Talk:Autism spectrum/Archive 11

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IVF and autism

Regarding this recent edit by Akilash (talk · contribs), although the source is quoted accurately I am concerned that the incidence of autism within children conceived by IVF is compared with the general population rather than the age group (as noted in the report) that more represent those who conceive via IVF. It is noted that incidence of autism is higher where the mother is older. Should this source be used with this discrepancy uncommented? LessHeard vanU (talk) 00:29, 19 June 2010 (UTC)

It looks you are better knowledged in this subject. So you decide on whether to keep this source or not. I added it just because I read it in several articles related to autismAkilash (talk) 00:37, 19 June 2010 (UTC)

I am hoping that the regular editors to the article can find a source that addresses my concerns, but per WP policy your edits are appropriate - if there is no other reference, then yours will remain. LessHeard vanU (talk) 11:59, 22 June 2010 (UTC)

Please see WP:MEDRS, WP:UNDUE and WP:RECENTISM; we don't include primary studies, we use secondary review articles, and we don't give undue weight to recent primary studies, much less when they are unreviewed, unreplicated, and reported in the news media. SandyGeorgia (Talk) 12:09, 22 June 2010 (UTC)

autistic children do not prefer being alone

There seems to be some confusion about this, so here comes a direct quote from the article: "...it is not the number of friends but the quality of the friendships that are predictive of satisfaction or loneliness for children with autism. For children with autism, friendships lacking intimacy, reciprocity and emotional enrichment led to more intense and frequent loneliness compared to non-autistic peers, despite the common belief that children with autism prefer to be alone." Lova Falk talk 09:52, 27 June 2010 (UTC)

However, the authors of this article (Burgess et al) quote another article when they write the above: Bauminger, N., & Kasari, C. (2000). Loneliness and friendship in high functioning children with autism. Child Development, 71, 447–456. And as the title of the article says, this is about high functioning children, and as far as I know, more than half of children with autism are not high functioning... Lova Falk talk 10:09, 27 June 2010 (UTC)

I just looked if I could find something more about autism and preferring to be alone, but I could not find it. Lova Falk talk 10:30, 27 June 2010 (UTC)

Anyway, I'll change the sentence so it is closer to the Burgess article, because (and this is just my common sense) many children, both with and without autism, sometimes do prefer to be alone. Lova Falk talk 10:31, 27 June 2010 (UTC)

Seems good. Bauminger and Kasari (whom Burgess cites) say "It also is important to note that our findings can be extended only to high-functioning children with autism who represent 25–30%." (p. 454) Anthony (talk) 11:48, 27 June 2010 (UTC)

REALITY

The prevailing drug company supported rightthink of psychological conditions as neurochemically reducible, congenital and genetic, has never been more than supposition and circuitous reasoning. Indeed, the epigenetics are coming to light. —Preceding unsigned comment added by AaronAgassi (talk • contribs) 04:54, 7 July 2010 (UTC)

Gut bacteria

There is an article about N-methyl-nicotinamide and Clostridium http://www.newscientist.com/article/dn19011-gut-bacteria-may-contribute-to-autism.html

Can one add this after verifying?

--Nevit (talk) 20:04, 7 June 2010 (UTC)

Not until it is assessed in an authoritative literature review or meta-analysis, per WP:MEDRS. Anthony (talk) 07:33, 28 June 2010 (UTC)

Be aware there is NO rule against including primary research sources if they are identified as such. The people who like to dominate this article repeatedly claim there is, but there is not (unless the rules have been changed very recently).

Carefully read the rules. There are limitations put on primary sources, (eg, one paper stating a new finding) but they are not at all forbidden.

Please people, stop mispresenting the rules. —Preceding unsigned comment added by 75.61.132.104 (talk) 19:45, 26 July 2010 (UTC)

Inaccuracies/ Lack of clarification

"Noted autistic Temple Grandin described her inability to understand the social communication of neurotypicals, or people with normal neural development, as leaving her feeling "like an anthropologist on Mars".[19]"

The Temple Grandin refernce lacks clarity, particularly due to the highly variable level of difficulties that people on the spectrum experience (given that Autism is a spectrum condition, and not a soingular diagnosis). Propose instead that clarification focus on difficulties with the understanding of metaphors, tone of voice, body language, etc (please see www.autism.org for citational info). This is, of course, not denigrating Temple Grandin herself - rather clarifying that an individual case cannot be representative of ASD as a whole, her quoted example lacks specificity and also that Grandin herself qualifies as a potential case of overlap of diagnosis between "classic" Autism and Asperger's Syndrome due to temnporal understanding). Perhaps citing the "triad of impairments" would be more suitable?

"Unusual social development becomes apparent early in childhood" is a point of contention - recognition of Autistic Symptoms relies heavily on an individual's personal awareness. An NAS study, repeated in the UK Governments Adult Autism Strategy ("Fulfilling and Rewarding Lives" (2010)) cited that over 80% of UK General Practitioners (GPs, or local Doctors) stated that they have an inadequate knowledge of Autsim to recognise it in their patients. Perhaps a more appropriate wording would be along the lines of "Early in childhood, unusual social development can be a possible sign of the presence of an Autistic-Spectrum Disorder" (also: define "unsual" - potential cause of offence among the ASD community). On top of this point, it is worth mentioning that pathways to diagnosis for service users is globally regarded as rather poor (this ties in with established issues surrounding a lack of data for general Autism prevalence studies). Thus, this point runs the risk of being interpreted as saying that symptoms of ASD will be immediately apparent or that ASD diagnosis as a service is more prevalent than it is. It's predicted that many hundreds of thousands of adults in the UK alone are Autistic but have yet to be diagnosed (see again research by NAS).

"About a third to a half of individuals with autism do not develop enough natural speech to meet their daily communication needs". Again, this seems to be an issue caused by the change in understanding of what "Autism" constitutes. Asperger's Syndrome is generally considered to be the most common form of Autism, and is actually differentiated by other ASDs by its lack of delay in language development. Therefore, this statement needs reviewing in context of the definition of the word "autism" and the legal definition of "communication".

"Autistic individuals display many forms of repetitive or restricted behavior, which the Repetitive Behavior Scale-Revised (RBS-R)[32] categorizes as follows."

Should be rephrased as "MAY" display. Due to the highly variable nature of ASDs, Special Interests (as repetitive/restrictive behaviour is known within the Autistic communicty) and their intensity vary from one individual to the next. To suggest that all individuals on the Spectrum have Special Interests is inaccurate.

"Unusual eating behavior occurs in about three-quarters of children with ASD" - Citation please. As a person on the spectrum, after talking with professionals, and through all research I have found no evidence that eating disorders are common within the Autistic Spectrum. Most difficulties with "eating behaviour" are more often linked with sensory difficulties such as over-sensitivities to food texture, taste or smell. This statement can be misconstrued as stating that most people with Autism suffer from eating disorders, rather than their eating habits being informed by sensory issues that do not qualify as specific eating disorders.

"Autism is one of the five pervasive developmental disorders (PDD)" - Contradicted by your articles on Autism, Autistic Spectrum Disorder, and other related articles (which state between 3 and 4 conditions) (Autism is listed as a "featured" article). Sort it out please, these contradictions are embarrassing and insulting.

"Of the five PDD forms, Asperger syndrome is closest to autism in signs and likely causes" - Autism is an umbrella term, not PDD. PDD is a separate diagnosis given when more typical symptoms of an ASD are not prevalent enough to warrant a specific diagnosis (as demonstrated by the full term, Pervasive Developmental Disorder - Not Otherwise Specified). The phrasing of this term is misleading, as Asperger's Syndrome IS classed as "Autism" due to the status of Autism as a "spectrum" consisting of multiple diagnoses.

I am too tired/annoyed to continue, but within the first few paragraphs of this article these are the issues I have identified. Unfortunately, these errors appear to be mirrored across all autism-related articles on Wikipedia and as such I cannot recommend Wikipedia as an accurate source of information (indeed, my NHS consultant actually ridicules the standard of information that Wikipedia gives on ASD. On a personal note, a lawyer's attempt to submit an article regarding Autism to a Judge in a legal case was immediately dismissed on the basis that Wikipedia's reliability on Autism articles makes it immediately irrelevant as a source of information). —Preceding unsigned comment added by 86.22.162.189 (talk) 01:17, 21 July 2010 (UTC)

A lot of this seems reasonable, too. But nothing changes without reliable sources confirming it. It is hard, tedious work but if you're fired up, I'm (and I'm sure others are) willing to help. And it is worth doing, because it is the top result on Google for "autism" with 6,000 people consulting it every day. [1] Anthony (talk) 17:50, 21 July 2010 (UTC)

This article can be greatly improved if people stop misrepresenting the rules on including primary research.

Bold textA previous long discussion on what is appropriate to include in this article has now been archived.

Very quickly, when I wanted to put in recent research findings by researchers at a respected medical school, I was told this was forbidden because they had not been the subject of a review article.

When I checked the rules, I found out this was simply not true.

There are different rules for latest findings, and as a matter of style, it's hard to know what to exclude, but the content I wanted to include, (findings by researchers at the University of California Davis Medical School that about 10% of autism cases are associated with maternal antibodies to fetal brain, and that the antibodies had never been found in control group mothers of typically developing children) did not violate the rules, and had the important aspect of possibly being something mothers with an autistic child can check to see if they will have another one, truly life changing information in other words.

The latest reseach is NOT banned from wikipedia articles. It MUST be identified as only one finding by one researcher or research group, not given "undue weight" and not used to refute other findings which are generally accepted.

However, you are allowed to use them, and the editors who constantly remove them are violating Wikipedia rules. And they KNOW it perfectly well. —Preceding unsigned comment added by 75.61.132.104 (talk) 19:55, 26 July 2010 (UTC)

Crespi on autism/shizophrenia link

I have cleaned up, copyedited, and formatted the citation for the new text added on the autism/schizophrenia link, but I am unaware if this is a high-quality source; it is most unfortunate that Eubulides is not here to weigh in. The article cited is a review article, but the discussion in that article is cursory, and I'm not sure if this text enjoys broad consensus or has been subjected to other review. Comments? The text was also added at Schizophrenia, so I will add a link to this talk section from that talk page. SandyGeorgia (Talk) 14:55, 1 September 2010 (UTC)

I need to sleep now. Will look tomorrow sometime. I'd be inclined to leave on subpage on schizophrenia article (Causes page) as I don't think it is really making waves ATM Casliber (talk · contribs) 15:10, 1 September 2010 (UTC)

Thanks, Cas-- what concerns me about that review is that 1) it is lacking a real "discussion" section, 2) it doesn't seem well cited by other articles, and 3) I don't know the authors. Perhaps you can evaluate? It's not my territory-- missing Eubulides :) SandyGeorgia (Talk) 15:25, 1 September 2010 (UTC)

It's shocking that this is a featured article

This article is loaded with errors regarding Autism.

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

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

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

These are just the most obvious inaccuracies.

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

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

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

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

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

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

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

I agree that

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

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

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

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

NPOV this article, reallly?

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

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

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

Edit request from ShillIHA, 7 September 2010

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

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

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

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

Sorry no. For a start, Medical hypotheses is a non-peer reviewed journal and is explicitly excluded as a RS by WP:MEDRS. In contrast, the Paediatrics is a reputable journal, but the study is a highly preliminary one,[2] that, for example, only followed the subjects for 4 weeks. Reading WP:MEDRS will show that we need this treatment to be mentioned in review articles published in high quality journals. The reason for this is obvious when one considers other reliably sourced studies such as this one [3] find no effect for HBO. The ad link is obviously inappropriate, as Ohnoitsjamie says. --Slp1 (talk) 19:30, 7 September 2010 (UTC)

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

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

Bias about Causes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Suggested changes:

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

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

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

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

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

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

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

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

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

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

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

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

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

And then I am told there must be consensus for the edit, even though the consensus is not being based on any fundamental reference to the science. Please, just let people put in the new science if it's done in the proper way and is not against the rules. —Preceding unsigned comment added by 75.61.137.248 (talk) 11:36, 15 October 2010 (UTC)

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

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

I'd prefer WP:MEDRS to be iron clad and only allow authoritative reviews as sources. But it allows recent, unreviewed primary studies, provided that doing so does not give them undue weight. If you propose replacing existing text, it will be simpler for other editors if you can put the old and new texts side by side with the exact quote that you are paraphrasing from the paper, and provide the source's PubMed ID number. (Search for the title here and the ID number will appear below the article's abstract.) Something like this, maybe:

The existing text says "Working all the time makes Jack an interesting and stimulating person."

I propose "All work and no play makes Jack a dull boy."

Quote from Jones et al. PMID 20949507 "Working constantly, to the exclusion of recreation, makes Jack boring."

(You can copy the code I used for the table from the Talk:Autism edit page.

None of this is obligatory, of course, but lots of people from all perspectives watch this page, and doing that would save them time and maybe encourage more input. Anthony (talk) 06:05, 17 October 2010 (UTC)

Minor edits

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

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

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

I would like to point out a couple errors.Mainly the facts about the prevalence of autism.According to http://www.autismspeaks.org/whatisit/index.php and many other sources,the prevalence is much higher than is stated in the article.208.110.227.127 (talk) 03:08, 17 October 2010 (UTC)

HI. This article is about "autistic disorder" or "classic autism," the severe form originally described by Kanner. I just glanced at the Autism Speaks article and it is referring to the broad class of disorders that autistic disorder belongs to, the Pervasive Developmental Disorders (PDD). Anthony (talk) 03:52, 17 October 2010 (UTC)

Engineering and autism

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

Martin Luther

I fully read the lengthy purported source of the claim that Martin Luther once stated that a child should be suffocated. I think the wikipedia article would be more accurate if it stated that the context and accuracy of this statement are in doubt. The wiki article does indicate that it is relaying the hearsay of another, but fails to make clear that the source which is cited inline not only isn't directly quoting Luther, but rather is quoting another source purporting to quote Luther, and the cited essay does so in a discussion which questions whether Martin Luther really said or meant what he is purported to have said or meant. Dkm125 (talk) 17:08, 30 October 2010 (UTC)

Thanks, Dkm125. The cited text says:

In 1540 came the notorious reported discussion about a strange 12-year-old boy at Dessau, who was said to do nothing but eat voraciously and to excrete. [18]

"Luther suggested that he be suffocated. Somebody asked, "For what reason?" He {Luther} replied, "Because I think he's simply a mass of flesh without a soul. Couldn't the devil have done this, inasmuch as he gives such shape to the body and mind even of those who have reason that in their obsession they hear, see, and feel nothing? The devil is himself their soul. The power of the devil is great when in this way he holds the minds of all men captive, but he doesn't dare give full vent to the power on account of the angels." (LW 54: 397, No. 5207)

Much caution is needed in studying this report. The editor adds a footnote about a later version, in which John Aurifaber

"elaborated on the original by stating that Luther had himself seen and touched the boy and that he advised the prince of Anhalt to have the boy drowned. What had at first been the private expression of an opinion here became a formal recommendation to a ruler." (Ibid.)

