Talk:Autism/History as of 2007 July 31

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[edit] Omitting URLs

Eubulides, it's good to link to free full text whenever we have it, and PubMed central is stable; you might want to reconsider eliminating URLs. [1] SandyGeorgia (Talk) 19:11, 30 June 2007 (UTC)

Three of those four citations have DOI links, which link straight to the free full text; surely we don't need to duplicate that work. With the fourth (Yu et al.) the reader can click on the Pubmed ID for the abstract, and click on the abstract for the full text; won't that suffice? The tradeoff for Yu et al. is whether to lessen the maintenance effort (and article size), or whether to give the reader one-click access to the full text. Eubulides 03:59, 1 July 2007 (UTC)
Whatever consensus is on this article is fine with me, but on articles I write, I like to keep in mind that not all laypersons are familiar with PMIDs and DOIs, and they're accustomed to just clicking on an article title for a link to the text, as that is the way most other types of artices (non-medical) are referenced. It's just an extra help for our non-medical-oriented readers. SandyGeorgia (Talk) 05:48, 1 July 2007 (UTC)
OK, thanks for explaining, I put them back in. I looked at a few other medical pages and didn't find any consensus, so if you want them for cites you edit that's fine with me. Personally I don't think they add much; the browser highlights PMIDs and DOIs the same way it highlights titles, and it's not that hard to figure out that clicking them gets you there. So I probably won't bother for cites I add. I did notice that the pubmed URLs weren't consistent in format so I tried to make them consistent (for the ones I put back in, that is). Eubulides 07:36, 1 July 2007 (UTC)
The first link that SandyGeorgia pointed out above actually linked to a full-text version of the article rather than just the Pubmed abstract - that's an even more important link to have. My thought is to agree with you, a URL to pubmed is redundant to the PMID link, but the full-text links should definitely be there. WLU 13:37, 1 July 2007 (UTC)
Just to follow up: a few weeks after the above, after the references settled down a bit, I went through and added URLs for every freely-available version I could find, except for URLs that smelled like copyright violations. Eubulides 04:35, 25 July 2007 (UTC)

[edit] Mirror neurons

Is this two-sentence section going to grow, or can the third-level heading be eliminated by merging content ? No hurry, just wondering—not a fan of third-level headings for limited content. SandyGeorgia (Talk) 20:26, 2 July 2007 (UTC)

My guess is that the 3rd-level heading will go. Should know in a couple of days. There are a lot of papers to wade through. Eubulides 20:57, 2 July 2007 (UTC)
OK, I did a first cut at the mirror neuron rewrite. It doesn't need a 3rd level heading now so I removed it. Haven't finished rewriting the containing section Autism#Pathophysiology though; its first half is still a mess. Eubulides 06:31, 3 July 2007 (UTC)
Looking good ! (I'm hoping you'll dispose of that parenthetical statement somewhere in there that says what an EEG is by just linking it earlier on.) SandyGeorgia (Talk) 10:14, 3 July 2007 (UTC)
Yes, that got fixed in a later rewrite. Eubulides 06:57, 11 July 2007 (UTC)

[edit] Heels?

I know a girl in my school who works with severely autistic kids, and she said that one of the kids couldn't even touch his heels to the ground. She continued to say that autistic people dislike the sensation of pressure on their heels. I was suprised to learn this is a trait of autism, because I have always walked without touching my heels to the ground when not wearing shoes, and have been previously diagnosed with AS. It's interesting to find out what are my personal quirks, and what is symptomatic of autism. Anyway, I thought someone should find a source for this and enter it, because anecdotal evidence usually doesn't go very far.—Preceding unsigned comment added by 172.190.124.193 (talk • contribs)

I'm kinda surprised that this isn't in the article either as I've read about it as a common association. WLU 15:44, 4 July 2007 (UTC)
It's not always heels. A 1992 study of 91 autistic children and adolescents reported they were more likely to "put excessive weight either on one foot or on a single heel or toe, eventually reducing weight below 10% on one of the remaining foot parts." I'd prefer to see a review article though, before putting this in. Can anyone find a better citation? Here's the one I found:
Kohen-Raz R, Volkmar FR, Cohen DJ (1992). "Postural control in children with autism". J Autism Dev Disord 22 (3): 419–32. doi:10.1007/BF01048244. PMID 1383190. 
I am planning to edit Autism#Characteristics next, once I finish with Autism#Mechanism; it'd be nice to use any better citation then. Eubulides 18:54, 4 July 2007 (UTC)

A later rewrite added Ming et al. (2007), which mentions toe walking, so this issue is now moot. Eubulides 06:57, 11 July 2007 (UTC)

[edit] "See also" formats poorly due to portal

Now that Autism#See also has been whittled down to a single invocation of the portal template, the formatting looks bad with Firefox 2.0.0.4: the portal's box cuts into the "Notes" section and the first reference does not flow around it nicely. Is there some better way to format a portal template? I realize the portal template is supposed to go into "See also", but if "See also" is otherwise empty is there a better place to put the template? It seems a bit odd that the portal template is so far away from the "Pervasive development disorders" template and the "Mental and behavioural disorders" template. Eubulides 06:56, 5 July 2007 (UTC)

In terms of WP:MOS and WP:GTL, I don't know the answer to that, but agree with your assessment. I guess, IAR, and put it wherever it looks best ? SandyGeorgia (Talk) 14:10, 5 July 2007 (UTC)
Thanks, I moved the portal to Autism#External links, next to the other goodies in that section which are actually internal links. Might as well keep the troublesome stuff together. At least the table of contents is one line shorter now.… Eubulides 15:54, 5 July 2007 (UTC)
Well, now I'm eyeing that spoken articles link and wondering why we should have a link to such an outdated version; does anyone know policy and know whether we can delete that link? SandyGeorgia (Talk) 15:55, 5 July 2007 (UTC) Or move it here to the talk page ? SandyGeorgia (Talk) 15:56, 5 July 2007 (UTC)
I couldn't find any official policy but the discussions I found suggested that people who rely on spoken articles probably prefer an outdated copy to no copy at all. Eubulides 06:57, 11 July 2007 (UTC)

[edit] Comprehensiveness

I haven't read through the new article yet (waiting until work is further along), but wondering if two items are covered; differential diagnoses and common comorbids? SandyGeorgia (Talk) 16:04, 5 July 2007 (UTC)

OK. SandyGeorgia (Talk) 18:08, 5 July 2007 (UTC)
  • I have now added a paragraph to Autism#Diagnosis that talks about differential diagnoses and the average diagnosis delay. Eubulides 21:41, 5 July 2007 (UTC)
Also, on mention of medications (eg risperidone), see discussion and methods used at Tourette syndrome (the issue is one of making the article "global" vis-a-vis trade names on medications in the US -- need to specify generic names, but in a way that footnotes US trade name vs. others). SandyGeorgia (Talk) 16:07, 5 July 2007 (UTC)
  • Trade names are such a hassle when trying to write articles for an international audience; Tourette syndrome's special footnote on this subject is a symptom of the hassle. If we tried to mention the names in all English-speaking countries we'll unnecessarily bulk up the article with talk about "Risperdal", "Ridal", etc. Is this issue covered in WP:MEDMOS? I'm sort of hoping that it's OK to just mention the generic name here, as anyone who cares to find out the trade name in their locale can do so by following the wikilink to Risperidone. Eubulides 17:49, 5 July 2007 (UTC)
I'm not sure if MEDMOS deals with it; if not, we should tackle that at some point with Fvasconcellos. For this article, since only one med is mentioned, probably not worth worrying about, and the wikilink to risperidone covers it. SandyGeorgia (Talk) 18:08, 5 July 2007 (UTC)
MEDMOS recommends the generic name for article names. It seems logical to follow the through to article references except where there is a strong country-specific focus to the article. This isn't the case for Autism. I've noticed, with anticonvulsants, that US physicians and patients mention trade names more freely than in the UK. I'm not convinced there is any justification for mentioning trade names in this article on International-English WP unless it is a direct quote. Colin°Talk 22:41, 5 July 2007 (UTC)
Having slept on this, I can think of some reasons to additionally mention a brand name. The case is strongest when the drug is still under patent, so only one or two brands exist in English-speaking countries; it is genuinely novel, rather than a me-too; it is widely discussed in the mainstream media using the brand name (e.g. Ritalin). Care should be taken to avoid e.g. a US-centric view. We should really discuss this over at Med/Pharm projects. Colin°Talk 08:24, 6 July 2007 (UTC)
I'm not in favour of listing all the brand names on the drug pages either. Current MEDMOS and WP:PHARM guidelines encourage just listing the initial brand name(s). The brands of generic and non-English versions are too numerous. Colin°Talk 22:41, 5 July 2007 (UTC)

