Talk:Autism spectrum

See also: Wikipedia:Notice board for autism-related topics

The definition of Autism

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

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

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

Perseveration

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

DSM-IV-TR doesn't say "perseveration"; it says "restricted repetitive and stereotyped patterns of behavior, interests, and activities".[1] What reliable source says "perseveration"? Eubulides (talk) 06:23, 4 March 2009 (UTC)

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

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

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

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

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

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

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

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

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

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

There's one question:

• There are two definitions of autism in the article that diverge a bit, IMHO:

  Autism is a highly variable brain development disorder

  and

  Autism is one of the five pervasive developmental disorders

  The first one is close to ICD Q00-Q07 (as far as I understand), the second refers to ICD10 F84. Is it O.K.? I've asked at the Neurodevelopmental disorder if the article fits into ICD Q list. Or maybe the latter article is vague and overlaps several ICD sections.. --CopperKettle 12:03, 19 February 2009 (UTC)

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

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

• Another quote:

  Its individual symptoms occur in the general population and appear not to associate highly, without a sharp line separating pathological severity from common traits.[14]

  - seems a little clumsy: "separating severity from traits" - maybe better would be "separating pathological from common traits" or somehow otherwise? Because severity has a bit of "adjective" role (don't know the exact phraseology of linguists), trait is a "noun".. Maybe: "separating pathological manifestation from common traits"? Best regards, --CopperKettle 16:04, 19 February 2009 (UTC)

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

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

• Autistic toddlers have more striking social deviance; for example, they have less eye contact and anticipatory postures and are more likely to communicate by manipulating another person's hand.[16]

  - meaning they mainly tug adults by hand to get what they want? (Translating word-for-word could expand the meaning to something akin to sign language, so I want to say in the Russian version: "they manipulate the other's hand to get something they want\indicate something they want"). --CopperKettle 12:58, 23 February 2009 (UTC)

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

• "desynchronization of vocal patterns with the caregiver"

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

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

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

March issue of Br J Hosp Med

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

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

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

Kanner image

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Connection to wireless?

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

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

We may ask ourselves the following questions:

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

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

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

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

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

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

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

HBOT

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

Asperger image

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

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

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

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

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

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

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

• old image; no longer present on Wikipedia, so I'm linking to an offsite copy
• New image: Image:Asperger-Vienna-clinic.jpeg

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

3rd opinion on Asperger image

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

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

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

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