Talk:Autism/History as of 2008 March 30

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Contents

Lead text

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

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

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

These characteristics may occur in all ASD's, but it's in Autistic Disorder that symptoms from across the entire triad must be present. That might be made clearer, perhaps with something like: "The presence of symptoms in each of these three area's distinguish autism from milder autism spectrum disorders (ASD) such as Asperger syndrome". Fenke (talk) 22:08, 19 November 2007 (UTC)
Good point, thanks. Even better, we can shorten "The presence of symptoms in each of these three areas" to "This set of signs", and I made that change. Eubulides (talk) 22:21, 19 November 2007 (UTC)
The goal behind those changes was to use simpler words, so that the article is less off-putting to non-expert readers. I see Colin's point about "repeated"/"repetitive" so I changed it back. I wanted to avoid "impairments" as it is a bit too fancy too. I don't quite follow Colin's point about "interferes with" (interference pretty clearly denotes a problem, not a bonus) but I changed it to "impairs". The statement that autism impairs communication is supposed to distinguish autism from the "no general delay in language" in Asperger syndrome. Eubulides (talk) 22:21, 19 November 2007 (UTC)
For some motivation behind these changes, by the way, please see WebMD's autism article, or HealthWise's. These articles are considerably easier to read than Autism, even though their technical quality is quite high. I don't think Wikipedia can match them in being easy-to-read (Wikipedia is much more ambitious, among other things), but on the other hand we can be easier to read, at least in the lead. Eubulides (talk) 22:21, 19 November 2007 (UTC)
I'll look again tomorrow, but just a quick explanation of "interferes": a two-year-old may interfere with the volume control on your TV. It might be louder or quieter, become distorted or just annoy the neighbours. Bad social interaction isn't always diminished/impaired: one can be too extrovert/opinionated/loud or even too friendly for ones own good (loss of self-control or fear of strangers). For definitions, we have to use precise language. I think both "impairs" and "impaired" are better than "impairment" for the reasons Eubulides gives. On the other point: delay is not the same thing as impairment, as it implies the possibility of achieving the same end-point. One's speech may be abnormally delayed but end up normal. Cognitive ability isn't mentioned in the lead. It is here, perhaps, that the difference between HFA and AS become difficult to explain. Colin°Talk 23:21, 19 November 2007 (UTC)
It's just a small thing (since we've changed it back to "impairs"), but a 2-year-old who interferes with your TV's volume control necessarily impairs the control of your TV's volume, and vice versa. I agree that "impair" and "interfere" have different meanings but the difference doesn't much matter here and "interfere" is more easily understood by more people. As for delay versus impairment, in both cases the article is using terminology taken from the diagnosis standards, which are designed so that AS and autism are mutually exclusive diagnoses. Admittedly there are judgment calls and in practice there is a fuzzy line between AS and HFA, but the big picture is that autism has major impairments with communication, while AS does not, and that is an important distinction between the two diagnoses. Eubulides (talk) 06:08, 20 November 2007 (UTC)

Link to nonexistent "Austimus" in Latin Wikipedia?

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

You mean we're supposed to check those things (d'oh)? Since it's not doing any harm, I'd suggest leaving a talk message for the editor who left it, and if s/he doesn't respond within a few days, then revert. SandyGeorgia (Talk) 05:58, 27 November 2007 (UTC)
Thanks, I left a note on that editor's talk page. This business about foreign-language links remains mysterious to me, as it's unclear whether they're supposed to be maintained by hand or by bots. Wikipedia:Interlanguage links #Links to pages that do not exist suggests that I may remove the link by hand, but other times I've fiddled with that section (by sorting it), a bot has undone the change. Eubulides (talk) 07:18, 27 November 2007 (UTC)
Whenever I encounter something about bots et al that needs an answer, my first stop is at Gimmetrow (talk · contribs)'s page; he seems to know everything about everything, in case you want to explore further. You could also ask at WP:VPT. SandyGeorgia (Talk) 17:03, 27 November 2007 (UTC)
I asked at WP:VPT #Link to nonexistent "Austimus" in Latin Wikipedia? and learned that the foreign-language links are a bit of a messy situation. Graham87 helpfully removed the link by hand, and I see that Duomillia (the original editor) just put the link back in, this time to a real (albeit brief) Latin page. An ironic thing here is that the word autism is in fact derived from autismus, a New Latin word that first appeared in 1910 (in a paper written in German, of course …). Eubulides (talk) 00:20, 29 November 2007 (UTC)
I will slowly work on this article in Latin, translating it bit by bit! :) --Duomillia (talk) 00:24, 29 November 2007 (UTC)

