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Autism epidemiology

The recent edits to Autism made several nice changes, but I have some qualms about some of them:

• The following text was removed with the comment being only "removed untrue statement":

Autism's incidence, despite its advantages for assessing risk, is less useful in autism epidemiology, as the disorder starts long before it is diagnosed, and the gap between initiation and diagnosis is influenced by many factors unrelated to risk.

But this cites Newschaffer et al. 2007, a high-quality source. Here is a direct quote from that source:

The most commonly reported measures of autism frequency are point prevalence or period prevalence. Incidence rates, despite their theoretical advantages for studying risk, are of more limited utility in autism epidemiology because not only is autism diagnosis distal to disease initiation but also time between initiation and diagnosis is likely influenced by a wide range of other factors potentially unrelated to risk. Cumulative incidence, however, may be informative for descriptive epidemiologic studies of birth cohorts.

The point is an important one, so if the Autism statement doesn't reflect the source accurately, then let's fix it, not remove it. You can find a more discussion on this issue at Talk:Autism/History as of 2007 July 31 #usefulness of epidemiological statistics.

It is impossible to say in general whether one specific statistical measure is useful or not, it all depends on what purpose you use it for. In the context of that specific article, that deals mostly with causes and risk factors, incidence is less useful than prevalence indeed. But that does not justify including that sentence here. --WS 23:40, 9 August 2007 (UTC)

But the removed text says incidence "is less useful in autism epidemiology". That is, it talks about one particular purpose, not about whether the statistical measure is useful in general, so it addresses the "impossible to say" objection. And the removed text matches the wording of the cited source; Newschaffer et al. say that incident rates "are of more limited utility in autism epidemiology" without limiting their claim to causes and risk factors. So I still don't see why the text was removed. Do you disagree with Newschaffer et al.? or is it that you disagree with the removed paraphrase of their words? If the latter, what would be a more accurate paraphrase? Eubulides 05:10, 10 August 2007 (UTC)

For now I restored the sentence; we can fix its wording later (or remove it, if it really needs to be removed). Eubulides 05:42, 10 August 2007 (UTC)

• Prevalence estimates for related disorders were removed, using the argument that these statistics belong in Autism spectrum disorders. But these estimates are also useful here, to give readers a feel for how common autism is compared to closely related disorders. There is some dispute about whether Autism should be separate from Asperger's (this is discussed in Autism #Classification) and PDD-NOS is often just autism with a symptom or two missing. So the prevalence estimates for these related disorders are relevant and interesting information here.

These prevalence rates are of course all interesting, but as I said, I think the specific rates of all of them don't belong here. Autism spectrum disorders (which needs some drastic improvements) is the best place to compare rates of the different disorders. --WS 23:43, 9 August 2007 (UTC)

My main point was that the ASD prevalence is highly relevant; I agree "interesting" is secondary. Another reason to include ASD prevalence is that much of Autism talks about ASD when reliable information for autism proper is not available, and including ASD prevalence will give readers a better intuition for how estimates for the narrower syndrome might be. Still another reason, and perhaps the most important one, is that it's all too common for people to get confused about autism prevalence versus ASD prevalence, and we forestall that error here by mentioning both numbers, making it crystal clear that autism is not the same as ASD and the two prevalences should not be confused. The error I'm talking about appeared in a long New York Times piece on Sunday, for example; see #Regarding Autism in Girls above. It's a very common error, I'm afraid. Eubulides 05:10, 10 August 2007 (UTC)

And now that I went back and reread the edit, I see that I misunderstood it; it didn't remove all the text about ASD vs. autism prevalence, just the part that talked about prevalence of PDD-NOS, Asperger's, etc.; plus it removed some duplication about prevalence of autism and ASD. That duplication was indeed irritating so it was good to remove it but for now I put the PDD-NOS etc. part back in. Since most of ASD is PDD-NOS, and PDD-NOS means to some extent "we dunno what it is", I think it's helpful to say PDD-NOS prevalence is relatively large, to make it clear to readers how fuzzy this area is and how the prevalence figures have to be treated with care. Similarly, the dispute about whether Asperger's and autism are distinct means that Asperger's prevalence is relevant. The prevalence of Rett syndrome and childhood disintegrative disorder aren't so relevant, so the text doesn't give them. Eubulides 05:42, 10 August 2007 (UTC)

• The terminology "real prevalence" was introduced. I don't see why this change is needed. Epidemiology does not have a standard notion for "real prevalence"; there is just "prevalence".

That is mentioned twice more: some of the observed increase in autism in California was real and real changes in autism's prevalence.. I just wanted to make clear the difference between the estimated prevalence and the actual "real" prevalence, as earlier it is discussed that prevalence rates have increased..

Good point about the two "real"s elsewhere. The first one is a paraphrase of someone else's paraphrase of the source, and is too far removed in wording. I reworded it to reflect the source better. The second "real" can go. I made this change to install the fixes. Eubulides 05:10, 10 August 2007 (UTC)

• The word "warning" was replaced by "the first", resulting in the sentence "Parents usually notice the first signs in the first year or two of their child's life." with the comment "parents don't experience 'warning signs'". But the original sentence didn't say parents experience warning signs; it said they notice them, with the implication (which I thought was a clear one) that they notice them in their children. Perhaps the sentence could be reworded for clarity, but its current version is worse than the earlier one, since it repeats "the first" in a confusing way.

I just don't think the concept "warning sign" is appropriate here. Few parents will have a notion of what a warning sign is, they rather notice some things about their child that make him different. A warning sign sounds more like something a doctor would use. But indeed this could be reworded better. --WS 23:54, 9 August 2007 (UTC)

Fair enough. The multiple "the first"s grate, though. And the first "the first" is not needed. I removed it. Eubulides 05:10, 10 August 2007 (UTC)

I sense that WS is still editing so I'll stay out of the water for a bit until things settle down. WS, thanks for taking a interest in the article; it's always a pleasure to see high-quality editing. Eubulides 23:27, 9 August 2007 (UTC)

Thanks. I hope it gets featured soon. --WS 23:56, 9 August 2007 (UTC)

Early diagnosis and intervention

It is mentioned several times in the article that early diagnosis and intervention are important and affects outcome. Is there any evidence for these statements? I couldn't find any myself. Early screening might even be harmful because of the high rate of false-positives at early age. --WS 00:15, 10 August 2007 (UTC)

I add Bryson et al. as a citation for that claim, here. Eubulides 01:41, 10 August 2007 (UTC)

Screening change strayed from source

Autism #Screening was recently changed, replacing "As delay in evaluation may postpone treatment and affect long-term outcome, any of the following warning signs is reason to have a child evaluated by a specialist immediately:" with "The following signs may be indicative of autism:". I'm afraid this change caused the article to represent its source less accurately. Here is what the original source (Filipek et al. 1999, page 469) says about the signs in question:

The following developmental milestones are nearly universally present by the age indicated. Failure to meet any of these milestones is an absolute indication to proceed with further evaluations. Delay in referral for such testing may delay early diagnosis and treatment and affect the long term outcome

I understand the concern about the use of the word warning so that word should go, but the rest of the original text reflects the source much better than the replacement does.

The trend since 1999 is to be even more alert for early signs of autism, and I expect the next consensus review in this area will reflect this trend; for examples, please see Dover & Le Couteur 2007 PMID 17515625, Landa 2007 PMID 17326115, Barbaresi et al. 2007 PMID 17088521, and Crais et al. 2006 PMID 16941286. I agree that questions remain on the important benefits of intervening particularly early (a point also made in Rutter 2006 PMID 16685186) but the "may" in the original text captures some of that doubt, and if there is to be serious coverage of this particular issue it belongs under "Treatment", not "Screening".

I made these changes to implement the above comments. These changes don't revert to the original version, as they try to address some of the concerns that I sense were underneath the recent edit. Eubulides 18:15, 10 August 2007 (UTC)

I looked up a few articles referenced in the Bryson study, and from that I made up that while early diagnosis (as early as <2 years) is possible, but improvements in longterm outcome have only been proven in studies with 4-7 year old children and older. That would mean that at the time the child should have reached the listed developmental milestones, there is still plenty of time for diagnosis and start of treatment, without affecting outcome. However there might be studies that prove the contrary? --WS 21:16, 10 August 2007 (UTC)

The Bryson et al. study is a 2003 review, and so is a bit dated (I'd prefer a more recent high-quality review on this particular topic but don't know of one). The recent trend has definitely been toward earlier diagnosis and intervention. For example, Howard et al. 2005 (PMID 15766629, cited in Autism) reported improvement in outcomes, with average age at treatment program intake of about 31 months (s.d. about 5 months). In the U.S. the average delay between first evaluation by a qualified professional and formal ASD diagnosis is 13 months; see Wiggins et al. 2006 (PMID 16685189, also cited in Autism). If you do the math, you'll see why it's not recommended to wait until after age 24 months to take your possibly-autistic child to the doctor. Eubulides 22:36, 10 August 2007 (UTC)

The study by Howard et shows that treatment is effective even at young age, but it doesn't say anything about long term outcome and neither does it show a benefit of starting treatment early compared to starting at e.g. 4 years. --WS 00:21, 11 August 2007 (UTC)

Correct on both points. However, the Howard et al. study does demonstrate benefits of early intervention, and these benefits are among the most firmly established in the literature. Given the time constraints mentioned above, a parent who wants an autistic child to use the approach demonstrated by Howard et al. will need to take the child to the doctor well before the child's 2nd birthday. Filipek et al. were quite conservative, as they had to be to achieve their paper's unusually wide consensus; I don't see why Autism should be even more conservative than they were. Let's put it this way: does any reliable source contradict Filipek et al., and say that early diagnosis is unimportant? Eubulides 01:23, 11 August 2007 (UTC)

So you agree that it has not been proven that intervention at the ages mentioned in the screening paragraph affects longterm outcome, and this should be removed? --WS 11:00, 11 August 2007 (UTC)

I agree that it has not been proven that intervention at ages 12–24 months affects long-term outcome. But the article does not make this unproven claim, so I don't see any text that needs removing. There is a long temporal gap, for both technical and administrative reasons, between the parents first taking their child to the specialist (the point of the "Screening" section), and the child receiving treatment (the point of the "Treatment" section). This long gap is clearly mentioned in the intervening "Diagnosis" section. I don't think the gap needs to be restated in the "Screening" section; that would just confuse the chronology. For clarity, it's better to keep the sections of the Autism in the same chronological order that parents and children typically go through. Eubulides 15:51, 11 August 2007 (UTC)

It says: As postponing treatment may affect long-term outcome, any of the following signs is reason to have a child evaluated by a specialist without delay:' followed by signs at ages 12-24 months, so at least it suggests that. Btw. the first half of the screening section is not about screening and belongs to the symptoms or diagnosis section. --WS 17:04, 11 August 2007 (UTC)

I don't see the suggestion in that wording, but if you see it can you propose a wording that better represents the cited source? I removed the wording that was unnecessarily duplicative of the symptoms ("Characteristics") section. I don't agree that the remaining wording belongs in "Diagnosis": it's part of a recommendation to parents as to whether more-formal screening should be done, and "Screening" is a better location for it. The "Screening", "Diagnosis", "Treatment", and "Prognosis" sections are ordered temporally, and the initial parent concern comes first temporally. Eubulides 17:50, 11 August 2007 (UTC)

Featured

Congratulations, Eubulides, for restoring a wreck; you can add the star to the article now. If GimmeBot isn't through here to update the talk page and articlehistory tonight, I'll do it manually. SandyGeorgia (Talk) 15:26, 14 August 2007 (UTC)

Cause has not been found

This topic has strong view points on both sides of the fence. Some from a lack of understanding, some from fear and some from frustration because of the complexity of the disorder. Yet it is a disorder of the brain. The most important organ and most misunderstod organ in the human body. This is one reason for the puzzle pieces being a part of almost every logo for Autism. What Autism Is This link has shown in plain simple language what it is and how it affects people. As it says it this and many other articles, the cause has not been found. You can only treat the symptoms and retrain the brain. The earlier you do so the better the chances are. There are lots of cases that site people have been cured of the symptoms like a stroke patient can regain use of his or her arm. ( Just in a different manner.) Some have gone too long to be cured or retrain the brain. Lots of money has been spent to find out what the cause is and is still on top of the main discussion board and will remain to be so until a cause for ASD is found. Jresner 02:33, 29 August 2007 (UTC)

Autistic rights movment

many autistics don't want the terms disorder used to descripe this condition. sine the condition has positive effects and some belive to be benificial negitive terms should be removed

the autistic savant Trev_lite —Preceding unsigned comment added by 67.170.219.52 (talk) 06:05, 2 September 2007 (UTC)

Autism attempts to follow the Wikipedia Manual of Style for medicine-related articles in using careful language to describe medical conditions. The standard medical terminology uses the word "disorder" here; see, for example, the World Health Organization's ICD-10 F84.0. The Autism article has to describe the mainstream medical usage, as that is a core goal of the encyclopedia, but the article attempts as best it can to avoid pejorative words under the constraint of sticking to standard medical terminology. If you can suggest specific places where this goal hasn't been met please let us know here. Eubulides 06:29, 2 September 2007 (UTC)

Genetics and immunization changes strayed away from sources

These changes altered the article's text so that it disagreed with its cited sources. Doja & Roberts (PMID 17168158) do not say the epidemiological evidence is "inconclusive"; instead, they write phrases like "overwhelming majority showing no causal association". Sykes & Lamb (PMID 17764594) do not say that the 90% statistic is "probably" an overestimate; they say it "may be overestimated" as well as things like autism being "one of the most heritable neuropsychiatric syndromes"; they use the notion of "probably" for a different statistic (to quote them: "Previous estimates of the number of genes involved are likely to be underestimates"). Nor do Sykes & Lamb say that the problem is that the 90% estimate "does not address the interplay between genetics and vulnerability to environmental factors"; on the contrary, they list environmental factors as a relatively small part of the overall picture (to quote them: "The recent identification of unanticipated levels of structural genetic variation in individuals with autism suggests that the genetic aetiology of autism is likely to be much more complex than previously supposed, caused by a combination of rare and common variants, and involvement of karyotypic and submicroscopic structural variation, together with interaction of variants with each other and with the environment."). Since this topic is controversial, the article needs to keep close to the reliable sources; let's try to avoid bias in our summaries. Eubulides 06:39, 5 September 2007 (UTC)

June 2007 telephone survey

I'm tempted to simply delete this phrase: "A June 2007 telephone survey of about 11,817 households suggests that vaccinated kids have a 2.5 times greater chance than completely unvaccinated kids of developing a neurological disorder . [50]", as the study in question has huge statistical flaws (reviewed here: http://photoninthedarkness.blogspot.com/2007/06/survey-says-nothing.html ) and the researchers have competing financial interests.