[edit] Random items

Putting more random notes here of things as I notice them—maybe better not to use approximate (~) shorthand, as not all laypersons know that notation? Earlier prevalence estimates were lower, centering at ~0.5 per 1,000 for autism during the 1960s and 1970s and ~1 per 1,000 in the 1980s, as opposed to today's 1–2 per 1,000. SandyGeorgia (Talk) 16:09, 5 July 2007 (UTC)

  • Thanks, fixed. Eubulides 17:49, 5 July 2007 (UTC)

Another random note: Eubulides, if you have an autism-echolalia reference document, you may be interested in working on echolalia at some point. Some of the content was there before I started editing it, and I'm not sure how much of the autism-related content there is accurate. SandyGeorgia (Talk) 17:15, 9 July 2007 (UTC)

Recent studies don't tend to report echolalia prevalence separately, I suspect because it's taken for granted that it's a symptom. Echolalia refers to one source; a related one is Prizant BM (1983). "Language acquisition and communicative behavior in autism: toward an understanding of the "whole" of it". J Speech Hear Disord 48 (3): 296–307. PMID 6621020.  I don't have easy access to either paper, though. The phrase "75% of verbal people with autism have some form of echolalia" in Echolalia is a bit weird and I can understand why you'd like it reworded, for clarity if nothing else, but I don't see how to do that with what I have easy access to right now. Eubulides 20:31, 9 July 2007 (UTC)
I was hoping you had access to some of those; I don't, but if you come across anything, the echolalia article needs help on the autism stuff. SandyGeorgia (Talk) 20:36, 9 July 2007 (UTC)

I've never heard of BAP: can it be further defined with a few more words, since we don't have a wikilink? Or, create a stubbified article ?

OK, thanks, I did the former. Eubulides 04:05, 10 July 2007 (UTC)

Is the vagueness about the IQ cutoff in this sentence deliberate? Sometimes it is divided into "low-functioning autism" (LFA) and "high-functioning autism" (HFA) based on whether IQ is less than some cutoff figure like 70,[13]... I'm not sure those terms should be in quotes; see WP:MOS??

The vagueness is deliberate. Some authors use 50, some 70, some different values. I suspect it has to do with whatever figure the local authorities use to define whether children need more educational help. I considered changing "some cutoff figure" to "some relatively-arbitrary cutoff figure" but if anything that wording makes matters more confusing. I did drop the quotes, though; thanks. The quotes predated me and I think were put in because LFA and HFA are controversial terms, but the text now states the controversy explicitly so I hope the quotes aren't needed now.. Eubulides 04:16, 10 July 2007 (UTC)
The "some cutoff" is awkward, but I don't know how to fix it. Maybe after a good night's sleep :-) SandyGeorgia (Talk) 04:31, 10 July 2007 (UTC)

Individuals with Asperger's tend to perform better than those with autism ... tend to perform better ... cognitively? Socially? over all functioning ??

It's a long story (hey, we're summarizing an entire book in one sentence!) but "cognitively" is good enough, so I added that. Eubulides 04:26, 10 July 2007 (UTC)

I don't know what this means: Several studies have reported autistic symptoms in some children due to a loss of language or social skills, as opposed to a failure to make progress. A loss of language skills causing autism ????

Thanks, I reworded that. The idea is that a loss of language skills caused a diagnosis of autism; i.e., had the language skills not been lost, the child would not have been diagnosed to have autism. Eubulides 04:30, 10 July 2007 (UTC)

What counts is a pattern of symptoms ... What counts is a bit informal; can it be refined somehow?

I tried rewording it but the reworded versions were all longer and/or harder for me to understand. Suggestions welcome. Eubulides 04:41, 10 July 2007 (UTC)
I can spot 'em, but rarely can I fix them; Colin and Tony are good at this. SandyGeorgia (Talk) 04:52, 10 July 2007 (UTC)

Other symptoms, such as atypical eating, are also common but are not essential. essential for diagnosis ... ?

Thanks, I added that. Eubulides 04:41, 10 July 2007 (UTC)

Can this be re-phrased to avoid starting the sentence with a number? 3- to 5-year-old autistic children are less likely to exhibit social understanding, approach ...

I spelled the numbers out. Eubulides 04:41, 10 July 2007 (UTC)

First occurrence of samples, should be linked or use lay language ... They display moderately less attachment security than usual, though this difference disappears in samples with children with higher mental development or with ASD ...

I changed "samples with" to "groups containing". Eubulides 04:41, 10 July 2007 (UTC)

Many is redundant: There are many anecdotal reports but few systematic studies of aggression and violence in individuals with ASD ... Have you verified this? I may have succumbed to anecdote, but I find this very surprising. Considering the level of anecdote, and well-recognized books such as Ross Greene's The Explosive Child that discuss the explosiveness due to autism, I find it difficult to accept this hasn't been studied more ?? The tantrum data are particularly weak, ...  ????

  • Here's the quote from Dominick et al. that I'm basing the summary on:

There are numerous anecdotal reports of violence and aggression in people with autism spectrum disorders, particularly Asperger's syndrome, but little systematic research concerning its frequency and character has been published (Baron-Cohen, 1988 and Kohn et al., 1998; Mawson, Grounds, & Tantam, 1985). The limited studies suggest that among children with mental retardation, a diagnosis of autism is associated with a higher incidence of tantrums, aggression, and destruction of property (Ando & Yoshimura, 1979a; McClintock et al., 2003).

Notice how old those studies are! Anyway, given the "numerous" in the above quote I'm a bit inclined to keep the "many" (or change it to "numerous" if you prefer). This is a 2007 publication so it provides some evidence that there is no scientific evidence yet that ASD not coupled with mental retardation is associated with violence and aggression. I wrote "the tantrum data are weak" because the summary doesn't mention tantrum data for ASD in general, only for autism coupled with mental retardation. I see now that this was an overstatement, so I've removed that bit. Eubulides 04:58, 10 July 2007 (UTC)
It's still surprising and counterintuitive, but if there are no studies, there are no studies. My understanding has always been that explosive behaviors were highly associated with Asperger's (no mental retardation). Studies in Tourette syndrome specifically showed that explosive behaviors come from the comorbids or the number of comorbids (linear correlation with number of comorbids), and autism is a comorbid often mentioned as leading to explosive behaviors. Anecdote is strong in this area. And now I wonder what data Greene based his book on. Weird. SandyGeorgia (Talk) 05:08, 10 July 2007 (UTC)
PubMed coughs up little useful info, mostly treatment (abstracts only): PMID 17354570 PMID 16401147 PMID 12672261 I don't understand why this hasn't been studied. SandyGeorgia (Talk) 05:18, 10 July 2007 (UTC)
For the other (minority) side, PMID 1938780 argues against the common lay opinion that violence is common with Asperger's, PMID 14969115 argues that that comorbid psychopathology is at fault and not PDD itself, and PMID 7559846 found an association for girls with AS but not for boys. Having fun yet? Eubulides 06:22, 10 July 2007 (UTC)
It seems like those are focusing more on serious psychopathology and criminal violence, rather than the anecdotal childhood tantrums, explosive and inflexible behaviors. It's just strange to me that this has been studied in TS (to dispel the myths and optimize treatment options?), and hasn't been studied in autism. SandyGeorgia (Talk) 13:52, 10 July 2007 (UTC)
The Dominick et al. paper itself is a study, albeit just one (and with flaws that its authors readily admit). It's better to give the reader some feeling for the prevalence of tantrums etc. among children with autism, so I put a few of their numbers into the article. I'll look for figures for other symptoms as well but high-quality numbers aren't that easy to come by. Eubulides 16:44, 10 July 2007 (UTC)

This might be a place to wikilink neurotypical ... compared to typical children, ...

