Talk:Autism spectrum

Please somebody add link to "Is there a link between engineering and autism? " http://www.autismresearchcentre.com/docs/papers/1997_BCetal_Engineer.pdf Thanks! —Preceding unsigned comment added by 62.85.27.234 (talk) 17:57, 7 October 2010 (UTC)

It's shocking that this is a featured article

This article is loaded with errors regarding Autism.

Primarily, Autism is no longer considered to be a separate diagnosis. The term "Autism" is used as an Umbrella diagnosis that includes Asperger's, HFA, PDD and Kanner's Syndrome ("Classic Autism"). As such, the term "Autism" should not be used in this way as it encompasses all ASDs. For clarity, someone with Asperger's Syndrome is Autistic, so is someone with PDD or HFA. The term "Autism" as a descriptive for a particular diagnosis has been replaced by "Kanner's Syndrome" or "Classic Autism." I would propose that searches on "Autism" redirect to "Autistic Spectrum Disorder", which would be more consistent with current medical understanding.

The article stated that there are 3 conditions on the spectrum - Autism, Asperger's and PDD-NOS. It made no mention of High-Functioning Autism (which has a separate clinical criteria for diagnosis from Autism, characterised by the inclusion of delay in Language Development). I have attempted to correct this (in fact, PDD-NOS is actually a diagnosis given when there is insufficient evidence for a conclusive diagnosis that an individual is on the Autistic Spectrum as their symptoms do not fit clinical understanding of Autism - so its place on the Spectrum is open to interpretation).

Discussions on prevalence in the article are hugely misleading. In the UK alone, the Government has admitted that it has no idea regarding prevalence and relies on a "rough guess" idea through the use of isolated, non-representative studies. This issue is a primary focus of the Autism Act (2009) and is predicted to be adressed in statutory guidance published before the end of 2010 that will commit all Local Authorities to undertake rigorous prevalence studies as well as increase the availability of diagnostic pathways for service users through the NHS. There is NO authoritative or quantifiable study on Autism Prevalence worldwide. In addition, increases in reported diagnoses are mainly due to increased awareness among healthcare practitioners rather than an increase in the amount of sufferers (there are many National Autistic Society studies on this).

These are just the most obvious inaccuracies.

In short, it is absolutely shocking and disgusting that this article has been granted "featured" status when it actually propogates misunderstanding and misinformation.

Sort this out, it's insulting to those of us on the Spectrum. —Preceding unsigned comment added by 86.22.162.189 (talk) 22:57, 20 July 2010 (UTC)

Ive reverted your edit as it doesnt match with what Ive learned and what seems to be stated by the various sources in the article. But perhaps I am wrong and things have changed, at least in certain diagnostic manuals. You say above that HFA is distinguished from classic autism by the inclusion of a language delay; did you mean to say it's distinguished from Asperger syndrome? —Soap— 23:24, 20 July 2010 (UTC)

If I was wrong to revert your edit I apologize for the disruption. —Soap— 23:24, 20 July 2010 (UTC)

--Yes. Read the Wikipedia Article on HFA (and other autism-related articles) for starters and how it is differentiated - Wikipedia's articles are contradicting each other. "Kanner's Syndrome" redirects here. This article ahould really be re-named as "Kanner's Syndrome" or "Classic Autism" and heavily edited, as Autism is now considered the name for all conditions on the spectrum (I have a diagnosis of Asperger's Syndrome, for example, and am classed as being a person with Autism by the UK Government and the NHS). The search term "autism" would be more properly redirected to "autistic spectrum disorder" (I'm not going to start arguing about the use of the word "Disorder" when the trend is leaning towards replacing it with "condition", at least within the NHS, but there you go). My main point is that a lot of the Autism-related articles on Wikipedia provide contradictory information, linked search terms are inaccurate, and actually a lot of this information can be easily found to be incorrect (or at least wrongly-termed) through very basic searches or reading on sites such as the National Autistic Society, the UK government's Adult Autism Strategy (2010), etc. Forgive me for not providing citations for my edits as I am new to this whole thing and not sure how to do all that, but please believe me that, as a person with Autism and after actually discussing this with professionals, and the fact that I even work for a Mental Health organisation that has specialist units on autism, I know what I am talking about. Some of the stuff on the autism-related articles on here is inaccurate, other stuff is just downright insulting. A citation does not in itself make a statement accurate (particularly in an area where common-accepted fact is ever-changing, as is the case with ASC). —Preceding unsigned comment added by 86.22.162.189 (talk) 23:36, 20 July 2010 (UTC)