While a bit of criticism could balance the statement, I believe such a discussion belongs on MMR_vaccine_controversy instead. Low vaccination coverage associated with the MMR scare has already resulted in several new outbreaks of measles (including deaths) and unbalanced statements based on horribly conducted studies on this issue are grossly irresponsible at best.

Smocking 14:20, 16 September 2007 (UTC)

I already deleted it once. A telephone survey is about as unreliable and unscientific as it gets; perhaps useful in politics and other propaganda, but has no place in a medical or scientific article, neither here or at the MMR vaccine controversy issue. It's also redundant, as the topic is already covered. This "survey" is a clear case of ascertainment bias in a biased sample; those who subscribe to this theory respond positively, while everyone else is likely to hang up. SandyGeorgia (Talk) 14:30, 16 September 2007 (UTC)

Thanks for removing it. This has probably been discussed before, but given the pervasiveness of pseudoscience, fear-mongering and quackery, it's no surprise to find it on Wikipedia as well. It's not technically vandalism, since the people who make these edits truly believe them to be true and include sources which look reliable to them at first glance. While a different point of view is refreshing now and then, and mostly deserves a place on Wikipedia, it starts to get a bit hazy if it can kill people. Is there a policy page on this? Smocking 16:37, 16 September 2007 (UTC)

There are a lot of policy decisions from ArbCom on pseudoscience, but I'm not sure they specifically apply here. What is really missing—in fact, it's quite a pet peeve of mine lately—is a policy to somehow elevate medical content to the same sort of status enjoyed by biographies of living persons; that is, when content has the potential to harm real people in real life, that content should be held to the very highest standards of sourcing (as is the case on BLPs). We have blatantly, horrificly wrong medical content on Wiki, being spewed across other mirror websites and regularly hitting number one on Google, and that is disgusting. I've been considering launching an initiative in this area for some time, as I am *so* disgusted at the level of medical misinformation on Wikipedia, and the apparent disinterest of the Medicine Projects in doing something about it. The Medicine Projects are ineffectual and disinterested; I suggest this issue needs to be brought to Jimbo's attention and elevated to the same level of importance given to BLPs. SandyGeorgia (Talk) 16:49, 16 September 2007 (UTC)

Done; I posted a query to Jimbo. SandyGeorgia (Talk) 16:58, 16 September 2007 (UTC)

Given all the trouble we've been having with BLP, I do not want to start another BLP-style shitfest. On the other hand, the arbitration committee has already given you what you seek [1]: Wikipedia:Verifiability and Wikipedia:Reliable sources require that information included in an article have been published in a reliable source which is identified and potentially available to the reader. What constitutes a reliable source varies with the topic of the article, but in the case of a scientific theory, there is a clear expectation that the sources for the theory itself are reputable textbooks or peer-reviewed journals. Scientific theories promulgated outside these media are not properly verifiable as scientific theories and should not be represented as such.. Medicine is an applied science, and clearly medical articles should rely on sources appropriate for a scientific article. A voodoo poll is not that. Raul654 17:07, 16 September 2007 (UTC)

Thanks, Raul; that helps, if we can just get better an enforcement (and for that, we need a stronger WP Medicine). SandyGeorgia (Talk) 17:11, 16 September 2007 (UTC)

Concur with Sandy and Raul. A poll is not a good reliable source for this article. The standards for what is deemed reliable vary depending on the topic at hand. For scientific and especially medical articles, we have higher standards and expect peer-reviewed scholarly literature to be used. Also, Exceptional claims require exceptional sources. A telephone poll is anything but exceptionally reliable. --Aude (talk) 17:15, 16 September 2007 (UTC)

This survey does not belong in Autism for the reasons that you mentioned. I don't think MMR vaccine controversy would be a good place for it either; the survey wasn't specific to MMR, and in the U.S. vaccine concerns have mostly centered around thiomersal, not MMR. A better place would be Thiomersal controversy #Rationale for concern, next to the claims that autism is rarer in the Amish community. Eubulides 16:05, 16 September 2007 (UTC)

I share this concern, this is exactly the reason I was so dogged in gaining consensus for the wording of WP:V that states "Academic and peer-reviewed publications are highly valued and usually the most reliable sources in areas where they are available, such as history, medicine and science." It is critical that Wikipedia does not misinform on medical matters, legal disclaimers do NOT free us of moral responsibility. Tim Vickers 17:59, 16 September 2007 (UTC)

Some random thoughts:

• I agree there are similarities with WP:BLP. Certainly, we have a similar moral duty.
• Bad science can appear in respectable journals. Even good science can be interpreted wrongly. For example, extending the results from a small sample to the population as a whole. Newspapers do this all the time. How could we stop WP editors doing the same? Journals like Medical Hypotheses publish utter crap from time to time.[2]
• There isn't a clear cut-off where you can say "these figures are good; those figures are bad". Policy needs this kind of assurance.
• WP:BLP will take a respected newspaper as a reliable source. Many of us wouldn't be happy with even that level of WP:RS for medical facts. Therefore, you are asking for a much, much higher level of sourcing to become policy.
• Based on the trouble Tim had at WP:V, I'd say the chances of WP:MEDRS becoming a guideline are currently slim. The chances of any part of it becoming policy are zero. There are too many editors on WP who oppose science and the medical establishment. They elevate WP:NPOV above WP:V and complain that cutting out the weak sources will deny the minority POV a voice.
• I think we can see Raul's opinion that good medicine is based on science therefore the ArbCom ruling applies. Others don't equate medicine with science, or else feel the "applied" part of "applied science" means there is scope to consider non-science aspects. The eugenics movement is an example where scientific medicine without a heart or conscience can go badly wrong.
• Wrt what the Medicine Projects should do: I think we should ask directly. The weekly/fortnightly collaborations clearly aren't churning out FA material on a regular basis. There is too much medical material and too few active participants. Only topics that a championed by an editor with a special interest make it to FA. We should set our sights lower. In addition, perhaps we should have a "litter cleaning" collaboration that works on articles that have become overloaded with rubbish. Having a handful of FAs is all well and good, but I think that WP would be better if we made a general, wider improvement of medical material, and tried to eliminate the "blatantly, horrificly wrong medical content". I'm not saying we should abandon creating/maintaining FAs. But our efforts in that respect should be more targeted and over a longer duration.

Colin°^Talk 08:51, 18 September 2007 (UTC)

Link: Regarding Aspergian Island

Just a quick note observing the fact that there are no links to the aspie community on here. So, being the biased individual I am, (ha ha) I thought I would add http://www.aspergianisland.com/ as I passed. But, seeing how that isn't possible, I'm sticking it here for people to rave about as they wish.

Hoping this gets supported, Damon Haughton, (former frequenter.) —Preceding unsigned comment added by 212.219.41.130 (talk) 17:05, 17 September 2007 (UTC)

Please review WP:EL, WP:RS and WP:NOT. SandyGeorgia (Talk) 17:11, 17 September 2007 (UTC)

Why do Doctors still ignore the physcial causes of Autism?

Modern medicine sees all mental illness deriving only from the brain - primarily from neurotransmitter imbalance and nothing else - the truth is that in many cases there is often an underlining physical cause (eg: infection, celiac disease, etc) and this is often never investigated, and so its no wonder today we are faced with the current tragedy that the Mentally ill die 25 years earlier, on average. Psychiatrist Dr Reading Chris reading knew this and treated hundreds of patients with mental illness including autism and found a common link - infection, celiac disease, auto-immune tendencies and malabsorbtion, after treating patients with dietry modification, antibiotics and nutritional supplementation many patients recovered, yet current day medicine does not accept this. 'Enterocolitis discovered in the majority of children with Autistic spectrum disorders' see GUTandmental illness —Preceding unsigned comment added by 211.30.235.237 (talk) 06:02, 19 September 2007 (UTC)

It's not clear what change you're proposing to the article. The topic you mention is briefly addressed in the section Autism #Causes and more extensively in the subarticle sections Causes of autism #Leaky gut syndrome and Causes of autism #Viral infection. Perhaps you can propose specific changes, if any, after reading those sections. Eubulides 06:18, 19 September 2007 (UTC)

Choice of words.

I have a real problem with the choice of words here. I have been diagnosed with PDDNOS, and I fully disagree with using terms such as "brain development disorder" and such. I would like to note that i'm in a school for people with autism and ASD and that actually, the people always are suprised when I tell a certain person from my class or myself are autistic (I don't know what word I should use). Also I think that autism isn't some kind of illness, disease, disorder or whatever, it's just a difference which all people have, and of course SOME people will have similarities. Another thing is that most people I know with autism have good marks, do high level education. And believe me my whole family has some sort of "disorder" and we don't see what the difference is. --Vincspenc 19:03, 19 September 2007 (UTC)

There are a couple of things going on here. First, this article uses autism to talk about the classic autistic disorder, which is a different diagnosis from PDD-NOS. Autism typically has more-severe symptoms than PDD-NOS does, and to some extent this explains the difference in choice of words. Second, the article uses standard medical terminology, which currently uses words like "disorder" to describe autism. Recently there has been some effort to rename autism spectrum disorders (a broader term that includes autism, PDD-NOS, and a few other syndromes) to autism spectrum conditions, which would I think be a better term in your view. However, Google Scholar reports that in sources published in 2006 and so far in 2007, the phrase "autism spectrum condition" has 11 hits, but "autism spectrum disorder" has 1,230 hits; so clearly any change in terminology hasn't happened yet in reliable sources. Wikipedia's job is to summarize what reliable sources say, so to some extent I'm afraid the article is stuck with "disorder" unless reliable sources change their wording. That being said, the article should not emphasize "disorder" over and above what reliable sources say, and if you find some instances of overemphasis please let us know. Eubulides 21:48, 19 September 2007 (UTC)

Searches don't involve claimed causes?

This change to the article had several problems. In decreasing order of importance:

• It inserts the phrase "and other epidemics of childhood diseases" which is undoubtedly true but is not supported by the given citation. We should change either the wording or the citation. The former is easier, but if you have a citation obviously we can do the latter.
• It inserts the phrase "some groups claim" which is (1) again, not supported by the given citations, and (2) is ad hominem language that distracts from the core function of this article. There are indeed controversies about autism, but Controversies in autism is a better place for them.
• It inserts the phrase "have no basis other than anecdotes", which is not true for all other claimed environmental causes. For example, there is some evidence that exposure to pesticides soon after conception may contribute to autism. That evidence isn't strong enough to make the cut in this article, but you can read about it in Causes of autism #Pesticides.
• The change log justified the change by saying "the wording is misleading, since the searches don't involve the claimed causes." First, do you have evidence that none of the searches mentioned by Szpir involve any vaccine-based etiology? I'm skeptical. Second, that sentence was meant to refer to environmental causes in general, not just vaccines. I'll reword it to make that clearer.
• The change overuses "However". For example, it is normally considered bad style to begin two consecutive sentences with "However".
• It creates the misleading wikilink "[[Measles#Public health|measles]]", where the reader will expect to arrive at Measles but instead will get some paragraph within Measles.

I attempted to fix these problems with this change. Eubulides 23:00, 23 September 2007 (UTC)

I'm kind of uncomfortable with it because some - not all - of the items in the lists have been more-or-less outright disproven - vaccines, heavy metals - and overly-cautious phrasing, like were using, could be misleading and give undue weight to these fringe theories. Adam Cuerden ^talk 07:03, 24 September 2007 (UTC)

The revised wording was intended to make this point more clearly; does it suffice? For example, for vaccines and heavy metals, the article currently says this:

"… there is overwhelming scientific evidence showing no causal association between the measles-mumps-rubella vaccine and autism, and there is no convincing evidence that the vaccine preservative thiomersal helps cause autism …"

which is by design very close to what the reliable source (a recent literature review, PMID 17168158) says. If this wording is overly cautious, what wording would be less-cautious but still well-supported by the source? Eubulides 07:14, 24 September 2007 (UTC)

I support Eubulides desire to stick close to our best sources. These may be "fringe theories" from the POV of medical science but to readers of daily newspapers, they appear as an important minority view. That so much money has been spent doing studies to investigate these "fringe theories" testifies to either their importance scientifically (which I doubt) or the wider public heath / reassurance factors. If the language is too aggressively dismissive, then I fear an edit war with the kind of editor who holds science and medicine in poor regard. Colin°^Talk 08:40, 24 September 2007 (UTC)

Well, yes, but the information we supply needs to be accurate, and I'm worried that, as it stands, it gives Wikipedia:Undue weight to fringe theories by being oddly, and probably unintentionally, defensive of them. 13:01, 24 September 2007 (UTC) —Preceding unsigned comment added by Adam Cuerden (talk • contribs)

I also support Eubulides' version; stability on the article is a concern, and Eubulides has done a good job of balancing the need to explain the fringe theories with the need to stay accurate to reliable sources without giving undue weight to the fringe theories. It is a difficult balancing act in a controversial area, and I believe Eubulides hit the target. Adam, perhaps you can suggest a few wording tweaks to make it seem less "unintentionally defensive" of them? SandyGeorgia (Talk) 13:14, 24 September 2007 (UTC)

This article is actually pretty good, but there's one section that seems to synthesise information to tone down the fringiness of the material.

