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Rett syndrome/review

Me and my mother who is a professional in the field had a chance to review part of the article (not as much as I hoped... we'll have more time in a couple weeks) and she asserts with 100% certainty that rett syndrome is not (or is no longer) considered a autism spectrum disorder... many sources are available to back this up, such as 1 and 2 - she suggested putting it under a new heading "Other neurological(sp) conditions". Also, she took objection to the notion that it is a "controversial" disorder... but I'm unsure whether removing that will make the intro too POV... so I'll leave it in for now and come back to it as time allows. --RN 04:39, 27 July 2005 (UTC)

Suggested changes - part 1 (LONG)

OK, from button to top....

First off, the puzzle-laden ribbon... I really think this should be moved to a more appropriate page such as autism controversies and explained in more detail why some (probably many) feel it to be derogatory.

Dedicated to the eradication of autism.

Should be "Dedicated to finding a cure for autism" to be more politically correct

"Autistic Pride Day, an initiative from Aspies For Freedom, is on 18 June each year, st[...]"

How is this a "major autism event"? This is a fringe group at best... I understand the point of the cause but I really think a link would be much more appropriate as this can be offensive to some people ("Acceptance not cure")... at the very least it should not pretend it represents all autistics

"Aspies for freedom"

Two notes: First off this generally should belong in the aspergers section as at least that is what "aspies" (more in-crowd speak too that makes this article hard to read) generally refers to.... secondly it goes to the points raised above that this should really be a link - plus there are several other wikipedia articles that reference the cause in great detail - this should really be kept understandable for the parents etc..

Some autistic adults, especially those with high-functioning [...]

This is kind of hard to read... my suggestion would be rewording as follows

Some autistic adults are able to work successfully in mainstream jobs, usually those with high-functioning autism or Asperger's syndrome. Nevertheless, communication and social programs often cause difficulties in many areas of the autistic's life.

It is estimated that 10% of autists are savants, compared to 1/2% of other people.

Where's the reference? Estimated by whom?

"Autism and computing"

Anything past the first sentence in this paragraph is filled with jargon and - I really think this section could be helpful to parents etc. if it was reworded to mention that using emails and other computer communication methods help with some autistics (milage does vary quite a bit, however...). Also Monotropism was (attempted to be) explained previously in the article...

"Other theories address the rise of autism in recent times. They suggests the rise of visual media and thereby the increasing central role of visual information processing in the breakdown of language and the rise of autism."

Where's the reference for this? It sounds like complete nonsense... also suggests should be suggest et al.

"The analysis of autism as "mind blindness"—the inability to create models of other people's thoughts. The typical example of this is "where does X look for the object they stored, but which was moved by Y"—see theory of mind. Not all autistics fit this pattern, however."

Should be "mental models" instead of just models... also the last sentence isn't needed as its already mentioned its a theory (theory should be capitalized in the heading too). In addition, the example is hard to understand... it should probably be changed to something similar to

"autistic looks for object at point X, but which was moved to point Y"

Even then its probably just better to reference theory of mind

"The underconnectivity theory indicates a deficiency in the coordination among brain areas (the brain is known to be modular). With the aid of (fMRI), it was seen that white matter, which connects various areas of the brain like cables, has abnormalities in people with autism."

the bit about the brian is known to be modular should be removed... its confusing at best and is sort of implied by the sentence. Also, the parenthases around fMRI should be removed... 

The underconnectivity theory holds that autism is a system-wide [...]

This paragraph should be merged with the previous one, and the last sentence seems like it doesn't provide any benifit to the understanding of the theory.

The monotropism hypothesis argues that the central feature of autism is attention-tunneling, or monotropism. [...]

What's attention-tunneling? This whole paragraph is pshycobabble and needs a rewrite to make it easier to understand...

Anyway, I'm out of time and that's part one... hopefully someday we can make this a featured article. --RN 23:34, 25 July 2005 (UTC)

reply regarding suggested changes

Couldn't agree more that this article has, at very best, extreme NPOV problems. Also, it is difficult to read. I've got a bachelors in psychology and I still have only a vague idea what "attention-tunneling" might be - it sounds like a term straight from the journal literature and could use explanation for the lay person. Also there are no peer-reviewed references for the suggestion that autism is "on the rise" as a result of visual media saturation. I am not aware of any published study which has shown this effect.

