recently reported from India on a discussion group, apparently the father has DS but the mother not, and the literature isnt especially sound on this issue. I guess there are also cases of Mosaic DS which makes it al quite tricky. Excalibur

Keeping in mind that discussion groups aren't reliable sources ... we need to maintain the FA standard. :-) Sandy (Talk) 15:49, 9 December 2006 (UTC)

I know, but this post came from Len leshin, who (though I hate to make him blush) is a leading authority in this field:

>FYI:

To date, there had been only two documented cases of men with DS fathering pregnancies. There is now a third. A paper was just published from India about a 26 year old man with nonmosaic DS married to a 22 year old female with normal chromosomes. They had a normal baby boy.

Len Leshin, M.D., F.A.A.P. Father to Avi, 13 y/o with DS Down Syndrome: Health Issues [11] <

is that good enough? Sorry I'm not good at the protocols for citation. Excalibur

The link you gave as the source doesn't point towards the text you supplied, or the Indian paper? Perhaps the abstracts you give below are one of those papers? You can just list the PMID: I'll try to track them down. Sandy (Talk) 17:43, 9 December 2006 (UTC)

Pregnancy

Significantly impaired fertility of both sexes is evident in the Down syndrome population (Rogers and Coleman, 1992). While males have long been assumed to be sterile, Sheridan reports one case of a cytogenetically normal male infant that was fathered by a man with Down syndrome (Sheridan et al, 1980). Women have impaired but still significant fertility: a number of reviews document women with Down syndrome carrying pregnancy to term and delivering infants with and without Down syndrome (Bovicelli et al, 1982; Rani et al, 1990). Infants born to mothers with Down syndrome are at increased risk for premature delivery and low birth weight (Bovicelli et al, 1982). Pregnancy outcomes obtained from a study of mothers with Down syndrome are displayed in Table 5. Whether a woman with Down syndrome constitutes a high risk pregnancy depends largely on cognitive level and medical status. Obviously, the presence of maternal cardiac, thyroid, or hepatic disease, as well as seizure disorder, complicates a pregnancy. The high incidence of congenital heart disease in any offspring with Down syndrome contributes to pregnancy risk, including stillbirth and neonatal death (Gordon, 1990). Offspring without Down syndrome have a greater than average number of congenital anomalies (Bovicelli et al 1982) (see Table 5).Table 5. Reported results of pregnancy in Down syndrome Paper Parent Offspring Sheridan et al, 1989 1 man with Down syndrome 1 normal male Bovicelli et al, 1982 26 women with Down syndrome 10 normal 10 Down syndrome 2 mentally retarded 1 set of premature, nonviable normal twins 3 malformed 1 slightly microcephaly 1 still born 2 abortion, phenotype unknown Rani et al, 1990 1 woman with Down syndrome 1 normal 32 pregnancies total Ref: Sheridan et al, 1989; Bovicelli et al, 1982; Rani et al, 1990.

Excalibur

Replacing text with direct link to PMID 11937181 on cancer study, for brevity: hope you don't mind, Excalibur. Sandy (Talk) 17:48, 9 December 2006 (UTC)

IQ Scores

The article states that

Most individuals with Down syndrome have mental retardation in the mild (IQ 50–70) to moderate (IQ 35–50) range

Can someone either state which IQ index is being used here or alter the descriptors. And IQ of 50 to 70 on the Wechsler IQ scale (which is the most commonly used scale) is extremely low, not mildly impaired. An IQ of 35-50 is quite exceptionally impaired, not moderate. I'm hesitant to change the article in case this is a valid description of a scale that I'm not familiar with, but if people have no objections I'll change the article to the more widely known Wechsler IQ values. Shinji nishizono 22:27, 30 December 2006 (UTC)

As far as I know, the classification being used in the article corresponds to levels used in the DSM-IV:

Borderline Intellectual Functioning	IQ 71-84
Mild Mental Retardation	IQ 50-55 to ~ 70
Moderate Retardation	IQ 35-40 to 50-55
Severe Mental Retardation	IQ 20-25 to 35-40
Profound Mental Retardation	IQ below 20 or 25

Also as far as I know, the DSM-IV is used almost exclusively in a clinical context, while the Wechsler scale is more widely used in educational settings. I am unsure as to which would be more appropriate for this article; perhaps other editors could join in the discussion. Fvasconcellos 22:40, 30 December 2006 (UTC)