Fever and ASD

There's a new study out reporting that children with ASD who have a fever (body temperature greater than 38°C) have fewer symptoms of irritability, hyperactivity, stereotypy, and inappropriate speech. My kneejerk reaction is that this is a high-quality study but it's just one study and its implications aren't that clear, so it's probably not suitable (at least not yet) for inclusion in the article. Thought I'd mention it here, in case someone else thinks otherwise. It's not in Pubmed yet but here's a citation: Curran LK, Newschaffer CJ, Lee LC, Crawford SO, Johnston MV, Zimmerman AW (2007). "Behaviors associated with fever in children with autism spectrum disorders". Pediatrics 120 (6): e1386–92. doi:10.1542/peds.2007-0360. PMID 18055656. Lay summary – WebMD (2007-12-03).  Eubulides 04:53, 4 December 2007 (UTC)

I think that any high quality study deserves a mention; Wikipedia may be getting a reputation for quality but I hope it never becomes so well-reputed that it can't describe interesting research. On a more speculative note, I was curious whether MDMA, which transiently increases body temperature, could have a positive effect. While I didn't find any evidence of human trials, there's one group trying to collect Internet reports of whether people with Asperger's or high-functioning autism have noticed beneficial effects.[1] Of course, MDMA has potent psychotropic effects said to make people more "social", and they're thinking about that activity rather than the temperature rise. (Please note that I am not advising anyone try this drug, which has some indications of neurotoxicity) 70.15.116.59 (talk) 06:22, 7 December 2007 (UTC)
Autism does not have room enough to mention all high quality studies on autism. Pubmed reports 11,516 medical-journal articles about autism; even if only 20% are "high quality" that's over 2,000 studies, and there's no way we can mention them all. Please see Wikipedia:WikiProject Medicine/Reliable sources for the standards we are trying to meet here. I don't think Curran et al. 2007 quite meet those standards as they are merely a primary source (we prefer high-quality reviews) and their results are not that clear. As for MDMA, until reliable sources cover MDMA and autism we should not mention MDMA in the article. Eubulides (talk) 06:34, 7 December 2007 (UTC)
The guideline you mention does not say not to use primary sources, just not to interpret them on your own. As for the numbers, I don't think Wikipedia should be designed under a space constraint. It is possible to split articles if they grow too large - so people should add relevant, well-sourced data without trying to decide if it's the most important thing they could possibly say about a topic. (I don't actually think anything about MDMA should actually be added yet - it was just an interesting parallel to the fever study) It is not right that people should be out there waxing floridly on every weapon and monster in every version of a video game without restraint, but people editing autism should feel afraid to mention a good, interesting publication. Yes, there are 11,516 articles - and if you want to go through them all just look them up on PubMed. What Wikipedia has that PubMed doesn't is that it only lists the articles that some passing human being, for whatever personal reason he might have, has picked out as interesting - and I think that is actually worth quite a bit. Peer review for journals focuses on accuracy, with some attention to "significance" in the higher profile journals, but not really whether something is "interesting" in the most vulgar sense of the word. 70.15.116.59 (talk) 04:55, 9 December 2007 (UTC)
The guideline says secondary sources (such as high-quality reviews) are preferred; this helps resolve not only the problem of interpreting primary sources, but also in deciding which are important and which are not (which is the issue here). Wikipedia overall may not have a space constraint, but Autism does; it's already oversize and does not have room to contain reports of every new primary study on autism. Dozens of new primary studies are published every month, far too many to summarize them all on Autism. If there were some important reason to mention this particular study that would be another story, but I don't see it: it's merely a curiosity for now, and an unconfirmed one at that. Eubulides (talk) 05:55, 9 December 2007 (UTC)
For what it is worth, our daughter has Aspergers and we noticed that her behaviour was more modulated (she didn't act out as much) and was more passive after she was sick. We thought that she was just exhausted after using so much energy to get better. On another note, many children have "night terrors" and don't sleep well. My daughter seems to sleep through the night but will wake with dark circles under her eyes and always feel tired. I notice a lot of Aspie kids seem to have these dark circles. Their realities also seem to follow the rules of dreams. Are these children never fully asleep nor never fully awake?63.146.238.102 (talk) 02:54, 11 December 2007 (UTC)
The paper that started this thread said that the interesting thing wasn't that children are calmer when they have fevers (that is unsurprising); it was that their communication and socialization deficits improve. Autism #Other symptoms talks about sleep problems and ASD (not that this addresses your last question). Eubulides (talk) 03:08, 11 December 2007 (UTC)
ok, I could have been clearer. My daughter is also gifted (tested with a 132 IQ at age 3) so communication has always been advanced even compared to NTs. Normally he speech is drawn out on topics and there can be long pauses as her mind moves faster than her mouth. After a sickness, her speech is more relaxed & fluid. It is like she is "here" and not off in her own world. She also seems more empathetic of others rather than her "normal" egocentricity.63.146.238.102 (talk) 04:29, 11 December 2007 (UTC)