The article says

The Table Talk of Martin Luther contains the story of a 12-year-old boy who may have been severely autistic.^[162] According to Luther's notetaker Mathesius, Luther thought the boy was a soulless mass of flesh possessed by the devil, and suggested that he be suffocated.^[163]

What exact wording do you propose, Dkm125? -- Anthony (talk) 18:22, 30 October 2010 (UTC)

Please excuse my lack of clarity. The text by M. Miles appears to conclude generally that Martin Luther opposed the mistreatment of the disabled, and casts doubts specifically on the veracity and context of the reported suggestion that a child be smothered. Quoting from M. Miles:

"These strongly suggest that throughout his career as a religious and social reformer, Luther repeatedly made written and spoken comments in which children and adults with disabilities [or deafness] were understood to have full human value and were considered worthy members of the Church."

The discussion of the purported suffocation recommendation falls under the heading "Dubious hearsay on the strange boy at Dessau", and notes "much caution is needed in studying this report." To cite it as supporting the notion that Martin Luther advocated the suffocation of a child is, to borrow a word, dubious. The cited text actually appears to be part of an indirect refutation, or least contextual reevaluation, of the quote.

Miles concedes the possibility the comment may have been made, discussing it as a hypothetical:

Supposing then that Luther did discuss the case of the strange boy at Dessau, it is quite possible that he did make either a casual or a more purposeful suggestion that this 'being' should be suffocated, as a body in which no human person resided...

However he then describes the purported statement as "a dubious suggestion reported from a discussion over dinner centuries ago". Miles also writes

Clearly, some of Luther's written views on illness, disability and the devil's intervention are not the received wisdom in Europe now...On the other hand, there is evidence in Luther's writings, in his personal conduct as observed by contemporaries, and in the social changes for which he campaigned, that he was keenly concerned for both the spiritual and temporal welfare of pregnant mothers, new-born babies, infants and for human beings of all sorts and conditions.

In order to make the wikipedia entry more fully supported by the cited text, I think the wikipedia entry should read along the lines of:

"The Table Talk of Martin Luther, compiled by his notetaker Mathesius, contains the story of a 12-year-old boy who may have been severely autistic. [162] Luther reportedly thought the boy was a soulless mass of flesh possessed by the devil, and suggested that he be suffocated, although a later critic has cast doubt on the veracity of this report. [163]

—Preceding unsigned comment added by Dkm125 (talk • contribs) 19:43, 30 October 2010 (UTC)

Nice. That is a more accurate reflection of the tone of the source. I've inserted it into the article. You'll be able to edit semi-protected articles once you've made 10 edits to unprotected articles. Welcome to Wikipedia. -- Anthony (talk) 20:15, 30 October 2010 (UTC)

Thank you for the edit. It looks like there is a formatting glitch, with the edited text appearing twice. Perhaps you or another confirmed editor could fix formatting issue. Thanks for accepting my suggestion regarding the wording.Dkm125 (talk) 00:03, 31 October 2010 (UTC)

I removed the duplicate text at the beginning. —Soap— 00:05, 31 October 2010 (UTC)

Thanks Soap. Sorry for the trouble. -- Anthony (talk) 04:32, 31 October 2010 (UTC)

As of 2010 Oct 23 prevalence data is incorrect

Two new government studies indicate about 1 in 100 children have autism disorders (2009 Oct) http://www.huffingtonpost.com/2009/10/05/autism-rates-government-s_n_309290.html —Preceding unsigned comment added by 92.249.234.100 (talk) 01:54, 23 October 2010 (UTC)

One is a telephone survey which seems less than rigorous, the other is a survey of health and education records. I'd prefer to see how the latter is reviewed before we consider including it. Anthony (talk) 18:24, 2 November 2010 (UTC)

Inclusion for Children with Autism in the General Education Population.

This is an important part of any discussion of autism today as it is exactly where the rubber meets the road for a large percentage of the population effected by autism. It needs to be a distinct part of the article and should not be neglected. Specifically, it would be a very good idea to include some of the research and models being proposed and used by R. L. Simpson and a number of others including S. R. de Boer, K. A. Quill, M. Garcia-Winner, Koegel & Koegel, etc. All of these authors have widely used textbooks in print that are used for education in autism related fields--including education. All of these authors address inclusion

I proposed a small edit to the "Management" section of the article that was immediately reversed citing the wikipedia requirement for reliable sources. However, the reference cited was a major work by a major publisher on exactly the topic discussed. It is hard not to see this as an arbitrary reversal or worse, one motivated by bias. Certainly the reasons given are not sufficient or correct. —Preceding unsigned comment added by Reibwo (talk • contribs) 23:24, 1 November 2010 (UTC)

Please sign your posts by entering four tildes ( ~~~~ ) after them. I hope you have now read WP:MEDRS, although I recognize you contend that your second edit doesn't require medical sourcing. However, there are secondary peer-reviewed medical sources that address educational issues, and in a broad overview article-- already long-- we have to be selective in what to include. Also, please have a look at Summary style and notice that at the top of several sections in this article, there are "hatnotes" to daughter articles-- this article summarizes those, and extra detail is often in those articles. Also, on Wiki, we don't typically use "currently": see WP:MOSDATE#Precise language. With respect to your allegations of "bias", please read WP:AGF. Further, if you discuss your edits on talk, it may be possible for us to find a way to include any text you feel is missing, properly sourced and written: see WP:OWN#Featured articles. As a final point, Wiki articles should have a global viewpoint, and not overly focus on practices in any given country, like the US. SandyGeorgia (Talk) 23:33, 1 November 2010 (UTC)

I have removed the disputed information again[ http://en.wikipedia.org/w/index.php?title=Autism&diff=394276119&oldid=394274530]. My reasons are that the Reibwo's edit is not fully verifiable. Having looked at de Boer's book on Googlebooks, she does indeed write that there are debates about whether inclusion is a "good idea", but her book is a how-to, and she runs a consultancy business out of the website linked. There is no hard evidence in her book, other than the title, that these approaches are "successful". The statement needs to be WP:Verifiable for sure. I also take SandyGeogia's point that this article might not be the right place for a discussion about inclusion in any case. Slp1 (talk) 00:01, 2 November 2010 (UTC)

I have reverted the edit once again. That pushes me to the 3 revert limit for the day. If I am reversed without adequate reason again I may resort to a resolution on this topic as this is beginning to feel like a cabal to me. Slp1 thanks for your comments. They are far more relevent than the others so far. As to your point of "hard evidence"--glancing through a few pages of a book on Google Books hardly qualifies anyone for making a judgment on this, or any, matter. Dr. de Boer spends a good part of four chapters extensively discussing the research basis for her models of inclusion. I would be surprised if you read that much of it. To be clear, I cited the book, not the website. Moreover, I only linked to her website as a means to show her credentials (that she notes there) which are both a Phd from one of the leading university programs working on autism and an ABA board certification to boot, along with other major works she has published on the topic. Remove the link if you like, but it is not grounds for revert. Moreover, the book is a text used in many classes across the globe (which gets to one of Sandy's points) in special ed classes and inclusion programs. Dr. de Boer has other notable book length publications on the topic as well. She is, simply, one of the world's leading experts on the topic. She is not the only one. I took pains to note some of the other experts of a similar caliber on the topic in my note above. All could be cited here, and I am happy to provide more appropriate citations. However, none of them is quite as on-point as this publication. Slp1 your revert on that basis amounts to little more than, "I don't own that book, so I can't confirm your source."

Sandy, WP:MOSDATE#Precise language does not apply to articles which are frequently edited, as this one clearly is. It is not a ban on the language, just that it be used sparingly and appropriately, which it is here. If you want me to defend that further, I will. Moreover, WP:OWN#Featured articles is not a ban on all further edits. In my opinion, your long history of instant reverts on this article gave me good reason to see your reversal as one more in a chain of someone pursuing a non-neutral point of view (whatever yours might be) as noted in the policy, "This guideline does not require that editors continue to assume good faith in the presence of contrary evidence." I feel your actions qualify. I may be wrong, but that is how I see it. At any rate, an unwillingness to allow new information, especially one that is so important to the topic, hurts the article, it does not make it better. WP encourages BOLD edits, not stagnation, right? Thus, SLP, this is exactly the place for information about the controversy, which I have supplied, with verifiable accurate references. The topic of including children with autism is not just one of the things parents are interested in but also a hot topic of research and legislation. It is silly not to mention right here, in the main article. I do not believe either of you have grounds for a complete revert, although I am open to appropriate modifications. If you feel you have something more to say, I am open to discussing it, but not simply enduring endless reverts based on sloppy application of logic from WP policy. Sorry, but consensus is not required.Reibwo (talk) 06:19, 2 November 2010 (UTC)

I believe your contribution is an improvement to the article. But for the word "successful" to remain, you'll need to show an independent third-party systematic review of the practice that mirrors the sentiment. The efficacy of interventions (and putting or not putting a child in with the general school population is a therapeutic intervention here) is probably the most important part of any health-related article.

You are wrong about the motives you assign to the above editors. I have been watching this page closely for two years and agree with, or at least understand the benign intention behind all of their edits over that time. Anthony (talk) 07:00, 2 November 2010 (UTC)

.

Thank you Anthony. You are removed what I consider to be the most problematic part of the edit. And, yes, I did more than flip through the book, Reibwo, and there is no evidence at all that her approach has been evaluated in any systematic fashion based on the book and a search of journal articles. Or that anybody's else's approach has, either. Incidentally, de Boer's status as "one of the world's leading experts on the topic" is very muddy to me. She appears to have only one scholarly publication in the area, where is not even the lead author.[4]. She certainly isn't well-known in this part of the world (Canada).--Slp1 (talk) 11:57, 2 November 2010 (UTC)

FYI, concerns over the same WP:REFSPAM issue are being raised at Talk:Inclusion (education). WhatamIdoing (talk) 05:16, 9 November 2010 (UTC)

Side effects of alternative treatments

I replaced "...most alternative treatments, such as melatonin, have only mild adverse effects." with "...most alternative treatments are relatively benign." and was reverted by SandyGeorgia. The source says that, though adverse effects of melatonin are generally reported as mild, it is in fact associated with an increase in seizure frequency in susceptible children. Our article says it is only associated with mild adverse effects. That is, it misrepresents the source. The present formulation also implies there are mild adverse effects associated with most alternative treatments. The source does not say that, and it can't be inferred from the source, which mentions side effects for

• Pyroxine and magnesium
• Omega-3 and omega-6 fatty acids
• Melatonin
• Chelating therapy

but mentions no side effects for

• Probiotics
• B12
• Vitamin C
• Dimethylglycine
• Casein and/or glutin dietary elimination
• Secretin
• Metallothioneins
• Glutathione
• Zinc

Would anybody like to suggest a wording that accurately represents the source? Anthony (talk) 15:04, 10 November 2010 (UTC) I have removed the sentence from the article for now, in case I'm right. Anthony (talk) 21:15, 10 November 2010 (UTC)

New portal-inline template

I have recreated the previously deleted {{Portal-inline}} for use in this article. The problem with the current {{Portal}} is this: the box is a floating object, so objects around it are placed on the left, causing the reflist to be narrowed. We could solve this by making the reflist float or by creating an empty floating object underneath the portal box, like this. But this makes the See also section even more ugly. So I made Portal-inline in the vain of e.g. {{Wiktionary-inline}} (WhatLinksHere), which is especially suitable for sections containing no normal/non-interwiki links. Looks good with me. Cheers, theFace 20:10, 23 November 2010 (UTC)

Another user just added the empty floating object I suggested (and disapproved of) above. Ok then, how about this? - theFace 13:39, 24 November 2010 (UTC)

Now someone has put the box in the Ref paragraph and removed the See also section, claiming that "when there is no "See also", portals go in [the] first apprendix [sic]". As the user in question is an expert in this area, I'm tended to take her word for it, but there's nothing about it in the layout-related MOS (see here), and it only recreates the problem I pointed out above. I've thought this over one more time, and I came to the conclusion that a change to {{Portal}} itself may be the best solution here. For my rationale behind this, go here (edit). Cheers, theFace 20:15, 24 November 2010 (UTC)

ABA Lovass

Anyone know the complex citenews citing procedure this article uses? I didn't want to do the basic formatting (that I know of - the one that this Wiki article doesn't use), which would ruin the article. I added the information about ABA therapy and the claims of recovery. It is currently the "big heat" of discussion among parents and professionals and the claims of "recovery" (which studies say is "questionable" in terms of recovery.) It is listed in this scientific journal: [5]. I will use another source already used in the article (right after the comma - describing the "proven" efficacy and popularity that I added in the lead already.) For now, I put citation needed tag about the "recovery" claims. Thanks. ATC ^{. Talk} 03:41, 4 December 2010 (UTC)

Actually, I came up with a better idea in the meantime. Instead of the citation needed tag, I'll source it with the basic formatting (with the URL showing in the reflist, as to not to do the basic citenews formatting that I know of) to the scientific journal until the citenews formatting can be done. ATC ^{. Talk} 04:06, 4 December 2010 (UTC)

ATC, {{Cite news}} is for citing newspaper articles. This article mostly cites scientific journals so {{Cite journal}} is more appropriate and includes fields for PMID and DOI, etc. This article uses a variant of the citation templates that are almost identical in use but have "vcite" as the first word rather than "cite". They produce must more compact HTML and the citation output format is different. See WP:MEDMOS#Citing medical sources. Colin°^Talk 10:24, 4 December 2010 (UTC)

I've removed the ABA/Lovaas edits you made to the lead. See this earlier discussion. The lead should summarise the body so new text should be added to the body and the lead can follow. In that discussion, Eubulides said "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 agree with Eubulides. Colin°^Talk 10:24, 4 December 2010 (UTC)