--On a slightly related note, I think perhaps it is important to note than in UK law, Asperger's Syndrome is afforded "default" protection under the Disability Discrimination Act (2005) following the legal case of Hewitt v Motorola (2004). The outcome of that case decreed that the definition of "communication" in the DDA be expanded to include the subtleties of human non-verbal communication such as tone of voice, body language, etc - which are prerequisites for a diagnosis of Asperger's (a simple browser search will corroborate that). The issue of Autism Spectrum Disorders/Conditions being covered under existing UK Disability Legislation is currently a heavily-discussed issue (due to the fact that Autsim does not fit into traditional disability boundaries of Mental Health, Physical or Learning Disabilities) and is, again, one of the primary reasons for Autism being the subject of the UKs first disability-specific legislation. If you want more information on the Adult Autism Strategy, I believe the full title of the UK government paper is "Fulfilling and Rewarding Lives" (2010) —Preceding unsigned comment added by 86.22.162.189 (talk) 23:56, 20 July 2010 (UTC)

--Apologies if I am coming across as overly blunt - it's just "my way". I don't mean to be perceived as overly agressive or critical. —Preceding unsigned comment added by 86.22.162.189 (talk) 00:17, 21 July 2010 (UTC)

I agree that

1. this article addresses Kanner's syndrome/classic autism,
2. these days "autism" means "on the autism spectrum", and
3. a search for "autism" should automatically redirect to a page that briefly explains how the term is used today (with a brief history of the term), describes the spectrum, and directs readers to specific articles about the peculiarities of each condition on the spectrum.

The problem is, changes to Wikipedia's medical articles are strictly governed by this policy: WP:MEDRS, and rightly so - just because you and I think this or know this (and I'm sure we're both reliable people), there are just as many unreliable editors wanting to put stuff they know into medical articles. I would support those changes, if you can find a recent, authoritative secondary source (clearly, uncontroversially conforming to WP:MEDRS) that fully supports them. Are you interested, or do you have the time and resources to take that on? I am mildly interested and short on time and energy, but have access to most med/psych/bio journals.

A tip. As a courtesy to other editors, keep your contributions as concise as possible; and Register - it is a pleasanter experience for editors to interact with others who have a name. Great to have you here, by the way. This place can be fun and satisfying. Anthony (talk) 10:20, 21 July 2010 (UTC)

In the present versions of DSM and ICD, there is a condition named "Autistic Disorder" (DSM) and "Early Infantil Autism" (ICD); there is nothing called "Kanner's Syndrome" or "Classical Autism". And, btw, "High Functionig Autism" has not "a separate clinical criteria for diagnosis from Autism" - HFA is simply Autism without mental retardation, and both Autism with and without mental retardation are classifies as "Autistic Disorder"/"Early Infantil Autism"--95.93.123.114 (talk) 09:38, 4 September 2010 (UTC)

NPOV this article, reallly?