Other species

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

Strictly speaking no, since dogs and cats can't speak so the diagnostic criteria for autism proper do not apply. However there is a huge amount of interest in animal models for autism. That is a tricky area. Perhaps there should be a sentence about it in Autism? Anyway, here's a fairly recent review in case you want to explore the subject: Tordjman S, Drapier D, Bonnot O et al. (2007). "Animal models relevant to schizophrenia and autism: validity and limitations". Behav Genet 37 (1): 61–78. doi:10.1007/s10519-006-9120-5. PMID 17160702. 
Interesting to bring that up though, many autistics do speak and do not have speech delays (this has erroneously been called Asperger syndrome). What it brings to my mind is the experiments done on cats by Bernard Rimland which he talks about in his book Infantile Autism (1967). He removed or disabled the reticular formation of the brain in several cats. This is supposed to be an area that handles the ability to associate current sensory input with stored information, so that the current input makes sense. The cats exhibited several behaviors consistent with autism and discontinued them on being given regular doses of vitamin B6. I don't know about his followups on this although I assume there were some. --Bluejay Young (talk) 22:25, 9 December 2007 (UTC)
It's true that some people with autism speak without delays in development, but the diagnosis of autism does require at least one qualitative impairment in communication (one such impairment, for example, would be stereotyped and repetitive use of language), and I can't see a dog or cat satisfying this requirement. Rimland's 1960s work is not much cited these days; for example, Tordjman et al. 2007 don't mention it. Three randomized controlled trials have studied vitamin B6 in humans; the smallest one (8 individuals) found improved verbal IQ in the treatment group and the other two trials found no significant difference, so it's hard to say whether this approach has effects greater than placebo. See Angley et al. 2007 (PDF) and Francis 2005 (PDF). Eubulides (talk) 00:36, 10 December 2007 (UTC)

Neuropsychology

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

Is it covered in reliable sources? Further, are they high quality sources suitable for a medical article? If you have some sources, try posting them on the talk page for review and see what other editors say about them. WLU (talk) 14:58, 16 December 2007 (UTC)
I am having difficulty accessing Hobson's research via the internet (PsycInfo has nothing of his online, but I can view a long list of his published work). I will need to return from abroad before I can access the volumes that include his work, so I won't be able to do this properly until later. I should also look further into research into theory of mind deficit (Baron-Cohen, Frith, etc), as Hobson's theory puts ToM deficits secondary to a lack of 'affective resonance' development at an early age.--Ripcurlprfection (talk) 15:27, 16 December 2007 (UTC)
Sure, but if you're running into problems finding his research, he may not be suitable per WP:MEDRS. You could also try [www.pubmed.org pubmed]. WLU (talk) 15:37, 16 December 2007 (UTC)