The paragraph in question reads (as of time of posting:

Although extensive searches are underway for other environmental causes,[46] evidence for them is anecdotal and has not been confirmed by reliable studies.[3] Examples of claimed causes include gastrointestinal or immune system abnormalities, allergies, and the exposure of children to drugs, infection, certain foods,[47] heavy metals, and vaccines. Although there is overwhelming scientific evidence showing no causal association between the measles-mumps-rubella vaccine and autism, and there is no convincing evidence that the vaccine preservative thiomersal helps cause autism, parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and parental concern has led to a decreasing uptake of childhood immunizations and the increasing likelihood of measles outbreaks.[48][49] such as the measles cases in Britain during summer 2007.[50]

"Although extensive searches are underway for other environmental causes," links to a report ([3]) that has NOTHING WHATSOEVER to do with the fringe theories being mentioned in the rest of the paragraph - search that paper for words like "vaccine", "heavy metals" and so on in vain. The second half of that sentence, "evidence for them is anecdotal and has not been confirmed by reliable studies" refers to completely different things. This is misrepresentation of the evidence.

Szpir 2006 does support the cited claim, namely, that extensive searches are underway for other environmental causes. The Szpir citation is not intended to support the claim that vaccines cause autism, and I don't see how the current wording can be interpreted to say that it does support the claim. If there is real confusion here, perhaps you can suggest better wording. Eubulides 20:32, 24 September 2007 (UTC)

There are other problems with this - It's not just that there's "anecdotal evidence that hasn't been confirmed". Let's go through these.

• "gastrointestinal or immune system abnormalities" I'm guessing this refers to Wakefield and the MMR. Andrew Wakefield is now undergoing prosecution for accepting money from lawyers involved in vaccine cases and creating fraudulent evidence. However, none of the cites mention this, so I can only speculate as to what this is supposed to refer to.

• Come to think of it, GI and immune dysfunction are not environmental factors and so do not belong in this paragraph. They are already adequately covered in Autism #Other symptoms and Autism #Pathophysiology, so there's no harm in dropping them here. I'll drop them. Eubulides 20:32, 24 September 2007 (UTC)

• "allergies" - None of the cites mentions this, that I can find.

• That's a subset of "immune system abnormalities" and can also be dropped.

• "exposure of children to drugs" - Meaningless statement. There's thousands, if not millions of drugs.

• I'll change this to be more specific and mention alcohol, smoking, and illicit drugs, all of which are mentioned in Newschaffer et al. (PMID 17367287). Newschaffer et al. should have been cited here (thanks for catching the problem) so I'll add a citation. Eubulides 20:32, 24 September 2007 (UTC)

• "infection" - Wakefield again, I think, again, no cites.

• That's mentioned in Newschaffer et al. in their section "Infection and Immune Dysfunction". Reading it closely, they're talking only about infectious disease, so I'll change "infection" to "infectious disease". Eubulides 20:32, 24 September 2007 (UTC)

• "certain foods" - Cite given is not about causes of autism, but about changing the diets of already autistic children in an attempt to help them after the fact.

• Yes, sorry, that wasn't clear. I will change the wording to say that the environmental factors listed "have been claimed to contribute to autism or exacerbate its symptoms, or are of concern". Eubulides 20:32, 24 September 2007 (UTC)

• "heavy metals" - Crank theorists, notably chelationists. No evidence, all published research is against it except for some studies in non-peer-reviewed fringe journals, like "Medical Hypotheses".

• Reliable sources disagree with you. For example, Newschaffer et al. (page 247) write "There are a number of environmental exposures, including potential endocrine disruptors such as phthalates and phenols used in plastic products, pesticides, and PBDEs, that have known neurodevelopmental effects, as well as heavy metals that may be important to consider in further risk factor investigations." I'll add this list of factors to the text and cite them. Eubulides 20:32, 24 September 2007 (UTC)

• "vaccines" - Link disproven. This and the previous one are notable as there are some large parental groups claiming these, and notable cranks like the Geiers making up therapies they offer to the children. But they are NOT science

• I'm not sure what you are proposing here. Do you intend that the article should not mention the vaccine hypotheses at all? If so, I disagree: these hypotheses are more widely publicized than any other part of this section. These hypotheses deserve some coverage, even if they are incorrect. The article does this, by giving a long sentence (which we'll discuss in the next bullet). Eubulides 20:32, 24 September 2007 (UTC)

• "there is no convincing evidence that the vaccine preservative thiomersal helps cause autism" Vastly understates the case: thimerosol was removed in vaccines in America in 2002. The rates of autism in the under-5s have not changed since then. Other cites: [4][5]

Adam Cuerden ^talk 13:27, 24 September 2007 (UTC)

• Two points. First, are you saying that this article should mention that thiomersal has been removed from almost all childhood vaccines in the U.S.? That might be worth mentioning, though the wording will be a bit tricky: if thiomersal wasn't a problem, why was it removed? Also, why hasn't it been removed from vaccines used outside the U.S. and Europe? Going into a lot of detail about this here seems a bit out of place, but if someone can come up with brief wording along those lines, I wouldn't object. Eubulides 20:32, 24 September 2007 (UTC)
• Second, the language used to summarize the evidence against the vaccine hypotheses is very carefully worded and closely resembles that taken from the reliable source. It sounds like you want more-aggressive language. If so, please give the language that you want, along with a reliable source that justifies the more-aggressive language. Eubulides 20:32, 24 September 2007 (UTC)

These are good points and I hope we can address them. I'm keen to avoid edits that change the text without apparent support in the sources. Even if the edits produce correct text, once we start deviating from the sources then we are lost. If the text is changed, but the sources aren't, then please use the edit summary to indicate why the new text is closer to the sources (I see Eubulides does this a lot, which is good).

I'm not arguing that the language shouldn't change or in a few areas be less "unintentionally defensive". However, sometimes defensive language is the compromise we must accept. Scientists don't like saying things definitely are or absolutely are not. The FDA-thimerosal article Adam links to says:

The committee concluded that this body of evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism, and that hypotheses generated to date concerning a biological mechanism for such causality are theoretical only.

The "evidence favors rejection" is defensive language. Agressive language says "We totally reject…". The wording "Thimerosal-containing vaccines do not cause autism" is a headline/soundbite that you see in newspaper and article titles. The text within scientific papers is usually more cautious. Look at this news article in the BMJ. You see the difference between the headline and the body text:

The researchers found no convincing evidence that early exposure to the additive in vaccines had any deleterious effect on neurological or psychological outcomes.

Which is surprisingly similar language to this article. Colin°^Talk 14:13, 24 September 2007 (UTC)

Weel, it's a fair point, but it does seem a bit like mistargeting, because we're writing for a popular medium, not scientists, and this is the only part we slip into defensive language. Adam Cuerden ^talk 18:02, 24 September 2007 (UTC)

I disagree that this is the only place Autism uses defensive language. It appears in many other places, e.g., "claims that intervention by age 2–3 years is crucial are not substantiated." And even if this were the only place defensive language appears, that still wouldn't mean the article shouldn't use it. If reliable sources use defensive language, the article should too. Eubulides 20:32, 24 September 2007 (UTC)

I have attempted to resolve the issues mentioned above with this change. It pretty clearly fixes the "synthesis" issue, since it just runs down the list of concerns in Newschaffer et al., so I've removed that template. It is also intended to fix any remaining POV issues; if there are still remaining concerns please let us know here. Eubulides 20:32, 24 September 2007 (UTC)

That looks pretty good. Sorry to be difficult about this, but we're the third entry if you google autism, and I think that means we have to get this right.

I made a few minor copyedits. "or cause for concern" made that sentence kind of awkward to read, and I added a paragraph break before the discussion of vaccines. Since we discuss vaccines in-depth immediately thereafter, I removed it from the Newschaffer list.

Logic, of course, is that every other item on the list is something that we aren't discussing in detail, so it makes sense to have a clean break before we go into detail about one claimed cause. Adam Cuerden ^talk 21:53, 24 September 2007 (UTC)

Third? You had me wondering for a minute, so I went and checked Google. We're first (as usual); the other two are sponsored links. Glad this is worked out; was surprised to see a POV tag pulled out so fast after discussion had just begun. SandyGeorgia (Talk) 21:56, 24 September 2007 (UTC)

Sorry. I put up the tag, not because I thought it wouldn't be resolved, but just as a temporary warning to any parents reading that it might be slightly misleading. I'd have used a much gentler tag if I knew of one.

Anyway, I will say this: I was worried that it could be misunderstood, but I never thought that it was intentional POV-pushing, or anything like that. A bit of an excess of caution at worst. I probably should have made my concerns clearer, earlier on. Would've saved a lot of time. Adam Cuerden ^talk 22:02, 24 September 2007 (UTC)

No problem. I should say, though, that Autism now emphasizes possible environmental causes more than it did before this current round of edits started. Autism#Causes now devotes 3 paragraphs to environmental causes rather than 1, and it now mentions several more potential causes. This is likely to lead inexpert readers to assume that there is more to the issue of possible environmental causes than the old version of Autism would have. Also, the last paragraph of the current version is now a bit redundant. No big deal either way, but I propose that we snip a few redundant words from the last paragraph via careful copyediting, and merge the last 3 paragraphs into one paragraph; this can be done without losing any information. Eubulides 23:10, 24 September 2007 (UTC)

Media plagiarism of Wikipedia articles

The Daily Sun of Nigeria had an article that plagiarized a considerable amount of text from Autism, without attribution or conformance to the GFDL, in one case even quoting from Autism but crediting the quote to clinical psychologist Okey-Martins Nwokolo, founder and national coordinator of Autism Associates of Nigeria. Is there a Wikipedia category for this sort of thing? Talk:Autism already uses Template:Onlinesource, which generates text saying "This page has been cited as a source by a media organization." Is there/should there be a template for plagiarism by the media as well?

Are the Wikipedia muckymucks interested in this sort of thing? m:Talk:Communications committee perhaps? Or is it too common to worry about?

Here's the news article that plagiarized from Autism. The article's 2nd, 3rd, 4th, and 5th paragraphs all copy text from the then-current version of Autism:

Ejiogu E (2007-08-28). "190,000 kids suffer brain disorder yearly". Daily Sun. Retrieved 2007-09-26. {{cite news}}: Check date values in: |date= (help)

I've been through this a ton of times with TS; I have to dig back into my talk page to find the place to report it, but the bottom line is that unless you pursue it yourself, no one else on Wiki will do anything. I've got about three reports in already on TS, and I stopped reporting. The most irritating aspect is people come up with these things, and think *we* plagiarized them. Let me know if you want me to dig up the page for reporting it and the steps you have to go through to try to rectify it. SandyGeorgia (Talk) 21:26, 26 September 2007 (UTC)

For example, scroll down to the Disorders section at http://www.k12academics.com/ Their entire page is plagiarized from Wiki, I reported them eons ago, and unless I lead the charge, nothing will happen. SandyGeorgia (Talk) 21:30, 26 September 2007 (UTC)

Most of what you need to get started is at Wikipedia:Mirrors and forks. SandyGeorgia (Talk) 21:33, 26 September 2007 (UTC)

The sincerest form of flattery. Tim Vickers 21:40, 26 September 2007 (UTC)

Right. Heck, I wrote this page, and they're peddling it for a fee, when I'm just a layperson! SandyGeorgia (Talk) 23:43, 26 September 2007 (UTC)

Fixing-redirects bot went too far

This bot-supplied change had a few good ideas, but most of the changes were unnecessary and make the article harder to edit. Problems fell into the following categories:

• Many of the changes (for example, replacing "[[autism spectrum disorders]]" with "[[autistic spectrum|autism spectrum disorders]]") replace a wikilink to a redirect with a wikilink to the target of the redirect. But that's not what is wanted here. Currently, Wikipedia does not have a separate page for Autism spectrum disorders, which redirects to Autistic spectrum. But in the future, there may well be a separate page for Autism spectrum disorders; if that occurs, we will want the disorder page, not the spectrum page. There are similar problems with replacing "[[DSM-IV-TR]]" with "[[Diagnostic and Statistical Manual of Mental Disorders|DSM-IV-TR]]", "[[diesel exhaust]]" with "[[exhaust gas|diesel exhaust]]", "[[illicit drug]]s" with "[[illegal drug trade|illicit drugs]]", etc.

• Some of the changes (for example, replacing "[[PDD-NOS|pervasive developmental disorder not otherwise specified (PDD-NOS)]]" with "[[pDD not otherwise specified|pervasive developmental disorder not otherwise specified (PDD-NOS)]]") introduced bizarre capitalization like "pDD". This doesn't affect the appearance of the page, but it makes things harder on editors.

• Some of the changes (for example, replacing "[[IQ]]" with "[[Intelligence quotient|IQ]]") introduce long names where the short names are unlikely to change in meaning. This unnecessarily makes the article longer, which makes the editors' job a bit harder.

