Talk:Autism (incidence)

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Contents

[edit] Genesis

Since other suggestions have been made about it, here is the true story of how this article arose.

Autism epidemic was not a good article. I rfa'd it. It survived after a typically rancourous discussion.

user:KimvdLinde suggested in the rfa, a couple of hours later that if one stripped out the extraneous garbage there might be an article there

"Delete if unaltered.  Otherwise, major weeding out of junk, non-verifiable stuff, 
speculation, POV etc could make it a basic article"

she said.

So I focussed on a definite topic - what is the incidence of autism and why is it difficult - and by stripping out anything not about it, and anything else that was junk, non-verifiable stuff, speculation, POV and other bad things found that indeed, there was something that looked quite like an article.

So then I put it up here for other people to edit further, and remarked upon it. Saying as is below ... 12:35, 7 April 2006 (UTC)

[edit] too long

This is still too long, with too much in it, but a page on what the incidence is and whether it is changing, but not why, has a chance of beng useful if only to other pages. Midgley 01:59, 6 April 2006 (UTC)

[edit] that graph

It was a problem - rather an advertising presentation graph - someone must have a graph of incidence by time for one or more countries that is available for use... Midgley 00:54, 7 April 2006 (UTC)

[edit] Russia, and landmark events might be ruled in

I'm not quite convinced that stripping out the remark in Russia "incidence ... since 1985 when Thimerosal was abandoned..." is necessary. COnsidering changes in incidence relative to a particular event/date/change is not unreasonable for an incidence article. I agree it is reasonable, and pure, and I personally would be inclined to oppose any amplification of thimerosal's discontinuation such as commonly gets repeated near the word (that is what links are for and that link might well be to Thimerosal controversy rather than Thimerosal (chemical), but perhaps concensus may grow to favour putting that one clause back in. Maybe. I however shall not do it. Midgley 21:53, 7 April 2006 (UTC)

It is interpretation, and as such original research. No citation that links the change with the cause.KimvdLinde 21:57, 7 April 2006 (UTC)
Read with emotional tone absent: Hmmmm. Those are two reasons to not do it, yes, or might they be seen as excuses to not do it. One might consider whether it would be of assistance to the reader to be told why the date given is given, and the answer there is that I think it might well be of assistance. I agree that a citation is essential, but I'd more require one that said that "In 1985 Russia abandoned Thimerosal" than a citation of the widespread rumour that Thimerosal is worthy of note for some reason. I think the latter could actually be left as common knowledge, for two reasons: - firstly the references that might be cited almost all without exception simply suck; and secondly, few if any people will arrive here without having been alerted to the mentions of Thimerosal and autism in adjacent sharply indrawn breaths. As I said, I will not add it myself, and nor will I press anyone else to do it, but like Hemingway, if we leave out an important plot point or character development we must know that we do so, and know that our readers will interpolate it themselves and not have their experience diminished thereby. Midgley 22:34, 7 April 2006 (UTC)
I am in extreme verifiable mode with this article, just to get that kind of shit weeded out (you are going to regret that I am here ;-). If there is a good primary or secondary source providing evidence of the link with Thimerosal, fine. If not, it has to stay out, or we have to list all possible causes (Collapse of the USSR and subsequant worsening of the mediacal system? Changed diagnostic criteria? etc) So, without a source backing that specific link, it is original reseach. KimvdLinde 15:11, 8 April 2006 (UTC)
That is an entrirely reasonable view, and the material now presented in this article will not suffer from application of so pure a principle to it. I'm satisfied with that and feel the presence or absence of that clause has been discussed sufficiently. It stays out, in teh knowledge tehat there is a reason for it being out. Thanks. Midgley 17:07, 8 April 2006 (UTC)

[edit] It needs ...