Is it just me or is this article and related articles biased in favour of neurotypicals; because it keeps going on about all the difficulties that autistic people have and not really giving them any credit. Just because an Autistic person can't speak, doesn't mean they're stupid, thick, retarded whatever just means they can't speak, simple. Amanda Baggs has autism, can't speak but is really intelligent and is even an autism rights activist. I do think this article should be cleansed of it's bias because a neutral point of view is not showing any bias towards a particlar group or persective, I think this article DOES show bias. Any arguments against that, fine by me. —Preceding unsigned comment added by Antidanguy (talk • contribs) 22:39, 2 August 2010 (UTC)

If you have reliable sources that are not reflected here, by all means list them here. SandyGeorgia (Talk) 14:55, 1 September 2010 (UTC)

I agree that this article could be greatly improved with respect to WP:NPOV. I see some problems in the Prognosis section, in accordance with the sort of bias you describe. But we need to be cautious about how we go about removing bias; the term "neurotypical" itself is a bit of a normative term itself, representing a specific point of view, so if we are to use it in the article, I think it needs to be introduced with a context and definition, backed up by reliable sources representing multiple perspectives. I don't like the way the article uses the term once, without definition or context. Cazort (talk) 19:35, 25 September 2010 (UTC)

Edit request from ShillIHA, 7 September 2010

{{editsemiprotected}} This text should be removed because it is incorrect: Although many alternative therapies and interventions are available, few are supported by scientific studies.[23][131] Treatment approaches have little empirical support in quality-of-life contexts, and many programs focus on success measures that lack predictive validity and real-world relevance.[24]

It should read as follows: Although many alternative therapies and interventions are available, few are supported by scientific studies.[23][131] However, mild hyperbaric oxygen therapy (1.3 ATA) has been shown to help in the areas of speach and focus in placebo-controlled, double-blind studies.

ShillIHA (talk) 18:34, 7 September 2010 (UTC)

Looks OK to me, except for the hbotreatment link (per WP:ADVERT and WP:EL). OhNoitsJamie ^Talk 18:49, 7 September 2010 (UTC)

Sorry no. For a start, Medical hypotheses is a non-peer reviewed journal and is explicitly excluded as a RS by WP:MEDRS. In contrast, the Paediatrics is a reputable journal, but the study is a highly preliminary one,[1] that, for example, only followed the subjects for 4 weeks. Reading WP:MEDRS will show that we need this treatment to be mentioned in review articles published in high quality journals. The reason for this is obvious when one considers other reliably sourced studies such as this one [2] find no effect for HBO. The ad link is obviously inappropriate, as Ohnoitsjamie says. --Slp1 (talk) 19:30, 7 September 2010 (UTC)

Agreed. This is extremely preliminary and a very small study at that; the overall evidence is still equivocal at best. While a secondary source is available (PMID 19917212, a systematic review), it was authored by Dan Rossignol, the lead researcher of the BMC Pediatrics trial, and even it does not include HBOT as a "promising treatment". Fvasconcellos (t·c) 02:55, 8 September 2010 (UTC)

Agree with Slp1 and Fvasconcellos; the text does not hold up to medical referencing standards, and should not be included unless a secondary review supports it. SandyGeorgia (Talk) 03:48, 8 September 2010 (UTC)

Bias about Causes

Quote: "Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to theories that vaccines or their preservatives cause autism, which was fueled by a scientific study which has since been proven to have been falsified. Although these theories lack convincing scientific evidence and are biologically implausible, parental concern about autism has led to lower rates of childhood immunizations and higher likelihood of measles outbreaks in some areas.[7]"

I think this change would be less biased : "Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to theories that vaccines or their preservatives cause autism. This theory was first presented in a scientific study which was recently retracted due to ethics concerns. Further studies have not been able to link vaccines to autism. Parental concern about autism has led to lower rates of childhood immunizations and higher likelihood of measles outbreaks in some areas.[7] Seizure disorders are markedly increased in ASD and persons with seizure disorders may have reactions to vaccines[reference needed].

