Talk:Autism
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| Frequently asked questions (FAQ) | |
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| Many of these questions have been raised in the scientific and popular literature, and are summarized here for ease of reference.
The main points of this FAQ can be summarized as:
Q1: Why doesn't this article discuss the association between vaccination and autism?
A1: This association has been researched, and is mentioned in the page - specifically with some variant of the statement "there is no convincing evidence that vaccination causes autism and an association between the two is considered biologically implausible". Despite strong feelings by parents and advocates, to the point of leaving children unvaccinated against serious, sometimes deadly diseases, there is simply no scientific evidence to demonstrate a link between the two. Among the organizations that have reviewed the evidence between vaccination and autism are the Centers for Disease Control and Prevention (United States), Institute of Medicine (United States), National Institutes of Health (United States), American Medical Association, the Cochrane Collaboration (British/international), British Medical Association (Britain), National Health Service (United Kingdom), Health Canada (Canada) and the World Health Organization (international). The scientific community took this issue seriously, investigated the hypothesis, designed and published many studies involving millions of children, and they all converged on a lack of association between autism and vaccination. Given the large number of children involved, the statistical power of these studies was such that any association, even an extremely weak one, would have been revealed. Continuing to press the issue causes unnecessary anguish for parents and places their children, and other children at risk of deadly diseases (that disproportionately harm the unvaccinated).[1][2][3] Q2: Why doesn't this article discuss the association between thiomersal, aluminum, squalene, toxins in vaccines?
A2: Thiomersal has also been investigated and no association is found between the two. Vaccines are heavily reviewed for safety beforehand, and since they are given to millions of people each year, even rare complications or problems should become readily apparent. The amount of these additives in each vaccine is minuscule, and not associated with significant side effects in the doses given. Though many parents have advocated for and claimed harm from these additives, without a plausible reason to expect harm, or demonstrated association between autism and vaccination, following these avenues wastes scarce research resources that could be better put to use investigating more promising avenues of research or determining treatments or quality-of-life improving interventions for the good of parents and children.
Specifically regarding "toxins", these substances are often unnamed and only vaguely alluded to - a practice that results in moving the goalpost. Once it is demonstrated that an ingredient is not in fact harmful, advocates will insist that their real concern is with another ingredient. This cycle perpetuates indefinitely, since the assumption is generally a priori that vaccines are harmful, and no possible level of evidence is sufficient to convince the advocate otherwise. Q3: Why doesn't this article discuss X treatment for autism?
A3: For one thing, X may be discussed in the autism therapies section. Though Wikipedia is not paper and each article can theoretically expand indefinitely, in practice articles have restrictions in length due to reader fatigue. Accordingly, the main interventions for autism are dealt with in summary style while minor or unproven interventions are left to the sub-article. Q4: My child was helped by Y; I would like to include a section discussing Y, so other parents can similarly help their children.
A4: Wikipedia is not a soapbox; despite how important or effective an intervention may seem to be, ultimately it must be verified in reliable, secondary sources that meet the guidelines for medical articles. Personal testimonials are primary sources and can only be synthesized through inappropriate original research. If the intervention is genuinely helpful for large numbers of people, it is worth discussing it with a researcher, so it can be studied, researched, published and replicated. When that happens, Wikipedia can report the results as scientific consensus indicates the intervention is ethical, effective, widely-used and widely accepted. Wikipedia is not a crystal ball and can not be used to predict or promote promising interventions that lack evidence of efficacy. Without extensive testing, Wikipedia runs the risk of promoting theories and interventions that are either invalid (the Refrigerator mother hypothesis), disproven (secretin and facilitated communication),[4] or dangerous (chelation therapy, which resulted in the death of a child in 2005).[5] Q5: Why doesn't this article discuss Z cause of autism? Particularly since there is this study discussing it!
A5: No ultimate cause has been found for autism. All indications are that it is a primarily genetic condition with a complex etiology that has to date eluded discovery. With thousands of articles published every year on autism, it is very easy to find at least one article supporting nearly any theory. Accordingly, we must limit the page to only the most well-supported theories, as demonstrated in the most recent, reliable, high-impact factor sources as a proxy for what is most accepted within the community. Q6: Why does/doesn't the article use the disease-based/person-first terminology? It is disrespectful because it presents people-with-autism as flawed.