A picture to reach the GA standards. Midgley 09:31, 8 April 2006 (UTC)

If there is some verifyable data out there, I can make a good graph of that. KimvdLinde 15:02, 8 April 2006 (UTC)

And if there was anyone who knew anything about autism and New Jersey it would be useful if that paragraph acquired some citations. Even in Autism epidemic that would be useful. Midgley 09:31, 8 April 2006 (UTC)

[edit] Epidemiology

I don't think the new discription of epidemilogoy is relevant here. As I've wrote several times already in autism & Asperger talk, autism is not as disease. Therefore, it should not be here. Just as naming an article "autism epidemic" is POV and wrong, so is useing the word "disease" in this or any other autism-related article. --Rdos 13:43, 8 April 2006 (UTC)

I can agree with avoiding the word disease, what term woruld you use instead? Condition? KimvdLinde 15:02, 8 April 2006 (UTC)
Even though I don't like that term either, DSM uses disorder. Disorder at least does not say anything about the causes of autism, which disease implies. Condition is better, but it isn't used in DSM, so could be found POV by the other side? --Rdos 10:11, 9 April 2006 (UTC)
  • I think its relevance is entirely limited to distinguishing incidence from prevalence. There is no reason at all for the word disease to be in there, condition, variant, or event would be perfectly correct and I'd be pleased if someone picks one and changes it.
  • I think it is relevant though. The article is about incidence, and empirically there is a lot of confusion between incidence and prevalence in writing about the number of cases of {thing} that one sees or has. I am firmly of the opinion that presenting that definition and distinction in the first piece of the article will reduce the maintenan ce load and assist subsequent editors in avoiding writing about something else. (I'm not suggesting they shouldn't write about Autism (prevalence) or Autism (epidemiology), just that it is best not to do it in an article titled "Incidence".) The second box, noting a difference between new cases and indcidence also addresses a confusion which I believe has added fluff and work. Making a clear distinction within body text seems to me less easy and effective. But then, I like boxouts. Midgley 10:58, 9 April 2006 (UTC)

[edit] Drop in cases

Does anyone know the reason why the cases dropped in the US? Just another star in the night T | @ | C 01:23, 13 April 2006 (UTC)

The short answer seems to be no. Indeed, there is still argument about whether the cases have dropped. It seems accepted that case incidence rose, but when it all settles down and people are looking at it neutrally that may still turn out to have been an illusion (I don't think it will). I wonder if we are stopping watching TV now - that seems to fit quite well. Midgley 08:36, 13 April 2006 (UTC)
A possibly banal explanation, but nonetheless relevant. Diagnoses are subject to the "fad effect," just like many other things in society. The statistics are also influenced by this effect, and they will swing up and down in harmony with this phenomenon. One will always experience a steep increase in the statistics starting with the "discovery" of a disease, even if it has actually existed for the last million years. This attracts attention, diagnostic criteria are refined, more and more clinicians become better at recognizing and diagnosing the condition, the press gets involved, the internet gets involved, activist groups get involved, ...... you get the picture.
This creates a false picture of the real incidence, and the numbers go up, then yo-yo up and down a bit, and then fall slightly, only to stabilize once the big hub-bub is all over and the disease is accepted as a "so what" part of life. Only then (and it can take a number of years to reach that point!) can one get an accurate picture of the real incidence, and then measure if there is a real increase, decrease, or stable situation. My son is an Aspie, so this is also of personal interest to myself. It would be very tempting to play the blame game and join the activists, but I still retain some critical thinking abilities.....;-) As a skeptic I need good proof first. -- Fyslee 18:21, 13 April 2006 (UTC)

[edit] Stable article

By the (low) standards of the genre, this is a stable article. I propose we work toward good article (I think it is too specific to be FA) status, and make a stable version of it. Midgley 20:56, 13 May 2006 (UTC)

I agree. I might read over it this evening and see what I think. Kim van der Linde at venus 22:43, 13 May 2006 (UTC)
But ultimately, at the end of the day, a merger with frequency of autism would be necessary to avoid having two articles on the same topic. Andrew73 00:10, 14 May 2006 (UTC)
What is frequency of autism about though? It isn't prevalence, it isn't incidence, and it isn't settling down - it really continues to be an assertion that there is an epidemic. Midgley 01:26, 14 May 2006 (UTC)
I don't think the lay person would necessarily appreciate the difference between "frequency" and "incidence." In any event, a merger would serve to tone done the epidemic POV in the frequency of autism article. Having two articles on the same topic seems a bit excessive, and risks orphaning the important points made in the autism (incidence) article. Andrew73 01:47, 14 May 2006 (UTC)
Only this article was created by leaving behind everything of Autism epidemic that was referenced, and only then adding anything else. Merging it back in recreates the old article. And there is a voice for not losing the old article, whatever it ends up being called. I looked at pulling out an article on prevalence of Autism/PDD, but there isn't the material there. Antivaccinationist might be warming up again ... they are all tied together still. Midgley 02:05, 14 May 2006 (UTC)
The main problem is that it is nearly impossible to change something to NPOV in autism articles due to the continued soapboxing of some editors. But I would be very much in favour. Kim van der Linde at venus 03:46, 14 May 2006 (UTC)