—Preceding unsigned comment added by 70.126.115.123 (talk) 05:00, 11 September 2010 (UTC)

Thanks for your comments. It was more than just "ethics concerns" that destroyed that study and the original "since been proven to have been falsified" is accurate. The "biologically implausible" aspect should not be removed as most (possibly all) the world's heath organisations repeat that aspect when explaining the vaccination/autism issue. There is an association between seizures and vaccines (particularly those that may cause a fever), and there is an association between epilepsy and autism. I'm not aware of any link between these two associations and mentioning them together here (implying such a link) is original research without a reliable source that does the same. Colin°^Talk 09:39, 11 September 2010 (UTC)

Just to chime in, I think people may have over-reacted to the autism-vaccine issue...in the sense of using WP:POV language that dismisses (without source) all or most proposed environmental factors. I did a slight cleanup and also introduced one more proposed factor (television), with a source. From what I have seen, there is uncertainty and often controversy surrounding all proposed / theorized environmental causes. But just because there's a scientific consensus dismissing the vaccine theory doesn't mean there's a consensus on other environmental factors--this seems to be a largely uncertain / unknown area with ongoing study and a great deal of uncertainty. Cazort (talk) 19:39, 25 September 2010 (UTC)

Cazort - it's a bit of an overstatement to say "scientific consensus dismissing vaccine theory".

There is pretty good acceptance of the theory that vaccines can cause autism in kids with mitochondrial diseases. And the vaccine court even awarded one kid money based on that. It's not accepted that this is a big cause of autism, however, it's also not thought that this kid was the ONLY kid whose autism was caused by vaccines. In fact, it's widely believed that fever with mitochondrial disease can cause very serious brain problems, ie, autism in some, and so it's not much of a jump to say that vaccines, which also cause fever and immune reaction such as an infection, might also cause some cases.

Most studies we hear about indicate most cases of autism must not be caused by vaccines, but it's not accurate to say that vaccines have been rejected in all cases, or that it's a "biologically implausible" cause. —Preceding unsigned comment added by 75.61.143.252 (talk) 01:46, 13 October 2010 (UTC)

The "Causes" section is hopelessly bad. Just hopeless, throw out all but two or three sentences.

Virtually all researchers agree there are many causes for autism. And that some genetic syndromes do cause autism all by themselves.

There is this gang of people who won't let the articel become good, who actively prevent it. The fact is, literally dozens, perhaps hundreds, of studies reveal very heterogeneous biomarkers for autism, so that for example, some autistic kids have larger than average brains, some have smaller. Some have elevations of various molecules, some have reductions of the same molecules.

Some cases of autism are widely accepted to be caused by mitochondrial disease, most are not.

The causes section should go into some of the dozens of highly variable biomarkers to illustrate why nearly all researchers believe in many different causes. I was at a conference recently where a geneticist told me they are looking at 300 genes. Also, the question of heratibility should address, at least slightly, the findings of respected researchers that while identical twins have as much as 90% concordance, dizygotic twins have a much higher concordance rate than siblings, strongly implying "environmental" (maybe prenatal and having nothing at all to do with any man-made thing or condition)factor influence a significant minority of cases.

It's a VERY BAD article for anyone who's been following the science of the last several years, at least the past 3 years but probably much longer. —Preceding unsigned comment added by 75.61.143.252 (talk) 01:21, 13 October 2010 (UTC)

Suggested changes:

Autism is not a single condition, and does not have a single cause. The concordance rate for identical twins indicates a very high genetic component, but isolating single gene causes for the great majority of cases has so far been impossible.

The fact that persons diagnosed as autistic or having autistic spectrum disorder have great variability in biomarkers indicates many different causes, and the great majority of researchers agree many causes will eventually be found.

While genetic causes predominate, the concordance rate for fraternal twins is much higher than that for siblings, which indicates "environmental" causes for the disorder, although "environmental" in this context does not mean man-made, and it may be that the most important environment is that of the womb.

A small percentage of cases are due to defects in mitochondrial genes. In some cases, the beginning of autism in a child is an onset of autistic regression, the loss of skills a child already has, and can be tied to the presence of mitochondrial disease,and an infection with fever. Although this may only represent a small percentage of cases, it means that the vaccine hypothesis is not completely "biologically implausible".