I don't know what bot was used to generate these changes, but in the future I urge that its results be applied more carefully, as most of the above-mentioned changes unfortunately made the article text a bit worse. I fixed the problem by applying this change. The combination of the bot's change and my change can be found here, which shows that the bot can help improve articles even if most of its suggestions should not be followed. Eubulides 20:25, 4 October 2007 (UTC)

The page Wikipedia:Redirect #Do not change links to redirects that are not broken discourages changing of valid redirects for most of the reasons mentioned above. There was a craze of redirect-bypassing bots about a year ago - there are fewer of them now that the above-linked advice is at Wikipedia:Redirect. Graham87 04:38, 5 October 2007 (UTC)

TELL ME!!!

Hi I'm a sixth grader at Kennett middle school and I'm reaserching Autism for a report and I'm very interested in it and I want to know a lot more. Is there any information you can give me?

visit our school website at www.kcsd.org —Preceding unsigned comment added by 204.108.230.104 (talk) 14:04, 10 October 2007 (UTC)

Please take a look at Autism#References and Autism#External links. Not all of the references are accessible on the web, but many of them are, and there is a lot of information there. Warning: some of it is heavy going. Eubulides 16:49, 10 October 2007 (UTC)

Unsourced material about metal toxicity

This change inserted text about heavy metal toxicity that is not supported by reliable sources. The revised text incorrectly claims that MMR vaccine contains thimerosal; but that vaccine doesn't contain thimerosal, and never has. The revised text also contains a theory that mercury "sinks to the bottom of the vaccine bottle" if the bottle is not shaken well before each usage; I have found this theory on random discussion sites on the Internet but the theory needs to be verified by reliable sources before it can be put into Wikipedia, and even then it belongs in Thimerosal controversy, not here.

The edit summary for the change said "Article needs to show both sides". Autism already discusses both sides of the issue: it mentions both the MMR vaccine controversy and the thiomersal controversy, states parental concern as the source of the controversies, and gives a summary of the scientific evidence. In contrast the revised text badly misstates the scientific consensus by falsely claiming that there are "overwhelming" scientific reports of success stories due to heavy metal detoxification. This is simply not the case: single success stories are not "overwhelming". It's true that there is plenty of anecdotal evidence to support biomedical intervention; many parents who try one or more therapies report some progress, and there are a few well-publicized reports of children who are able to return to mainstream education after treatment, with dramatic improvements in health and well-being. However, this evidence may be confounded by improvements seen in autistic children who grow up without treatment, by the difficulty of verifying reports of improvements, and by the lack of reporting of treatments' negative outcomes. (See pages 9–12 of: Schreibman L (2005). "Critical evaluation of issues in autism". The Science and Fiction of Autism. Harvard University Press. ISBN 0674019318. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)) For the evidence to be "overwhelming" you'd need randomized controlled trials that are replicated by different groups; only a very few biological interventions are well supported at this level, and chelation therapy is not one of them. (See "Other controversial approaches to treatment" in: Angley M, Semple S, Hewton C, Paterson F, McKinnon R (2007). "Children and autism—part 2—management with complementary medicines and dietary interventions" (PDF). Aust Fam Physician. 36 (10): 827–30. PMID 17925903.{{cite journal}}: CS1 maint: multiple names: authors list (link))

In controversial areas, the Wikipedia policy is to "fairly represent all significant viewpoints that have been published by a reliable source, and should do so in proportion to the prominence of each", and to "present competing views in proportion to their representation among experts on the subject, or among the concerned parties" (see WP:NPOV). In Autism, all controversial facts can and should be backed by a reliable source. The change in question is not only wrong, it is not backed by a reliable source. I've therefore reverted it.

If you feel that the current text does not follow the Wikipedia policy, please discuss the problem in detail on the talk page, as is suggested by the "This is a controversial topic" block at the top of the talk page. It's certainly true that the article can be improved and improvements are welcome. Changes needs to be backed by reliable sources, however. Eubulides 19:53, 16 October 2007 (UTC)

Thimerosal has a molecular weight of 404 atomic mass units. However long you leave a solution of this molecule you will not generate a concentration gradient due to gravity. This is simply impossible due to brownian motion. To separate out uranium, an extremely heavy element, you have to spin uranium gas at 1,500 revolutions per second, generating a G-force over 6,000 times that of normal gravity. This just won't happen by itself. Tim Vickers 20:15, 16 October 2007 (UTC)

I checked with my Chemistry professor and you are incorrect. Brownian motion is only the fact that molecules which comprise a fluid at it's constant temperature are constantly moving. It only counteracts the gravity of molecules which are similar in weight to the fluid in question, or lessens sepparation due to extreme heat forces. If you pour liquid mercury into a beaker of water, the liquid mercury molecules are neutral atoms which are consistantly moving, but they are moving much slower than the water molecules and will still collect at the bottom. Another possibility that I'm not sure of is the idea that the thimerosol is an ion, in which case it may resist collectively sinking to the bottom based on the electrical gradient of the solution. But here's the thing, the vaccine is basically a cocktail of molecules. If the thimerosal molecule is a positive ion, then if there are other positive ions floating in the solution as spectators, such as the sodium ion, sodium ions will be more collectively at the top of the solution, counteracting the negative electrical gradient of that area while the thimerosal ions still gather at the bottom. If thimerosol is a negative ion, then the same effect will occur with a commonly soliable negative ion in the solution, such as the chlorine ion. Which by the way is known to be insoliable when combined with one particular ion of mercury. Both sodium and chlorine ions are very common in biological systems, including the human body. They form what we know as table salt. In this cocktail and in the human body are multiple points where the thimerosal molecule can become neutralized and sink, sink of its own accord, or allow it's mercury ion component to be attached to another ion and become solidified to likely sink to the bottom. I suggest you consult your local college chemistry professor to confirm or refute this point. The reason Uranium might have difficulty sepparating due to brownian motion is likely because it is radioactive and/or hot. What you are sepparating it out of could have some effect of its own too.Youngidealist 06:37, 18 October 2007 (UTC)

I'm not going to argue with you about this, but thank you for injecting a little humor into my day. As a note to the other editors here the post above contains no less than 12 basic errors and should not be taken in the least seriously. Tim Vickers 16:29, 18 October 2007 (UTC)

I enjoyed that, too :-) Tim, please "consult your local college chemistry professor to confirm or refute this point" :-) SandyGeorgia (Talk) 16:36, 18 October 2007 (UTC)

Yeah, laughing's fun... But I am being serious here and if you're up for it I'd like to see those 12 errors you're talking aboutYoungidealist 16:40, 18 October 2007 (UTC)

Show it to your "professor", they'll point them out for you. Tim Vickers 16:42, 18 October 2007 (UTC)

Will do, but it should be clear that I'm going one more step further than you were willing to go to make a point by doing so. You really sound more like you are evading the issue.Youngidealist 16:54, 18 October 2007 (UTC)

You are engaging in original research here. Wikipedia is not for original research; see WP:OR. To put this theory in the article we would need at the very least a reliable published source. Eubulides 08:31, 18 October 2007 (UTC)

This is not origional research. It's facts regarding brownian motion and the references as to what brownian motion is need only be mentioned on the page about brownian motion. Why exactly do you call this statement origional research and not Tim's? He didn't have a source mentioned. The claim only needs to be logically possible and something that people are claiming for it to be mentioned. The fact that people are claiming this and that it is possible based on what wikipedia can and does provide regarding chemistry, is grounds for it to be posted as a claim and then allow it to be refuted or confirmed by sources as needed.68.231.200.13 16:15, 18 October 2007 (UTC)

This is not an article about what is "logically possible". It is an article about what is reliably known about autism. There are many, many theories about autism causes that are logically possible (for example, autism is caused by watching TV), but Autism does not have room to cover them all and should not give the unsupported theories undue weight (see WP:UNDUE). Controversies in autism is a better article to talk about controversial theories propounded by unreliable sources. 16:44, 18 October 2007 (UTC) —Preceding unsigned comment added by Eubulides (talk • contribs)

Yes, and it is reliably known about autism that this claim is logically possible. Mercury toxicity has far more validity than watching TV. For one, mercury toxicity causes neurodevelopmental disorders while autism is a neurodevelopmental disorder. Electromagnetic waves, whatever their wavelength/frequency does not have a history of showing neurodevelopmental disorder at all. What's more, it deserves mentioning because PEOPLE ARE TALKING ABOUT IT. You are not being open minded about the issue. It's a controvercy because people are being convinced. If few were ever convinced, then it might not be mentioned in wikipedia because it's appearantly not enough for the points on here to be true. On another note, there's plenty of room on wikipedia for any and all truth despite your bellyaching. People want information, they go to wikipedia. There's no honest excuse for people to not be able to be directed to the information that they want to hear about except for potential server overload. Creating neutrality on this article is not going to cause that to happen.Youngidealist 17:07, 18 October 2007 (UTC)

We need reliable sources for claims about autism. "PEOPLE ARE TALKING ABOUT IT" is not a reliable source. We can use evidence of that talk as a reliable source for the fact that there is controversy about autism, but that is a different subject: Controversies in autism is the article for that subject. As for your scientific points: let's see some reliable sources, please. (A source for the TV-watching theory can be found in Causes of autism #Television watching.) Eubulides 19:16, 18 October 2007 (UTC)

You are making a big deal from one point of view and denying the reality of what is being talked about. By all means, put all of these points on the article, but do not simply remove all opposing view points. Wikipedia doesn't have a policy for you to determine or assume what is reliable. You simply need sources or to put (citation needed. You don't even seem to care about the inaccuracy of the article before my change was made. I'll look into more detail about both sides, but you need to put the information that is suggested from both sides. Just claiming a few sources to be "reliable" which only make claims, not detailed reports, is not an honest claim to reliability. The topic is very polarized, but wikipedia should not be. Point out the flaws of these claims on the article, but don't pretend that they are completely unsourced or unfounded.Youngidealist 06:37, 18 October 2007 (UTC)

Thanks for looking into more detail about both sides. While you're looking, and thinking about a proposed change, please bear in mind that it does not suffice to merely have sources. Wikipedia policy is to have reliable sources; see WP:V for the policy. For medical articles such as this one, reliable sources include peer-reviewed scientific publications, preferably high-quality secondary sources such as a review article or specialist textbook from a reputable publisher that is written by an expert in the field and is reviewed by peers or editors. The general idea is that articles on medical topics should reflect the prevailing medical or scientific consensus, and that significant-minority views should be presented in the context of their acceptance by experts in the field. For details please see Wikipedia:WikiProject Medicine/Reliable sources. The above discussion covers several important technical flaws in the proposed change. Eubulides 21:40, 16 October 2007 (UTC)

OK, I will find peer reviewd sources for medical claims, but right now I only want it to be stated that such sources say 'this' and such sources say 'that' the neutrality of what I want to place is that some sources say one thing while others say differently, and I don't like that the article is attempting to govern what sources are reliable or in majority of the medical opinion. You cannot gage medical opinion, especially not by only claiming that the medical opinion of one view is "reliable". The article needs to be revised for neutrality of the subject.Youngidealist 06:37, 18 October 2007 (UTC)

Look right here Eubulides, you say "It's true that there is plenty of anecdotal evidence to support biomedical intervention; many parents who try one or more therapies report some progress, and there are a few well-publicized reports of children who are able to return to mainstream education after treatment, with dramatic improvements in health and well-being. However, this evidence may be confounded by improvements seen in autistic children who grow up without treatment, by the difficulty of verifying reports of improvements, and by the lack of reporting of treatments' negative outcomes." How does that make the change completely false or worth removing? You disagree with there being "overwhelming" numbers. Ok, I don't like the word "overwhelming" as it stands now either. It should be stated who's making the claim so that people can decide independently if it's a reliable source. Hell, I'll even use your words exactly and see what you think.Youngidealist 06:37, 18 October 2007 (UTC)

Please stop adding unsourced material to this article. Inserting talk-page-discussion-text into the article is also inappropriate. Discuss the changes here, and find some sources to back up the claims. Colin°^Talk 08:13, 18 October 2007 (UTC)

How is that "inappropriate"? The current text is already insinuating the claimed cause and Eubuledes is refusing to allow it to be changed, even when it's his own words being used. The current text does not have or need any more of a source to insinuate the claimed cause of metal toxicity, other than the wikipedia itself in the related articles, so why does the change that more clearly states what the claimed cause is need to be sourced further?68.231.200.13 15:59, 18 October 2007 (UTC)

The quoted text is reasonable for Autism therapies#Biomedical interventions, which is a specialized article devoted to the topic of autism treatment. It is not reasonable for Autism#Causes, which is a general article about all issues related to autism, and is also a section that talks about causes, not therapies. There simply isn't enough space in Autism#Causes to talk about all the theories of causation for autism; that section is already too long. Even the specialized subarticle Causes of autism doesn't have enough room for all the theories; it defers most of the heavy lifting to a sub-subarticle Heritability of autism, and it defers the controversial topics to MMR vaccine controversy and Thiomersal controversy. The material added in your change has important technical errors, but even if corrected it would be more appropriate for Thiomersal controversy or for Autism therapies, and is out of place here. Eubulides 08:31, 18 October 2007 (UTC)

Eubulides, the quoted text is stating a point about the validity of the possible cause not about therapies. I also didn't extend the section, if anything it's about the same size as it was before. You are defending biased laguage in this article regarding a controvercy. If you were acting honestly, you'd see that it is biased and change the language appropriately in a fashion that doesn't have so many "technical errors" in your opinion, rather than simply revert anything that is done to remove the bias. BTW, why exactly do you hord over so much control of these subjects regarding autism anyway?68.231.200.13 15:59, 18 October 2007 (UTC)