[edit] Picture

What can we use as a picture, to illustrate it? Or would a graph do? 02:08, 14 May 2006 (UTC)

[edit] Merge

This article should be merged with Frequency of autism. — Reinyday, 23:00, 13 July 2006 (UTC)

Better, this article should replace it, that article is full of POV, and unreadable stuff. -- Kim van der Linde at venus 01:57, 14 July 2006 (UTC)
What actually is frequency of autism? I mean as a definition? We can do "Incidence" because we know what that is. We could do "prevalence", but what would the scope fo frequency of autism be if someone wrote an article about it? (Note that the article referred to was a sopaboxy effort arguing that there is an epidemic of autism. Also note, if you wouldn't mind, that there is a description of the geenration of this article already in this page, and merging it seems wholly illogical - deleting it would be logical ... Midgley 22:31, 14 July 2006 (UTC)


[edit] Level One Autism

There is no mention of the fact that the least ambiguous diagnostic category of autism, "level one", is the category least susceptible to false increase of incidence.

[edit] New Cases

There are a couple info boxes that use the term "New Cases" in this article. That metric is not a useful metric, the way it's calculated. To be an indication of incidence, "new cases" should be the number of persons diagnosed in that period of time (quarter or year). But this information is generally unavailable from administrative data. For example, when people speak of "new cases" in the California DDS, they are referring to the difference in caseload from one quarter to the next. But unfortunately, this is not the same as the number of new clients in the system. That's because some clients leave the system every quarter, and not a negligible number of clients at that. The number of clients who leave periodically obviously must depend on the total size of the population, confounding matters further. Neurodivergent 20:08, 19 October 2006 (UTC)

New cases is a difficult term - it appears in the literature, and the purpose of one of the boxes is to distinguish between "new cases" and "incidence", since they don't appear to be the same thing. In an older less focussed article they are not distingushed, with results that could confuse the reader. Midgley 21:16, 9 March 2007 (UTC)

[edit] Proposal to redirect "Frequency of autism" to "Autism (incidence)"

Please see Talk:Frequency of autism. aLii 01:55, 14 February 2007 (UTC)

[edit] Totally disputed

This article barely reads like an article. Opinions are stated as facts, speculations are presented as conclusions, etc., and numerous questions are omitted. --Leifern 02:02, 18 February 2007 (UTC)