Removed text

69.228.117.220 (talk · contribs · WHOIS) has twice removed the following text, "Autism affects information processing in the brain by altering how nerve cells and their synapses connect and organize; how this occurs is not well understood." which is sourced to PMID 19819542. Specifically, the source says "Together, results of clinical, neuroimaging, neuropathological, and neurochemical studies show that autism spectrum disorders are disorders of neuronal-cortical organisation that cause deficits in information processing in the nervous system, ranging from synaptic and dendritic organisation to connectivity and brain structure. These changes probably alter developmental trajectory of social communication and seem to be affected by genetic and environmental factors." This review paper, from The Lancet in November 2009, is a fine source for the article text IMO. I have restored the text. Colin°^Talk 21:29, 6 December 2010 (UTC)

I agree with Colin that Autism correctly reflects the Lancet article's position, that autism is a disorder of cortical neuronal organisation. It implies that this is its primary cause, which I believe is an unsupported assumption, but this assumption is shared by all the recent reviews I've read. If you, 69.228.117.220 (talk · contribs · WHOIS), can find a WP:MEDRS-compliant source that challenges that assumption, bring it here and we'll incorporate it. Anthony (talk) 05:45, 7 December 2010 (UTC)

Anthony- in American English, your "autism is a disorder of cortical neuronal organization" would not be a good wording. "Organisation" which I noticed you spelled with an "s" the English way, would not be the precise word to describe say a defect at the synapses, which is one of the major areas of inquiry now. Maybe in England that statement would be regarded as including synapse defects, or many other problems in the neurons of the cortex, but not so much in the US. Also, attention has been given to the amygdala in a lot of research, so I am not sure you can say cortical neurons are the only thing implicated in all review articles. Finally, I don't think Wikipedia rules require only review articles as citations. —Preceding unsigned comment added by 76.232.8.183 (talk) 00:10, 21 December 2010 (UTC)

I think it is a bit hubristic for researchers and theorists to call it "a disorder of x". It implies etiology, and that's not known yet, and I'd be surprised if subcortical regions aren't deeply implicated in etiology. I'm pretty sure "organisation" in neuroscience covers strength of synaptic connection. Anthony (talk) 16:48, 23 December 2010 (UTC)

Autism Statistics

The Autism and Developmental Disabilities Monitoring Network (ADDM) are charged with monitoring and producing statistics related to autism and ASD. These statistics are then used by the CDC 1 and the National Institutes of Health U.S., National Library of Medicine 2 and reporting science journals. Their full set of statistics should be restored to the article.

"In 2006, on average, approximately 1% or one child in every 110 in the 11 ADDM sites was classified as having an ASD (approximate range: 1:80--1:240 children [males: 1:70; females: 1:315])."

Statistics from Asia and Europe (worldwide) indicate 1% prevalence (with data table).

"Studies in Asia, Europe and North America have identified individuals with an ASD with an approximate prevalence of 0.6% to over 1%."3

75.120.185.48 (talk) 15:40, 26 December 2010 (UTC)

This article is about one of the ASDs - autistic disorder. The info you cite may be appropriate at Autism spectrum, if it is not already covered there and the source conforms to WP:MEDRS. Anthony (talk) 19:02, 26 December 2010 (UTC)

Links to ARI

Many people visit this link, I think it would be noteworthy to mention if any significant body has done some work in trying to overcome this disorder. I would like to add links to ARI (Autism Research Institute) a wiki page already exists this a link to it should be fine? 71.231.182.103 (talk) 19:47, 2 January 2011 (UTC)

I am not sure that it would be appropriate to highlight one specific organization or research body out of the many hundreds which exist — and particularly one which espouses the use of discredited and disproven theories of disease and therapies more likely to harm than help children. While this article doesn't separate ongoing research out under its own heading, a cursory examination of the article suggests that research into both causes and therapies is quite broadly discussed. Prominent links are already provided the articles Autism therapies and Causes of autism, which go into quite a bit more detail regarding both our current understanding and our research in progress. TenOfAllTrades(talk) 20:12, 2 January 2011 (UTC)

Ambiguity of the word autism

I have just done a Google Scholar search for "the term autism." The first ten results that defined the use of the word "autism" are below. "Autism" can mean either

• autistic disorder (AD), the DSM IV syndrome
• AD, Asperger syndrome (AS), and pervasive developmental disorder not otherwise specified (PDD/NOS)
• AD, AS, PDD/NOS, and disintegrative disorder
• AD, AS, PDD/NOS, and high functioning autism

This ambiguity needs to be addressed in the lead.

Quotes & sources

Quotes

• ...most recent studies use the term autism interchangeably with that of ASD to include children with AD, PDD-NOS, AS, and DD, but not RS (Rett syndrome).^[1]
• Autism spectrum disorders, including autistic disorder, high functioning autism, Asperger syndrome and pervasive developmental disorder not otherwise specified... We employ the term autism to refer collectively to these disorders.^[2]
• The term 'ASD' encompasses autism, pervasive developmental disorder not otherwise specified, and Asperger's syndrome.^[3]
• These tools were designed to detect deficits in three behavioral domains: (i) reciprocal social interaction skills; (ii) qualitative communication skills; and (iii) restricted, repetitive, and stereotyped patterns of behavior. For milder autism cases, the AGRE sample used a “broad-spectrum” category based on the presence of severe deficits in one of three domains of functioning, moderate deficits in two of three, or milder deficits in all three domains. We use the term “autism” or “Autism Spectrum Disorder” to refer to all three of these patterns.^[4]
• The term autism is herein used to describe all autistic spectrum disorders, the broad category, which includes the various types of pervasive developmental disorders according to DSM-IV^[5]
• The term 'autism' refers to the prototypical form of a spectrum of pervasive developmental disorders that includes Autistic Disorder as well as subthreshold disorders labeled Asperger's Disorder and Pervasive Developmental Disorder Not Otherwise Specified^[6]
• Many of the sources of data simply used the term autism and did not differentiate between the different autism spectrum disorders.^[7]
• We use the term autism to refer to autistic disorder, as specified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)^[8]
• I will use the term 'autism' to refer to individuals across the whole spectrum^[9]
• Autism is the term many clinicians and investigators—and we in this review—use to refer to the entire range of autistic-spectrum disorders.^[10]

Sources

1. ^ Tuchman R, Moshé SL, Rapin I (February 2009). "Convulsing toward the pathophysiology of autism". Brain Dev. 31 (2): 95–103. doi:10.1016/j.braindev.2008.09.009. PMID 19006654. PMC 2734903.
   
2. ^ Geurts HM, Corbett B, Solomon M (February 2009). "The paradox of cognitive flexibility in autism". Trends Cogn. Sci. (Regul. Ed.) 13 (2): 74–82. doi:10.1016/j.tics.2008.11.006. PMID 19138551.
   
3. ^ Landa RJ (March 2008). "Diagnosis of autism spectrum disorders in the first 3 years of life". Nat Clin Pract Neurol 4 (3): 138–47. doi:10.1038/ncpneuro0731. PMID 18253102.
   
4. ^ Zhao X, Leotta A, Kustanovich V, et al. (July 2007). "A unified genetic theory for sporadic and inherited autism". Proc. Natl. Acad. Sci. U.S.A. 104 (31): 12831–6. doi:10.1073/pnas.0705803104. PMID 17652511. PMC 1933261.
   
5. ^ Canitano R (February 2007). "Epilepsy in autism spectrum disorders". Eur Child Adolesc Psychiatry 16 (1): 61–6. doi:10.1007/s00787-006-0563-2. PMID 16932856.
   
6. ^ Reznick JS, Baranek GT, Reavis S, Watson LR, Crais ER (October 2007). "A parent-report instrument for identifying one-year-olds at risk for an eventual diagnosis of autism: the first year inventory". J Autism Dev Disord 37 (9): 1691–710. doi:10.1007/s10803-006-0303-y. PMID 17180716.
   
7. ^ Ganz ML (April 2007). "The lifetime distribution of the incremental societal costs of autism". Arch Pediatr Adolesc Med 161 (4): 343–9. doi:10.1001/archpedi.161.4.343. PMID 17404130.
   
8. ^ Barbaresi WJ, Katusic SK, Colligan RC, Weaver AL, Jacobsen SJ (January 2005). "The incidence of autism in Olmsted County, Minnesota, 1976-1997: results from a population-based study". Arch Pediatr Adolesc Med 159 (1): 37–44. doi:10.1001/archpedi.159.1.37. PMID 15630056.
   
9. ^ Hill EL, (2004). "Evaluating the theory of executive dysfunction in autism." Developmental Review 24 (2): 189-233. ISSN 02732297
   
10. ^ Tuchman R, Rapin I (October 2002). "Epilepsy in autism". Lancet Neurol 1 (6): 352–8. PMID 12849396.

Anthony (talk) 20:25, 10 November 2010 (UTC)

I agree. User:SandyGeorgia reverted my previous edit and maybe if she sees the sources and addresses the issue, maybe I could ask if she could add the text back, and then maybe, you could add these sources that you've just found. ATC ^{. Talk} 00:59, 11 November 2010 (UTC)

Anthony, I'm not following what you feel is missing from our text:

It is one of three recognized disorders in the autism spectrum (ASDs), the other two being Asperger syndrome, which lacks delays in cognitive development and language, and Pervasive Developmental Disorder-Not Otherwise Specified (commonly abbreviated as PDD-NOS), which is diagnosed when the full set of criteria for autism or Asperger syndrome are not met.

We cover all of that ? What is your proposed change ? SandyGeorgia (Talk) 02:33, 11 November 2010 (UTC)

I think Anthony is saying (according to all the sources he listed) that "autism" is a synonym for the ASDs: autistic disorder (or "classic"), PDD-NOS, and Asperger's syndrome, and that "Autistic disorder" would distinguish the meaning in this article. ATC ^{. Talk} 02:56, 11 November 2010 (UTC)

ATC, I reverted some of your edits, too. If you want to bring change to this article, and it gets reverted, defend your change concisely (I emphasise that because nobody reads lengthy exposition on talk pages) here, with a link to your source, and a (short) quote if it's pay-per-view; with a separate section per change; one—or at most two—changes at a time. (This is advice, not policy.)

SandyGeorgia, "autism" has more than one distinct meaning. It can refer to autistic disorder (one of the autism spectrum disorders) or, far more frequently, it means the autism spectrum disorders, collectively. But the lead simply states, "It is one of three recognized disorders in the autism spectrum (ASDs)...", and the second, more popular usage is not explained until Autism#Classification: "In this article, autism refers to the classic autistic disorder; in clinical practice, though, autism, ASD, and PDD are often used interchangeably."

A sentence or two could be devoted to clarifying the dual use in the lead. But I don't know much about nosology, and may have misunderstood something here, so am asking others to comment. If there's no feedback from experts, I'll propose something. Anthony (talk) 05:01, 11 November 2010 (UTC)

I noticed that sentence too, maybe to compromise (with anyone else who comments that disagrees with tweaking it) instead. Where it says "In the article, autism refers to the classic autistic disorder; in clinic practice, though, autism, ASD, and PDD are often used interchangeably" should be cut and pasted into the lead section (where it fits and makes sense with minor tweaks to the lead.) Also, I noticed the lead section is cluttered with sources (I believe some, if not most, of the information mentioned in the lead section, are mentioned elsewhere in the article, so it should be tagged only once.) Lastly, the prevalence of autism is frequently mentioned (in TV commercials, Autism Speaks, the Center for Disease and Prevention) that Autism now affects, as of studies that were taken in 2009, 1 in 110 children (which translates to 9 per 1,000.) Can anybody find 9 per 1,000 in a scientific journal? I looked up prevalence and couldn't find it (apart from 6 per 1,000 aka 1 in 150, which was the study in 2007.) ATC ^{. Talk} 06:36, 11 November 2010 (UTC)

Anthony, the "expert" (Eubulides) is gone, and I just don't have time to read all of this-- would you be able to post at WT:MED to get others in here? I need to see a concrete proposal for wording change, and it's not clear to me if you're suggesting moving the article to a new name-- white rabbit, no time, no time. SandyGeorgia (Talk)

Sure. Done. Your suggestion looks good, ATC but I'd prefer to wait a few days and see if I/we haven't misunderstood something here. Hopefully some experts from WT:MED will chime in.

Opinions are divided here about reference numbers in the lead. They're neither mandatory nor forbidden per Manual of style. But I'm in favour of them in medical articles, just because most people don't want to have to scour the article to source a fact in the lead.

Didn't you add something from US Center for Disease Control and Prevention to the lead, which I trimmed and Sandy reverted, which stretched the ASD figure to 9 per 1,000? That CDC report may or may not meet WP:MEDRS. Do you want to familiarise yourself with WP:MEDRS to see if that figure is suitable for inclusion? Anthony (talk) 14:34, 11 November 2010 (UTC)

It seems to me that we have four somewhat overlapping terms to deal with, and here's how they relate to each other:

Conditions that might be called "Autism"

Autism spectrum disorders
Autism	Asperger's syndrome	PDD-NOS

That is, "Autism" is a type of Autism spectrum disorder, "Asperger's" is a type of Autism spectrum disorder, and PDD-NOS is a type of Autism spectrum disorder, but these three things do not (theoretically) overlap with each other.

The question then is what this article should be about. IMO it should be about the Autism-that-is-neither-Asperger's-nor-PDD-NOS, rather than the Autism-that-is-properly-called-"Autism spectrum disorders".

And its title should be plain "Autism", because there's really no other viable option. The three-disease category has a viable name that isn't potentially confusing ("Autism spectrum disorders"). The one-disease entity does not: It's Autism, or.... well, Autism.