I rewrote it to avoid the "typical" instead. There were too many "typical"s in the article anyway. The first use of "typical" for people is wikilinked to neurotypical. Eubulides 05:04, 10 July 2007 (UTC)

I'm not sure stereotypy should link to Stereotypic movement disorder; one is a diagnosis, the other is a symptom (is stereotypic movement disorder covered in differential diagnosis?) ... though stereotypy and stimming are somewhat different notions ... ' this needs to be better fleshed out on Wiki (I mostly wrote stereotypy and stereotypic movement disorder, but stimming needs work, saying it's "jargon" for stereotypy is off). Self-injury is another dubious link, because the Wiki article isn't comprehensive and focuses on other aspects; I don't think it covers the self-injury this article intends ?

You're right about stereotypy, thanks. (The differential diagnosis is that a diagnosis of stereotypic movement disorders excludes a diagnosis of childhood autism.) You're also right that Stimming needs work, but I suppose that can wait, and in the meantime the wording in Autism is OK, right? Self-injury currently attempts to cover both the symptom and the diagnosis; no doubt it could be split, but in the meantime it does mention autism so it appears to be the right place to wikilink to. Eubulides 05:22, 10 July 2007 (UTC)
Yes, I think the current wording here is fine; it's just the links that frustrate me. I had to build almost everything when writing TS; too many of these minor articles on Wiki were non-existent, or still need work. I don't personally know how to sort out the subtleties of stimming vs. stereotypies. I do know that Stereotypic movement disorder is not autism, because Roger Freeman drills that concept in (I think it's discussed in his blog). I think that article is OK, but stimming -- a fundamental concept in autism -- is in bad need of work. SandyGeorgia (Talk) 05:27, 10 July 2007 (UTC)

... show some savant skills, ranging from minor, or splinter skills to the ... first occurrence of savant could be linked, not sure what "splinter" skills means ...

I reworded that to explain splinter skills. Eubulides 05:57, 10 July 2007 (UTC)

(I stopped after Characteristics; will continue later.) SandyGeorgia (Talk) 02:34, 10 July 2007 (UTC)

I'll keep going tomorrow, but do you think it's in good enough shape to go ahead and submit to peer review, since that can be so slow ? The article structure is in place, and everything is cleaned up. SandyGeorgia (Talk) 06:04, 10 July 2007 (UTC)
Yes, I think it's in good enough shape for peer review now. If you'd like to start the ball rolling on that please feel free, otherwise I'll do it after your review tomorrow. Eubulides 07:11, 10 July 2007 (UTC)
Will let you do it after I get through some more later today. SandyGeorgia (Talk) 13:52, 10 July 2007 (UTC)

[edit] Random comments

Continuing from Causes ... a lot of this is the kind of smoothing out that Tony or Colin would be good at ... the article is quite good, but the prose could still be reviewed to really polish it to a squeaky shine (not my strong point ... but highlighting some areas for attention, feel free to ignore if not helpful):

... but in most cases its etiology is not yet known. It's known for some cases ? This is perhaps spelled out later in the text, but may leave the reader confused at this stage. Not sure how to best fix this ...

Yes, it is known in some cases. Maybe 10–15% if you assume today's bleeding-edge technology (which most people don't use or even know about). One estimate (quoted in the article) is that the percentage will rise to at least 30–40% with near-future advances. Perhaps this can help you suggest a rewording? Eubulides 20:39, 10 July 2007 (UTC)

Tracking down the causes is often hard, because autism should perhaps not be seen as a single disorder, but rather as a triad of core aspects (social impairment, communication difficulties, and repetitive behaviors) that have distinct causes but often co-occur. Tony can help with this kind of sentence. The "because" isn't working, and while I can figure out what the sentence is trying to say, it makes my brain hurt. But I'm not good at fixing this sort of thing.

Perhaps change "because" to "as?" Eubulides 20:39, 10 July 2007 (UTC)

It can happen that parents first notice autism symptoms near a routine childhood vaccination. I can see the problem you're having here, but this sounds too passive. Reword to more active voice ?

Suggestions welcome. The point I want to preserve is the serendepity between autism symptoms and vaccinations. Eubulides 20:39, 10 July 2007 (UTC)

The overwhelming majority of scientific evidence shows no ... Agree, but it's usually safer to avoid words like "overwhelming" and "vast" majority. Can we just say, "Scientific evidence shows no ... "? The rest can be viewed as redundant, and might attract undue (over)focus on the passage. (I think I saw a "vast" majority somewhere else yesterday? By the way, these are only suggestions ... )

The "overwhelming" phrase comes from the cited source. It might be best to use the same adjective as opposed to trying to paraphrase it, as this is a contentious area. The exact quote from the abstract is "In particular, some have suggested an association between the Measles-Mumps-Rubella vaccine and autism. Our literature review found very few studies supporting this theory, with the overwhelming majority showing no causal association between the Measles-Mumps-Rubella vaccine and autism." Eubulides 20:39, 10 July 2007 (UTC)
Ah, that's good news. Because this is a contentious area, how about using the quote parameter on the cite template to include that exact quote, lest it's challenged in the future? (I don't want to suggest rewording on some of the other areas. Since I don't have the sources, and am not that well-versed in autism, I'd rather leave wording to others.) SandyGeorgia (Talk) 20:45, 10 July 2007 (UTC)
That quote's a bit long. But if the citation is challenged often enough, it'd make sense to put it in as you suggest. How about if we wait and see? Eubulides 21:09, 10 July 2007 (UTC)

The problem can be divided into two areas: ... Can "the problem" be reworded? It's not really a problem ... is it?

Changed to "Its mechanism". Eubulides 20:39, 10 July 2007 (UTC)

Can these two thoughts be somehow combined with different punctuation or structure? Brain weight and volume and head circumference are greater in autistic children, but <snip> ... It may be due to poorly regulated growth of neurons.

Suggestions welcome. The two sentences come from different citations which is why they're separate now. Eubulides 20:39, 10 July 2007 (UTC)

... might possibly help cause ASD in some cases ... Very weasly. How about just "might cause some cases of ASD"? However, given the lack of data in this area it is still hard to draw conclusions about the role of immune factors in autism. There is insufficient data to draw conclusions about ... ?? I know this is dicey territory, but perhaps it can be less weasly?

  • For the first quote, I changed "might possibly" to "potentially could". Some weasel words are appropriate here, as the cited source says "There is potential that such aberrant immune activity during vulnerable and critical periods of neurodevelopment could participate in the generation of neurological dysfunction characteristic of ASD." Eubulides 20:39, 10 July 2007 (UTC)
  • For the second quote, the cited source says as the first sentence of its conclusion, "Although various immune system abnormalities, involving both cellular and humoral aspects of the immune system, have been reported in children with autistic disorder, previous studies are largely association based, and it remains difficult to draw conclusions regarding the role of immune factors in the etiopathogenesis of this neurodevelopmental disease." Suggestions welcome for summarizing this in a less-weasley way, but the area is pretty uncertain now and we don't want to give a false impression of certainty. Eubulides 20:39, 10 July 2007 (UTC)

... distortion in the development of the MNS interferes with imitation ... "interferes with learning by imitation"? Not sure ... don't know this territory, but laypersons (like me :-) could use a few more words to help us out before diving into subsequent explanation.