The quoted text that I was talking about is the quote that begins "It's true that there is plenty of anecdotal evidence to support biomedical intervention…". This is a quote about interventions, not about causes. If the article's language is biased, please explain the bias here and propose a changed version here, a changed version that is supported by reliable sources. That is what talk pages are for. The "Causes" section is already too long; growing it (which is what your change did) is an option I'd rather avoid. Of course it is more important to be unbiased and correct than to be short, so if extra words are necessary here then we should add them. But the need for the change needs to be explained. Eubulides 16:53, 18 October 2007 (UTC)

Please read the section above regarding reliable sources, and stop inserting speculation and original research into the article. SandyGeorgia (Talk) 16:13, 18 October 2007 (UTC)

I'm not inserting speculation or origional research. I'm inserting the point that there is speculation and grounds for speculation despite "reliable" research. I've noticed many points here about my ststements being unsourced, yet the controvercy page on thiomerosol has every single quote unsourced! If you have a means of directly refuting without needing to rely on sources, then it should be stated. We know that mercury in thiomerosol is biologically hazardous even according to the "reliable" sources. And while it is openly stated that the opposing view is riddled with a lack of revealing details, I have yet to see anything less from the assumed "reliable" and "convincing" sourcesYoungidealist 16:51, 18 October 2007 (UTC)

The point that "there is speculation" is already in the article, which states "parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and parental concern has led to a decreasing uptake of childhood immunizations". Perhaps this text could be worded better (suggestions are welcome), but the point is there now. Autism is a featured article and has much higher editorial standards than Thiomersal controversy; we should not let the low standards of the latter cause use to lower the standards of the former. The claim that there is no convincing evidence that thiomersal helps cause autism is backed by a reliable source in the text right now, namely Doja & Roberts 2006. Eubulides 16:58, 18 October 2007 (UTC)

Proposed rewrite of "Causes" last 2 paragraphs

Here's a proposed rewrite of the last two paragraphs of Autism#Causes, which takes into account some of the criticisms voiced by Youngidealist in #Unsourced material about metal toxicity above. The idea is to combine the two paragraphs into one, and to give a bit more emphasis to the popular theories that vaccines cause autism.

Although extensive searches are underway for other environmental causes, evidence for them is anecdotal and has not been confirmed by reliable studies. Several other pre- or post-natal environmental factors have been claimed to contribute to autism or exacerbate its symptoms, or may be important to consider in future research. They include certain foods, infectious disease, heavy metals, solvents, diesel exhaust, PCBs, phthalates and phenols used in plastic products, pesticides, brominated flame retardants, alcohol, smoking, illicit drugs, and vaccines. Although parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and parental concern about vaccines has led to a decreasing uptake of childhood immunizations and an increasing likelihood of measles outbreaks, there is overwhelming scientific evidence showing no causal association between the measles-mumps-rubella vaccine and autism, and there is no convincing evidence that the vaccine preservative thiomersal helps cause autism.

Eubulides 22:24, 18 October 2007 (UTC)

No further comments, so I applied the change described above. Eubulides 02:23, 22 October 2007 (UTC)

Hi, Eubi .. While I don't have the time or energy to edit what you wrote, I did think that the comments on vaccines will lead to more trouble rather than less. Europe took out mercury preservatives ages ao, and have found zero correlation between the presevative and autism, and here in the states, thimeresol has been elimated for a long time, too - with ONLY flu shots still using that preservative.... Yet children, in ever increasing numbers, continue to develop autism. The vaccine issue is SO DEAD it deserves zero mention in this article unless it is to merely point out that it has been removed for years and there is no reason to avoid vaccines. That the studies have been CONCLUSIVE. Then if anyone still wants to thrash it out, point them to the causes article. This "gentle approach" I find unacceptable for an encyclopedia that deals in facts, not appeasement and concern for feelings.

If I missed something in my assessment, I'm sorry I didn't have more time to mush it all out... Kiwi 08:34, 23 October 2007 (UTC)

OK, I did a bit more surgery by merging another paragraph, so what was now 3 paragraphs about environmental causes is now just 1. If you take a look at the changes in the past month you'll see that the overall effect is to deemphasize gastrointestinal or immune system abnormalities and allergies (which aren't really environmental influences anyway). Further proposals for wording changes are welcome. (We can't really say "The vaccine issue is SO DEAD". :-) Eubulides 16:40, 23 October 2007 (UTC)

Time to remove the semi protect?

Just a propisition here. I have looked through the previous edits for Autism, and I have found no vandelism from registered users. I am asking for a statement, who thinks its time to let go of the semi protect to see what happens? Javascap 20:05, 31 October 2007 (UTC)

What do you mean registered users? The semi-protection blocks unregistered users. Is that a typo or have I just missed your meaning? Tim Vickers 20:27, 31 October 2007 (UTC)

I believe you have missed my meaning. There is no vandelism from users who are registered, so I dont see why the block still stands. In case you are wondering, I am able to edit it, I am just proposing that due to the lack of vandelism, it should revert to anyone being able to edit it. Javascap 22:42, 31 October 2007 (UTC)

I see, but the vandalism was from unregistered users, this was why semi-protection was chosen, have you taken a look at the situation before protection was applied on the 22nd September? Tim Vickers 22:51, 31 October 2007 (UTC)

Will dot. 22nd of september. Javascap 19:46, 1 November 2007 (UTC)

Rename "Treatment" section title to "Management"?

Wikipedia:Manual of Style (medicine-related articles) #Diseases/disorders/syndromes says that the "Treatment" section could be called "Management" instead. Perhaps it should be given that name? I'm saying this because there's a new high-quality review of autism treatment a.k.a. management out, and its title says "management" rather than "treatment". "Treatment" connotes a cure, or at least a palliation, whereas "management" connotes a recognition that there is no cure, so the title matters. Here's a citation: Myers SM, Johnson CP, Council on Children with Disabilities (2007-10-29). "Management of children with autism spectrum disorders". Pediatrics. doi:10.1542/peds.2007-2362. PMID 17967921. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link) Eubulides 02:10, 1 November 2007 (UTC)

Concur, did the same in Tourette syndrome a year ago for the same reason. I argued the same on Asperger syndrome, but I don't recall the outcome there. SandyGeorgia (Talk) 02:12, 1 November 2007 (UTC)

Sounds a good idea, also might be a less upsetting subtitle to those who don't consider autism an illness. Tim Vickers 16:22, 1 November 2007 (UTC)

Thanks for your comments. I renamed it. Eubulides 07:04, 2 November 2007 (UTC)

Copyediting issues

I noticed a few areas where this excellent article could get even better. The way it expresses numbers is inconsistent. When I saw two fractions using different styles, one hyphenated and the other unhyphenated within the same sentence, I couldn't leave it alone. Excuse me if this seems trivial, but wouldn't it read better to have some regular standard for when to express numbers as digits and when to write them out? I propose that single digit numbers be expressed digitally and double digit or greater be expressed in written form. Would anyone object to that change? Kroyw 03:46, 4 November 2007 (UTC)

Please see WP:MOSNUM; also, I wasn't able to decipher what you had changed ... edit summaries are helpful :-) SandyGeorgia (Talk) 03:49, 4 November 2007 (UTC)

I'll go look. All I did was remove a few stray hyphens. Some people overpunctuate. Kroyw 03:51, 4 November 2007 (UTC)

Hm, looks like they want us to standardize all fractions. I went for consistency in the other direction. Will fix that first. Thanks for linking. Kroyw 03:53, 4 November 2007 (UTC)

I reinstated all of them, because they were all correct per WP:HYPHEN and WP:MOSNUM. It was really hard to tell what you had changed, since you hadn't provided an edit summary and I couldn't see the small change, but now that I know ... SandyGeorgia (Talk) 03:54, 4 November 2007 (UTC)

Thank you. I'm relatively new at this. I suppose it's shyness. Kroyw 04:01, 4 November 2007 (UTC)

What's expected, actually? Should I summarize every edit everywhere? Kroyw 04:02, 4 November 2007 (UTC)

Yes, it's good practice; I'll scare up a link and put it on your talk page. SandyGeorgia (Talk) 04:03, 4 November 2007 (UTC)

All right. When I gave things a close look it did turn out to mostly comply with that guide. Just a couple of minor things to update. Thank you for the guidance. Kroyw 04:17, 6 November 2007 (UTC)

Good catches! SandyGeorgia (Talk) 04:22, 6 November 2007 (UTC)

Portrait

Why is the man who discovered Asperger syndrome portrayed at the autism article? Unless he discovered both conditions, I don't see the relevance. Kroyw 03:51, 4 November 2007 (UTC)

We use what images we have, and we don't always have a lot of them that meet the Fair Use and other licensing requirements. SandyGeorgia (Talk) 03:55, 4 November 2007 (UTC)

It seems confusing to include a portrait of a man who discovered a different condition at this article. I read the caption and the passage three times wondering whether he had discovered autism also. Kroyw 04:00, 4 November 2007 (UTC)

Eubulides will likely give you a more thorough answer tomorrow. SandyGeorgia (Talk) 04:02, 4 November 2007 (UTC)

Asperger was the first to use the word autism in its modern sense. I changed the caption as follows to try to clarify things a bit. Eubulides 05:18, 4 November 2007 (UTC)

Lead image

I tweaked the lead image a bit more, I didn't overwrite the original so if people prefer that version we can revert the changes. Tim Vickers 22:29, 14 November 2007 (UTC)

Lead text

A recent change to "Simplify and shorten the wording in the lead, to make it more easily accessible" has, I think, made it less precise, and the wording is not equivalent. The "impairments in" was changed to "interferes with". An impairment means reduced functionality. Interference might increase or alter in some way that is neither up nor down but still different. The word "repetitive" was changed to "repeated", which doesn't convey the same persistency. I'd prefer something a bit closer to the original:

Autism is a brain development disorder characterized by impaired social interaction and communication, combined with restricted and repetitive behavior, all starting before a child is three years old.

However, the follow-on sentence "These characteristics distinguish autism from milder autism spectrum disorders (ASD) such as Asperger syndrome." repeats the "character..." word, which is to be avoided. But I'm not sure about the first sentence clearly distinguishing AS from autism. For example, the AS article says "AS is distinguished from the other ASDs in having no general delay in language or cognitive development." neither of which are mentioned in the first sentence. So, I think the lead still needs a little work to ensure autism is properly defined and distinguished from the other ASDs. The lead section is short enough that there is room for a little expansion. Colin°^Talk 21:26, 19 November 2007 (UTC)

These characteristics may occur in all ASD's, but it's in Autistic Disorder that symptoms from across the entire triad must be present. That might be made clearer, perhaps with something like: "The presence of symptoms in each of these three area's distinguish autism from milder autism spectrum disorders (ASD) such as Asperger syndrome". Fenke (talk) 22:08, 19 November 2007 (UTC)

Good point, thanks. Even better, we can shorten "The presence of symptoms in each of these three areas" to "This set of signs", and I made that change. Eubulides (talk) 22:21, 19 November 2007 (UTC)

The goal behind those changes was to use simpler words, so that the article is less off-putting to non-expert readers. I see Colin's point about "repeated"/"repetitive" so I changed it back. I wanted to avoid "impairments" as it is a bit too fancy too. I don't quite follow Colin's point about "interferes with" (interference pretty clearly denotes a problem, not a bonus) but I changed it to "impairs". The statement that autism impairs communication is supposed to distinguish autism from the "no general delay in language" in Asperger syndrome. Eubulides (talk) 22:21, 19 November 2007 (UTC)

For some motivation behind these changes, by the way, please see WebMD's autism article, or HealthWise's. These articles are considerably easier to read than Autism, even though their technical quality is quite high. I don't think Wikipedia can match them in being easy-to-read (Wikipedia is much more ambitious, among other things), but on the other hand we can be easier to read, at least in the lead. Eubulides (talk) 22:21, 19 November 2007 (UTC)

I'll look again tomorrow, but just a quick explanation of "interferes": a two-year-old may interfere with the volume control on your TV. It might be louder or quieter, become distorted or just annoy the neighbours. Bad social interaction isn't always diminished/impaired: one can be too extrovert/opinionated/loud or even too friendly for ones own good (loss of self-control or fear of strangers). For definitions, we have to use precise language. I think both "impairs" and "impaired" are better than "impairment" for the reasons Eubulides gives. On the other point: delay is not the same thing as impairment, as it implies the possibility of achieving the same end-point. One's speech may be abnormally delayed but end up normal. Cognitive ability isn't mentioned in the lead. It is here, perhaps, that the difference between HFA and AS become difficult to explain. Colin°^Talk 23:21, 19 November 2007 (UTC)

It's just a small thing (since we've changed it back to "impairs"), but a 2-year-old who interferes with your TV's volume control necessarily impairs the control of your TV's volume, and vice versa. I agree that "impair" and "interfere" have different meanings but the difference doesn't much matter here and "interfere" is more easily understood by more people. As for delay versus impairment, in both cases the article is using terminology taken from the diagnosis standards, which are designed so that AS and autism are mutually exclusive diagnoses. Admittedly there are judgment calls and in practice there is a fuzzy line between AS and HFA, but the big picture is that autism has major impairments with communication, while AS does not, and that is an important distinction between the two diagnoses. Eubulides (talk) 06:08, 20 November 2007 (UTC)

Link to nonexistent "Austimus" in Latin Wikipedia?