So this article needs to define the term, and educate the reader about the distinctions, and send them over to the ASD article if they're looking for the three-disease conglomeration. After explaining the classification, the content here needs to focus as much as reasonable on the one-disease entity, not the three-disease category. Any content here that is really about three-disease ASD rather than one-disease Autism should be moved to the ASD article, where it belongs. WhatamIdoing (talk) 04:13, 12 November 2010 (UTC)

The one-disease entity is called "autistic disorder" in the DSM IV and "early infantile autism" in the ICD. I'm inclining towards moving this article to Autistic disorder with a redirect from Early infantile autism. If so, Autism could become a disambiguation page like this, similar to Depression (a term that suffers from an almost identical ambiguity problem). And (off topic) I'd like to create a page about the trait/symptom described by Bleuler (1911) and employed by Kanner (1943) beginning along these lines. Anthony (talk) 07:37, 12 November 2010 (UTC)

That is a good idea, as "autism" is a term with many meanings, like politics with its own spectrum of definitions, which often have more then one meaning to it. ATC ^{. Talk} 07:15, 13 November 2010 (UTC)

Also as stated further into the articles under "Classifcation - Other symptoms":
Sensory abnormalities are found in over 90% of those with autism, and are considered core features by some,[36] although there is no good evidence that sensory symptoms differentiate autism from other developmental disorders.[37]
I feel it is important to add in the lead section that a common symptom of autism is sensory integration deficits, using both sources. ATC ^{. Talk} 07:15, 13 November 2010 (UTC)

I don't know enough to comment on that. Anthony (talk) 10:33, 13 November 2010 (UTC)

Proposal to move this article to Autistic disorder

and begin the lead with

Autistic disorder (or early infantile autism or, sometimes, autism)...

and make Autism a disambiguation page along these lines. Please familiarise yourself with the thread immediately above before commenting. Anthony (talk) 08:02, 13 November 2010 (UTC)

I made some recent edits for clarity on your sandbox. Also, what if the lead said:

Autistic disorder (or early infantile autism or, more commonly, autism)...

ATC ^{. Talk} 09:07, 13 November 2010 (UTC)

Nice. Anthony (talk) 10:04, 13 November 2010 (UTC) Actually, I prefer "include in" to "encompass into". But I like the other suggestions. Anthony (talk) 10:25, 13 November 2010 (UTC). Sorry, I just thought of one more thing. I've taken it to the disambiguation page sandbox.

Regarding

Autistic disorder (or early infantile autism or, more commonly, autism)...

I don't know if "autism" is used in the literature to denote this syndrome more often than "autistic disorder" and "early infantile autism" are. I don't even know for sure that it is used more often in everyday parlance. So for now it may be more prudent to just say it is "sometimes" called "autism", without specifying or implying frequency. Anthony (talk) 14:33, 14 November 2010 (UTC)

Above, SandyGeorgia implies she doesn't know of any autism experts presently editing. If that is the case, I'd like to approach some experts for their opinions. Can anyone suggest a name or two? I'm thinking Simon Baron-Cohen, Temple Grandin, some major contributors to DSM V's "neurodevelopmental disorders" category, James Russell. Anthony (talk) 10:19, 13 November 2010 (UTC)

Um, I'd be more inclined not to approach those particular individuals, who don't necessarily have any knowledge of Wiki conventions (and I wouldn't pay attention to Baron-Cohen's opinion in any case, and Grandin isn't a physician). I'm neutral so far on the proposed move, pending more feedback from Wiki editors. You might ping Colin (talk · contribs) and MastCell (talk · contribs). SandyGeorgia (Talk) 16:06, 13 November 2010 (UTC)

• Purely non-expert opinion: favor current title as the more popularly recognized terminology (subsequently elaborated upon by Colin below). JNW (talk) 16:13, 13 November 2010 (UTC)

Done. Agreed, Temple Grandin was a mistake. The rest, I'd welcome with open arms, provided they know how to behave and how to edit. And right again, it's not their opinions I want, I want to be pointed to a WP:MEDRS that illuminates this question (what is the clearest, most unambiguous name for this syndrome, autistic disorder or autism?). Anthony (talk) 14:33, 14 November 2010 (UTC)

Colin is very good at that sort of thing, but I know he's busy IRL for a few days ... it may take a while to get his feedback. SandyGeorgia (Talk) 14:43, 14 November 2010 (UTC)

The main guidelines on this matter are Wikipedia:Article titles, Wikipedia:Disambiguation and to a lesser extent Wikipedia:Manual of Style (disambiguation pages). The Disambiguation guideline encourages us to think about whether we have a Primary Topic for the term "autism". Autism is not like depression in that with that term there are several uses for the word that are really quite distinct. The Article title guideline encourages us to use the common name and MEDMOS prefers the medically correct name. We don't have any conflict here because "autism" is a medical term rather than a lay term. The issues with the proposed changes are:

• Autism can't become a dab page. There are 3,276 pages that link to autism and, well, essentially none that link to autistic disorder. This is a clue that the former comes naturally and the latter does not. Since editors are strongly discouraged from linking to dab pages, that's around three thousand articles that need fixed up, and it requires editors to then forever use a piped link whenever they want to link the word "autism". That just isn't going to happen. So at most, autism could become a redirect to autistic disorder and a new autism (disambiguation) page linked via a hatnote on the latter.

Addressed below. Anthony (talk) 15:38, 16 November 2010 (UTC)

• Is "autistic disorder" more precise than "autism", and even if so, have the world's writers and the worlds experts become convinced to use the former? The above "what links here" test shows that Wikipedian's don't find "autistic disorder" to be a natural term. I'll resist the Google search test as I'm a long-standing campaigner against using Google results to mean anything (in summary: Google's mission is to find you the one page you are looking for, or perhaps a handful; Google's mission is not to give an accurate measure of the number of times a word is used in English writing by reliable sources). Let's search PubMed instead. To avoid PubMed being "helpful" with keyword synonyms, I'll search for ' "autism"[ti] ' which finds whenever that exact word appears in an article title. Let's also restrict it to the last year to keep things up-to-date. My search finds 1,153 articles. Doing the same for ' autistic disorder[ti] ' finds 19 articles. I accept some of the former articles are discussing "autism spectrum disorders" (singular and plural forms of which produce 432 articles) and also may well be using the word "autism" for the looser meaning of all ASDs. Reading the abstract of a few of the 19 articles shows those authors are quite happy to use the word "autism" as a synonym for "autistic disorder". So, regardless of the merits of "autistic disorder", the worlds medical writers are just not using the term (yet). Where medical writers feel their use of the word "autism" is non-standard or just needs clarification, then they do so (as noted in the section above). We likewise make it clear that this article is about one disorder rather than the whole spectrum.

Yes, "autistic disorder" is a more precise term than "autism". I've looked at the first 20 PubMed [title] results for "autism" that I could access (I couldn't access four articles) ignoring those with "spectrum" in the title, and 14 discuss ASD, three discuss AD, one discusses social withdrawal, one HFA. and one does not define its use (the article was not about autism per se).

PubMed results for [title] "autism" but not "spectrum"

PMID 20699105 ASD
PMID 20880122 ASD
PMID 20954799 AD
PMID 20655060 ASD
PMID 20176116 ASD
PMID 21055719 ASD
PMID 20950788 ASD
PMID 20433873 Social withdrawal
PMID 21072692 AD
PMID 21069446 ASD
PMID 20833154 AD
PMID 21061054 HFA
PMID 21062623 ASD
PMID 21055864 ASD
PMID 21048139 ASD
PMID 21055902 Not defined
PMID 20889652 ASD
PMID 20634369 ASD
PMID 21041596 ASD
PMID 20805019 ASD

In the scholarly literature the word "autism" may be used to mean any, some or all of AD, ASD, PDD-NOS and CDD, but it is almost always made clear (usually in the abstract but occasionally in the body of the article) precisely which is being referred to. Anthony (talk) 15:38, 16 November 2010 (UTC)

• What do our reader's search for? There is no simple way to find out but the Wikipedia traffic statistics (imperfect as they are) give 304,809 hits for October 2010 for "autism" and 762 hits for "autistic disorder".

"Autism" is the term they're searching for but a more pressing question is which of it's possible meanings are they looking for? From the above PubMed results, it seems they're likely looking for ASD. Anthony (talk) 15:38, 16 November 2010 (UTC)

• Should we have a dab page at all? The example dab page links to three articles and one sandbox page. The Autism article's lead and Classification section make it clear where autism/AD fits within the other two topics. I think we can do it better in article text than in an dab (which, for example, isn't allowed to cite sources).

We don't need a dab page if the community will trust me to go through the pages that link here. piping them, where necessary, off to the Wikipedia article about the "autism" referred to in the source. Perhaps you could consider this conversation an examination/interview to determine my competency for the task. Anthony (talk) 15:38, 16 November 2010 (UTC)

On second thoughts, I think we do need an Autism disambiguation page, like this. Anthony (talk)

• Should we have a Autism (symptom) page (which appears on the example dab)? I'd argue quite strongly we should not. It isn't a symptom. Autism is a disorder that itself has symptoms (characteristics). The "trait" alternative isn't good either as this isn't an aspect of someone's character. Possibly, "autistic" is what you are looking for, but we don't generally have articles on adjectives in Wikipedia.

I'm not sure which definition or convention you are referring to here. I use "trait" to mean "a particular feature of mind or character; a distinguishing quality; a characteristic" (OED) and was using it in contradistinction to "state". Bleuler in Dementia praecox coined "autism" to mean the symptom "withdrawal from society and reality."

Quotes from Bleuler (1911)

• P. 63 The inner life assumes pathological predominance (autism).
• P. 63 This detachment from reality, together with the relative and absolute predominance of the inner life, we term autism.
• P. 65 Particularly in the beginning of their illness, these patients quite consciously shun any contact with reality because their affects are so powerful that they must avoid everything which might arouse their emotions. The apathy toward the outer world is then a secondary one springing from a hypertrophied sensitivity.
• P. 345 The autism makes their thoughts and actions more independent. They are much more prone to carry out an idea than other people who are restrained by weighing the good and the bad arguments, by the spirit of the crowd, by greater suggestibility in respect of the thinking of the majority, and above all, by greater adaptability to their millieu as it actually is.
• P. 354 ...altered relations to reality (autism)...
• P. 460 The patient renders reality harmless by refusing to let it touch him (autism); he ignores it, isolates it, withdraws into his own thoughts. For these patients, autism has the same meaning as the walls of the monastery have for the monks, that the lonely desert has for some saints, and their studies for some scientists. In this respect, the difference between sickness and health is merely a quantitative one.
  

Eugen Bleuler; trans. Joseph Zinkin (1911/1961). Dementia praecox: or the group of schizophrenias. International Universities Press: New York. ISBN 9780899202440.

Anthony (talk) 17:41, 16 November 2010 (UTC)

Sorry this is so long. I don't think we need to change or rename the article or create a dab page. Colin°^Talk 18:15, 14 November 2010 (UTC)

Thank you for your thoughtful response, Colin. I want to pay it serious attention, so won't reply immediately. But yesterday I looked at the first twenty links to this page and I've pasted the details below. I wonder if you agree with me that there is a problem. I am in no way wedded to my solution - I put it forward as the best I could think of, but hope more experienced editors can think of a more elegant response.

In most cases when the term "autism" links to this article about autistic disorder, the term is referring to the ASDs, and so should be linking to Autism spectrum disorder.

What links here - first 20 articles

Blindness: "Blindness can occur in combination with such conditions as ... autism..."

The article doesn't cite a source but Hobson (2002, p. 195) says: "... we made close comparisons between nine of the blind children who met the criteria for autism and nine sighted children with autism who were of similar age and IQ … only two of the nine blind children displayed the quality of social impairment that was characteristic of the sighted but autistic children, a quality that involves the special feel one has of a lack in emotional contact." Hobson describes the autistic blind children in his study as either having or not having social impairment. Assuming whatever source the article drew on agrees with Hobson, Blindness is referring to PDD-NOS and at least one of the other ASDs, so should link to Autism spectrum disorder, not this article, which is about autistic disorder. Hobson, P. (2002) The Cradle of Thought. London: Macmillan.

Behavior: "...behavior ... can play a part in diagnosis of disorders such as autism." The statement is true for all ASDs, so should link to: ASD, not here.

Catatonia: "A version known as "catatonia-like deterioration" occurs in 12-17% of autistic young adults." The source is referring to Wing and Shah (2000) "Catatonia in autistic spectrum disorders" and so the link should be to ASD.

Consciousness: "There are, however, speechless humans ([...] severe forms of autism)..." This refers to autistic disorder and correctly links to this article.

Cognitive behavioral therapy: "...severe, chronic psychiatric disorders, such as psychotic behavior and autism." This refers to autistic disorder and correctly links to this article.

Denis Leary: "There is a huge boom in autism right now because inattentive mothers and competitive dads want an explanation for why their dumb-ass kids can't compete academically." This refers to the ASDs and should link to ASD.

Eugenics: "The possible elimination of the autism phenotype is a significant political issue in the autism rights movement, which claims autism is a form of neurodiversity." This refers to the ASDs and should link to ASD.

Epilepsy: "Epilepsy is prevalent in autism." The source is referring to the ASDs and should link to ASD. Source: "the frequent observation of epileptiform activity in patients with autistic spectrum disorders (ASD)" (P. 33)

Hugh Hefner: "...Generation Rescue, a controversial autism campaign organization supported by Jenny McCarthy." This refers to the ASDs and should link to ASD.

Intelligence quotient: "Standard intelligence tests, such as the Stanford-Binet, are often inappropriate for children with autism." The source addresses autistic disorder, so this link is correct.

Microserfs: "A gifted programmer with high-functioning autism." Should be linked to HFA.

Mental disorder: I couldn't find a link to this page from there.

Milk: "In the early 1990s it was hypothesized that casomorphin can cause or aggravate autism..." The source is "Elimination diets in autism spectrum disorders: any wheat amidst the chaff?" so this should link to ASD.

Omega-3 fatty acid: "Although not supported by current scientific evidence as a primary treatment for ADHD, autism, and other developmental differences, omega-3 fatty acids have gained popularity..." The source is "Novel treatments for autistic spectrum disorders." and this should link to ASD.

Pittsburgh Steelers: "...the Allegheny Valley School in Coraopolis, Pennsylvania, which cares for over 900 people with mental retardation and physical disabilities, including Cope's autistic son." Refers to autistic disorder; correct link.

Proteasome: "Impaired proteasomal activity may underlie cognitive disorders such as autism..." The source refers to the ASDs and should link to ASD. Source: "Further evidence of the global importance of UBE3A, other ubiquitin ligases and related UPS proteins in cognitive function has come in a very recent publication identifying these proteins along with neuronal adhesion proteins as exhibiting copy number variation in a cohort of over 800 patients suffering from autism spectrum disorders."

Paul Dirac: "Both father and son had autism, to differing degrees." Refers to the ASDs and should link to ASD.

Schizophrenia: "Relations have been found between autism and schizophrenia based on duplications and deletions of chromosomes." The source refers to the ASDs and should link to ASD. Source: "...autism-spectrum conditions tend to be associated with up-regulation of pathways due to loss of function mutations in negative regulators, whereas schizophrenia is associated with reduced pathway activation. [...] These convergent lines of evidence appear most compatible with the hypothesis that autism and schizophrenia represent diametric conditions..."