The cited source doesn't say "learning". It says "Considering the factors discussed in previous sections, such dysfunction could prevent or interfere with imitation, or perhaps more fundamentally, lead to the ‘impaired formation/co-ordination of specific self-other representations’ proposed to lie at the root of the cascade of autistic problems [21]. This in turn could explain the failure to develop reciprocal social abilities including shared/joint attention, gestural recognition and language (particularly the social/pragmatic aspects that Rogers and Pennington [21] note are the most affected), as well as breakdowns in the development of empathy and a full ToM." I condensed this down to "interferes with imitation and leads to autism's core features of social impairment and communication difficulties"; does the fuller quote help you to suggest a better condensation? Eubulides 21:09, 10 July 2007 (UTC)

... in MNS regions of ASD patients, ... Must this say "patients" or can it say "individuals with ASD"? Not sure if you intend to highlight a clinical or referred population, or if it's just semantics?

The source says "patients" but this isn't relevant. I changed it to "individuals". Eubulides 21:14, 10 July 2007 (UTC)

ack ... I got lost in here ... can you simplify? The underconnectivity theory of autism hypothesizes that autism is marked by underfunctioning higher level, or integrative, neural connections and synchronization, along with an excess of lower level processes.

Simplified it to "The underconnectivity theory of autism hypothesizes that autism is marked by underfunctioning high-level neural connections and synchronization, along with an excess of low-level processes." Eubulides 21:17, 10 July 2007 (UTC)

There's no definition of these terms at these points, and no links ... we can't assume knowledge of terms like "systematize" ... Hyper-systemizing hypothesizes that autistic individuals can systematize by processing law-governed events, ... It's sort of discussed at EQ SQ Theory, but could be better flushed out earlier in this article.

Thanks, I reworded it to explain "systematize". Eubulides 21:28, 10 July 2007 (UTC)

oh, for gosh sakes, yet another deficiency in Wiki content—we have no article on executive dysfunction and it's a redirect to the executive system, which never clearly discusses or defines executive dysfunction (we need a separate article). Executive dysfunction hypothesizes that autistic behavior results in part from deficits in flexible planning, working memory, and impulse control. I get lost here because executive dysfunction is a (diagnosis? entity?) that involves more than autism, but the way the sentence is worded, combined with the lack of an article on ED, leaves the impression that executive dysfunction is an autism-only construct. One strength is predicting stereotyped behavior and narrow interests ... One strength of what/whom? I really got lost here. Posting some to continue reading ... SandyGeorgia (Talk) 18:05, 10 July 2007 (UTC)

We need to fix Executive dysfunction at some point, yes. "Executive dysfunction" is supposed to be a theory here. I added some "of this theory"s to try to make the strength comments clearer. All the theories, including executive dysfunction, are broader than autism, but it's fair to say that all of them are closely related to and/or motivated by autism. Eubulides 21:37, 10 July 2007 (UTC)

Any delay in evaluation may delay early diagnosis and treatment, .. Any delay may delay ...

A pediatrician commonly performs stage 1 of a diagnosis ... As a layperson, I'm not familiar with this terminology, if these stages are medical-speak, do we have a link or definition?

I rewrote it to get rid of "stage 1" and "stage 2". They are not standard medical terms, and different sources use different phrases. For example, the NICHD flowchart says "Level 1" and "Level 2". I switched to "preliminary investigation" and "diagnosis and evaluations". Eubulides 21:49, 10 July 2007 (UTC)

Medications are sometimes used to treat severe behavioral problems associated with ASD. This gets us back to the discussion above. What are these "severe behavioral problems associated with ASD?" Have we defined them sufficiently prior to this point?

The previous discussion has been changed to give numerical estimates for severe tantrums, aggression, and self-injury; is that good enough? Eubulides 22:19, 10 July 2007 (UTC)

For example, serotonin reuptake inhibitors and dopamine blockers ... Can't believe we don't have an article for dopamine blockers, should drop a note to the pharm project. Just noticed I had the same issue at Treatment of Tourette syndrome, where I had to word around it.

Most children with autism lack social support, meaningful relationships, future employment opportunities or self-determination. Is this also true for Asperger's, and is that within the scope of this article or separate? Prognosis is a depressing read; is there something positive that can be reported? Something that predicts a better outcome?

Yes, the prognosis is what stood out when I read the current version of this article (which is much improved from a couple of weeks ago, BTW!). I hope this isn't considered "original research," but I took a crack at this. The subjects of the Howlin et al. study were diagnosed between 1950 and 1979, before intensive early behavioral was available. Therefore, the prognosis for recently diagnosed children may not be as grim as implied by this study. The Newschaffer et al. epidemiology review (2007) briefly addresses this issue on p. 237. NighthawkJ 19:45, 10 July 2007 (UTC)
oops, Nighthawk, sorry—I added a fact tag before reading the talk page. Perhaps the statement you added can be better cited to the Newschaffer source? I don't have the sources, so not sure how to best cite that. SandyGeorgia (Talk) 20:14, 10 July 2007 (UTC)
Sorry, I should have cited Newschaffer when I initially added the statement. I added the reference. NighthawkJ 20:29, 10 July 2007 (UTC)
The "Most children with autism" comment refers to autism not to ASD, since the cited reference is about autism proper. NighthawkJ, thanks for relieving the grim prognosis with the Newschaffer citation. I modified it to mention that changes in diagnostic practice also cast some doubt on the grimness of the Howlin study (a point that Newschaffer also makes). Eubulides 22:19, 10 July 2007 (UTC)

The sex ratio is greatly modified by cognitive impairment: it may be close to 2:1 in cases with mental retardation but more than 5.5:1 without. I had to work through this several times: brain hurt :-) Twice as many boys as girls when there is MR, but five times as many boys as girls when IQ is normal. Why? Girls with normal IQ aren't getting accurately diagnosed?

I haven't seen any studies that would confirm that theory. There have been several recent prevalence studies, using fancy techniques like capture-recapture and active ascertainment, but nothing I've seen recently indicates less-accurate diagnosis for girls. Eubulides 22:39, 10 July 2007 (UTC)

It remains controversial whether some of the increase was real. Slipping into passive voice on the controversial sections :-)

I changed it to "It is not known whether any of the increase was real." Still passive, but worded more neutrally and accurately I hope, and matches the caption and the lead section better. Eubulides 22:39, 10 July 2007 (UTC)

A few examples of autism and its treatment can be found from long ago, before it was named. Don't like this sentence. Can't explain why. Maybe Colin or you can fix.

Perhaps remove the "ago, "? That would make it shorter, anyway. Eubulides 22:40, 10 July 2007 (UTC)

OK, that's too much nitpicking from me: I think you're ready for uninvolved editors to give fresh input via peer review. SandyGeorgia (Talk) 18:41, 10 July 2007 (UTC)

[edit] What about later?

The current Wikipedia article only describes autism in childhood, but what about later on when this autist child grows up? with and without treatment? I'm really interested.