This change established a link from Autism to the Latin page for Autism, la:Autismus. But there is no Latin page; when I follow that link I get a "In hac pagina nondum litterae sunt" page, which means the Latin Wikipedia does not have an article with that name. Am I missing something, or should I revert that change? Eubulides (talk) 05:40, 27 November 2007 (UTC)

You mean we're supposed to check those things (d'oh)? Since it's not doing any harm, I'd suggest leaving a talk message for the editor who left it, and if s/he doesn't respond within a few days, then revert. SandyGeorgia (Talk) 05:58, 27 November 2007 (UTC)

Thanks, I left a note on that editor's talk page. This business about foreign-language links remains mysterious to me, as it's unclear whether they're supposed to be maintained by hand or by bots. Wikipedia:Interlanguage links #Links to pages that do not exist suggests that I may remove the link by hand, but other times I've fiddled with that section (by sorting it), a bot has undone the change. Eubulides (talk) 07:18, 27 November 2007 (UTC)

Whenever I encounter something about bots et al that needs an answer, my first stop is at Gimmetrow (talk · contribs)'s page; he seems to know everything about everything, in case you want to explore further. You could also ask at WP:VPT. SandyGeorgia (Talk) 17:03, 27 November 2007 (UTC)

I asked at WP:VPT #Link to nonexistent "Austimus" in Latin Wikipedia? and learned that the foreign-language links are a bit of a messy situation. Graham87 helpfully removed the link by hand, and I see that Duomillia (the original editor) just put the link back in, this time to a real (albeit brief) Latin page. An ironic thing here is that the word autism is in fact derived from autismus, a New Latin word that first appeared in 1910 (in a paper written in German, of course …). Eubulides (talk) 00:20, 29 November 2007 (UTC)

I will slowly work on this article in Latin, translating it bit by bit! :) --Duomillia (talk) 00:24, 29 November 2007 (UTC)

Fever and ASD

There's a new study out reporting that children with ASD who have a fever (body temperature greater than 38°C) have fewer symptoms of irritability, hyperactivity, stereotypy, and inappropriate speech. My kneejerk reaction is that this is a high-quality study but it's just one study and its implications aren't that clear, so it's probably not suitable (at least not yet) for inclusion in the article. Thought I'd mention it here, in case someone else thinks otherwise. It's not in Pubmed yet but here's a citation: Curran LK, Newschaffer CJ, Lee LC, Crawford SO, Johnston MV, Zimmerman AW (2007). "Behaviors associated with fever in children with autism spectrum disorders". Pediatrics. 120 (6): e1386–92. doi:10.1542/peds.2007-0360. PMID 18055656. {{cite journal}}: Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link) Eubulides 04:53, 4 December 2007 (UTC)

I think that any high quality study deserves a mention; Wikipedia may be getting a reputation for quality but I hope it never becomes so well-reputed that it can't describe interesting research. On a more speculative note, I was curious whether MDMA, which transiently increases body temperature, could have a positive effect. While I didn't find any evidence of human trials, there's one group trying to collect Internet reports of whether people with Asperger's or high-functioning autism have noticed beneficial effects.[6] Of course, MDMA has potent psychotropic effects said to make people more "social", and they're thinking about that activity rather than the temperature rise. (Please note that I am not advising anyone try this drug, which has some indications of neurotoxicity) 70.15.116.59 (talk) 06:22, 7 December 2007 (UTC)

Autism does not have room enough to mention all high quality studies on autism. Pubmed reports 11,516 medical-journal articles about autism; even if only 20% are "high quality" that's over 2,000 studies, and there's no way we can mention them all. Please see Wikipedia:WikiProject Medicine/Reliable sources for the standards we are trying to meet here. I don't think Curran et al. 2007 quite meet those standards as they are merely a primary source (we prefer high-quality reviews) and their results are not that clear. As for MDMA, until reliable sources cover MDMA and autism we should not mention MDMA in the article. Eubulides (talk) 06:34, 7 December 2007 (UTC)

The guideline you mention does not say not to use primary sources, just not to interpret them on your own. As for the numbers, I don't think Wikipedia should be designed under a space constraint. It is possible to split articles if they grow too large - so people should add relevant, well-sourced data without trying to decide if it's the most important thing they could possibly say about a topic. (I don't actually think anything about MDMA should actually be added yet - it was just an interesting parallel to the fever study) It is not right that people should be out there waxing floridly on every weapon and monster in every version of a video game without restraint, but people editing autism should feel afraid to mention a good, interesting publication. Yes, there are 11,516 articles - and if you want to go through them all just look them up on PubMed. What Wikipedia has that PubMed doesn't is that it only lists the articles that some passing human being, for whatever personal reason he might have, has picked out as interesting - and I think that is actually worth quite a bit. Peer review for journals focuses on accuracy, with some attention to "significance" in the higher profile journals, but not really whether something is "interesting" in the most vulgar sense of the word. 70.15.116.59 (talk) 04:55, 9 December 2007 (UTC)

The guideline says secondary sources (such as high-quality reviews) are preferred; this helps resolve not only the problem of interpreting primary sources, but also in deciding which are important and which are not (which is the issue here). Wikipedia overall may not have a space constraint, but Autism does; it's already oversize and does not have room to contain reports of every new primary study on autism. Dozens of new primary studies are published every month, far too many to summarize them all on Autism. If there were some important reason to mention this particular study that would be another story, but I don't see it: it's merely a curiosity for now, and an unconfirmed one at that. Eubulides (talk) 05:55, 9 December 2007 (UTC)

For what it is worth, our daughter has Aspergers and we noticed that her behaviour was more modulated (she didn't act out as much) and was more passive after she was sick. We thought that she was just exhausted after using so much energy to get better. On another note, many children have "night terrors" and don't sleep well. My daughter seems to sleep through the night but will wake with dark circles under her eyes and always feel tired. I notice a lot of Aspie kids seem to have these dark circles. Their realities also seem to follow the rules of dreams. Are these children never fully asleep nor never fully awake?63.146.238.102 (talk) 02:54, 11 December 2007 (UTC)

The paper that started this thread said that the interesting thing wasn't that children are calmer when they have fevers (that is unsurprising); it was that their communication and socialization deficits improve. Autism #Other symptoms talks about sleep problems and ASD (not that this addresses your last question). Eubulides (talk) 03:08, 11 December 2007 (UTC)

ok, I could have been clearer. My daughter is also gifted (tested with a 132 IQ at age 3) so communication has always been advanced even compared to NTs. Normally he speech is drawn out on topics and there can be long pauses as her mind moves faster than her mouth. After a sickness, her speech is more relaxed & fluid. It is like she is "here" and not off in her own world. She also seems more empathetic of others rather than her "normal" egocentricity.63.146.238.102 (talk) 04:29, 11 December 2007 (UTC)

Other species

Can an animal, such as a dog or cat, be autistic? Lestrade (talk) 23:05, 4 December 2007 (UTC)Lestrade

Strictly speaking no, since dogs and cats can't speak so the diagnostic criteria for autism proper do not apply. However there is a huge amount of interest in animal models for autism. That is a tricky area. Perhaps there should be a sentence about it in Autism? Anyway, here's a fairly recent review in case you want to explore the subject: Tordjman S, Drapier D, Bonnot O; et al. (2007). "Animal models relevant to schizophrenia and autism: validity and limitations". Behav Genet. 37 (1): 61–78. doi:10.1007/s10519-006-9120-5. PMID 17160702. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)

Interesting to bring that up though, many autistics do speak and do not have speech delays (this has erroneously been called Asperger syndrome). What it brings to my mind is the experiments done on cats by Bernard Rimland which he talks about in his book Infantile Autism (1967). He removed or disabled the reticular formation of the brain in several cats. This is supposed to be an area that handles the ability to associate current sensory input with stored information, so that the current input makes sense. The cats exhibited several behaviors consistent with autism and discontinued them on being given regular doses of vitamin B6. I don't know about his followups on this although I assume there were some. --Bluejay Young (talk) 22:25, 9 December 2007 (UTC)

It's true that some people with autism speak without delays in development, but the diagnosis of autism does require at least one qualitative impairment in communication (one such impairment, for example, would be stereotyped and repetitive use of language), and I can't see a dog or cat satisfying this requirement. Rimland's 1960s work is not much cited these days; for example, Tordjman et al. 2007 don't mention it. Three randomized controlled trials have studied vitamin B6 in humans; the smallest one (8 individuals) found improved verbal IQ in the treatment group and the other two trials found no significant difference, so it's hard to say whether this approach has effects greater than placebo. See Angley et al. 2007 (PDF) and Francis 2005 (PDF). Eubulides (talk) 00:36, 10 December 2007 (UTC)

Neuropsychology

Should Hobson's affective deficit approach be included as another explanation for the social/cognitive deficits found in autistic people? It attempts to explain the emotional symptoms that are largely ignored or brushed over by other theories. This could contribute to the article's viewpoint which states, accurately, that the likely explanation for these deficits lies in combinations of theories (theory of mind, executive function, affective resonance, central cohesion, etc). --Ripcurlprfection (talk) 14:52, 16 December 2007 (UTC)

Is it covered in reliable sources? Further, are they high quality sources suitable for a medical article? If you have some sources, try posting them on the talk page for review and see what other editors say about them. WLU (talk) 14:58, 16 December 2007 (UTC)

I am having difficulty accessing Hobson's research via the internet (PsycInfo has nothing of his online, but I can view a long list of his published work). I will need to return from abroad before I can access the volumes that include his work, so I won't be able to do this properly until later. I should also look further into research into theory of mind deficit (Baron-Cohen, Frith, etc), as Hobson's theory puts ToM deficits secondary to a lack of 'affective resonance' development at an early age.--Ripcurlprfection (talk) 15:27, 16 December 2007 (UTC)

Sure, but if you're running into problems finding his research, he may not be suitable per WP:MEDRS. You could also try [www.pubmed.org pubmed]. WLU (talk) 15:37, 16 December 2007 (UTC)

Advancing Paternal Age and Autism

I think the people would benefit from links to studies of autism, such as the Israeli study published in Sep 2006 in the Archives of General Psychiatry. Full Text of Arch Gen Psychiatry. 2006;63:1026-1032. If you know any other studies and their results relating paternal age and autism, please add to this discussion page. User:Yaz —Preceding unsigned comment added by 71.112.23.82 (talk) 08:04, 31 December 2007 (UTC)

I have heard of that study, and all I want to say is that I believe it's the age of the mother rather than the age of the father that is correlated with autism. But of course, the people taking the questionnaire were men, so they went with what they got. Haplolology ^Talk/_{Contributions} 14:21, 31 December 2007 (UTC)

On second thought (sorry, I only just clicked the link now) it looks like they have answered my objection, so nevermind. Haplolology ^Talk/_{Contributions} 15:02, 31 December 2007 (UTC)

The article currently covers this topic under Autism#Epidemiology and cites Kolevzon et al. 2007 (PMID 17404128), a review article that surveys seven primary studies including the one that you mention. WP:MEDRS suggests that the article should prefer reliable secondary sources like this, so I don't think we need to mention the primary study in Autism; this sort of detail would be more appropriate for Epidemiology of autism. For reference, here's a list of the seven primary studies reviewed. There are four prospective population-based cohort studies, namely Eaton et al. 2001 (PMID 11518482), Croen et al. 2002 (PMID 12108623), Lauritsen et al. 2005 (PMID 16108999*), and Reichenberg et al. 2006 (PMID 16953005*; this is the study you mentioned), along with three population-based case-control studies, namely Hultman et al. 2002 (PMID 12094096), Glasson et al. 2004 (PMID 15184241), and Larsson et al. 2005 (PMID 15870155*). The "*" marks the three studies that looked at paternal age. Eubulides (talk) 17:20, 31 December 2007 (UTC)

Suggested link

I agree there were far too many external links to this page. However I'd like to propose that the link to http://www.autism-help.org be reinstated, as its sole aim was to provide practical evidence-based knowledge to parents of children on the autistic spectrum. Where possible, I've adapted information from this site to form new autism intervention articles for Wikipedia, and propose this link simply to further the spread of accurate useful information for parents. Autie62 (talk) 07:58, 3 January 2008 (UTC)

That external link was removed on 2007-10-05 with the commentary "remove autism-help.org, not a reliable source, copyvios, they have completely plagiarized the TS article from Wiki with no credit". I just now checked, and it also seems to be plagiarizing from Autism with no credit. As a general rule, Wikipedia does not refer readers to sites that plagiarize (especially sites that plagiarize from Wikipedia itself!). Eubulides (talk) 08:40, 3 January 2008 (UTC)

Autism and bullying

This change added "Many of these differences in communication can make children the target of bullying." to Autism#Communication. This claim is plausible, but we need a reliable source to back it up. Does anybody know of a reliable source that says this with some authority?

A similar claim was added to Asperger syndrome; the same issue arises there.

I know of one recent study on autism and bullying, which found that children with autism appear to be more likely to bully other children. I'm not sure that bullying is reliably-sourced enough to merit being in Autism, but if it is covered then we should probably tackle this sort of bullying as well. See: Montes G, Halterman JS (2007). "Bullying among children with autism and the influence of comorbidity with ADHD: a population-based study". Ambul Pediatr. 7 (3): 253–7. doi:10.1016/j.ambp.2007.02.003. PMID 17512887.