Scientific misconduct: "Andrew Wakefield, who claimed links between the MMR vaccine, autism and inflammatory bowel disease." Cites no source, but Wakefield (1998) uses "autism" and "ASD" interchangeably, and his sample included ASD, DD and autism. This should link to ASD.

Vaccine: "...controversial claims have been made that thiomersal contributes to autism..." The source author does not define his terms and cites no sources but the thimerosal-autism hypothesis applies to the ASDs and this should link to ASD.

Victor of Aveyron: "Professor Uta Frith has stated that she believes Victor displayed the signs of autism." Refers to autistic disorder, correctly linked.

• Fourteen pages discussing the ASDs incorrectly link "autism" to this article about autistic disorder.
• Four pages address autistic disorder and are correctly linked to this article.
• One referred to HFA
• I couldn't find the link on one page.

I'll get back when I've thought a little more. Thanks again for your time. Anthony (talk) 12:17, 15 November 2010 (UTC)

We must be extremely careful not to reword what people say. If our sources in these articles say "autism" but you think they mean ASDs, then we cannot reword it or change the link to ASD. People, including experts, are using the word "autism" in a way I'd describe as careless, but we can't put words into their mouths. I've added a hatnote (take from the Classification section) which I hope helps. Colin°^Talk 22:14, 15 November 2010 (UTC)

I was trying to be careful with the above, but may well have misread or misunderstood something. If you disagree with my summary, please feel free to correct it, or tell me where I'm wrong. I have added links or quotes from sources, where sources are cited.

I've corrected my proposed disambiguation page to include only Autistic disorder and Autism spectrum disorder because fewer users of "autism" apply it to PDD (though some do [6][7][8]), and items on a disambiguation page should contain the ambiguous word; and I'm likely to never get round to writing an article about "autism" as used by Bleuler and Kanner.

I didn't understand your comment about the hatnote. Anthony (talk) 05:04, 16 November 2010 (UTC) Ahhh. I see, it's on the article. That's a lot more elegant than my solution!

Would you mind having a careful look at the above list of 20 links to this page, and evaluating my assessments? In every case I went to the sources, and sometimes the sources' sources to clarify what was meant by "autism". If you think I've gotten it right above, I'd like to start going through "what links here," piping links off to ASD, etc. where appropriate. Anthony (talk) 06:42, 16 November 2010 (UTC)

I think there is a fundamental misunderstanding, by nearly everyone who is a major contributor to the page, about autism. Autism is a very vague term, and encompasses too much to make all this debate over words worthwhile at all. In other words, all of this is pretty much meaningless. People of very high intelligence are considered "autistic" like Temple Grandin, but also people who can barely speak, or don't speak at all, because cognitively they are not capable of it. In fact, rather than trying to define autism, or trying to decide the words used to head a topic, it would be infinitely more producutive to simply tell people about the different types and how they differ. The article does this to an extent but you need much more, with less wasted mental energy on the precise meanings of words. —Preceding unsigned comment added by 76.232.8.183 (talk) 00:01, 21 December 2010 (UTC)

Perhaps the article could make it more explicit that it is about just the severe form of autism, and that the spectrum you are describing is discussed at Autism spectrum. Can you propose a change that would make that clearer to the reader? --Anthonyhcole (talk) 15:10, 6 January 2011 (UTC)

Changing Autism links

Copied from User_talk:Anthonyhcole#Changing_Autism_links

Hi Anthony. I'm a bit concerned about your mass edits to change wikilinks from autism to autism spectrum. As I noted in the discussion at #Ambiguity of the word autism, I don't think we can change people's words. If the source says autism then so must we. We mustn't second-guess the source and say "well, they mean this". Also, I don't think it is a good idea to have the word "autism" in an article link to autism spectrum. People will click on that link rightly thinking it goes to our article on Autism and will be confused when it goes elsewhere (see WP:EASTEREGG). For example, in MMR vaccine, Wakefields paper uses the words "autism" [9] and nine of the twelve children were classified as having autism, only one as having an autistic spectrum disorder. So I think discussion of MMR really must use the word autism, even if some people feel the issue is related to other autistic spectrum disorders too. That's just one example. So, in summary, I think it is safe to change autism to autism spectrum (or autism spectrum disorder) only if the source uses that term, and that easter-egg wikilinks are not appropriate in this case. Colin°^Talk 10:58, 27 November 2010 (UTC)

Thanks for the feedback, Colin.

In the two threads above, "Ambiguity of the word autism" and "Proposal to move this article to Autistic disorder," I have shown that the word "autism" is used in the scholarly literature to mean either the psychiatric syndrome "autistic disorder," or any or all of the syndromes covered by the term "autism spectrum," and that it is most often used to denote "autism spectrum" (by a factor of about 4 to 1). I have also shown that in most cases where a Wikipedia article links the word "autism" to this page, which is about the syndrome "autistic disorder", it should in fact be linking to autism spectrum. The ratio of errors to accurate linking is about 4:1. I declared my intention to go through what links here, correcting the links where necessary and asked you if you would look at the 20 examples I offered above under "What links here - first 20 articles" and assess my judgment before I embarked on that task. I got no reply to that request and so began.

I completely agree with you with regard to second-guessing. If you see any instances of me guessing, please don't hesitate to point them out. But, if "autism" is indeed ambiguous, someone needs to exercise intelligent judgment when an article or source doesn't define what they mean by the term, and decide whether they are discussing the syndrome, autistic disorder, or the spectrum, and link accordingly. If "autism" is ambiguous, as I assert, simply linking "autism" to autistic disorder by default is going to result in an incorrect link in four out of every five cases.

You criticise my edits to MMR vaccine where I piped the word "autism" away from this article, which discusses autistic disorder, and to Autism spectrum. I understand this is a less clear case than the other edits. My reasoning is this: Since Wakefield's sample included both autism spectrum and "autism" (presumably, autistic disorder - one of the autism spectrum disorders), he is clearly studying and discussing the relationship between MMR vaccine, gut disorder and autism spectrum disorders.

I believe I have made a good case in the threads above for the ambiguity of the term "autism" and for the frequent mis-linking of the word in Wikipedia articles, and would appreciate a comment from you on both of those points. If I am right, some work needs to be done. If I am wrong, please correct me. I have undertaken the onerous task of working through the thousands of Wikilinks to this page, to assess and correct where necessary. I haven't asked for help in that task, though it would be welcome, but have asked you (or if you're too busy I throw it to any competent reader) to critically and rationally assess my judgment in the above 20 examples.

To summarise, your comment would be appreciated on

• whether "autism" is ambiguous
• whether many Wikipedia articles link "autism" mistakenly to this article about autistic disorder, when they in fact discuss autism spectrum
• my judgement on the 20 consecutive "what links here" articles above

Anthony (talk) 02:21, 28 November 2010 (UTC)

I think "autism" has become ambiguous due to imprecise usage but if you asked anyone (expert or lay) what the word means, they'd give the meaning used by the article here (autistic disorder). For that reason, Wikipedia's page on "autism" should be as it is. We discussed several ways of handling the ambiguity and there's no perfect solution. I thought you were happy with the hatnote on the article pointing out the alternative meanings.

I think articles containing the word "autism" must link to autism and articles saying "autism spectrum" link to autism spectrum.

If the source refers to "autism spectrum" then the article should refer to "autism spectrum"; similarly for "autism". If the source uses a mix of terms then a judgment must be made.

If the article is using the wrong word, change the article text, not just the wikilink. That way, readers and editors can discuss whether the source and text agree or not. Is the change appropriate or employing too much original research (second guessing)? It also eliminates the imprecise usage.

One could make a case for pervasive developmental disorder wrt Wakefield's paper because that what the title says, though few people will know what that term means.

I'll try to find time to investigate your examples later. Colin°^Talk 08:49, 28 November 2010 (UTC)

Thanks. I would appreciate it if you could look at the first 20 results of the Google Scholar search for the phrase "the term autism" (under #Ambiguity of the word autism, Quotes & sources), where most define "autism" as meaning ASD or PDD; and the first 20 articles that link here, most of which are referring unequivocally (unlike MMR vaccine) to ASD. My hope is, once you've done that, you may change your view that experts and laity habitually use "autism" to mean autistic disorder. I take your point that, rather than pipe "autism" to Autism spectrum where an article is addressing ASD, I should change the term from "autism" to "autism spectrum disorder."

I'm sorry, I am wavering between the hatnote and a disambiguation page but won't be arguing the point now, if ever. Anthony (talk) 10:50, 28 November 2010 (UTC)

I feel that as long as their is clarity, it is much easier to understand. BTW, most people who search "autism" will be referring to the severe form on the spectrum. So now I think it's good as it is, plus it got a "Featured article" nomination and retrieved the grade with the article calling the delay: "autism"; this is not a scientific journal but an encyclopedia that people can read - without going into too much detail within the lead. Also, "autism" is NOT a "psychiatric" syndrome, but rather a profound development delay. ATC ^{. Talk} 20:42, 2 December 2010 (UTC)

Clarity is what we are all striving for here. It is the motivation behind my starting these threads.

Most people who search "autism" are likely not referring to the severe form. Most journal articles and Wikipedia articles that use the term are referring to Autism spectrum (See Quotes and sources and What links here - first 20 articles above).

Autistic disorder is unequivocally a psychiatric syndrome. This article is about a psychiatric syndrome, as is Asperger's syndrome.

"Autism" is an ambiguous word, which usually refers to the ASDs, sometimes the ASDs and childhood disintegrative disorder, sometimes autistic disorder, and sometimes simply "withdrawal from others" or "withdrawal from reality." Anthony (talk) 03:28, 3 December 2010 (UTC)

You are right about that, in regards to the scientific journals, but the average person searching "autism" will NOT be referring to Asperger's syndrome, PDD-NOS, Rett's syndrome, High-functioning autism nor CDD; unless they type in "different types of autism", then they may be referring to all of the "spectrum disorders". Also, everything is going to be changed in 2013. Because diagnosticians debate over the difference over PDD-NOS, clinicians realized that their "is a spectrum of a variety of severities and milder cases". They are referring to all the disorders (CDD, Autistic disorder, Asperger's syndrome, PDD-NOS) underneath the single diagnosis of: "Autism Spectrum Disorder" (ranging from mild to severe). Rett's syndrome is going to be permanently removed from the "autistic" lable, as did Fragile X Syndrome in the '90s. To find out more about the change, please see here: [10] and here: [11]. ATC ^{. Talk} 02:15, 4 December 2010 (UTC)

Anthony, I haven't forgotten to review the 20 links about, just haven't got round to it. I agree with ATC that most people searching for "Autism" are looking for the "most severe form" rather than, say, Asperger's. Indeed, this makes me even more nervous about "second guessing" what other articles are referring to by their wikilinks. Colin°^Talk 10:18, 4 December 2010 (UTC)

I really do know how it is, Colin. Whenever you feel like it is fine with me. But if you ever decide you can't be bothered (as I frequently do), let me know and I'll find someone you approve of to review them. I'd prefer you to do it, though, and don't mind waiting months.

By the way, thank you for that excellent response in the thread below. Anthony (talk) 10:46, 4 December 2010 (UTC)

The two of you have convinced me. Journal articles discussing autism spectrum disorders, frequently abbreviate it to "autism", but people referring to the conditions use the individual nouns "Aspergers", "HFA", "PDDNOS", etc., and reserve "autism" for autistic disorder. (Judging by ATC's second link above, people with Asperger's aren't too thrilled about having their condition characterised as autism.) Sorry it took so long for me to come round; I appreciate your patience.

And thank you for those links ATC. They're very well written, clear explanations. Anthony (talk) 11:56, 4 December 2010 (UTC)

Anthony, I've had a chance to look at some of the links you gave above. Here's the first eight. Let me know if there are any of the rest that need looked at but I see a pattern emerging in my responses:

• Blindness. PMID 12639331 Higher frequency (in congenitally blind) of both people meeting the full criteria for classic autism and people with autisic-like features. this also discusses "autistic tendencies". I don't think ASD covers it. Perhaps best just to say "autism and autistic-like features".

• Behavior. While statement is true for all ASDs, it is also true for just autism and since the sentence already contains "disorders" and autism is given as just one example of many disorders, I think it is best to pick just one disorder here.

• Catatonia. Agree it should be to ASD as that is the study-group the figures are for.

• Consciousness, Cognitive behavioral therapy. Agree it should link here.

• Denis Leary. Feel very strongly this should link to autism. This is a direct quote and we absolutely mustn't put words in people's mouths. In fact, the backlash was probably stronger because he refered to the most severe form.

• Eugenics. There's no source. I think this is best left linking here. The advocates use the term autism; so should we.

• Epilepsy. Agree it should be to ASD.

• Hugh Hefner. The campaign group uses the term autism; so should we.

Generally if the source (or the people/organisations mentioned) use the term "autism" then so should we and we should link here. If the source uses "autism spectrum disorder" or similar, then we should use the term "autism spectrum disorder" and link there. The blindness example is complex and I don't think having "autistic-like features (or tendencies)" would necessarily classify someone as having an ASD. If both terms are used by a source then it is a judgement call but I wouldn't necessarily assume ASD is a safer option. For example, the MMR controversy is about autism and that's the term everyone uses when discussing it, even if two of the patients in the original paper had an ASD rather than classic autism. If the article text is just giving autism as an example of a disorder (like with behavior) then I don't think there is any need to widen it even if widening it would be technically correct (it doesn't make it more correct). Colin°^Talk 20:15, 9 December 2010 (UTC)

Infantile behaviors

Can anyone verify that this text added here is in the cited source? PMID 10638459. If not, it should be removed as anecdote or cited to a review. SandyGeorgia (Talk) 03:06, 3 January 2011 (UTC)

The new content is not mentioned under "screening" in the source, so I have reverted. Our text:

• No babbling by 12 months.
• No gesturing (pointing, waving goodbye, etc.) by 12 months.
• No single words by 16 months.
• No two-word spontaneous phrases (other than instances of echolalia) by 24 months.
• Any loss of any language or social skills, at any age.

is actually a copy-paste from the source so I've enclosed it in quotation marks for now. Anthony (talk) 05:14, 3 January 2011 (UTC)

Actually it was an extremely close paraphrase. I'm not sure it could be thoroughly paraphrased without harming the clarity and readability, so am leaving it as a quote for now. Anthony (talk) 05:25, 4 January 2011 (UTC)

Wakefield

"the vaccine hypotheses are biologically implausible and lack convincing scientific evidence" from the lead has been linked to a news report of the BMJ article and editorial asserting Wakefield was likely behaving fraudulently. Is this an appropriate source for the "biologically implausible" claim? If so, should we link to a news report, the BMJ editorial or Deer's article? --Anthonyhcole (talk) 12:25, 6 January 2011 (UTC)

The Deer article is peer reviewed by BMJ, so I like that one. Dbrodbeck (talk) 12:38, 6 January 2011 (UTC)

I've updated with the Gerber and Offit paper used elsewhere, which actually does support the "biologically implausible" and "unconvincing" claim. The recent Deer article and the editorial in the BMJ are dynamite, but are more concerned with "fraud" than just "unconvincing". Colin°^Talk 13:31, 6 January 2011 (UTC)

Thanks, Colin. --Anthonyhcole (talk) 14:51, 6 January 2011 (UTC)

The folks at ITN are looking for someone to update the controversy article so they can put it on the main page-- ideally, that would be someone who has access to the BMJ article, I'm just waking up and have guests today. SandyGeorgia (Talk) 14:53, 6 January 2011 (UTC)

Sandy, you should be able to read the BMJ article and editorial as it is free. Colin°^Talk 14:59, 6 January 2011 (UTC)

Coffee. Not awake yet. Link? SandyGeorgia (Talk) 15:05, 6 January 2011 (UTC)

BMJ editorial
Deer's article
MMR vaccine controversy has already been updated. As has Andrew Wakefield. --Anthonyhcole (talk) 15:19, 6 January 2011 (UTC)

Thanks, Anthony (I woke up to an out-of-control watchlist when I have a busy day, and don't know where to start or even if I should-- I appreciate the update). The folks at ITN don't consider that a sufficient update, they want more attention there. SandyGeorgia (Talk) 15:40, 6 January 2011 (UTC)

Inadvertent removal of thread?