A6: This aspect of autism is controversial within the autistic community. Many consider autism to be a type of neurological difference rather than a deficit. Accordingly, there is no one preferred terminology. This article uses the terms found in the specific references. Q7: Why doesn't the article emphasize the savant-like abilities of autistic children in math/memory/pattern recognition/etc.? This shows that autistic children aren't just disabled.
A7: Savant syndrome is still pretty rare, and nonrepresentative of most of those on the autistic spectrum. Research has indicated that most autistic children actually have average math skills.[6] Q8: Why doesn't the article mention maternal antibody related autism or commercial products in development to test for maternal antibodies?
A8: There are no secondary independent third-party reviews compliant with Wikipedia's medical sourcing policies to indicate maternal antibodies are a proven or significant cause of autism, and commercial products in testing and development phase are unproven. See sample discussions here, and conditions under which maternal antibody-related posts to this talk page may be rolled back or otherwise reverted by any editor. References
Past discussions For further information, see the numerous past discussions on these topics in the archives of Talk:Autism:
External links
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| This article is written in American English, which has its own spelling conventions (color, labor, traveled), and some terms that are used in it may be different or absent from other varieties of English. According to the relevant style guide, this should not be changed without broad consensus. |
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Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Autism.
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This article has been mentioned by multiple media organizations:
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| This talk page is automatically archived by Lowercase sigmabot III. Any threads with no replies in 30 days may be automatically moved. Sections without timestamps are not archived. |
| This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Assigned peer reviews: Rmaharjan7cl7yp. |
Contents
I don’t think cocaine and alcohol cause autism[edit]
As someone with autism, I am pretty sure that instead of causing autism, that cocaine and alcohol would do something else. I am not an expert about the causes of autism, but I am pretty sure that cocaine and alcohol would cause another disability or just result in death. Bubba2018 (talk) 01:47, 28 September 2018 (UTC)
- @Bubba2018: The part about cocaine and alcohol is sourced, do you know of a source that says cocaine and alcohol don't cause autism? Just saying "I am pretty sure" without a reliable source to back you up is not a valid reason to change the article. Tornado chaser (talk) 02:03, 28 September 2018 (UTC)
- Clarification: The article (as sourced) says that cocaine and alcohol use by the mother during pregnancy are "risk factors". That is to say women who use cocaine and/or alcohol during pregnancy are more likely to have children with autism. It does not mean drug use by the mother necessarily causes autism, only that mothers using EtOH/cocaine are more likely (as a group) to have children with autism.
- Whatever the case, Reproductive Toxicology is a reliable source for the info. Is our wording of "risk factors" an appropriate wording for the source's "factors associated with"? While "risk factor" does not mean causative, would other wording be clearer/more appropriate? - SummerPhDv2.0 04:32, 28 September 2018 (UTC)
@SummerPhDv2.0, oh! Like I said I am not an expert on the causes! No, I don’t have a source but I heard that the causes were unknown. Bubba2018 (talk) 02:28, 29 September 2018 (UTC)
- It's a correlation. Some correlations are because one thing causes another (like smoking and lung cancer). Others are further down the line (people who use smoker's toothpaste have higher rates of lung cancer than people who use regular toothpaste, but only because they tend to be smokers). Still others are unrelated or tangential connected.
- Causes of autism are not known. Several correlations are known. - SummerPhDv2.0 04:38, 29 September 2018 (UTC)
- I reworded the lede “caused” to “associated with”. “Cause” is a very strong conclusion requiring strong evidence, and is not supported by the references. Ref 4 uses “results from”, which is stronger than “associated with” but is well short of “caused by”. A key point in all reliable sources is the lack of certainty. —SmokeyJoe (talk) 05:31, 29 September 2018 (UTC)
Speech therapy[edit]
"People with ASDs have deficits in social communication, and treatment by a speech-language pathologist usually is appropriate."[1] Why was this removed? Doc James (talk · contribs · email) 03:52, 27 October 2018 (UTC)
- I just mentioned the importance of services being carried out by behavior analysts, speech pathologists, special education teachers, and licenced psychologists in the treatment section. No reason to be in the infobox or lead. ATC . Talk 21:47, 31 October 2018 (UTC)
- Yes a speech language pathologist is typically one of the key specialists involved.[2]
- The 2007 Pediatrics paper says "People with ASDs have deficits in social communication, and treatment by a speech-language pathologist usually is appropriate."
- This is greater evidence than any of the meds mentioned.