Eubulides (talk) 09:04, 3 January 2008 (UTC)

Question: Doesn't that study focus on the autistic subpopulation? Avb 12:54, 3 January 2008 (UTC)

The study merely says "children with autism". Its intro says "Children with autism are more likely to be victimized" (than neurotypical children are) and it cites Little 2001 (PMID 11556644) and Marini et al. 2001. Little 2001 is about Asperger's, not autistic disorder proper, so presumably Montes & Halterman 2007 are talking about ASD but are being a bit sloppy about it. Montes & Halterman 2007 also notes "many children with autism require treatment for aggression, suggesting that this population may be at high risk for aggressive behaviors, which may potentially include bullying." and cite Hughes et al. 2002 (PDF), McCracken et al. 2002 (PMID 12151468), and McDougle et al. 2003 (PMID 12672261). Eubulides (talk) 18:21, 3 January 2008 (UTC)

I guess I did not make myself clear. I wondered whether the study said something about bullying within the autistic subpopulation (i.e. the bullying of autistic children by autistic children) versus within the general population (i.e. the bullying of unspecified victims by autistic children). Avb 23:43, 3 January 2008 (UTC)

The latter. Eubulides (talk) 01:31, 4 January 2008 (UTC)

It's kinda hard to read without greater definitions - the only conclusion in pubmed is that kids with comorbid disorders are at increased risk for bullying behaviors, which I read as they bully more. The results section of the abstract I don't find particularly clear. I think the full article would be required to really state anything firm about the study. WLU (talk) 12:58, 3 January 2008 (UTC)

Agreed.

I looked around for some sources; it would be surprising if such an (IMO predominant) problem had not been documented in V RS. One example would be PMID 11934121. Admittedly this study (like the one above) reports on interviews with parents, but the questions asked are real enough and reading the abstract brought back some very painful memories of direct and indirect suffering. Avb 13:19, 3 January 2008 (UTC)

In view of the lack of sources found in PubMed searches, there isn't much by way of scientific research on the subject. This usually means one of two things: it's obviously nonsense so no serious scientist is going to bother with it, or it's obviously true. The former may lead to some negative mention in skeptic sources, that can be used to source Wikipedia content on pseudoscience and the like; the latter generally appears in books by experts and on parent/patient org/government/self-help web sites. Here's a Google Scholar search with a sampling of the latter. Avb 14:07, 3 January 2008 (UTC)

The source you cite, Little 2002 (PMID 11934121) is essentially the same study as Little 2001 (PMID 11556644), which I (just now) mentioned above. Given the number of studies on both sides of this issue (autistic children as bullies / as the bullied) I would prefer a reliable review on the subject to our guessing how to stitch together primary sources. Unfortunately, the best quote I've found on the subject in a reliable review is: "there is more evidence to suggest that children with AS occupy the role of victim rather than victimizer." Tsatsanis KD (2003). "Outcome research in Asperger syndrome and autism". Child Adolesc Psychiatr Clin N Am. 12 (1): 47–63. PMID 12512398. However, this source is about AS, not about autism in general, which is not good for Autism. Also, the review is careful to note that it's just counting papers, and that nobody has measured whether the increased bullying by children with AS outweighs the increased being-bullied. It's easy to speculate what the numbers would be (I certainly have my opinion), but we shouldn't be speculating in this article. Eubulides (talk) 18:21, 3 January 2008 (UTC)

Did you take a look at the Google Scholar search above? This source, for example, is good enough for me to source/attribute the above statement in the AS article, as it states: "This lack of social skills can and often does make students with Asperger Syndrome the object of teasing, victimization, and bullying by their peers". Another one summarizes Little 2001 as "there is considerable evidence that children with AD, because of their awkwardness and other characteristics, constitute easy targets for bullying by peers and others". I hope this helps you with the part of your question about sourcing the AS article and encourage you to check the search results for same regarding the Autism article. This looks promising to me. Avb 01:14, 4 January 2008 (UTC)

As far as I can tell, none of those three citations address autism and bullying. The first two are about Asperger's, not autism or ASD, and as sources are inferior to Tsatsanis 2003 which is already cited in Asperger syndrome. The last one is about bullying in general; it talks about developmental disorders but not about autism or ASD (it's pretty long though; perhaps I missed something). We would need better sources than this. Montes & Halterman 2007 (PMID 17512887) is much better than those three sources, and it's not that good either. The Google Scholar search has 2,380 hits, which I don't have time to investigate. Eubulides (talk) 01:50, 4 January 2008 (UTC)

I do not think that any bulling can be related to any type of autism, of course being one does not say for all. SG4TACOZ! (talk) 01:57, 4 January 2008 (UTC)

The question was whether or not being bullied happens much more often to children with autism than to children in general. Avb 02:23, 4 January 2008 (UTC)

Eubulides wrote: "As far as I can tell, none of those three citations address autism and bullying." -- Once again, the first two are about AS, intended to answer your question insofar as it addresses the AS article. The last relates clearly to autism: I linked specifically to its page #30. Montes & Halterman 2007 (PMID 17512887) is clearly inferior here as it does not address the question at all (it is about bullying, not about being bullied, as already argued). Avb 02:23, 4 January 2008 (UTC)

I don't recall having any questions about the Asperger syndrome article. The link to page 30 did not work for my browser and I did not notice it. I just now read the article you mentioned; here is a citation: Taylor J, Creer C (2004). "Vulnerable populations for bullying" (PDF). Utah Spec Educ. 25 (2): 30–1. The authors are/were staff members of the Utah State Office of Education, and the magazine is an unrefereed house organ. Here's the article's claim about autism: "Because of a general lack of social awareness, many children with autism can be particularly vulnerable to specific bullying situations." The article has no citations; instead, it supports the claim by mentioning an unpublished Internet survey conducted in 2004. However, none of the quoted questions in the survey mention autism. I'm afraid that this source is too weak. It is neither a primary study nor a reliable review article, it is not refereed, and it is far below the usual quality of the sources cited in Autism. Let's hope we can find a better source. Eubulides (talk) 04:39, 4 January 2008 (UTC)

Condition vs. Disorder

In the following text: "... with some seeking a cure and others believing that autism is a condition rather than a disorder," I don't think this is completely accurate. While sometimes advocates of the view that autism is not a disorder accept using the word "condition" as a compromise, it does seem unusual for them to use preference for that word, and most of the advocacy of people with this perspective seem to emphasize the belief that autism is a disorder much more than the belief that autism is a condition. Would anyone mind if I change that text to read, "... with some seeking a cure and others believing that autism is not a disorder"? Q0 (talk) 11:35, 4 January 2008 (UTC)

Did you mean to say "emphasize the belief that autism is not a disorder" (my emphasis)? The word "condition" simply means a state/mode/form of being, which seems neutral enough. If the text said "medical condition" then I could seem how some might think there is an implicit pathology. One problem with just saying that some think "that autism is not a disorder" is that it doesn't offer a replacement. At the end of the article, it says "autism is simply another way of being". IMO, "condition" is an appropriate shortened form of "another way of being". Colin°^Talk 16:33, 4 January 2008 (UTC)

Early Abnormal Physical Growth Patterns

Is there any reason why there is no mention in the article of the recent studies showing abnormal early physical growth patterns found in autistic infants in there first year of life? I don't see any mention of it on the talk page or the related pages. For more information, here is one recent example:[7]. Dtolman (talk) 22:19, 8 January 2008 (UTC)

I think it's covered. Autism #Pathophysiology says "Brain weight and volume and head circumference tend to be greater in autistic children" and goes on to discuss four related hypotheses. The discussion cites four recent review articles. Eubulides (talk) 22:28, 8 January 2008 (UTC)

The linked study in the pathophysiology is discussing the size and shape of the brain. The studies I'm referring to are looking at rates of growth, for the head, and the body as a whole - things that can be measured with just a tape measure - not with internal imaging equipment. Its also something that is being discussed as a early warning sign of autism in an infants first year of life - I think thats interesting because the wikipedia article implies that it can't be diagnosed that early, which is somewhat misleading. Dtolman (talk) 02:12, 9 January 2008 (UTC)

Autism #Pathophysiology mentions "head circumference", which can be measured with a tape. It cites DiCicco-Bloom et al. 2006 (PMID 16807320), a review that discusses head circumference in some detail and cites several studies. Autism #Screening does mention signs by 12 months that suggest evaluation by a specialist. I don't know of any reliable source claiming that one can diagnose autism in the first year; the source you mention, which talks only about head circumference, does not make that claim. Eubulides (talk) 04:50, 9 January 2008 (UTC)

OK thanks - I had missed those. Dtolman (talk) 12:32, 9 January 2008 (UTC)

News story: Rare genetic glitch hikes risk of autism

• Rare genetic glitch hikes risk of autism
• Ling.Nut (talk) 14:23, 10 January 2008 (UTC)

Thanks, that info has been added to Heritability of autism #Candidate gene loci; see "16p11.2 region". Eubulides (talk) 17:18, 10 January 2008 (UTC)

Thank you, Ling.Nut; it's nice to see you here. SandyGeorgia (Talk) 17:28, 10 January 2008 (UTC)

Helminthic therapy and autism

A gentleman having devoted his life to finding effective treatments for his childs autism (you can read his story here http://www.autismtso.com observed, as others have, that during fevers and illness his child's symptoms vastly decreased. He decided to pursue the idea that autism is an autoimmune condition and after many trials decided to treat his child using TSO from Ovamed. TSO is Trichuris suis ova, or pig whipworm eggs. The result, for him, has been total remission of his child's autism.

He has lectured on the subject and makes a convincing advocate.

The keepers of this board might want to investigate this theme for inclusion here. After all, if it works, getting the word out would be a good thing.

08:24, 23 January 2008 (UTC)

That treatment seems to really open up a can of worms. Q0 (talk) 10:51, 23 January 2008 (UTC)

I know of no reliable sources on the subject. The abovementioned website does not count as a reliable source, I'm afraid. Eubulides (talk) 17:44, 23 January 2008 (UTC)

Slimming down

This article has grown to be 229k (by Google's measure) and takes quite a bit of time to display, particularly on older machines. Now that some of its material is duplicated by subsidiary articles, it's time to prune away some chunks of the duplicated material. I started the job with this change; more work is needed. Eubulides (talk) 07:53, 26 January 2008 (UTC)

another news article; much less hard-science

• ABC defends show against outcry by pediatricians
• mmm, basic idea is potential risk (real or alleged; I dunno which) of autism formerly caused by vaccination:
  • "Critics of childhood immunization have argued that thimerosal, a mercury-based preservative formerly used in vaccines, is a primary cause of an autism in young children."
• Ling.Nut (talk) 09:16, 29 January 2008 (UTC)

I dunno, it's a fictional TV show. There are lots of fictional TV shows about autism and I don't see much special about this one. Eubulides (talk) 17:16, 29 January 2008 (UTC)

I did notice that there's a Wikipedia article for the show, Eli Stone, so I added a section to that article, to cover the controversy there. I also added briefer notes to the articles for the co-creators of the show. Sheesh, Wikipedia seems to have detailed articles about every little nook and cranny of the entertainment industry; if only its medical coverage could be that comprehensive! Eubulides (talk) 22:39, 29 January 2008 (UTC)

RE: some points to consider

"Autism is a brain development disorder"

- I was wondering if a more proper label would be 'neurobiological' disorder.

Autism is certainly a neurobiological disorder, but I much prefer the label brain development disorder in the lead because (a) it's easier for the average reader to understand, and (b) it's more specific. Eubulides (talk) 19:18, 1 February 2008 (UTC)

"Early intervention may help children gain self-care and social skills, although few of these interventions are supported by scientific studies."

- I think it is important to note that early intervention is key to helping children develop particular skills- and perhaps indicating that although most interventions are not considered evidence-based, that ABA-based intervention methods are considered evidence-based, best practice when referring to this population Reference: (Perry, A. & Condillac, R. (2003). Evidence Based Practices for Children and Adolescents with Autism Spectrum Disorders - Review of the Literature and Practice Guide" Toronto, Ontario, Canada: Children's Mental Health Ontario.

This is a difficult topic to summarize. As Howlin 2006 (doi:10.1053/j.mppsy.2006.06.007 points out, the claim that early intervention is key is not substantiated by scientific evidence. (By "early" here I mean by age 2 or 3.) And yet many experts believe the claim is probably true. Furthermore, there is some controversy about whether ABA-based methods are better than other approaches. For example, Magiati et al. 2007 (PMID 17683452) found not much difference between behavior and cognitive approaches. The lead is probably not the place to get into that controversy; it's too complicated. However, I agree that the quoted wording was a bit too pessimistic; I changed it to read "Early behavioral or cognitive intervention can help children gain self-care and social skills." I figure the details about substantiation by scientific evidence need not be emphasized so much in the lead (they're covered in the body). Eubulides (talk) 19:18, 1 February 2008 (UTC)

I noticed that you state that early intervention improves self-care and social skills, but what about language and communication ability? I know that Vince Carbone's work in Verbal Behavior takes an ABA-based approach and applies it to teaching language and communication with demonstrated success (Perry, A. & Condillac, R. (2003). Evidence Based Practices for Children and Adolescents with Autism Spectrum Disorders - Review of the Literature and Practice Guide" Toronto, Ontario, Canada: Children's Mental Health Ontario.) There are other interventions that also focus on increasing language and communication. The only reason I mention it, it looks like the only skills that early intervention improves are self-help and social skills, and I am sure that many people would be wondering about the communication aspect of the disorder and whether it can be improved with these methods as well...