Not sure whether the IP user who started a discussion of terminology meant to delete their own thread? Consequently I'm not sure whether it should be restored. Doniago (talk) 15:07, 6 January 2011 (UTC)

Left a message at the IP's Talk page. Doniago (talk) 15:36, 6 January 2011 (UTC)

Vaccines

All I ask of Wikipedia is an effort in objectivity. Millions of people go here for information. I urge you to explore all sides of an argument before stating them as supposed fact. This includes the research of the source itself (not just the content), who they are funded by and who they are connected to. There are numerous dissenting studies and opinions within the scientific community in regards to the relationship between autism and vaccinations. All I ask is that you acknowledge these sources instead of quoting the first pharmaceutical company backed study that you find. The CDC is no different, it is a tremendously flawed source with endless contradictions in it's presentation of "facts." I would be glad to enlighten you but I fear any truth that contradicts the establishment will seldom see the light of day. Contact me if you wish I would gladly start you in the right direction. You can email me at [email removed]. Although, it will take some time compiling the information into cohesive form. "First they ignore you, then they laugh at you, then they fight you, then you win." - Gandhi —Preceding unsigned comment added by 98.220.107.160 (talk) 08:25, 15 December 2010 (UTC)

All sourced information confirms that vaccines are not related to Autism. All studies that state otherwise have been proven unreliable. Besides, such information that you are proposing is already covered for in other articles. Aspie Lover (talk) 07:55, 19 December 2010 (UTC)

Although the science community has pretty much universally rejected vaccines as a cause of the majority of cases of autism, it's not accurate to say there is no link. The US' vaccine court decided one child got autism from vaccines, and there may be many more, I was at a DAN conference in Long Beach CA recently where a researcher on mitochondrial DNA from UC San Diego stated that a much larger percentage of autistics than normal kids have mDNA problems, (believed to be the reason the kid got sick from vaccine) and that it's not known, and implicitly can not be assumed, that an absence of general mitochondrial disease, (hard to diagnose but kids will NOT appear physically healthy as most autistics do) in the body in general, means absense of all mDNA problems in particular organs, ie, the brain in this case. In other words, there may be some number, perhaps small, perhaps not all that small, of kids whose autism is due to mitochondrial disease. According to this lecture, there is often significant neurological deterioration after a fever, or, in the case of some, vaccines. So, what I am trying to say is, "no link between vaccines and autism" is a bit simplistic. Also, just my own theory, but if an immune activating event can cause damage to the brain in those kids with unknown mitochondrial disease, then it may be they get autism after vaccines, but, at the same time, the percentage of kids with autism who have been vaccinated is the same as those who were not, because even if you are not vaccinated, sooner or later you get fever and that leads to the brain problems. THat last part is just my theory, but I think it should be pointed out vaccines do not seem to cause much autism but claiming it causes none is an oversimplication. Better to say something that states the current state of belief but emphasizes vaccines extremely low risk. —Preceding unsigned comment added by 76.232.8.183 (talk) 00:24, 21 December 2010 (UTC)

Please read WP:MEDRS and WP:OR Dbrodbeck (talk) 01:31, 21 December 2010 (UTC)

The vaccine court did not decide one child got autism from vaccines. The child did not have autism. That was why the case was settled, rather than tried as part of the omnibus. Vaccines were responsible for the child's rare complication, but it wasn't related to autism. If the lawyers could have proved the child had autism, they would never had settled, since they could have won a large class-action lawsuit by proving there was a link. —Preceding unsigned comment added by 72.187.99.79 (talk) 13:25, 12 January 2011 (UTC)

Terminology [Restored Thread]

"As someone who has Autism, I would strongly urge editors of this page to consider using more Neurodiversity aware terminology. Many aspies are offended by the (sometimes insulting)terms used in Wikipedia articles on this subject. I am very concerned that Austism is in certian "mental illness" catogories, Autism may be known as a disorder in medical terms, but there is no reason to call it an illness. Surely Wikipedia contributors can edit the wording of this article in a way that is medically acurate but still respects people on the autistic spectrum? Thanks." — Preceding unsigned comment added by Ariosto10 (talk • contribs) 12:18, 7 January 2011 (UTC)

Vaccine theory

There are just a couple of instances in which the autism/vaccine connection has been referred to as a theory. I checked the document briefly and saw the following.

Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to theories that vaccines or their preservatives cause autism, which was fueled by a scientific study which has since been proven to have been falsified.[69] Although these theories lack convincing scientific evidence and are biologically implausible,[8] parental concern about autism has led to lower rates of childhood immunizations and higher likelihood of measles outbreaks in some areas.[10]

I believe it to be incidental, since the rest of the document is worded quite carefully regarding immunizations. I suggest an alteration to the document to the following.

Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to the hypothesis that vaccines or their preservatives cause autism, which was fueled by a [strike]scientific[/strike] study which has since been proven to have been falsified.[69] Although these [strike]theories[/strike] hypotheses lack convincing scientific evidence and are biologically implausible,[8] parental concern about autism has led to lower rates of childhood immunizations and higher likelihood of measles outbreaks in some areas.[10]

This would more accurately reflect the concepts put forth. 74.204.87.18 (talk) 01:27, 20 January 2011 (UTC)

That looks good to me, but I suggest we wait for further feedback. SandyGeorgia (Talk) 03:02, 20 January 2011 (UTC)

Well I like it as well. Dbrodbeck (talk) 03:13, 20 January 2011 (UTC)

Looks good to me too. Yobol (talk) 03:24, 20 January 2011 (UTC)

I like striking "scientific" from "scientific study," but would prefer "proposition" rather than "hypothesis" to replace "theory" because, in this context, it conveys the same meaning but is slightly more accessible. No big deal, though. --Anthonyhcole (talk) 03:47, 20 January 2011 (UTC)

I happen to dislike the use of the word hypothesis as well, but that's just because I dislike connecting it with any part of the Scientific Method. That was mostly to keep it in line with the rest of the article, where the vaccination link is purported as a hypothesis rather than a proposition. If ::we're going to do it here, I think we should change hypothesis to proposition throughout the article.

Thoughts?

71.238.160.243 (talk) 05:59, 20 January 2011 (UTC)

I don't have a problem with using "hypothesis" in the lead and "proposition" in the body. While we're on this paragraph, I'd like to change "fueled by" to "supported by." --Anthonyhcole (talk) 06:43, 20 January 2011 (UTC)

I agree with this. Aspie Lover (talk) 09:51, 20 January 2011 (UTC)

I disagree with "supported by", as there was no support. I also think "proven" is a strong word. And the "likelihood" of measles outbreaks isn't needed, as multiple reliable sources document the actual measles outbreaks. There has also been a resurgence of mumps, and whooping cough, documented in reliable sources as tied to the controversy. Summarizing new suggestion: SandyGeorgia (Talk) 13:00, 20 January 2011 (UTC)

Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to the proposition that vaccines or their preservatives cause autism; this proposition was fueled by a study which has since been shown to have been falsified.[69] Although these proposals lack convincing scientific evidence and are biologically implausible,[8] parental concern about autism has led to lower rates of childhood immunizations and disease outbreaks in some areas.[10]

I like all that Sandy, except "fueled". What about

Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to the proposition that vaccines or their preservatives cause autism; the only apparent scientific support for this proposition was a study which has since been shown to have been falsified.[69] Although these proposals lack convincing scientific evidence and are biologically implausible,[8] parental concern about autism has led to lower rates of childhood immunizations and disease outbreaks in some areas.[10]

--Anthonyhcole (talk) 13:02, 20 January 2011 (UTC)

That works for me, except that "apparent" is weasly, and I think we have reliable sources that say there was no real support. I don't have access to full text of the currently cited sources, so don't know if they also support mumps and whooping cough, so we may need to add the additional sources there (they can be found at Andrew Wakefield or MMR vaccine controversy). SandyGeorgia (Talk) 13:05, 20 January 2011 (UTC)

I think my proposed sentence is saying pretty unequivocally that there was no actual scientific support. But I'm no judge of the the clarity of my own prose. --Anthonyhcole (talk) 13:12, 20 January 2011 (UTC)

I still disagree with using the term scientific in reference to the study conducted. It was not conducted scientifically, and that was why we took the term out earlier. We could change it to, "the only study appearing to supporting this proposition, was a study which has since shown to have been falsified." It would knock out the term scientific, and lessen the impact of the word, "apparently". I do agree that apparent (and derivatives thereof) can be weasly, but the only alternative is to say something like, "the only study contrary to the scientific consensus indicating a lack of causation between vaccinations and autism, has since been shown to be falsified." or some less wordy variation thereof.

216.55.112.130 (talk) 14:03, 20 January 2011 (UTC)

I agree with losing "scientific", but both "appearing" and "apparent" are weasly. We have enough reliable sources that describe the data as fraudulent and the premise unspported by any other research that we should be able to do this without any weasle words. Perhaps new wording could use "published" study? SandyGeorgia (Talk) 14:12, 20 January 2011 (UTC)

Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to the proposition that vaccines or their preservatives cause autism; journal-published support for this proposition was a study which has since been shown to have been falsified.[69] Although these proposals lack convincing scientific evidence and are biologically implausible,[8] parental concern about autism has led to lower rates of childhood immunizations and disease outbreaks in some areas.[10]

We may need to add additional sources. SandyGeorgia (Talk) 14:19, 20 January 2011 (UTC)

"Idea" seems like a plain English alternative to "proposition". "Belief" would be another alternative. Guettarda (talk) 14:19, 20 January 2011 (UTC)

I'm off for the day, but I think most of the issues are out on the table now-- good luck finalizing this! But before we add something, will someone please check the sources to make sure other disease outbreaks are supported, and add other sources if needed? Thanks to the IPs who've helped in this needed tightening. SandyGeorgia (Talk) 14:24, 20 January 2011 (UTC)

I like the idea, Sandy, but at that point, the sentence seems like it loses the meaning. Perhaps we could say:

Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to the belief that vaccines or their preservatives cause autism; one study supported these beliefs. The study has since been shown to have been falsified.[69] Although these proposals lack convincing scientific evidence and are biologically implausible,[8] parental concern about autism has led to lower rates of childhood immunizations and disease outbreaks in some areas.

Take care216.55.112.130 (talk) 14:27, 20 January 2011 (UTC)

Thanks again! Since we've got measles, mumps and whooping cough all tied to Wakefield's fraudulent data and the ensuing vaccine controversy, let's make sure we check the original source and add others if needed-- that is all over the reliable sources, cited in the other articles if needed. SandyGeorgia (Talk) 14:29, 20 January 2011 (UTC)

(outdent) Hold on. The fraudulent Wakefield study was only looking at the measles component of the MMR vaccine causing an autism-like illness. It has nothing to do with preservatives (thiomersal isn't in MMR) or other vaccines. So the "vaccines or their preservatives cause autism" theory/hypothesis/idea/proprosal isn't completely based on a fraudulent paper, and arguably that paper had a bigger impact in the UK than in some other countries. I think we need to rewind the suggested text a few versions. Colin°^Talk 16:16, 20 January 2011 (UTC)

Ugh. Colin is right, as usual. Well, we do have sources tying it all together, but it now needs to be recrafted more carefully if that's what we aim to do. Back to the new sources, on the other articles. SandyGeorgia (Talk) 16:18, 20 January 2011 (UTC)

I'm a little confused. Did you just want a source stating that the Thimersal is harmless? Wouldn't the burden of harm fall the other way? In any event, I have a BMJ report and a NYT report. Meh. After I found a couple and started, I figured I'd provide a breadth of sources.

The latter had a nice quote, that I wish I could find a legitimate place for.

Maybe Study Number Ten will suffice to reassure the one in four parents who have come to fear vaccinating their babies that doing so will not raise the likelihood of the kids' developing autism. Then again, maybe no number of costly and carefully designed and executed studies will dislodge the fear of vaccines among parents that has taken root in the United States.

Did that address the concern? 216.55.112.130 (talk) 17:26, 20 January 2011 (UTC)

What is needed to tie all of this together can be found at MMR vaccine controversy#Disease outbreaks. We need to sort the measles component of the MMR theory from the thiomersal issue, and then tie both of them to reduced vaccinations and disease outbreak, sorting the differences between the UK and other places. We haves sources on the other articles that do that-- I just don't have time to find them and craft it right now, and we don't need to use a blog-- we have reliable medical sources. SandyGeorgia (Talk) 17:36, 20 January 2011 (UTC)

None of the sources were blogs. NYTimes, LATimes, BMJ and FDA. Two primaries and two secondaries.