Advancing Paternal Age and Autism

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

I have heard of that study, and all I want to say is that I believe it's the age of the mother rather than the age of the father that is correlated with autism. But of course, the people taking the questionnaire were men, so they went with what they got. Haplolology Talk/Contributions 14:21, 31 December 2007 (UTC)
On second thought (sorry, I only just clicked the link now) it looks like they have answered my objection, so nevermind. Haplolology Talk/Contributions 15:02, 31 December 2007 (UTC)

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

Suggested link

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

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

Autism and bullying

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

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

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

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

Question: Doesn't that study focus on the autistic subpopulation? Avb 12:54, 3 January 2008 (UTC)
The study merely says "children with autism". Its intro says "Children with autism are more likely to be victimized" (than neurotypical children are) and it cites Little 2001 (PMID 11556644) and Marini et al. 2001. Little 2001 is about Asperger's, not autistic disorder proper, so presumably Montes & Halterman 2007 are talking about ASD but are being a bit sloppy about it. Montes & Halterman 2007 also notes "many children with autism require treatment for aggression, suggesting that this population may be at high risk for aggressive behaviors, which may potentially include bullying." and cite Hughes et al. 2002 (PDF), McCracken et al. 2002 (PMID 12151468), and McDougle et al. 2003 (PMID 12672261). Eubulides (talk) 18:21, 3 January 2008 (UTC)
I guess I did not make myself clear. I wondered whether the study said something about bullying within the autistic subpopulation (i.e. the bullying of autistic children by autistic children) versus within the general population (i.e. the bullying of unspecified victims by autistic children). Avb 23:43, 3 January 2008 (UTC)
The latter. Eubulides (talk) 01:31, 4 January 2008 (UTC)
It's kinda hard to read without greater definitions - the only conclusion in pubmed is that kids with comorbid disorders are at increased risk for bullying behaviors, which I read as they bully more. The results section of the abstract I don't find particularly clear. I think the full article would be required to really state anything firm about the study. WLU (talk) 12:58, 3 January 2008 (UTC)
Agreed.
I looked around for some sources; it would be surprising if such an (IMO predominant) problem had not been documented in V RS. One example would be PMID 11934121. Admittedly this study (like the one above) reports on interviews with parents, but the questions asked are real enough and reading the abstract brought back some very painful memories of direct and indirect suffering. Avb 13:19, 3 January 2008 (UTC)
In view of the lack of sources found in PubMed searches, there isn't much by way of scientific research on the subject. This usually means one of two things: it's obviously nonsense so no serious scientist is going to bother with it, or it's obviously true. The former may lead to some negative mention in skeptic sources, that can be used to source Wikipedia content on pseudoscience and the like; the latter generally appears in books by experts and on parent/patient org/government/self-help web sites. Here's a Google Scholar search with a sampling of the latter. Avb 14:07, 3 January 2008 (UTC)
The source you cite, Little 2002 (PMID 11934121) is essentially the same study as Little 2001 (PMID 11556644), which I (just now) mentioned above. Given the number of studies on both sides of this issue (autistic children as bullies / as the bullied) I would prefer a reliable review on the subject to our guessing how to stitch together primary sources. Unfortunately, the best quote I've found on the subject in a reliable review is: "there is more evidence to suggest that children with AS occupy the role of victim rather than victimizer." Tsatsanis KD (2003). "Outcome research in Asperger syndrome and autism". Child Adolesc Psychiatr Clin N Am 12 (1): 47–63. PMID 12512398.  However, this source is about AS, not about autism in general, which is not good for Autism. Also, the review is careful to note that it's just counting papers, and that nobody has measured whether the increased bullying by children with AS outweighs the increased being-bullied. It's easy to speculate what the numbers would be (I certainly have my opinion), but we shouldn't be speculating in this article. Eubulides (talk) 18:21, 3 January 2008 (UTC)
Did you take a look at the Google Scholar search above? This source, for example, is good enough for me to source/attribute the above statement in the AS article, as it states: "This lack of social skills can and often does make students with Asperger Syndrome the object of teasing, victimization, and bullying by their peers". Another one summarizes Little 2001 as "there is considerable evidence that children with AD, because of their awkwardness and other characteristics, constitute easy targets for bullying by peers and others". I hope this helps you with the part of your question about sourcing the AS article and encourage you to check the search results for same regarding the Autism article. This looks promising to me. Avb 01:14, 4 January 2008 (UTC)
As far as I can tell, none of those three citations address autism and bullying. The first two are about Asperger's, not autism or ASD, and as sources are inferior to Tsatsanis 2003 which is already cited in Asperger syndrome. The last one is about bullying in general; it talks about developmental disorders but not about autism or ASD (it's pretty long though; perhaps I missed something). We would need better sources than this. Montes & Halterman 2007 (PMID 17512887) is much better than those three sources, and it's not that good either. The Google Scholar search has 2,380 hits, which I don't have time to investigate. Eubulides (talk) 01:50, 4 January 2008 (UTC)
I do not think that any bulling can be related to any type of autism, of course being one does not say for all. SG4TACOZ! (talk) 01:57, 4 January 2008 (UTC)
The question was whether or not being bullied happens much more often to children with autism than to children in general. Avb 02:23, 4 January 2008 (UTC)
Eubulides wrote: "As far as I can tell, none of those three citations address autism and bullying." -- Once again, the first two are about AS, intended to answer your question insofar as it addresses the AS article. The last relates clearly to autism: I linked specifically to its page #30. Montes & Halterman 2007 (PMID 17512887) is clearly inferior here as it does not address the question at all (it is about bullying, not about being bullied, as already argued). Avb 02:23, 4 January 2008 (UTC)
I don't recall having any questions about the Asperger syndrome article. The link to page 30 did not work for my browser and I did not notice it. I just now read the article you mentioned; here is a citation: Taylor J, Creer C (2004). "Vulnerable populations for bullying" (PDF). Utah Spec Educ 25 (2): 30-1.  The authors are/were staff members of the Utah State Office of Education, and the magazine is an unrefereed house organ. Here's the article's claim about autism: "Because of a general lack of social awareness, many children with autism can be particularly vulnerable to specific bullying situations." The article has no citations; instead, it supports the claim by mentioning an unpublished Internet survey conducted in 2004. However, none of the quoted questions in the survey mention autism. I'm afraid that this source is too weak. It is neither a primary study nor a reliable review article, it is not refereed, and it is far below the usual quality of the sources cited in Autism. Let's hope we can find a better source. Eubulides (talk) 04:39, 4 January 2008 (UTC)