The article does focus on childhood, but it also mentions adults half a dozen times. You might want to look at Autism#Prognosis and especially Autism#Cultural references. I'm sure these sections could stand improvement; suggestions are welcome. Eubulides 23:00, 5 July 2007 (UTC)

[edit] Treatment costs context

It's unclear how the costs indicated in the article relate to the costs associated with neurotypical children (childrearing, medical etc.) ? Also, can the wording "autistic case" be avoided in terms of person-first language? SandyGeorgia (Talk) 16:26, 8 July 2007 (UTC)

Thanks for catching that; I reworded it. Eubulides 18:34, 8 July 2007 (UTC)
Much clearer now (I'm only keeping up sporadically—am eyeing Asperger syndrome, which is now in much worse shape). SandyGeorgia (Talk) 18:53, 8 July 2007 (UTC)
I hope that's because Autism is getting better and not because Asperger syndrome is getting worse! Anyway, I still have some work left to do in Autism#Characteristics and in the lead. Once that's done, what step do you suggest next? Wikipedia:Peer review? The goal is to bring Autism back to featured article status with a minimum of effort. Eubulides 19:24, 8 July 2007 (UTC)
Autism is getting better and AS is getting worse :-) I suggest making the full round before approaching FAC, even though it's more effort. A messy FAC is not what you want. TS had a clean FAC because so many eyes had seen it before I approached was dragged kicking and screaming by other editors to FAC. First, go to peer review. Wait a long time (they're slow—while you're waiting you can work on AS or copyedit Schizophrenia :-) Second, go for GAC—another wait. Once all that polishing is done, post a note at the Psychology and Medicine Projects to get more eyes. Then go for FA. That may be the long route, but will eliminate messy surprises while at FAC, and result in a productive candidacy. SandyGeorgia (Talk) 21:34, 8 July 2007 (UTC)
Sandy's advise is sound. I recommend advertising any peer-review on {{MCOTWannounce}} (though I'm not sure how many people are watching that) and on the talk pages of the medicine wikiprojects. Also, prior to FAC you should find someone good to copyedit the text as any weak points will be picked upon. I'm sure Sandy and I will be willing to review the prose but neither of us would claim to be expert copyeditors. I'm not sure how necessary GAC is. If there are medical areas that you have doubts about (e.g. in sections you haven't revised) then there may be folk on the medical wikiprojects who can help.
Let me know when you think it is getting stable, and I'll have a closer look. Colin°Talk 21:48, 9 July 2007 (UTC)
I don't think GAC is a necessary step at all, and it can be a waste of time, but I view it as another step towards developing broader support for the article. I didn't submit to PR or to GAC, and was surprised in both cases to find someone else had submitted TS while I was traveling, but Tim Vickers' GA input turned out to be helpful, and Dwaipayanc was wonderful at PR. When given enough time, Tony is an excellent medical editor. I got in line and waited months to collaborate with him, and was very pleased with the help he gave me. But you have to be patient :-) In hindsight, the long route was worth it, and made for an easier FAC. SandyGeorgia (Talk) 02:40, 10 July 2007 (UTC)

[edit] Unsourced, removed

Son-rise is a programme first establised by Barry Kaufman which can completely cure children of autism. His son Raun was very severly autistic, with the professional doctors telling Barry and his wife, Samahria, to put him in a home, as they thought he had no hope. Barry and Samahria did not want to put their son in a home. It is quite amazing how they both discovered this treatment, one of Raun's repetitive behaviours was rocking back and forth, and one day Samahria sat down with him and started to rock back and forth with him. For the first time he looked her in the eye - something he previously did not do. Obviously this was a very emotional moment for Samahria, and she and Barry took this to the next level, realising that you shouldn't force autistic children into a non-autistic world, it simply does not work. Instead you should try to copy them, and by doing so, enter their world, so that they know there are people in their life, they know they are not alone. Raun is now completely cured from autism after hours of the 'Son-rise' programme treatment, with Samahria relating to her son, and Barry observing, and therefore seeing what needs to be improved. I saw a lecture of Raun's, explaining his whole situation, and it was so incredible to see how someone who was completely locked in their own world, who could not speak, could now talk and even make jokes. A child who could not socialise in anyway had turned into one of the most sociable people I have ever met. There is no way you would be able to tell he ever had autism. So if that is not a cure, what is?

I removed the unsourced essay above. SandyGeorgia (Talk) 21:08, 9 July 2007 (UTC)

By the way, Son-Rise. SandyGeorgia (Talk) 05:43, 10 July 2007 (UTC)

[edit] Fractions

I left inline comments on a few fractions. WP:MOSNUM#Numbers in words says they should be spelled out in words, which makes sense, since they display awfully on my laptop monitor. I didn't fix them all since MOS doesn't say whether fractions are hyphenated. I left a question for Tony. SandyGeorgia (Talk) 22:37, 10 July 2007 (UTC)

Thanks, I changed the rest to words too. We can add hyphens later as needed. The style guides I consulted disagree about the hyphens. Eubulides 06:57, 11 July 2007 (UTC)
Tony mentioned hyphens, so you might want to check that MOS page before going to FAC. SandyGeorgia (Talk) 02:59, 14 July 2007 (UTC)
WP:MOS#Hyphens doesn't seem to have anything directly on point. Eubulides 08:01, 14 July 2007 (UTC)

On a separate MOS question, I think WP:MOSBOLD says that the list at Autism#Repetitive_behavior should be bolded rather than in italics. SandyGeorgia (Talk) 02:59, 14 July 2007 (UTC)

Thanks, I fixed that. Eubulides 08:01, 14 July 2007 (UTC)

Image:Autismbrain.jpg has a bad tag that probably will get scrutinized at FAC; if you need help, Durin (talk · contribs) is good at Fair Use. SandyGeorgia (Talk) 23:51, 17 July 2007 (UTC)

Thanks, I hope I fixed that now, here. Eubulides 01:44, 18 July 2007 (UTC)
Nice! (I don't speak images; they scare me to death.) 01:47, 18 July 2007 (UTC)

[edit] Size check

In case it comes up at FAC, per WP:SIZE, size is perfect, a bit of room to grow if needed. Per Dr pda's page size script:

  • Prose size: 35 KB
  • Ref size: 18 KB SandyGeorgia (Talk) 08:32, 14 July 2007 (UTC)

Saving this here for reference: version that came to FAR November 2006. SandyGeorgia (Talk) 15:50, 17 July 2007 (UTC)

[edit] Merging "Early infantile autism" into "Autism"

Early infantile autism was Kanner's name for what is now known as autism. All the material in Early infantile autism is discussed in Autism, and Autism mentions the origin of the term early infantile autism, so the Early infantile autism page is superfluous and should be a redirect to Autism.

Another page Regressive autism can serve as a good home for the issue about whether regressive and non-regressive autism are distinctive subtypes. But that issue is better served by having that one page, not two different pages.

Eubulides 17:03, 17 July 2007 (UTC)

Concur with merge and redirect; this is one of many examples of autism information that is unnecessarily split into daughter articles and should be merged/consolidated. SandyGeorgia (Talk) 17:40, 17 July 2007 (UTC)
OK, thanks, it doesn't seem to be contentious so I'll do the merge. Eubulides 16:16, 19 July 2007 (UTC)
I got a request to keep the discussion open for a reasonable amount of time, so I undid the merge for now. Eubulides 20:27, 19 July 2007 (UTC)
After two weeks there has been no discussion other than concurrence, so I did the merge. Eubulides 16:36, 31 July 2007 (UTC)

[edit] Hypothesis on Autism

New Scientist: Magazine issue 2610 (Abstract)

Web removes social barriers for those with autism

27 June 2007 Celeste Biever

TO CHAT to Torley Wong is to whirl from one delightfully unrelated topic to the next. Within a few minutes we are discussing the video of him dancing on YouTube, what it is like to be bullied, and his recent joy at finding a clock in precisely the same colours as a watermelon, his favourite fruit.

We are not chatting face-to-face, instead we are typing messages to each other inside the virtual world Second Life. As we type, our animated representatives, or avatars, nod their heads at each other on the screen.

Wong has Asperger's syndrome, a form of "high-functioning" autism...


Hypothesis: Autism will be increasingly understood and provided with adaptive solutions through a reconciliation of Humanity and Technology.
Method: The combination of approaches taken from the Evolutionary Algorithm, Neural Networks, Lemmatisation and similar Computational Linguistics technquies, empowered through emergent analytical meta model techniques provided by consortium such as the Object Management Group which aim to capture and model complexity, directly applied to a study of the evolution of communication in emergent Folksonomy technologies. They will achieve that because most have someone they know and Love with Autism.