As for the other part, I still don't understand the objection entirely, so I guess I'll wait for somebody else to do it. I know that we don't need to go in-depth to the autism/vaccine myth since there is an entire article on it. I assumed that if we could cite them as being untrue, we could just clean up the language to make it more accurate.216.55.112.130 (talk) 17:42, 20 January 2011 (UTC)

I saw http://latimesblogs.latimes.com/booster_shots/2010/02/vaccines-autism-parents.html, a blog? I'm sorry I'm wasting so much space here because I'm in a hurry, but we have somewhere on the other article NEJM, BMJ, and other medical reports specifically tying all of the issues together. SandyGeorgia (Talk) 17:45, 20 January 2011 (UTC)

How's this:

Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to concern that the MMR vaccine or a preservative used in vaccines may cause autism. One 1998 report appeared to support the MMR vaccine hypothesis, but was later found to have been fraudulent. Although these hypotheses theories hypotheses lack any convincing scientific evidence and are biologically implausible, parental concern about autism has led to lower rates of childhood immunization and disease outbreaks in some areas.

--Anthonyhcole (talk) 19:16, 20 January 2011 (UTC)

I have no objection to how you reworded the paragraph, except the hypothesis/hypotheses parts. I am much more comfortable with using idea or proposition. Other than that, I'm onboard. Homo Logica (talk) 19:33, 20 January 2011 (UTC)

It starts as a "concern" but when we're discussing it in relation to the (albeit unsound) theory/ies, I believe "hypothesis" is appropriate. --Anthonyhcole (talk) 19:48, 20 January 2011 (UTC)

Actually, I've just struck "hypotheses" and replaced it with "theories." I know this is winding back the changes you were arguing for, but these were (flawed) theories, so the term is most apt. --Anthonyhcole (talk) 19:57, 20 January 2011 (UTC)

The concern, in my eyes, is that it makes it sound like it is science. Besides my own view on the issue (which is basically that it was horrendous), there is precedent for this. It wasn't science in any way. They wrapped it up trying to make it sound like science. Puts it in pseudoscience category

Notes to editors:

1. This article uses scientific terminology, and as such, the use of the word 'theory' to refer to anything outside of a recognised scientific theory is ambiguous. Please use words such as 'concept', 'notion', 'idea', 'assertion'; see Wikipedia:Words to avoid#Theory.

2. Please use edit summaries.

The concept is similar. Hypothesis would fall under the scientific method like Theory, and I think we should avoid misusing it. If he had just been wrong, or slightly off, I could agree. As is, though, it was essentially a con. Certainly no part of Science. Homo Logica (talk) 20:05, 20 January 2011 (UTC)

The thiomersal and MMR vaccine theories were theories, by any definition. Bad theories. But theories. "The MMR vaccine causes autism" is the hypothesis of the MMR vaccine theory. I am as keen as anyone to drain every shred of legitimacy out of this nonsense, but shying away from "hypothesis" and "theory" when discussing unsound hypotheses and theories seems unnecessary to me. Where is that quote from? --Anthonyhcole (talk) 20:20, 20 January 2011 (UTC)

I could provide links stating them as pseudoscience, if that would help. My point is that the hypothesis and theory would both be listed under the bad theories and hypotheses category (I think we're in full agreement there ). It wasn't that they were unsound. It was that they weren't formed in the manner of a hypothesis or a theory.

Pseudoscience is a claim, belief, or practice which is presented as scientific, but which does not adhere to a valid scientific methodology, lacks supporting evidence or plausibility, cannot be reliably tested, or otherwise lacks scientific status.[1] Pseudoscience is often characterized by the use of vague, exaggerated or unprovable claims, an over-reliance on confirmation rather than rigorous attempts at refutation, a lack of openness to evaluation by other experts, and a general absence of systematic processes to rationally develop theories. The term "pseudoscience" is inherently pejorative, because it suggests that something is being inaccurately or deceptively portrayed as science.[2] Accordingly, those labeled as practicing or advocating pseudoscience normally dispute the characterization.[2]

Because of how the ideas were formed, backed up, and defended, as well as the status within the scientific community puts it firmly in the pseudoscience category. (Oh, and my objection isn't so much to the link with Vaccinations, which I do dislike, but rather that I ardently believe the worst thing that we can do as a society is trivialize Science in the manner that this concept does)

Quote is from the Pseudoscience Talk page -- Homo Logica (talk) 20:36, 20 January 2011 (UTC)

The OED defines "hypothesis" as

A supposition or conjecture put forth to account for known facts; esp. in the sciences, a provisional supposition from which to draw conclusions that shall be in accordance with known facts, and which serves as a starting-point for further investigation by which it may be proved or disproved and the true theory arrived at.

so I'm fairly confident "the MMR vaccine causes autism" and "thiomersal in vaccines causes autism" are hypotheses.

I may be misunderstanding "theory" though. I'll do a little more reading. --Anthonyhcole (talk) 21:15, 20 January 2011 (UTC)

That was educational. I've been thinking one meaning of theory is "an hypothesis and the argument in support of it." No idea where I got that from, but I can't find it anywhere but in my head. Sorry, more unknown unknowns. So I've struck "theory" from the proposed text. What do you think? Do you still have a problem with "hypothesis"? (I'm going to sleep now) --Anthonyhcole (talk) 22:23, 20 January 2011 (UTC)

I don't think the reader will be mislead if you call these theories, hypotheses, ideas, proposals or whatever -- it is all much the same in the end. I think the current wording (theories) is fine. I don't think we should label these theories as pseudoscience though I accept some are completely implausible and others are the manufactured product of greedy fraudsters. We already have several articles and biographies covering the vaccine/autism issue and I think the two long sentences we have in this article is plenty. I wouldn't want them expanded to give more weight to an issue that is dead from a scientific point of view. From a social point of view, they are important but we cover that in detail elsewhere. Colin°^Talk 23:09, 20 January 2011 (UTC)

No problem Anthony. It's the most commonly misunderstood thing about Science. That's why I put so much effort into it. I have an objection to hypothesis, and I'm going to post something longer once I get out of work. It'll also address your points, Colin. Still here. It'll just be about 2-3 hours until I can post it up. -- Homo Logica (talk) 23:30, 20 January 2011 (UTC)

We already had a big long conversation on this somewhere, where (I think?) TimVickers clarified that theory was not the right word, hypothesis was. It may have been at PANDAS; I'll see if I can find it, not sure I'll be able to, but may save you some time. I think he basically said that a theory has been tested according to the scientific method, but a hypothesis has not. I could be wrong :) SandyGeorgia (Talk) 23:32, 20 January 2011 (UTC)

Found at Talk:PANDAS/Archive_1#Hypothesis.3F. SandyGeorgia (Talk) 23:34, 20 January 2011 (UTC)

Sorry, don't have much time or I'd check it now. The main reason is that a hypothesis is formed by observation, and in this situation, the observations were formed by the belief. That's a notion or an idea. Not a hypothesis. (Maybe already covered, I just shouldn't really even be talking now) -- Homo Logica (talk) 23:38, 20 January 2011 (UTC)

Get back to work! Fortunately nobody is in a rush here, and we'll get it hammered out with time. SandyGeorgia (Talk) 23:40, 20 January 2011 (UTC)

(Outdent) Reswobslc, in that discussion, says the main problem with "hypothesis" is that it is an invalidating term, and in this discussion, Homo Logica is worried it will boost the idea. Tim Vickers sees hypothesis as a neutral and technical term colloquially equivalent to "Idea" and "Theory". I'm comfortable with my most recent version above. Colin, it's about the same word count as the existing version. --Anthonyhcole (talk) 00:12, 21 January 2011 (UTC)

On break now. Tim goes into it briefly there. The manner of progression for something scientific would be like this, and I'll use gravity as an example. It starts with an observation of something that is occurring. So, you see a ball drop from your hand to the ground. Next, you come up with a hypothesis to explain the phenomenon you observed. This hypothesis must be provable (in the mathematical sense), and describe the observed phenomenon. It need not be correct. Your hypothesis is that the less massive an object, the slower it will fall. After that, you would design an experiment to test this hypothesis. So, you drop 5 objects of varying masses, then observe and record the speed at which they drop. You would then analyze the data you gathered. You find that they all dropped at the same speed. This would cause you to form a new hypothesis. Your new hypothesis is that objects will drop at the same speed regardless of mass. So on and so forth. After doing this numerous times, you would arrive at a theory, gathered from all of your observations to describe the motion of objects in gravitational motion.

The key there, is that a hypothesis is formed from the observations to explain the causal relationship between any two things. In this situation, he did not observe a causal relationship from which he formed a hypothesis. He formed an idea that two things were related, then created evidence to support the notion.

I apologize if it seems like I'm getting off track, but my point from when I started the section, was that the word theory is being misused in this instance. The issue here isn't plausibility of the notion. It was not formed scientifically, yet it purports to be science. That is the definition of pseudoscience.

Colin, I would also appreciate it if you did not edit the section, until we've reached a consensus. -- Homo Logica (talk) 00:26, 21 January 2011 (UTC)

I note that this edit by Colin is factually correct; the fraud by Wakefield only spawned one of the theories tying vaccines to autism (the MMR vaccine controversy and not the thiomersal controversy) and really should be reverted back. Further discussion about the rest of the section can continue without us reverting to a factually incorrect version. Yobol (talk) 00:44, 21 January 2011 (UTC)

Ahead of you there. [12] --Anthonyhcole (talk) 00:49, 21 January 2011 (UTC)

That has also been discussed here. In addition, the changes that are being made are regarding the very specific paragraph that has been discussed on here, with no discussion in regards to the changes being made. I would request that it be reverted to the original form until there is agreement of some form other than simply being the first to edit. In fact, the original claim that is being ignored by Colin is that in the form it is in, it is factually incorrect. -- Homo Logica (talk) 00:51, 21 January 2011 (UTC)

Sorry HL, that was abrupt of me. Colin explained his reasoning here earlier in the thread and when no one acted on it, made the edit. He's right. The former version was misleading. The version I'm touting incorporates that change, but more lyrically :) --Anthonyhcole (talk) 01:04, 21 January 2011 (UTC)

I understand the problem. My issue is that I did in fact respond to him. There was considerable discussion following his comment. The version as it is now is misleading as well. I just don't agree with the unilateral action while a discussion is ongoing about that specific section. The change that was made has exonerated Wakefield, but has made the entire paragraph more incorrect. Including the re-institution of the word theory in two locations in the document, and using the term scientific study to describe a study that was not, per my links and considerable discussion, scientific.

I do think that we should take that into consideration on the rewrite of that area, though, as he is correct. -- Homo Logica (talk) 01:10, 21 January 2011 (UTC)

I'm confused how you came to the conclusion that (correctly) pointing out that Wakefield's fraud only spawned one of the theories linking vaccines to autism "exonerates Wakefield" or is factually incorrect. At this point, it isn't unilateral either; myself, Colin and Anthonyhcole believe the prior version was incorrect. Yobol (talk) 01:15, 21 January 2011 (UTC)

I was stating that it exonerates Wakefield of the other falsehood. The reason it was unilateral was that there was no discussion. I didn't say that it was factually incorrect that Wakefield was uninvolved in that. I stated that the way he changed it made the paragraph even more incorrect. I also agree that the section is wrong. That was why I created this section. To discuss it and find the most correct way to alter it. In fact, if you read the line immediately preceding your attack on me, I state that he is correct. The lines before that contain discussion wherein I explain exactly what I have just stated again.

I also believe that this is getting very far afield from the original discussion, and would request that further comments pertain only to how the section should be modified, rather than a discussion of the people involved. Homo Logica (talk) 01:22, 21 January 2011 (UTC)

So let's discuss "theory" and "hypothesis." We can avoid "theory" in that passage, but I can't follow your reasoning for avoiding "hypothesis." That may well be because the sun's up and I'm in that dissociated sleep-deprived state, But I was having trouble with it when I was awake. It seems to me the above OED definition embraces the MMR and thiomersal propositions: the quality of the hypothesis testing shouldn't determine whether they're an hypothesis or not. What am I missing? (I'm going for breakfast now and might do some sleeping, bit will get back. --Anthonyhcole (talk) 01:34, 21 January 2011 (UTC)

A hypothesis is when you make a prediction about the reason for a correlation between two or more observable phenomena. In this situation, he didn't observe the phenomena then make a prediction about the reason. He saw two phenomena he knew to be unrelated and manufactured evidence to make them seem to be correlated. In addition, I can find more articles if needed, that source it as not being scientific, and instead being pseudoscience. Per the pseudoscience page, we are supposed to refrain from using scientific terms to discuss pseudoscience. -- Homo Logica (talk) 01:41, 21 January 2011 (UTC)

Arbitrary section break

I'm upset that my edit, which corrected an obivous factual error, was reverted. I'm particularly upset that it was reverted for WP:POINTy reasons rather than because an editor found a problem with it. There are times when text should be debated before an edit is made but there are also times to be WP:BOLD and this is the encyclopaedia anyone can edit.

Can I remind folk that this is an article on autism and we are discussing text in a section on the causes of autism. Wakefield's paper is no longer relevant to establishing the cause of autism and hasn't been for a very long time. It is notable from a legal, social and historical aspect. At some future time, this article will no longer mention vaccine theories in the Causes section and they will be noted in passing in the History section. For this reason, I don't think it is good to explicitly single out Wakefield's study per WP:WEIGHT. We don't single out any other study, let alone an old discredited one. So I don't prefer Anthony's suggestion above.

There are three vaccine theories (off the top of my head) for autism: thiomersal, MMR and vaccine overload. They have been subject to scientific test and found wanting. We now know one of them was concocted as a money making scheme rather than as an honest attempt at scientific endeavour. I can see Homo Logica's point that Wakefield's work wasn't "science". But Mendel's work was a little bit cooked and that hasn't brought down the science of genetics. Other scientists have taken the MMR theory seriously and applied science to it. That science has discredited the theory but there is still good science there and the theory didn't involve alien abduction or water memory or any unscientific explanation. I think we're getting hung up on Wakefield and forgetting the other theories: see WP:RECENTISM.

My suggestion is that the text "since been proven to have been falsified." be replaced with "since been shown to have been "an elaborate fraud".", citing the BMJ editorial that contains the quoted text. The word "proven" has strong legal/mathematical aspects and is too heavyweight for our purposes here. The word "falsified" isn't clear IMO. I think the BMJ quote is a nice one on many levels.

You guys can debate the theory/hypothesis/proposal/idea wording till the cows come home; I'm not that interested and neither are our readers IMO. I will say that hypothesis is an erudite word that the reader may stumble on. The best solution, when there is disagreement among editors, is to use the term that our best sources use.