Condition vs. Disorder

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

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

Early Abnormal Physical Growth Patterns

Is there any reason why there is no mention in the article of the recent studies showing abnormal early physical growth patterns found in autistic infants in there first year of life? I don't see any mention of it on the talk page or the related pages. For more information, here is one recent example:[2]. Dtolman (talk) 22:19, 8 January 2008 (UTC)

I think it's covered. Autism #Pathophysiology says "Brain weight and volume and head circumference tend to be greater in autistic children" and goes on to discuss four related hypotheses. The discussion cites four recent review articles. Eubulides (talk) 22:28, 8 January 2008 (UTC)
The linked study in the pathophysiology is discussing the size and shape of the brain. The studies I'm referring to are looking at rates of growth, for the head, and the body as a whole - things that can be measured with just a tape measure - not with internal imaging equipment. Its also something that is being discussed as a early warning sign of autism in an infants first year of life - I think thats interesting because the wikipedia article implies that it can't be diagnosed that early, which is somewhat misleading. Dtolman (talk) 02:12, 9 January 2008 (UTC)
Autism #Pathophysiology mentions "head circumference", which can be measured with a tape. It cites DiCicco-Bloom et al. 2006 (PMID 16807320), a review that discusses head circumference in some detail and cites several studies. Autism #Screening does mention signs by 12 months that suggest evaluation by a specialist. I don't know of any reliable source claiming that one can diagnose autism in the first year; the source you mention, which talks only about head circumference, does not make that claim. Eubulides (talk) 04:50, 9 January 2008 (UTC)
OK thanks - I had missed those. Dtolman (talk) 12:32, 9 January 2008 (UTC)

News story: Rare genetic glitch hikes risk of autism

Thanks, that info has been added to Heritability of autism #Candidate gene loci; see "16p11.2 region". Eubulides (talk) 17:18, 10 January 2008 (UTC)
Thank you, Ling.Nut; it's nice to see you here. SandyGeorgia (Talk) 17:28, 10 January 2008 (UTC)