The argument concerning the prevalence of savants among autistic individuals and "normals" seems to be concerned more with arguing that those with autism are superior and less concerned with providing accurate information. There are plenty of places where a diagnosis of autism may be regarded as a social movement, but an informational encyclopedia is not one of them. Also it is innaccurate to state that all autistic people want "acceptance not cure". I'm sure anyone who has been a caseworker or behavioural therapist for an autistic child has seen the autistic individual's frustration and emotional pain at finding themselves unable to communicate. --adam black 01:19, 2005 July 26 (UTC)

Lining up their cars and trains

"As children, they might spend hours lining up their cars and trains in a certain way, rather than using them for pretend play."

What makes NTs believe that such play is not proper "pretend" play? It's called "roll call." For example, if I own several Fisher-Price Little People figures, and I line them up in a certain way, it might be the case that I'm seating them at their pretend desks at the start of class. It applies to toy cars as well: each has a designated parking space. And compare what grown-up collectors do with Precious Moments figurines and the like in display cases. --Damian Yerrick 03:40, 6 May 2005 (UTC)

Well, for one, because you could tell us about these little stories and imaginary situations you were creating when you played with the cars, right? But we lack these reports of imaginary play in autistic children, and even when pushed to engage in pretend play most kid's can't manage it.

I sure wish they'd interviewed me and my partner and most of our autie friends in that case. Autistic imaginary play sometimes works a bit differently from non-autistic, and we may be unable to describe it in words, but that's different from having no imagination at all. (My books and records would not be happy unless I put them in chronological order; crayons had to go by the spectrum. Sorting things into discrete groups was, and still is, I'll put it bluntly, a religious task comparable to the rosary.) What I think is more interesting is the fact that lining things up seems to be almost universal among autistics. --Bluejay Young July 5, 2005 07:42 (UTC)

Neanderthal theory

I removed the following paragraph since it is not referenced, not encyclopaedic, badly explained, and plain bullshit: "The Neanderthal Theory is that autism and other psychiatric conditions evolved from interbreeding between Homo Sapiens and Neanderthals. This interbreeding is believed to have caused genetic material from the Neanderthals to enter the Homo Sapiens genome. Whether such interbreeding ever actually occurred is controversial, and this theory is extremely speculative." Although this is not stated in the supposed 'theory', the paragraph suggests that autism is caused by the presence of Neanderthal genetic material, and therefore presumably that Neanderthals and Neanderthal-homo sapiens hybrids displayed traits characteristic of autism. Here are just a few reasons why this theory is pure non-sense:

  1. Neanderthals were a highly intelligent human species, with larger brains than modern humans, the capacity to make tools, and most likely also capable of speech. Neanderthals were a very successful species who suvived for many tens of thousands of years, they were very well adapted to their environment and probably became extinct because climate change created a new environment to which modern humans were better adapted. In other words, there is absolutely no reason to believe that Neanderthals had autistic traits.
So, uh, autistics are incapable of toolmaking or speech? You're sort of leaving out a KEY PREMISE of your argument, mostly because it's OBVIOUSLY false. Thsgrn 04:00, 16 July 2005 (UTC)
  1. Accoding to the Neanderthal "Theory", is autism monogenic or polygenic? If monogenic, is the Neanderthal-autism gene inherited in a dominant or recessive fashion? Suppose, it was polygenic. In that case, the very small number of Neandethal genes that may have entered the homo sapiens gene pool will have become progressively diluted, and could not explain the high incidence of autism today (between 1 in 100 to 1 in 1000 children). The same is true in the monogenic recessive scenario. The remaining possibility, i.e. of a monogenic dominant inherited condition is clearly wrong, as it doesn't match the pattern of autism. It just makes no sense.
  2. If the Neanderthal "Theory" were true, how likely is it that the autistic offspring of Neandethal-homo sapiens interbreeding would have survived ice-age conditions until their reproductive age and been successful at passing on their supposedly autism-causing genes?
  3. This extremely crude (mis)understanding of human genetics in which interbreeding (but not inbreeding) is regarded as detrimental, always reminds me of the Nazis and other eugenicists. The Neanderthal "Theory" is an insult to Wikipdia readers' intelligence, an insult to autists and an insult to Neanderthals. - pir 01:30, 6 Jun 2005 (UTC)
The Neanderthal theory[1] may not yet have withstood serious review, but some of the concepts outlined by the article's author have some merit: "it is very likely that climatic factors played an important role in the evolution of Homo." Perhaps the most salient aspect of this theory derives from the fact caucasions (who may harbor entire alleles or merely microsatellite chains - and/or 'junk dna' - from hybrid stock) have been acknowledged by many to be most vulnerable to autism spectrum diagnoses. Extended expression (or perhaps susceptibility to demethylation suppression) of vital genetic codes, particularly among Caucasions, may contribute to vulnerabilities caused by environmental conditions (fewer viral and bacterial infections in colder, northern climes) and/or evolutionary selection for later maturation, especially of the immune system. Besides, archeological evidence of apparently hybrid morphology is relatively concrete in comparison to mitochondrial dna statistical evidence from the 'Out of Africa' theorists. The Neanderthal theory passage can use some refinement, but should not be deleted just because of its novelty and evident lack of attention from experts. Ombudsman 03:31, 6 Jun 2005 (UTC)
I don't reject the inclusion of the Neanderthal "theory" because of its novelty and evident lack of attention from experts - in fact I'm all in favour of non-experts questioning commonly held dogmas if they do so in a serious and sensible way. Nor do I have any real problem with the assumption of interbreeding between Neanderthals and homo sapiens. I reject the inclusion of the Neanderthal "theory" because (1) it doesn't make sense, (2) it is not just unfounded in existing evidence, it is contradicted by existing data, (3) it does not explain anything about autism.
Even a quick google search [2] reveals that autism is not more prevalent in caucasians: Autism was not associated with parental education, occupation, racial origin, or religion [3] ; the prevalence was comparable for black and white children- 3.4 per 1000 for both [4]. This alone probably disproves the Neanderthal "theory" of autism.
For the Neanderthal "theory" to work, it would have to first give compelling and extensively referenced reasons why Neanderthals had genetically determind autism traits - it doesn't do this. Next it would have to explain how and why the posited autism genes of Neanderthal origin became wide-spread in homo sapiens populations. If the posited autism genes are phenotypically neutral in heterozygotes, then they would not have been subjected to evolutionary pressures, remained extremley rare in the homo sapiens gene pool and would have been diluted due to genetic recombination. If they were detrimental, then selective pressure would have quickly eliminated them from the homo sapiens gene pool. Hence the Neanderthal "theory" implies that the posited autism genes must confer some selective advantage (similar to sickle cell anemia which makes heterozygotes more resistant to malaria, or cystic fibrosis which confers some resistance to cholera). Now this is an extremely interesting aspect which all genetic theories of autism would have to address, even more so because autism is clearly not monogenic (unlike SCA and CF). However, the Neanderthal "theory" doesn't have much to contribute here either, and therfore doesn't add anything to our understanding of autism. - pir 10:33, 6 Jun 2005 (UTC)
Yes, it should be deleted unless it has been the subject of serious scientific research. Verifiability is a policy here at Wikipedia. If [5] is the only reference for this dubious theory, it shouldn't be included in the article. A brief scan of that article reveals that it's unscientific speculation by a layperson. Rhobite 04:10, Jun 6, 2005 (UTC)
What gets me about the Neanderthal theory is the people who state that this is a "mutant gene". No, if autism originated with Neanderthal traits, then the gene would be copying properly, it would just be old. That is atavism, not mutation. --Bluejay Young July 5, 2005 07:42 (UTC)

Header Language

It seems to me that the introduction/header section needs to be cleaned up, and fast - much of it is very subjective, vague, or just blatently wrong. I'm listing my gripes -- comments, please? If I don't hear back from anyone in the next few weeks, I'll probably just post some of these changes.