Colin°^Talk 09:18, 21 January 2011 (UTC)

@ Colin. "So I don't prefer Anthony's suggestion above." Not my suggestion. It was there when I came to this discussion. Nobody has a problem with you correcting the factual error when you did - except HL, who is new. Cut him some slack. The only reason I didn't make the change when you pointed it out was I didn't understand SG and HL's responses. So I left it to you, the proposer, to deal with, and I and Yobol were instantly onto it when it was reverted. I think we both saw the wisdom of it the moment you pointed it out. In fact, I thought it was flawed when I saw it and would have addressed it if you hadn't, though I don't have the weight that you do around here and was steeling myself for the effort.

I agree. Wakefield is unimportant here.

@ HL, I see that I lost track of the fact that I'm really not bothered what word we use here, and became absorbed in understanding your position on "hypothesis." How would it be if we replaced this paragraph

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

with

Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to concern that vaccination may cause autism. Although this idea lacks any convincing scientific evidence and is biologically implausible, parental concern about autism has led to lower rates of childhood immunization, and disease outbreaks in some areas.

? --Anthonyhcole (talk) 09:44, 21 January 2011 (UTC)

Let's compare the old text from March last year:

Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to theories that vaccines or their preservatives cause autism. Although these theories lack convincing scientific evidence and are biologically implausible, parental concern about autism has led to lower rates of childhood immunizations and higher likelihood of measles outbreaks

This is similar to Anthony's but the "vaccines or their preservatives" is replaced with "vaccination" and "Although these theories" with "Although this idea". I think the mistake here is to conflate the theories into one and to give that the term "vaccination". It isn't vaccination per se that anyone claims causes autism. The thiomersal theory concerns the mercury-based preservative in some vaccines. The MMR theory concerns the measles component of MMR (but not measles vaccination in general -- Wakefield promoted the use of alternative measles vaccines). The overload theory concerns the giving of multiple vaccines together. So if we really want to drop all mention of the fraudulent MMR paper, then I'd suggest we go back to Eubulides old wording. I see also that the suggestion above says "disease outbreaks in some areas" rather than just noting a "likelihood". Is that supported by the sources? If so then I'm fine with it.

However, at risk of contradicting myself, I think the current subtle mention of the MMR paper is ok and highlights a useful aspect of these theories: the people behind their promotion have some iffy morals. So for comparison, here's my suggestion (tweaked) in full:

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

Colin°^Talk 11:07, 21 January 2011 (UTC)

I'm quite happy with either your version or mine. The conflation of the three vaccine-autism hypotheses was not a mistake, though; not on my part: it was deliberate; and not in terms of the quality of the article. I believe it is valid to speak of the idea that vaccination causes autism, as it is the one idea shared by these theories. It is their unifying theory. Given that, I believe that discussing this single entity, rather than the three subordinate theories, is more concise and elegant; and going into the detail of the idea here is WP:UNDUE.. And mentioning Wakefield, ditto. The addition of certainty to the notion that there is a relationship between this idea and vaccination rates: Sandy mentioned at the time that it was supported. --Anthonyhcole (talk) 11:40, 21 January 2011 (UTC)

The issue is that few people are proposing or fearing that "vaccination" itself causes autism. Otherwise such people would avoid all vaccines, and that is a minority sport. Many people have avoided MMR but still take the other jabs. Wakefield himself promoted alternative measles jabs. Colin°^Talk 11:56, 21 January 2011 (UTC)

Colin. I can't see the merits of your argument, and that's quite likely my failure, but I also don't care very much, so please insert whatever text you believe has consensus. --Anthonyhcole (talk) 12:04, 21 January 2011 (UTC)

Answering Colin's question above about "disease" outbreaks vs measles, yes, sources support a direct link to Wakefield's paper-- of measles, mumps and whooping cough. See MMR vaccine controversy#Disease outbreaks; we have:

• Pediatrics, US vaccination drop tied to Wakefield's paper
• BMC public health, tie to Wakefield paper
• NEJM ties US pertussis outbreak to vaccine fears fueled by MMR controversy
• Time magazine 2011
• Time magazine 2010
• Associated press, vaccine rates in US tied to Wakefield

Those are just a few-- there are more-- whether this needs to be explored in this article is a separate matter. SandyGeorgia (Talk) 13:00, 21 January 2011 (UTC)

Hey there, Colin. I apologize for not explaining myself better, and I definitely see how you could have gotten that from my reversion. My intention was not to try proving a point, but rather to discuss the wording so it would be more accurate. I apologize if it came off that way. I also wasn't suggesting that the article be expanded. My suggestion is keeping it roughly the same size, and just altering a few words to make it more accurate. I don't believe that would cause WP:WEIGHT.

I prefer Anthony's version, in how it references the ideas and the study, and I like Colin's idea in differentiating the two subtly. How about if we tried it like this.

Parents may first become aware of autistic symptoms in their child around the time of a routine vaccination, and this has given rise to concern that vaccination may cause autism. A significant study supporting this idea has since been determined to be "an elaborate fraud". Although this idea lacks any convincing scientific evidence and is biologically implausible, parental concern about autism has led to lower rates of childhood immunization, and disease outbreaks in some areas.

That would differentiate the fraud study from the genuine studies, and still keep from giving the studies scientific legitimacy. -- Homo Logica (talk) 15:27, 21 January 2011 (UTC)

Changed the quote a little, since the claim I made was, upon reflection, incorrect. -- Homo Logica (talk) 15:34, 21 January 2011 (UTC)

This still keeps the "vaccination may cause autism" and "this idea lacks any convincing scientific evidence and is biologically implausible" aspect from Anthony's suggestion and I'm really quite opposed to that because it is wrong (rather than just not worded the best way). Although these three theories are related in that they concern vaccines and autism, they can't be unified to "vaccination may cause autism". If thiomersal was present in some vitamin injection that all infants got, then they'd be worried about that, not the fact that it is in a vaccine. Wakefield promoted alternative vaccines, so he wasn't concerned they caused autism. And I dare say if childhood vaccines were given separately at yearly intervals, the vaccine overload folk would be happier. Vaccination is the exposure of the body to a substance that triggers an immune response that the body later uses to prevent exposure to the real organism from causing disease. Is anybody suggesting that vaccination, by the above definition, is the means by which autism is caused? I don't think so. Colin°^Talk 16:25, 21 January 2011 (UTC)

Would you be more comfortable if we changed it to "vaccinations or their preservatives"? That would indicate that it is both the number of vaccinations, as well as the preservatives within, about which people are concerned. As for the other claim, it was well sourced before you removed it, and covered all three major claims, and was from a Reliable source. -- Homo Logica (talk) 19:53, 21 January 2011 (UTC)

This is getting very confusing. I haven't "removed" any text from the article. And the current text is "vaccinations or their preservatives", so we can hardly "change" it to that. I guess my suggestion of "certain vaccinations or their preservatives" includes only two of the three theories (it doesn't include the overload theory). The current text is a bit ambiguous but I suppose it could be said to cover all three. It is better than the "vaccination may cause autism" suggestion. It is difficult to cover all three concisely. As for your suggested "A significant study supporting this idea has since been determined to be "an elaborate fraud"", this would need to say "supporting one theory" for it to be accurate. And, of course, if we mention multiple theories rather than one unified idea, then the final sentence has to be plural like the current text too. I'm happy for the "disease outbreaks in some areas" text to be used provided a source is added that explicitly mentions outbreaks (rather than just drops in vaccination) -- see Sandy's links above.

For all that has been written here, we've progressed the article very little. There are, perhaps, more important things to worry about. I note that Gerber and Offit are happy to use both "hypotheses" and "theories". Hey ho. Colin°^Talk 23:28, 21 January 2011 (UTC)

Colin, my phrase "vaccination may cause autism" is no more or less wrong than the pre-existing phrase "vaccines or their preservatives cause autism". Would "some modes of vaccination may cause autism" express the idea more accurately? That would encompass preservatives and possibly multiple vaccination too. --Anthonyhcole (talk) 00:56, 22 January 2011 (UTC)

We're tying our selves in knots trying to concisely mention the theories. So I've been bold and edited the article to explicitly mention all three, with wikilinks. I've replaced "scientific" with "litigation-funded", which should please Homo Logica since it was the non-scientific nature of this study that started the whole discussion. I've included the "elaborate fraud" quote because it is great. I've also incorporated the mention of actual outbreaks and deaths rather than just "increased likelihood". What do you think? Colin°^Talk 18:08, 22 January 2011 (UTC)

Theories and hypotheses

I've reverted this edit which replaced "theories" with "concerns" and "ideas". I had been somewhat uninterested in the debate over those terms, but I have two concerns. The first is that it is clear that the desire to use a weaker term is pushing a POV. The second, and most important, is that is not the language used by our best sources. If Offit (the most notable and well-published opponent of the anti-vaccinationists) is happy to use both "hypotheses" and "theories" in his papers on the issue, then so should we. We really need a reliably sourced reason to use the weaker terms. The three theories weren't just "concerns". They were subject to scientific scrutiny and process just as with any theory. Colin°^Talk 21:20, 22 January 2011 (UTC)

[13][14][15][16][17][18][19]

Every single one refers to it as a myth, controversy, concern or concept. This is not POV. This is Science. -- Homo Logica (talk) 22:02, 22 January 2011 (UTC)

Some quotes would be helpful because I'm not managing to extract the same from those sources as you do. Your fourth link [20] uses the terms "research and theorizing". This may be poor or even fraudulent research, but theories are proposed nonetheless. Promoting already discounted theories as though they weren't is an aspect of pseudoscience. Having them in the first place isn't. It is perfectly valid and scientific to propose a theory that A causes B because of C. And it doesn't matter if your reasons for proposing that theory is the advancement of science and the health of children, or because you're trying to rip off the UK taxpayers. Also, many of those links are opinion-pieces, which will naturally use disparaging language to discuss something they disapprove of. We mustn't fall into that trap. An "idea" is "let's go to the beach today". A "concern" is whether it will rain when we get there. WP has a WP:NPOV requirement that means we really must try not to load our language the way an editorial might. Colin°^Talk 22:56, 22 January 2011 (UTC)

Colin, HL's behaviour is nowhere near what we understand as "POV pushing," he is arguing for a position. You are right that, when there is disagreement over language it is best to default to the language used by the best sources: this discussion has been an attempt at reaching agreement.

Like you, I see theory as meaning a proposition, assertion, etc, with maybe some evidence and arguments backing it up OR the current generally respected scholarly position. Though "theory" is ambiguous, reliable sources are happy to use it in the former sense, and their readers will understand the meaning it is carrying there. We are writing for a general audience, and I prefer using less ambiguous language wherever possible. But I'm certain most readers will not misread your version as implying scholarly or scientific respectability, and HL's version ("concerns" and "ideas" instead of "theories") leaves out the developed (though fraudulent and/or stupid) evidence and arguments implied by "theories."

Homo Logica, it may be possible to express this while avoiding "hypotheses" and "theories" but (a) you're not there yet and (b) so few people will think these words imply "good science" in this context that, unless you come up with a formulation as elegant and efficient as Colin's, I will oppose it.

Colin, your version is clear and readable, and the inclusion of the 3 vaccine hypotheses is concise. Though you have addressed my concerns about the inclusion of Wakefield - it may be a bit WP:UNDUE but it adds weight to the invalidity of the claims (and "elaborate fraud" is great) - I'd prefer to see it gone from this article, for concision. I still favour changing "fueled" to "supported by" because it makes the point just as well in less tabloid language, and no one is likely to read it as implying scientific support - in this context. But this is my last word on that. Anthonyhcole (talk) 04:42, 23 January 2011 (UTC)

I agree, I wouldn't label HL as a "POV pusher" and apologise if that caused offence. We're all on the same side here, and that is part of the problem. If we had someone from the "other side" participating in the discussion, there's absolutely no way they'd let us replace "theory/hypothesis" with something meant to imply the ideas/proposals weren't actually scientific. I really didn't want to get drawn into this debate but I'll do so from the point of view of "what do our sources say" rather than arguing over definitions.

Let's remember that some good scientists have been involved in studying these links, either because they thought there might be something in it, or because they needed to show for sure there wasn't. In addition to the Gerber & Offit paper, here are some more examples:

• [21] says it looked into "a theory that increased measles-mumps-rubella (MMR) immunization among young children may be the cause of an apparent marked increase in autism occurrence."
• [22] looked at the thiomersal and MMR "hypotheses" (a term used repeatedly in the paper).
• [23] says "A link has been postulated between measles-mumps-rubella (MMR) vaccine and a form of autism that is a combination of developmental regression and gastrointestinal symptoms that occur shortly after immunization. This hypothesis ..."
• [24] looked into a "modified hypothesis" where cofactors were required to induce autism.
• [25] says "In 1998, Wakefield et al22 suggested that MMR vaccine could ... This theory has been rebutted..." and also "the hypothesized link between MMR vaccination, autism, and inflammatory bowel disease"
• [26] says "the MMR-autism hypothesis", "Our hypothesis was that earlier age at vaccination, ie, before a possible critical time window for autism development, might be associated with", "Single-antigen measles vaccine has been hypothesized to be safer than MMR"
• [27] says "Bernard et al1 offered an hypothesis that autism is an expression of mercury toxicity resulting from thimerosal in vaccines. They base this hypothesis on "
• [28] examines the thiomersal "hypothesis".
• [29] says "Current studies do not support the hypothesis that multiple vaccines overwhelm, weaken, or "use up" the immune system."

The above papers are good science, not pseudoscience. So both "theory" and "hypothesis" are used by our best sources. There's naturally a tendency to use the word "hypothesis" in a research paper, since a scientific study sets out to examine a hypothesis and disprove it. I appreciate there is a difference between the two words, but any general dictionary will give multiple definitions that overlap. For this reason, and because "hypothesis" is rather erudite, and because Offit is happy to use the word "theory", I'm happy to keep using that term. However, I wouldn't oppose changing the text to "hypotheses" if there was consensus for that.Colin°^Talk 09:09, 23 January 2011 (UTC)

I've changed "fueled" to "supported" per Anthony's comment. The single "l" in "fueled" was annoying me :-). Colin°^Talk 09:11, 23 January 2011 (UTC)

Very well sourced. I think we're going to find examples on both sides. To that end, I would agree that the preponderance of evidence favours the use of, "hypothesis". Thank you for the research, Colin :-). Do we have consensus on that? -- Homo Logica (talk) 17:31, 23 January 2011 (UTC)