In-Limbo 12:30, 20 July 2007 (UTC)

The original reference would be nice for the info contained therein, but the stuff below the line looks like original research - if you put it together and thought it up yourself, it is not suitable for inclusion. It's a bit difficult to understand what you would like to happen with this information, could you clarify please? WLU 17:30, 20 July 2007 (UTC)
Also, the stuff above the line is already very briefly summarized in the article under Autism#History and the article already contains the Biever citation. This article is not really the place for lots more detail about the Internet and autistic culture; a better place would be Sociological_and_cultural_aspects_of_autism, which Autism#History refers to. Eubulides 20:27, 20 July 2007 (UTC)

Duly noted, will consider citations in conjunction with the applicability of moving references to the sociological and cultural aspects of autism and will tidy accordingly. Thankyou for the practical display on the folksonomy aspects.

In-Limbo 17:13, 24 July 2007 (UTC)

[edit] Fuddy22's "Autistic Teenager" photo

I removed the following picture which was captioned "Photo of a highly functional autistic teenager":

Image:Autism.jpg

I left the following note on User_talk:Fuddy22 and his/her response below:

I reverted your picture of "a highly functional autistic teenager I know." The picture is inappropriate, too large, in the wrong place, and we only have your word that the person is actually autistic. Notwithstanding all of that, the picture adds nothing to the article. -- Cecropia 22:46, 21 July 2007 (UTC)

Okay, so tell me how to prove that he is autistic. Should I have him show up at your house and arrange all the items on the desktop of your computer? If it is too large I will crop it or shrink it. If it is in the wrong place then tell me WHERE is the right place. Otherwise HOW is it inappropriate? All of the other pictures on the page show small children with autism, why is it inappropriate to show a picture of a teenager? [unsigned]

--end of copied material--

In addition to the comments I made above:
  • the picture does not add to the article because it is simply a person picture. There is no characteristic appearance of Autistic people as there is in other disorders. They may appear completely unremarkable and, if their stereotypical behaviors are not displayed, someone meeting them may not have a clue that they are atypical, or if they seem to be different, that their atypical nature is the result of Autism;
  • The picture could be of any teenaged boy;
  • No real name is given of the photographer or the subject, and you assert that you are not the photographer, but the photographer has given permission to use the picture. Even if you were the photographer, your only edits are related to this picture, so you are not a contributor who is known to the community, meaning that the community has judge the poster's veracity: i.e., you have no track record here. In short, the photographer him/herself must release the photo to Wikipedia under these circumstances;
  • Especially since you are not the photographer, and the person could easily be identified, there is a privacy issue involved. I have a high-functioning autistic daughter and she wouldn't want her picture posted because she does not identify Autism as being the core of her being, and wouldn't care to be held up as an example;
  • You say you have permission to post the photo, but you claim "fair use." It is not a published photo. You would have to have the photographer release it under either Public Domain or other rights protocol used by Wikipedia. -- Cecropia 03:08, 22 July 2007 (UTC)

I agree that the image is inappropriate. The image would not contribute anything to Autism, and should not be used regardless of whether it is a hoax or has copyright problems. The article could certainly use a good image for adult autism, but this isn't it. Eubulides 04:15, 22 July 2007 (UTC)

[edit] Omitting inline citations from the lead

The lead for Autism currently has 11 citations, each of which is duplicated in the main text. These citations make the lead look forbidding, due to all those raised square brackets and the corresponding little formatting glitches. Since the lead is supposed to encourage you to read the rest of the article, I'd like to remove its inline citations; people who want the citations can find them in the main text.

This topic recently came up in WP:LEAD, and the consensus there is that it's OK to omit citations from the lead so long as the citations are in the body, and that it is more of a style issue as to whether to put duplicate citations in the lead. See WP:LEAD#Citations. Any thoughts about omitting citations in Autism's lead? Eubulides 18:51, 22 July 2007 (UTC)

I'll have a look at WP:LEAD#Citations later, but my gut reaction is to leave them in. This is a controversial article, the lead makes several controversial claims. This lead is far more complex than e.g. a paragraph outlining the biography of a well known person. It is an attempt to condense an extremely big topic into a few paragraphs. Each sentence is a careful summary of the key points of a topic. That's one reason I gave it a thorough going-over at peer review. When this article see more eyes, believe me, you will be defending each word in the lead. Keep the citations - they are part of your defence. Colin°Talk 19:17, 22 July 2007 (UTC)
I'm not proposing to delete any citations; all of the citations would still be present, it's just that they would be cited in the body and not in the lead. It's really more of a style question, not a contents question. One possible intermediate position would be to cite just "the vaccine theories have no convincing scientific evidence" claim, and leave the rest of the lead's claims uncited in the lead. I'm not aware of serious controversies about the other claims made in the lead (I may be naive here, but I'll willing to be naive until proved wrong…). Eubulides 20:15, 22 July 2007 (UTC)
Watch out for naive; it can get you badly (don't I know :-) Yes, it's very controversial. Take the safest route on this. SandyGeorgia (Talk) 20:33, 22 July 2007 (UTC)
I should have been clearer. I see the citations are reused later and didn't mean for you to drop sources. I have to chuckle a bit here. Eubulides, imagine someone comes along and examines your lead word for word; questions each phrase; investigates every sentence. At bit like, oh I don't know, TS Epidemiology :-). It would be rather handy to be justify your words with direct citations than having to explain first that it is a fair summary of a later section, and then explain why the section is a fair reflection of its sources. As for controversies, the lead is packed with them: Is it a disorder; is it caused by genes or MMR; is early intervention worthwhile; is there no cure; are those prevalence figures accurate; and finally "It is not known whether prevalence has increased as well" is the biggest controversy of them all.
I'm being thorough on peer-review because I want this article to succeed at FAC. I want Google "Autism" to find a great, readable, accurate, NPOV source of information for the "general reader". I'm really pleased you've taken this on. It is a shame we don't have a knowledgeable neurologist or other autism expert to check things. You'll have to make do with amateurs like Sandy and me, doing our best. Colin°Talk 23:14, 22 July 2007 (UTC)
Sorry I haven't been around much to help, Eubulides. This is a controversial area. On TS, I cited anything that was likely to raise eyebrows, but tried to keep the rest of the lead general enough that nothing was "challenged or likely to be challenged". Unfortunately, this is a Wiki-political tightrope you'll have to walk. SandyGeorgia (Talk) 19:26, 22 July 2007 (UTC)
No need to apologize; your help is always appreciated. Eubulides 20:15, 22 July 2007 (UTC)

[edit] GA review?

By the way, what is your thinking on GA? Tim Vickers is the best GA reviewer for this article, and his input could be very useful at this stage. SandyGeorgia (Talk) 19:26, 22 July 2007 (UTC)

I think the article is ready for GA review now. The last comment made on the peer review page was Colin's, about 4 days ago. He ended "To be continued…", I guess meaning he would finish reviewing Autism#Epidemiology and then review Autism#History at some point, but hasn't had the time yet. Autism#History does have a "mergefrom" header in it, but that shouldn't affect a GA review I would think, as the merge wouldn't affect Autism itself. With all that in mind do you think we should ask for a GA review now? To some extent I'd rather get this over with while my neurons still remember all 101 references…. Eubulides 20:15, 22 July 2007 (UTC)
It's OK to be at peer review and GAC at the same time. Tim is such a good reviewer that it would be great to get him, so it's a matter of timing. How can I say this; I'm worried that you'll put it up at GAC and someone else will pick it up before Tim, since there's a GAC contest on right now. I'm not sure if it's "proper" to ask Tim in advance to pick it up. Colin, what do you think? I'm just not aware of other GA reviewers who will give it a going-over as thorough as Tim will; anyone can pick it up and give it a quick pass, since it's clearly GA. SandyGeorgia (Talk) 20:36, 22 July 2007 (UTC)
I do intend to finish the peer review. Sorry it is taking so long. Real-life, etc. Has it been four days! I know nothing about GAC. Perhaps you can request specific skills/experience from your reviewer (e.g. asking for someone who has experience of reviewing this kind of article, and is aware of the issues/controversies involved). If all you want are Tim's suggestions, then ask him direct for his suggestions, and don't confuse the two. Colin°Talk 22:49, 22 July 2007 (UTC)
Good idea; I'll leave that decision to Eubulides, though. SandyGeorgia (Talk) 23:02, 22 July 2007 (UTC)
Thanks, I asked him for his opinion and suggestions and he has edited the lead. Wow, he's good. I have minor quibbles and will follow up on them. Eubulides 01:14, 23 July 2007 (UTC)
Hah! I see now that Tim's rewrite of the lead added two "but"s, one of which I had removed in response to Colin's earlier request. Maybe the article's low-"but" diet was too severe after all? I'll wait a bit before jumping back in, in case he's still editing. Eubulides 01:24, 23 July 2007 (UTC)