1) "the psychiatric criteria for the diagnosis are based on behavioral attributes rather than clinical tests"

I'm not sure what we mean here by "clinical tests" -- Most psychiatric diagnoses are based on behavioral criteria, but that doesn't mean there aren't standardized clinical tests in place - i.e., the ADOS and ADI for autism. This statement makes it sound like a child with autism just walks into a doctors/psychologists/neurologists office, exibits some "behavior" and lands a diagnosis. (ok, this does occasionally happen -- but if we're meaning RESPONSIBLE diagnosis, why aren't we mentioning the most common and scientifically responsible instruments of diagnosis?

2)"Neurologists may or may not apply the DSM criteria but will more typically apply neurological criteria in determining a diagnosis of autism."

What "neurological criteria" is that? Again, any child diagnosed with autism that is not diagnosed according to DSM standards and with standardized autism assessments with the ADOS/ADI HAS NOT BEEN PROPERLY DIAGNOSED. And I'm at a loss to figure out what the vague "neurological criteria" was supposed to mean. And why do we make it sound like most children with autism are diagnosed by neurologists, rather than the clinical psychologists who do the bulk of diagnosis work?

3) "There are strong indications that the incidence is growing, and it is now estimated that it occurs in as many as 1 in 150 individuals"

This is a controversial figure and either needs to have a source quoted or be revised. I would suggest quoting both a low and high estimate and providing both sources.

4)"There are reports that children have recovered from autism to the point that they can fully participate in "mainstream" education"

I have major issues with the word "recovered" here - and I think a lot of parents and the vast majority of the research world do too. One does not "recover" and become "normal" with autism. We can a) put educational supports in place, b) get kids into intervention programs that help reduce dysfunctional behaviors that cause trouble in school/social environments, c) teach more socially functional behaviors that help kids be able to interact in a "neurotypical" world. I would be all for a sentence in this section that briefly covers some of these issues. But "recovered" is irresponsible, making autism sound like a passing infection or virus rather than a life-long group of traits.

Yes, "recover" and also "improve", which implies that autistic behavior is inferior to non-autistic behavior. --Bluejay Young July 6, 2005 06:56 (UTC)
improve is entirely appropriate eg "improve social skills" -- autism is a difference but it is also unarguably an impairment in social skills (you cannot get the diagnosis unless you are impaired in social skills) perhaps we need to separate the idea of autism as a medical disorder from the idea of autism as a cultural difference/cultural movement. adam black 2005 July 6 23:11 (UTC)
Right. Then let's be sure we say "improve social skills", rather than simply "improve" which has a medical connotation (e.g., "his condition is improving," implying recovering from an illness). --Bluejay Young 08:56, July 14, 2005 (UTC)

Definition of neurotypical

Neurotypical seems to be used a lot without being defined. I know this is probably ok for those in the field, but as my education was in physics, it took me a little reading into context to realize that it seems to just refer to what one would consider "normal" people. Any chance it can get an article of its own or a brief definition when it's first used?

I think it's got one at neurotypical... --Bluejay Young July 5, 2005 07:38 (UTC)

View on Autism

The problem I have with the way Autism is treated on this page is that the theories all deal with some kind of damage to the brain. I am currently 15 years old. When I was just a toddler or so, longer ago than I can remember, I was diagnosed with autism. I was quiet, I did not interact socially, and when I did it was often agressive. I talked late, walked early, pointed to things rather than speaking, hated being touched, and showed other symptoms as well. Obviously this cannot be labled as being caused by brain damage because I show no such symptoms now and brain damage is irreversable. There should be more coverage of theories that look into differences in thought processes rather than differences in the brain's ability to function. Another theory uncovered is using different parts of the brain, as neural scans have shown some cases might be related to lack of activity in certain parts of the brain, in particular parts that may be related to social interaction. By the way, most people in my classes have no idea that I was ever diagnosed with autism. I am a straight A student with plenty of friends, and in general I am friendly and people like me. I also find the the theory of Albert Einstein having autism perhaps realistic, as I take great interest in math and physics. In fact, I scored 107% on my Algebra exam. Most people think I'm a genius. Thus, while I have some social problems, and showed several symptoms of autism at a very young age, my brain is obviously not damaged and my I.Q. is probably higher than most people reading this, scoring around 150. Oh, and I still hate being touched, so whatever that has to do with anything, it seems to remain.