- But sure we can mention "Early behavioral interventions" first Doc James (talk · contribs · email) 06:31, 1 November 2018 (UTC)
- I still do not think their is relevance to mention speech therapy in the lead because under the "speech and language therapy" category of the Pediatrics source, all the therapies listed - "DTT, verbal behavior, natural language paradigm, pivotal response training, milieu teaching" - derive from the field of behavior analysis not speech pathology. Speech therapies would include, i.e., PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets), Articulation Therapy, Kaufman Speech to Language Protocol, etc. (none of which are recommended by the AAP, Surgeon General, or US National Research Council).
- The next two sentences following "People with ASDs have deficits in social communication, and treatment by a speech-language pathologist usually is appropriate," states: "However, traditional, low-intensity pull-out service delivery models often are ineffective, and speech-language pathologists are likely to be most effective when they train and work in close collaboration with teachers, support personnel, families, and the child's peers." What the Pediatrics source implies is that unless the speech pathologist is also a behavior analyst, speech pathologists should mainly consult and train other behavior analysts, special education teachers, and licensed psychologists when it comes to, i.e., incorporating oral motor imitation or tactile prompts into the Discrete Trials (DTT), but low-intensity speech related services (i.e., Articulation Therapy, Kaufman Speech to Language Protocol) are not beneficial enough for all the skills that need to be taught based on the intensity provided (or very few hours of traditional speech therapy). While speech therapy can be be helpful if offered on the side, they should not be the main course of treatment, and therefore, there is no relevance for it in the lead. ATC . Talk 20:18, 2 November 2018 (UTC)
- I just mentioned the importance of services being carried out by behavior analysts, speech pathologists, special education teachers, and licenced psychologists in the treatment section. No reason to be in the infobox or lead. ATC . Talk 21:47, 31 October 2018 (UTC)
Medications[edit]
Are not a primary treatment "Current evidence-based pharmacotherapy options in children with ASD are very limited, and many have substantial adverse events. Clinicians should use pharmacotherapy as a part of comprehensive treatment, and judiciously weigh risks and benefits."[3]
They are occasionally used for associated symptoms but poorly supported. Doc James (talk · contribs · email) 03:56, 27 October 2018 (UTC)
Behavioral therapy[edit]
A number of types are used and thus linking to the board category in the overview of the topic in question is perfectly appropriate. This ref for example discusses the use of CBT for associated anxiety.[4] Doc James (talk · contribs · email) 18:47, 31 October 2018 (UTC)
- I left CBT in the infobox as it has some evidence of effectiveness in older children with autism who have co-morbid anxiety. Although ABA and CBTs often overlap in theories in techniques (especially in counseling), the reason why I listed ABA and CBT seperately is because people often refer to ABA as the Early Behavioral Interventions (EBIs) - structured and naturlisric teaching interventions for young kids with autism - which is completley seperate from CBT, as it is more related to counseling. CBT (without the "s" at the end) is often used synonymously with Cognitive Therapy which is not really behavioral; it's just the branding name. ATC . Talk 21:59, 31 October 2018 (UTC)
- They can be well summarized as "behavioral therapy" as the term encompases both "ABA" and "CBT" Doc James (talk · contribs · email) 05:28, 1 November 2018 (UTC)
- I left CBT in the infobox as it has some evidence of effectiveness in older children with autism who have co-morbid anxiety. Although ABA and CBTs often overlap in theories in techniques (especially in counseling), the reason why I listed ABA and CBT seperately is because people often refer to ABA as the Early Behavioral Interventions (EBIs) - structured and naturlisric teaching interventions for young kids with autism - which is completley seperate from CBT, as it is more related to counseling. CBT (without the "s" at the end) is often used synonymously with Cognitive Therapy which is not really behavioral; it's just the branding name. ATC . Talk 21:59, 31 October 2018 (UTC)
New section[edit]
I suffer from Autism and personally I think stacking bricks is more related to OCD than Autism and also Autism more than likely is NOT caused by alcohol and drugs, because my parents didn't take any
Kieran R. Halfpenny (talk) 22:54, 12 November 2018 (UTC)
- @Kieran R. Halfpenny: New comments actually go at the bottom, so I have moved your comment here.
- wikipedia is based on reliable sources, not editors' personal experience, so you will need to find a reference for the fact that stacking bricks is associated more with OCD that autism, and the article doesn't say that the only cause of autism is parental substance abuse, just that this increases the likelihood that the baby will have autism. Tornado chaser (talk) 00:10, 13 November 2018 (UTC)
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