Helminthic therapy and autism

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

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

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

08:24, 23 January 2008 (UTC)

That treatment seems to really open up a can of worms. Q0 (talk) 10:51, 23 January 2008 (UTC)
I know of no reliable sources on the subject. The abovementioned website does not count as a reliable source, I'm afraid. Eubulides (talk) 17:44, 23 January 2008 (UTC)

Slimming down

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

another news article; much less hard-science

  • ABC defends show against outcry by pediatricians
  • mmm, basic idea is potential risk (real or alleged; I dunno which) of autism formerly caused by vaccination:
    • "Critics of childhood immunization have argued that thimerosal, a mercury-based preservative formerly used in vaccines, is a primary cause of an autism in young children."
  • Ling.Nut (talk) 09:16, 29 January 2008 (UTC)
I dunno, it's a fictional TV show. There are lots of fictional TV shows about autism and I don't see much special about this one. Eubulides (talk) 17:16, 29 January 2008 (UTC)

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

RE: some points to consider

"Autism is a brain development disorder"

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

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

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

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

This is a difficult topic to summarize. As Howlin 2006 (doi:10.1053/j.mppsy.2006.06.007 points out, the claim that early intervention is key is not substantiated by scientific evidence. (By "early" here I mean by age 2 or 3.) And yet many experts believe the claim is probably true. Furthermore, there is some controversy about whether ABA-based methods are better than other approaches. For example, Magiati et al. 2007 (PMID 17683452) found not much difference between behavior and cognitive approaches. The lead is probably not the place to get into that controversy; it's too complicated. However, I agree that the quoted wording was a bit too pessimistic; I changed it to read "Early behavioral or cognitive intervention can help children gain self-care and social skills." I figure the details about substantiation by scientific evidence need not be emphasized so much in the lead (they're covered in the body). Eubulides (talk) 19:18, 1 February 2008 (UTC)
I noticed that you state that early intervention improves self-care and social skills, but what about language and communication ability? I know that Vince Carbone's work in Verbal Behavior takes an ABA-based approach and applies it to teaching language and communication with demonstrated success (Perry, A. & Condillac, R. (2003). Evidence Based Practices for Children and Adolescents with Autism Spectrum Disorders - Review of the Literature and Practice Guide" Toronto, Ontario, Canada: Children's Mental Health Ontario.) There are other interventions that also focus on increasing language and communication. The only reason I mention it, it looks like the only skills that early intervention improves are self-help and social skills, and I am sure that many people would be wondering about the communication aspect of the disorder and whether it can be improved with these methods as well...
Thanks, I changed it to read "self-care, social, and communication skills". I figure that mentioning communication is enough in the lead; we needn't also mention language, as that is a subset of communication. Eubulides (talk) 21:15, 1 February 2008 (UTC)

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

- This is very ambigous. I have worked with many children who may be considered "severe" before intervention, and gain skills to be included in school settings without support. Temple Gradin herself states that she was diagnosed with Childhood Autism (which would not be our "Autistic Disorder", and she is living very independently.). Even though she was considered to have severe autism, through intervention, she has been able to overcome communication and social difficulties, and is a very independent woman. I think it is important to not say this without referring to growth and gains over time, as many parents may be reading this and could lose hope as a result. In addition, a study I know of off the top of my head: Seltzer MM, Krauss MW, Shattuck PT, Orsmond G, Swe A, Lord C.(2003). "The symptoms of autism spectrum disorders in adolescence and adulthood". Journal of Autism and Developmental Disorders, Vol 33(6): 565-581. states that there is about a 20% reduction of symptoms overall that appears with age. So, to simply say that "with severe autism, independent living is unlikely" it should be clear whether you are talking about young children with severe autism as having poor outcomes, or an adult with severe autism as not being able to live independently. A summary can be read at: == External links == [3]