I just had a quick glance; you may get some reviewer at FAC who only "looks at the pictures". This image caption may generate a comment:

The number of reported cases of autism increased dramatically in the U.S. from 1996 through 2005. It is not known how much, if any, of this increase was real.

Not all readers will understand "increase was real"; maybe a few more words that will help the layperson who looks at the image captions. SandyGeorgia (Talk)

  • The intent was "Here's the graph, but we don't know whether this increase was real." I don't know how to make it clearer without making it a lot longer but if you can think of good wording please let us know. On the theory that it might be challenged I added a citation; perhaps that will help. Eubulides 01:14, 23 July 2007 (UTC)

[edit] a typical vs. atypical

Hey, I made a change to the "other symptoms" section to the article "autism" by placing a space between "A" and "typical" and someone reverted it. What does "atypical" mean? Sean90 19:44, 23 July 2007 (UTC)

Atypical means "not typical." :) .V. [Talk|Email] 20:15, 23 July 2007 (UTC)

Yeah, I thought so. Sean90 02:28, 24 July 2007 (UTC)

"Atypical" is a word invented by those with neurotypical syndrome to describe those who don't meet their perfect standards. If someone finds people not as interesting as objects or animals, they're "atypical". Yes, if animals or objects are the only object of someone's attention then they should be checked out but if they just happen to find these things somewhat more interesting than certain people, "atypical" just goes too far. Scorpionman 23:51, 26 July 2007 (UTC)

[edit] "However"s and "but"s

The lead was just rewritten to add "however"s and "but"s, even though a recent peer review noted that the article uses "'but' a lot, which reads like the text is having an argument with itself". I just now changed the following text in the lead:

"Many other causes have been proposed, but these proposals are generally controversial. One proposal is that the disorder is due to the exposure of children to vaccines; however there is no convincing scientific evidence to support the vaccine hypothesis."

(which had a "however" and a "but") to this:

"Many other causes have been proposed, such as exposure of children to vaccines; these proposals are controversial and the vaccine hypotheses have no convincing scientific evidence."

which is briefer and has no qualifiers. Unless I'm missing something (and I may well be) shorter is better in this area. Eubulides 21:05, 23 July 2007 (UTC)

Wikipedia:Words to avoid mentions "however" but not "but". Not all uses of "but" are problematic. When two alternatives are contrasted in a way that implies the second overrides the first (to a greater or lesser extent) then there is the potential for subtle POV to creep in. I think using a neutral conjunction or semicolon can help make each half appear balanced. Even this isn't necessarily enough if one POV is expressed over-firmly.

Having said that, TimVickers is an editor I greatly respect. I would be interested to know his opinion. Colin°Talk 21:27, 23 July 2007 (UTC)

Here's one example. Tim put in the "However" in the last sentence of the lead, but it appears to me that it's unnecessary now (this may be due to later modifications in this area). Here is the quote: "The number of diagnosed autism cases has increased dramatically since the 1980s. Some of this increase is undoubtedly due to changes in diagnostic practice. However, it is not known whether prevalence has increased as well." How about deleting that "However"? I left it in mostly because of Tim's reputation.… Eubulides 23:46, 23 July 2007 (UTC)

Don't bother about my "reputation" my grammar is really no better than yours! :) Edit away! Tim Vickers 18:11, 24 July 2007 (UTC)

[edit] History on top ?

Why did Derek.cashman move History to the top? I disagree, per long-standing discussions on the Medicine Project and WP:MEDMOS. I don't understand his punctuation changes either. SandyGeorgia (Talk) 21:21, 23 July 2007 (UTC)

[edit] GA Passed

I have passed this article according to the Good Article Criteria. I feel it is an excellent article, and was also very interesting to read. It's informative to the outside reader, and I hope that it will continue to be improved further. Although there are many sources, it might help to in-line cite more sentences. Usually these are covered by sources cited elsewhere, but it would be good to cite them everywhere a citation might be necessary. Keep up the good work! Cheers, Corvus coronoides 20:15, 24 July 2007 (UTC)

[edit] Copy-editing

Hi all. I'm going to be making intermittent copy-edits and try to work my way through the article. I'm not fact-checking or correcting anything, but just trying to make what I understand as the meaning a bit more clear and less technical. Please check this as I go along and make sure I don't introduce any inaccuracies. Thanks Tim Vickers 03:39, 25 July 2007 (UTC)

Thanks for the help; I made some followup changes. On a related subject I have also been editing Causes of autism, but that's another huge project and it won't be ready for serious review for quite some time I expect. Eubulides 04:27, 25 July 2007 (UTC)

[edit] over-diagnosing

I find it extremely repulsive that people have to have everyone always focusing on them. It's so selfish! If a person gets preoccupied with color or patterns on an object, somebody finds it offensive because he is not always constantly on the receiving end of everyone's attention! And they call it autism. Someone is not completely focused on people all the time, he's an autistic! They really over-diagnose these things, and most of it's based on egotism. This article (just so you know that this comment is relevant) should stop catering to those who demand constant attention from everyone. Really, it matters little if someone finds an object or animal more interesting than a person. That does not serve as a basis for a diagnosis of autism, that's just selfishness on the part of the person who is not recieving the "autistic"'s attention. Scorpionman 23:43, 26 July 2007 (UTC)

Hi Scorpion; if you have a source for this content, we could all discuss a way to make the text more generalized. Regards, SandyGeorgia (Talk) 00:01, 27 July 2007 (UTC)

[edit] usefulness of epidemiological statistics

Text: "Autism's incidence is less useful a statistic than its prevalence, as the disorder starts long before it is diagnosed, and the gap between initiation and diagnosis is influenced by many factors unrelated to risk. Instead, attention is focused mostly on whether prevalence is increasing with time. Earlier prevalence estimates were lower, centering at about 0.5 per 1,000 for autism during the 1960s and 1970s and about 1 per 1,000 in the 1980s, as opposed to today's 1–2 per 1,000.[12]"

The first part of that is an unusual statement. I suspect it is simply wrong, but I don't know why it was written so I've not just changed it. Epidemiologists are likely to consider both incidence and prevalence as interesting and useful, but in different ways. Regardless of the incidence, the known prevalence of a newly noted disease will increase with time, at least until a human lifespan later or unless another diagnosis or division into diagnoses replaces the initial one. Changes in incidence related temporally to other events may suggest causation, and the planning of future services depends on current incidence, while the running of current services depends on current prevalence. The gap between the start of a disease and its diagnosis does not cause trouble beyond the book-keeping ones, for a disease induced early in life or present at birth the concentration is on birth cohorts (all the children born in a particular period, say 1983). Prevalence doesn't tell us much about risk, incidence is almost exactly that. Midgley 04:24, 27 July 2007 (UTC)