Thanks, I changed it to read "self-care, social, and communication skills". I figure that mentioning communication is enough in the lead; we needn't also mention language, as that is a subset of communication. Eubulides (talk) 21:15, 1 February 2008 (UTC)

"With severe autism, independent living is unlikely; with milder autism, there are some success stories for adults,[6]"

- This is very ambigous. I have worked with many children who may be considered "severe" before intervention, and gain skills to be included in school settings without support. Temple Gradin herself states that she was diagnosed with Childhood Autism (which would not be our "Autistic Disorder", and she is living very independently.). Even though she was considered to have severe autism, through intervention, she has been able to overcome communication and social difficulties, and is a very independent woman. I think it is important to not say this without referring to growth and gains over time, as many parents may be reading this and could lose hope as a result. In addition, a study I know of off the top of my head: Seltzer MM, Krauss MW, Shattuck PT, Orsmond G, Swe A, Lord C.(2003). "The symptoms of autism spectrum disorders in adolescence and adulthood". Journal of Autism and Developmental Disorders, Vol 33(6): 565-581. states that there is about a 20% reduction of symptoms overall that appears with age. So, to simply say that "with severe autism, independent living is unlikely" it should be clear whether you are talking about young children with severe autism as having poor outcomes, or an adult with severe autism as not being able to live independently. A summary can be read at: == External links ==

[8]

The "independent living" was intended to talk about adults, not children (children by and large do not live independently :-), but I can see how this could be misinterpreted. Although there are certainly some success stories, the available statistics suggest that most children with autism do not live independently after they become adults. Howlin et al. 2004 (PMID 14982237) followed up 68 children with autism and found that only 3 lived independently as adults. The statistics for today's children will probably be better but I don't know of any reliable source that says that a child today with autism (much less severe autism) is likely to live independently as an adult. To help remove some of the ambiguity I reworded it to read "Few children with autism live independently after reaching adulthood, but some become successful". Eubulides (talk) 19:18, 1 February 2008 (UTC)

"an autistic culture has developed, with some seeking a cure and others believing that autism is a condition rather than a disorder.[7]" - this contradicts with the brain development, and genetic component mentioned previously. I am not sure if you are trying to capture the mixed feelings of those who have Autism Spectrum Disorders - such as Temple Gradin who is proud to have autism, and says she wouldn't be who she is without it, and the Aspies website where Asperger's Syndrome is celebrated. On the other hand, there are other individuals with ASDs who are particularly challenged by the disorder and seek to find a cure such as Donna Williams who says if there was a cure she would seek it out. Or, are you trying to capture the greater invested community of professionals, parents, etc. who are also divided on this subject? --Svernon (talk) 17:52, 1 February 2008 (UTC)

Sorry, I don't see the contradiction here. The people who believe autism is a condition generally agree that autistic brains develop differently, and that there is a genetic component; it's just that they don't consider the result to be a disorder. The sentence is indeed trying to capture both the Grandin/Aspies position that there's nothing wrong with being autistic and the Williams position that a cure is desirable. Perhaps you could suggest a better wording that would address your concern? Eubulides (talk) 19:18, 1 February 2008 (UTC)

I have re-read it, and it seems to flow nicely now. Looks good!

EWMN

Recently, using Eshkol-Wachman Movement Notation (EWMN), researchers from the University of Florida were able to identify movement patterns in infancy that are precursors to the development of Autism. Reference: Osnat Teitelbaum, Philip Teitelbaum. Does your baby have Autism?. NY, USA: Square One Publishers.

Text removed from Diagnosis section for discussion and better sourcing. SandyGeorgia (Talk) 23:04, 8 February 2008 (UTC)

This sounds like it's Teitelbaum et al. 2004 (PMID 15282371). As it happens a high-quality review was published this week on early diagnosis of autism: Landa 2008 (PMID 18253102). It has 108 citations but doesn't mention Teitelbaum. So I briefly looked for reviews that do cite Teitelbaum et al. 2004. I found only one: Palomo et al. 2006 (PMID 16685187), which mentions Teitelbaum et al. 2004 in support of the following two remarks: "Home-movie methodology has recently been extended to investigate other questions, such as early motor development in autism and Asperger syndrome", and "we exclude works not focused on children with autism, PDDNOS, or Asperger syndrome". I guess they rejected Teitelbaum et al. 2004 because it studied infants, not children. Anyway, it looks like Teitelbaum et al. 2004 is not that big a deal; it's not being cited by reviews. There are lots and lots of other primary studies on early detection of autism; I'm not sure why we'd want to focus on this one. Eubulides (talk) 06:54, 9 February 2008 (UTC)

So the recently created EWMN article may need a look. SandyGeorgia (Talk) 15:14, 9 February 2008 (UTC)

Have any scientists done any research on....

the relationship of family dog petting history (death of dog) and the disease rate of new born child? My gut feeling is that the new born child found the disease at the later age maybe associated with the family or dwelling dog petting history. By introducing the autism service dog to rehabiliate the child, it could ease the symptom.

http://www.informaworld.com/smpp/content~content=a790001397~db=all

If there is a correlation between the died dog and new born child with the diasease, then it may suggest that the reincarnation theory is on the every corner of the world —Preceding unsigned comment added by 65.49.2.96 (talk) 11:11, 22 February 2008 (UTC)

Not as far as I know. Please see Autism therapies #Animal-assisted therapy for a bit more on the subject. Eubulides (talk) 17:27, 22 February 2008 (UTC)

Well, some literatures have shown that Autism and ADHD are associated with deep fried food. I only partially agree with the findings. I regard the diseases as multifactor related. Because before 1980's, Chinese people eat lots of deep fried food such as Chinese donuts and 油炖子 (deep fried radish doumplin), not many people get such diseases. Deep fried food could be a catalyst but not a root cause of the diseases and this could be analysed by Multi factor analysis technique. The other approaches could be taken from DNA mutation studies, using animal (suhc as dog, rat or mouse) markers to compare with the mutated DNA of sick children. This is only my imaginated ideas and I wish to get scientists to prove them

I reckon that DAT is only a kind of thereapy not a medicine and it eases the surface of the disease not a root cause. My explanation is that if one pretend to treat a sick child as an dog which has the nature of herd/tribal living. By introdusing another dog, it provides a herd living environment to ease the symtom. My this assumption could be wrong though

ARI, DAN!, those "alternative treatments", oxytocin, scientific references for these

<warning - extreme POV, but then, this is a talk page>

Why is there no mention of any of these? There ARE scientific references for the success of at least some of these treatments (especially oxytocin). This article looks like it was partly written by the APA and FDA. And why is there no mention or link to the various 'recovery testimonials/videos' that are in various places, or even to www.autism.com? Unless you want to maintain that ALL of these are complete fakes, it deserves mention. And if they are fakes, I want proof of that. There is an anemic little article on Defeat Autism Now, no link from this one, and no mention of the key players in DAN!, Bernard Rimland who started the ARI, the DAN! "think tank" (I've only been looking into autism for two weeks now)

At least there is a (negative) mention of chelation therapy. Surely there are scientific studies on metal content in the hair of autistic children? Nothing on HBOT (hyperbaric oxygen therapy). Nothing on the "chelation controversies" (4 or 8 hour dosing, when the half-life of DMSA is 4 hours.. No mention *of* the chelation agents either.. No mention of dietary intervention (gluten/casein/soy-free - there must be scientific evidence on this, at least empirical studies). No mention of low-oxalate diets (there is a HUGE controversy there over that versus the "Vitamin K2 protocol"), no mention of oxalobacter (eats oxalate in the gut).

And no mention of the major organizations besides ARI either - Autism Society of America, AutismOne, Autism Speaks (and the recent flap over Katie Wright, which I'm not completely familiar with). No mention of Jenny McCarthy or her book.

Hardly any or no mention of the raging vaccine controversy, or the role of metals and other environmental toxins in autism, or the MMR vaccine (IIRC, introduced about the time autism rates started to skyrocket.

I consider these ommisions shameful - but it is very hard to write ANYTHING about this without either doing what might be considered original research (almost ANYTHING on autism these days when it comes to the ARI or "alternative treatments" is "original research") or POV (almost anything is POV one way or the other - is it POSSIBLE to write about the vaccine controversy without POV? Even if there is convincing evidence one way or the other, if the "accepted status quo" is the other way (and there very much IS one here - mercury and other metals in vaccines is just fine), you are likely to be labeled as being POV.

I'm starting to think that Cult of the Amateur might be right (and I haven't even read it!) and am just going to do what I originally did with Wikipedia - stick to it for info on 1) computers, 2) chemistry and biochemistry, and 3) mathematics. These areas seem to be well written.

I just hope no parent of an ASD child comes to wikipedia and sees the despairing words that there are 'few treatments' (paraphrase). Or I hope she goes elsewhere - like to YahooGroups and the tens if not hundreds of ARI/DAN support groups there..

I might write an section on this, but it would most likely be biased.. Right now, I'm just too mad at the non-inclusion of this information to even think of trying to clean it up.. Anytime in the next several months.. —Preceding unsigned comment added by 216.9.143.237 (talk) 05:17, 25 February 2008 (UTC)

• Autism covers a huge topic and uses the Wikipedia summary style to spin off sections into subarticles leaving summaries in their places. There simply isn't enough room in Autism itself to talk about each subtopic in detail: doing justice to the abovementioned topics would require at least doubling the size of Autism, and probably more, and Autism is already on the long side.
• The topics you're mentioning are discussed partly in Autism therapies, which is briefly summarized in Autism #Management. Autism therapies discusses chelation therapy, HBOT, dietary intervention in general and gluten-free, casein-free diets in particular. For space reasons, it does not discuss details of each therapy; that is left to still-more-detailed articles like Chelation therapy. I don't know of scientific evidence on soy-free, low-oxalate, or the vitamin K2 protocol, but anything along those lines would be welcome there.
• Many other topics are discussed in Causes of autism, which is briefly summarized in Autism #Causes. These include the vaccine controversy, metals and other environmental toxins, the MMR vaccine, and the hair content of autistic children. Again, for space reasons most of these topics have their own subpages, such as MMR vaccine controversy.
• Autism organizations and so forth are discussed in Sociological and cultural aspects of autism, which is wikilinked to from the very last sentence in Autism (and is also wikilinked to from the last sentence in the lead). There are many, many organizations like DAN! and Autism Speaks. I'm sure that Sociological and cultural aspects of autism does not do justice to them all and can be improved, but there's not enough room in Autism to mention them. Autism used to have a lengthy "External links" section that pointed to some of them, but this ran afoul of WP:LINKFARM.
• Typically, there is no way to prove that a particular treatment is a "fake". At most, all a scientific review can say is that studies have shown the lack of certain desired effects from a treatment, or (more commonly) that there is no reliable scientific support for a treatment.
• Autism does not say that there are "few treatments". On the contrary, it says "Many alternative therapies and interventions are available." It does go on to say that "Few are supported by scientific studies." a claim that (unfortunately) is supported by several high-quality sources.
• Here is a list of sources relied on most-heavily in Autism #Management for coverage of complementary and alternative medicine. Alternate sources of similar (or better!) quality would be welcome; if you know of any, I'd appreciate their mention here. It can be a difficult subject to cover.

• Francis K (2005). "Autism interventions: a critical update" (PDF). Dev Med Child Neurol. 47 (7): 493–9. PMID 15991872.
• Myers SM, Johnson CP, Council on Children with Disabilities (2007). "Management of children with autism spectrum disorders". Pediatrics. 120 (5): 1162–82. doi:10.1542/peds.2007-2362. PMID 17967921. {{cite journal}}: Unknown parameter |laydate= ignored (help); Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link)
• Schechtman MA (2007). "Scientifically unsupported therapies in the treatment of young children with autism spectrum disorders" (PDF). Pediatr Ann. 36 (8): 497–8, 500–2, 504–5. PMID 17849608.

Eubulides (talk) 17:42, 25 February 2008 (UTC)

Educational therapies

This series of changes replaced:

Available approaches include applied behavior analysis, developmental, and structured teaching.

with:

Available approaches include: applied behavior analysis (ABA), Son-Rise, Floortime, the Lovaas technique, and Treatment and education of autistic and related communication handicapped childrenTEACCH.

There are some problems with this change:

• Lovaas is an example of ABA; it's not an independent approach.
• Son-Rise has no reliable scientific evidence and shouldn't make this short list.
• The change introduces a red link.
• Most important, the best source here (Myers et al. 2007, PMID 17967921) lists categories of therapies, not just single therapies, and we should do the same; this article is at too high a level to go into individual educational therapies, which are better discussed in Autism therapies.

I replaced the above text with:

Available approaches include applied behavior analysis, developmental models, structured teaching, speech and language therapy, social skills therapy, and occupational therapy.

citing just Myers et al. Eubulides (talk) 20:20, 24 March 2008 (UTC)

Much better. SandyGeorgia (Talk) 20:42, 24 March 2008 (UTC)

<copied from User talk:AnnieTigerChucky:>

Annie, autism is a featured article, one of Wiki's finest and using only the highest quality, peer reviewed sources. You're introducing text that is not supported by such sources; I suggest you carefully discuss any intended edits to that article on the talk page, as the text you are adding will not survive there, because it is not well sourced and belongs in other articles, even if sourced. SandyGeorgia (Talk) 20:01, 24 March 2008 (UTC)

Dear SandyGeogia,

I wanted to explain that Early Intervention may not only help gain self-care and social skills, but that you can get completely better from it. The word cure is complicated, people think either it means medically or get completely better from it. That's why I also put medical cure, because it's a development disorder. Through early diagnoses and therapy, they can get out of their private world and start to join ours. But they will still be on the autistic spectrum. If I find a reliable source and ref tag, could I add it on the talk page, and can you help me determine if I could change the wording. AnnieTigerChucky (talk) 21:31, 24 March 2008 (UTC)

Annie, see above; the text has already been corrected. SandyGeorgia (Talk) 21:36, 24 March 2008 (UTC)