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

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

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

EWMN

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

Text removed from Diagnosis section for discussion and better sourcing. SandyGeorgia (Talk) 23:04, 8 February 2008 (UTC)
This sounds like it's Teitelbaum et al. 2004 (PMID 15282371). As it happens a high-quality review was published this week on early diagnosis of autism: Landa 2008 (PMID 18253102). It has 108 citations but doesn't mention Teitelbaum. So I briefly looked for reviews that do cite Teitelbaum et al. 2004. I found only one: Palomo et al. 2006 (PMID 16685187), which mentions Teitelbaum et al. 2004 in support of the following two remarks: "Home-movie methodology has recently been extended to investigate other questions, such as early motor development in autism and Asperger syndrome", and "we exclude works not focused on children with autism, PDDNOS, or Asperger syndrome". I guess they rejected Teitelbaum et al. 2004 because it studied infants, not children. Anyway, it looks like Teitelbaum et al. 2004 is not that big a deal; it's not being cited by reviews. There are lots and lots of other primary studies on early detection of autism; I'm not sure why we'd want to focus on this one. Eubulides (talk) 06:54, 9 February 2008 (UTC)
So the recently created EWMN article may need a look. SandyGeorgia (Talk) 15:14, 9 February 2008 (UTC)

Have any scientists done any research on....

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  • Autism covers a huge topic and uses the Wikipedia summary style to spin off sections into subarticles leaving summaries in their places. There simply isn't enough room in Autism itself to talk about each subtopic in detail: doing justice to the abovementioned topics would require at least doubling the size of Autism, and probably more, and Autism is already on the long side.
  • The topics you're mentioning are discussed partly in Autism therapies, which is briefly summarized in Autism #Management. Autism therapies discusses chelation therapy, HBOT, dietary intervention in general and gluten-free, casein-free diets in particular. For space reasons, it does not discuss details of each therapy; that is left to still-more-detailed articles like Chelation therapy. I don't know of scientific evidence on soy-free, low-oxalate, or the vitamin K2 protocol, but anything along those lines would be welcome there.
  • Many other topics are discussed in Causes of autism, which is briefly summarized in Autism #Causes. These include the vaccine controversy, metals and other environmental toxins, the MMR vaccine, and the hair content of autistic children. Again, for space reasons most of these topics have their own subpages, such as MMR vaccine controversy.
  • Autism organizations and so forth are discussed in Sociological and cultural aspects of autism, which is wikilinked to from the very last sentence in Autism (and is also wikilinked to from the last sentence in the lead). There are many, many organizations like DAN! and Autism Speaks. I'm sure that Sociological and cultural aspects of autism does not do justice to them all and can be improved, but there's not enough room in Autism to mention them. Autism used to have a lengthy "External links" section that pointed to some of them, but this ran afoul of WP:LINKFARM.
  • Typically, there is no way to prove that a particular treatment is a "fake". At most, all a scientific review can say is that studies have shown the lack of certain desired effects from a treatment, or (more commonly) that there is no reliable scientific support for a treatment.
  • Autism does not say that there are "few treatments". On the contrary, it says "Many alternative therapies and interventions are available." It does go on to say that "Few are supported by scientific studies." a claim that (unfortunately) is supported by several high-quality sources.
  • Here is a list of sources relied on most-heavily in Autism #Management for coverage of complementary and alternative medicine. Alternate sources of similar (or better!) quality would be welcome; if you know of any, I'd appreciate their mention here. It can be a difficult subject to cover.
Eubulides (talk) 17:42, 25 February 2008 (UTC)

Educational therapies

This series of changes replaced:

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

with:

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

There are some problems with this change:

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

I replaced the above text with:

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

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

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

<copied from User talk:AnnieTigerChucky:>

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

Dear SandyGeogia,
I wanted to explain that Early Intervention may not only help gain self-care and social skills, but that you can get completely better from it. The word cure is complicated, people think either it means medically or get completely better from it. That's why I also put medical cure, because it's a development disorder. Through early diagnoses and therapy, they can get out of their private world and start to join ours. But they will still be on the autistic spectrum. If I find a reliable source and ref tag, could I add it on the talk page, and can you help me determine if I could change the wording. AnnieTigerChucky (talk) 21:31, 24 March 2008 (UTC)
Annie, see above; the text has already been corrected. SandyGeorgia (Talk) 21:36, 24 March 2008 (UTC)