It would help if you were more specific. aLii 01:33, 9 March 2007 (UTC)
It does suffer from having been derived from autism frequency by only throwing out the egregious and obvious errors and irrelevancies, there is clearly more work to do. SOme editors will wish to put them all back in, I see this POV stuff is well under way. Midgley 21:13, 9 March 2007 (UTC)
Well, as an example, the citation to the (UK) National Autistic Society is invalid, bordering on fraudulent. The NAS says that it's difficult to ascertain the exact incidence of autism and does not discuss any increase in incidence. --Leifern 13:35, 13 March 2007 (UTC)
As you insist on being vague, am I correct in assuming that you mean this one? It looks like a fair article to me, and references numerous journal articles. Would you be happier if the journal articles were referenced directly?
I can see that there is scope for balancing the point that some people are convinced that there is a huge increase in cases, whereas others are saying that it is not clear-cut. The NAS reference, although it has the latter viewpoint, is not referenced for that. I've just added a citation needed tag to "Public health organizations and researchers have not yet determined causes for the increase in reports of Autism."
Do you have any further points other than balancing the lead and first section? It seems like a sentence or two and a few extra references would do the trick. aLii 14:00, 13 March 2007 (UTC)
Yes, sorry that is the reference. The article is written in 1999 and takes no position - even at that point - on whether there is an increase in incidence, and discusses only the difficulty of measuring incidence. I've pretty much given up on making this subject matter NPOV, as it seems to be dominated by individuals who will not be convinced how serious this problem is until it either affects them personally or it is blindingly apparent. It all reminds me of Schopenhauer's quote: "All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident." --Leifern 14:04, 13 March 2007 (UTC)
In an article about the incidence of autism, a difficult topic of some interest to many people for various reasons, in a section of that article on the incidence in a particular country, a reference to a national organisation discussing the difficulty of measuring incidence there seems to me quite reasonable. A reference stating that incidence was increasing would perhaps be useful for an article called ((Autism epidemic)), but this is not the article called autism epidemic (nor is any other article, since nobody has been able to write one that passed muster) and therefore there is no need for all references to state that the incidence is increasing. References stating what the incidence _is_ at a particualr time, or set of times, would fit right in, and references to the various nations' organisations' views on the difficulty of estimating incidence in 1999, 2000, 2001, 2002, 2003 4 5 6 7 and indeed 8 would be useful contributions - a useful editor might offer them, if they exist. If they don't exist, then cavilling about the use of what has been published as WP:RS is unreasonable, pointless, non-contributory, adverse to process, and many other things not suitable for presence here. But consistent. Midgley 00:07, 14 March 2007 (UTC)
Leifern, no-one wants "to hide the truth" or even anything remotely similar. However one should attempt to stick with the prevailing medical opinion, rather than the opinions of the few. Global warming could be re-written as a complete hoax, if you were to believe some scientists. Putting in some references to the supposed epidemic is perfectly reasonable, if done so with the proviso that it isn't the prevailing opinion. aLii 17:17, 13 March 2007 (UTC)
Leifern's comments don't really indicate that he can read. "invalid, bordering on fraudulent. The NAS says that it's difficult to ascertain the exact incidence of autism". That is why the reference is adduced. Try reading without the red filter of rage, the English is very straightforward. Midgley 23:58, 13 March 2007 (UTC)
If anyone needs it side by side, here is the actual article text "The National Autistic Society estimated the prevalence of autism spectrum disorders in the total population at one in 110 and regarded the incidence and changes in incidence with time as unclear.[22]." I suggest the totally disputed tag be removed. Midgley 00:10, 14 March 2007 (UTC)

[edit] Picture

See previous mentions here. By all means present an alternative picture to illustrate the article. A picture of an epidemiologist is relevant to an article on an epidemiological topic. Midgley 21:32, 9 March 2007 (UTC)

[edit] Incidence

"Silicon Valley cluster A 2002 BBC article indicated that one in 150 children in the region had an autistic spectrum disorder.[39] A 2001 article in Wired suggested that the cluster is a result of a link between autistic disorders and computer skills.[40]"

Can we find anything about incidence in that or for it? An indication of the incidence _around_ Silicon Valley would also be useful, particularly to examine whether there is actually evidence of a cluster there. 1/150 is not higher than many of the claims that rattle around WP for prevalence in the general population. Midgley 01:39, 16 March 2007 (UTC)

In the paragraph below, on the Amish, for instance, there is an unsourced assertion that the surrounding incidence is 1/166 (coupled with a suggestion that that times 22000 is "dozens", but it is a figure even if not of incidence.) A difference between 1/166 and 1/150 is less than impressive - it looks like 7% which is a rather subtle clustering. Midgley 01:53, 16 March 2007 (UTC)

[edit] incidence in Amish community

The reference is broken. I'd suggest that a note that the incidence among Amish has been suggested to be low, along with whatever it might be known to be, and references go back when avaialble.

"

[edit] Amish anomaly

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No formal or prospective study of incidence or prevalence has been conducted. Informal efforts to assess the prevalence of autism in the Amish community revealed only a few cases of autism. About 22,000 Amish live in Lancaster County, yet only three or four[citation needed] Amish with autism have turned up so far in an informal survey of Lancaster County. 132 would be expected if the prevalence in society at large is 1-in-166[citation needed]. Dr Frank Noonan, a Lancaster County family doctor, reported that other conditions were found in expected numbers. The Department of Health and Human Services may study the Amish community.[1] There are substantial confounding factors among Amish lifestyle and genetic restriction and homogeneity. "

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