Thank you for your comment. I'm not sure that I understand you completely, though. The only reference to brain damage in the article is attributed to Rimland. The article does not claim that Autism is brain damage, although it does state that autism is viewed as a disorder by many people. It's not OK for the article to make a blanket statement that autism is a disorder, but the article should (and does) state that many doctors view it as one. This is a frequent issue with this article, because many autistics don't view autism as a disease. If you have any specific suggestions, please make them - pointing out specific issues is always better than general complaints.
I'm glad that you're doing well, by the way. Rhobite 05:49, July 16, 2005 (UTC)

Social angst

Is social anxiety a symptom of autism? Scorpionman 22:15, 27 July 2005 (UTC)

Not according to the DSM, although apparently autism and anxiety are frequently diagnosed together. —Simon 21:00, 31 July 2005 (UTC)
Simon is right - although usually depression et al. are not diagnosed officially until around the teen years. In pretty much all cases there is some form of social anxiety resulting from the symptoms from autism.--RN 21:42, 31 July 2005 (UTC)

categorically

"Autistic children categorically lack" what does this mean? Rich Farmbrough 16:17, 3 August 2005 (UTC)

from the article "Autistic children categorically lack 'theory of mind', the ability to see things from another person's perspective" I'm not an expert, but I think this means, "Children in the autistic category lack"... Gbeeker 17:49, 3 August 2005 (UTC)
It just means they just plain don't have it or posses it. I just removed categorically from the statement - maybe it clears it up --RN 22:34, 3 August 2005 (UTC)

Thanks, I guess Gbeeker was probably right, it looked like a tehnical usage. Rich Farmbrough 10:19, 4 August 2005 (UTC)


(Links and reading references removed for FAC)

Further reading

  • Williams, Donna (1996). Autism: an inside-out approach. Jessica Kingsley Publishers. ISBN 1853023876. (an interesting first person perspective on her experiences as a person with autism)
  • Seroussi, Karyn (2000). Unraveling the Mystery of Autism and Pervasive Developmental Disorder: A Mother's Story of Research and Recovery. Simon & Schuster. ISBN 0684831643. (apparent 'cure' through early diagnosis, dairy and gluten restriction and education)
  • Florance, Cheri (2003). A Boy Beyond Reach. Simon & Schuster. ISBN 0743221079. (apparent 'cure' through a person-centred approach)
  • Kennedy, Diane M. (2002). The ADHD-Autism Connection: A Step toward more accurate diagnosis and effective treatment. WaterBrook Press. ISBN 1578564980. (book explores similarities between attention deficit hyperactivity disorder (ADHD) and the spectrum of disorders diagnosed as pervasive developmental disorders)
  • Ratey, John J. and Johnson, Catherine (1998). Shadow Syndromes: The Mild Forms of Major Mental Disorders That Sabotage Us. Bantam. ISBN 0553379593.{{cite book}}: CS1 maint: multiple names: authors list (link) (note: the chapter "Autistic Echos" is about subclinical autism, autistic traits, and various case studies of people with different degrees of autism)
  • Lawson, Wendy (2001). Understanding and Working with the Spectrum of Autism - An Insider's View. Jessica Kingsley Publishers. ISBN 1853029718. (Lawson is diagnosed with autism and is currently working for her PhD on autism and stress)
  • Grandin, Temple (1995). Thinking in Pictures: And Other Reports from My Life With Autism. Doubleday. ISBN 0385477929. (Temple Grandin is diagnosed with autism and holds a PhD in animal science)
  • Grandin, Temple. "Educated students with autism". Genius May be an Abnormality: Educating Students with Asperger’s Syndrome or High Functioning Autism'. Retrieved July 30, 2005.
  • Firth, Uta (2003). Autism: Explaining the Enigma. Blackwell Publishers. ISBN 0-631-16824-9.
  • Maurice, Catherine (1994). Let Me Hear Your Voice: A Family's Triumph over Autism. Ballantine Books. ISBN 0-449-90664-7. (a personal account of a mother with two autistic children and her fight to get her children back to normal via Lovaas behaviour modification techniques)

--Ryan Norton T | @ | C 01:44, 5 August 2005 (UTC)

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