You are correct about incidence rates and risk, of course. The text attempted to summarize the following extended quote from the cited source (Newschaffer et al. 2007): "The most commonly reported measures of autism frequency are point prevalence or period prevalence. Incidence rates, despite their theoretical advantages for studying risk, are of more limited utility in autism epidemiology because not only is autism diagnosis distal to disease initiation but also time between initiation and diagnosis is likely influenced by a wide range of other factors potentially unrelated to risk. Cumulative incidence, however, may be informative for descriptive epidemiologic studies of birth cohorts." I made this change to try to clarify the point without going into too much detail. Epidemiology and service provisioning have somewhat different goals, and Newschaffer et al. have little to say about the latter; if we can have a reliable source on the latter then it would be nice to add. Eubulides 05:21, 27 July 2007 (UTC)
I don't want to sound too plonking, but "not only is autism diagnosis distal to disease initiation" - I know of no diseases diagnosed proximal to disease initiation. I'm not familiar with Newschaffer or al but that doesn't seem like an insight. Many - if not most - diseases are influenced by a range, sometimes wide, of other factors, potentially unrelated to risk also. A point of studying incidence rather than prevalence is that one can identify those influences. Newschaffer's an epidemiologist, yes? Midgley 00:17, 28 July 2007 (UTC)
I think the Newschaffer et al. quote is comparing autism to the likes of (say) strep throat, where disease initiation and diagnosis are separated by a matter of days, as compared to autism where the separation is months or even years. You're correct that this is not a huge insight—on the contrary, it's pretty obvious—but it does help to explain why incidence rates are less useful in autism epidemiology. The Newschaffer et al. "unrelated to risk" remark is about the time difference between initiation and diagnosis, not about the factors influencing disease. To learn a bit more about Newschaffer et al. you can visit its web page. You are correct that incidence rates for autism, if we knew them, would be more helpful for assessing risk, but the point of Newschaffer et al. is that we don't know them. To answer your last question, yes, Newschaffer is an epidemiologist: as Drexel's info page for him says, he chairs the Dept. of Epidemiology and Biostatistics at Drexel, and formerly was in the Dept. of Epidemiology at Johns Hopkins where he founded and directed the Center for Autism and Developmental Disabilities Epidemiology. Eubulides 00:47, 28 July 2007 (UTC)

[edit] Related content

We discussed this earlier in the development of this article. There's a proposal to merge stimming and stereotypy (psychiatry). My understanding has always been that they are subtly different entities, but I don't have the knowledge to explain further. Any help in resolving/clarifying? SandyGeorgia (Talk) 11:50, 27 July 2007 (UTC)

Discussion at Talk:Stereotypy (psychiatry). SandyGeorgia (Talk) 12:04, 27 July 2007 (UTC)

Now that you've fixed those, it could be tightened up here:

  • Stereotypy is apparently purposeless movement, such as hand flapping, head rolling, body rocking, or spinning a plate. Sometimes it is called self-stimulation or "stimming", though stereotypy and stimming are somewhat different notions.

SandyGeorgia (Talk) 21:37, 27 July 2007 (UTC)

Thanks, I fixed that by removing the 2nd sentence. Eubulides 23:46, 27 July 2007 (UTC)

[edit] Time for featured article candidate?

The recent peer review effort seems to be dying down. The last comment was by Colin four days ago; he's worked his way to the end of Autism#Epidemiology and has only the last section Autism#History left to review (I hope the autism treatment that Luther suggested didn't scare him off…). Wikipedia:Peer review currently lists Autism as 128th out of 147 on the list; at some point it'll fall off the end of the list, but I don't know when that will be. Tomorrow I plan to finish the merge with Early infantile autism as it will have been two weeks since the merge was proposed without any opposition (or even any discussion after the day of proposal). I hope Tim Vickers is still interested in reviewing but I realize his time is quite limited.

I consumed my recent free time cleaning up Causes of autism; it's now much better than it was and it's no longer embarrassing having it be the main article for Autism#Causes so I've now marked it as the main article rather than being "For further information". By the way, the Roberts et al. paper published today is quite the coolest result in years on autism's possible environmental factors but its results are too preliminary to be in the main article so I put it into Causes of autism.

Is there anything else that should get done before submitting Autism as a featured article candidate? Must this wait until Autism falls off the end of the peer review list? Eubulides 17:25, 30 July 2007 (UTC)

I think it's ready. If you want to remove the peer review from WP:PR, I'll add it to articlehistory here. SandyGeorgia (Talk) 17:57, 30 July 2007 (UTC)
Does it normally just fall off the end of Wikipedia:Peer review? That'd be OK, but if the existence of an outstanding peer-review request would hurt the FA chances then by all means let's move it. Eubulides 18:42, 30 July 2007 (UTC)
No, someone has to actually close the review; do you want me to do it and archive it? Technically, according to instructions at both places, you can't be at PR and FAC at the same time, so it must be closed if you're ready to go. I'll do it if you say the word. SandyGeorgia (Talk) 18:54, 30 July 2007 (UTC)
Thanks, please do. Eubulides 20:31, 30 July 2007 (UTC)
PS, the other you could do if you want is to request an A-class assessment at WikiProject Medicine. I'd say it's A-class, but I can't assess since I've been involved. A-class isn't a necessary step—only if you want. SandyGeorgia (Talk) 17:59, 30 July 2007 (UTC)
Thanks for the suggestion. How does that work? I visited Wikipedia:WikiProject Medicine, clicked on "Article rating", and found that it was a dangling link. How much delay is typical for the assessment process? I noticed you mentioned current efforts on Causes of autism and Heritability of autism on the talk page but so far it's just been you and me editing there. (I hope Causes of autism is passable now, but cleaning up Heritability of autism would be a big project, maybe even bigger than Autism was.) Eubulides 18:42, 30 July 2007 (UTC)
Well ... ummmm .... It doesn't work, yet :-) It's new. Better to post a talk page message at Wikipedia talk:WikiProject Medicine requesting an A-class assessment. SandyGeorgia (Talk) 18:56, 30 July 2007 (UTC)
OK, thanks, I did that. Eubulides 20:31, 30 July 2007 (UTC)

[edit] Draft of featured article nomination

Here's a draft for a featured article nomination for Autism.

Self-nomination. This former Featured Article was demoted on 2006-12-17 due to many {{fact}} tags, weasel words, undercitation, and lack of conformance to Wikipedia:Manual of Style (medicine-related articles). Since then it has been heavily rewritten to fix the above-mentioned problems, with the goal of making it the best encyclopedia-style reference for autism available anywhere. It has gone through a peer review and reached Good Article status. The article is 72 kb in total size, with 38 kb of readable text.

Comments and/or edits welcome; this would be only my 2nd FAC so I'm by no means an expert here. Eubulides 18:42, 30 July 2007 (UTC)

Be sure to link to the FARC in the nomination, indicating that it's an FFA that has already been on the main page. (See Wikipedia:Featured article candidates/Octopus card—this makes Raul's job easier.) I wouldn't mention evaluation of the daughter articles; that's not necessary. SandyGeorgia (Talk) 19:00, 30 July 2007 (UTC)
Strike. Silly me. I already set that up, days ago. Wikipedia:Featured article candidates/Autism. SandyGeorgia (Talk) 19:24, 30 July 2007 (UTC)
Also, the talk page has reached 80KB, so let me know if you want a month-end archive. SandyGeorgia (Talk) 19:27, 30 July 2007 (UTC)
Yes please, and thanks. And I struck out the sub-article sentence. Eubulides 20:12, 30 July 2007 (UTC)
Yes, archive the peer review, archive the talk page, or both? SandyGeorgia (Talk) 20:26, 30 July 2007 (UTC)
Both, please. Thanks. Eubulides 20:31, 30 July 2007 (UTC)

Eubulides, I added your draft submission text to Wikipedia:Featured article candidates/Autism, since I'm going to archive the page tonight. When you're ready to submit the FAC, you can edit that wording to whatever you like, and add your sig. SandyGeorgia (Talk) 16:39, 31 July 2007 (UTC)