However, there is widespread agreement in the medical community that the risk of not vaccinating children is much higher than vaccination, and in most cases, no statistically significant increase in autism risk can be related to vaccination"

This is just a sample, the point is, the article is completely misleading. —Preceding unsigned comment added by 75.61.143.252 (talk) 01:39, 13 October 2010 (UTC)

Please provide reliable secondary sources for any proposed changes, and please discuss them here first (as you are doing). Dbrodbeck (talk) 11:51, 13 October 2010 (UTC)

No, no more of this "secondary sources only" nonsense. The Wikipedia rules do NOT require that, only that primary sources are identified as such, not given undue weight, etc. NO REQUIREMENT TO USE ONLY SECONDARY SOURCES. IT DOES NOT EXIST. —Preceding unsigned comment added by 75.61.131.31 (talk) 18:12, 14 October 2010 (UTC)

Medical articles are stricter than most. The relevant policy, from WP:MEDRS, states All Wikipedia articles should be based on reliable, published secondary sources. Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors, or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources, as defined above. To clarify, you can use primary sources if that's all that exists to address a particular question or area of research, but if secondary sources also exist, they take precedence and you can never use a primary source to make a conclusion that is not found in any trusted "secondary source". In other words, if the researcher says one thing and the people who review him say another, their word overrules his.

Even going beyond that question, though, is the policy that applies everywhere: if recently added content is challenged and removed, there must be a consensus to add it back in. —Soap— 18:33, 14 October 2010 (UTC)

SOAP - I appreciate the quotes from the guidelines or rules for medical articles, but I don't think you can quite defend your statement that you say clarifies them, "you can never use a primary source to make a conclusion that is not found in any trusted "secondary source"".

If that statement, which I was never able to find in any Wikipedia rules, is true, please tell me where to find it. I was told this repeatedly, but it was never shown to be true. The fundamental problem with the autism articles is that a gang of people with very rigid beliefs, unfounded, about what the Wikipedia rules allow or disallow is not allowing recent research into any autism article. This is terrible, because you simply can not depend on reviews being done in a reasonable length of time. Right now, there is research at UC Davis showing an antibody pattern in some mothers of autistics which is never found in mothers of non-autistics. In other words, a very strong biomarker, which means if you have that antibody, you should not have kids.

Putting this information in Wikipedia might save a great deal of grief for the mothers to be who have this antibody pattern, but the autism article tyrants won't allow that, even if properly treated. Even if no secondary source refutes it, (which is not the rule anyway.

And then I am told there must be consensus for the edit, even though the consensus is not being based on any fundamental reference to the science. Please, just let people put in the new science if it's done in the proper way and is not against the rules.

Sorry if I get emotional about the secondary sources issue, but this was repeatedly mispresented to me as an iron clad rule, when it's not a rule at all. Also, about the causes section, I was at a conference where one of the top autism people shared the podium with a geneticist from a University of California medical school. and in a break the geneticist told me they are looking at 300 genes as possible causes. Although that comment is not allowed by the rules, and I would not put it in, the general agreement of many, many genetic causes is allowed, and it's the state of the science, not some flaky off beat idea this professor had.

It's good to simplify at times, but it's a terrible thing to oversimplify as the people who feel they control this article insist on doing. At least dozens, and probably hundreds of genes and epigenetic effects cause brain conditions which are classifed as autism. This should be stated clearly in the article. —Preceding unsigned comment added by 75.61.131.31 (talk) 18:41, 14 October 2010 (UTC)

Minor edits

I would like to make some very minor edits to this article. A few sentences don't flow very well. Information will not be changed, but it should make this article easier to read. FruitSalad4225 (talk) 21:11, 29 September 2010 (UTC)

Traditionally we ask for which specific edits you want done, and then add them ourselves, however I'd be willing to give you "confirmed" permission which would let you edit the article, would you prefer this? I still would like to hear what you're planning to do though. —Soap— 21:44, 29 September 2010 (UTC)

It's basically moot now since you've been here almost four days and will have the ability to edit this page just as soon as you make 10 edits. —Soap— 00:08, 2 October 2010 (UTC)