Talk:Asperger syndrome/Archive 13

This is an archive of past discussions about Asperger syndrome. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.

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lede

Latest comment: 17 years ago5 comments4 people in discussion

I think the sentence "Some positive characteristics include things such as enhanced mental focus, excellent memory abilities, superior spatial skills, and an intuitive understanding of logical systems" needs to be sourced point-by-point, or reworded, such that each ability mentioned can be RS'd per se. I've got a couple of sources, more tomorrow ... Z makes a good point about perhaps including the diagnostic controversy ... CeilingCrash 04:58, 17 August 2007 (UTC)

Besides that the lead is not a WP:LEAD:

It manifests in individual ways and can have both positive as well as negative effects on a person's life ... The disorder affects people in various ways,

Those two sets of wording says absolutely nothing to the reader. What does "manifests in individual ways" mean? Do some pick their noses? Become ax murderers? Have tics? Get cancer, warts, or asthma? The phrase imparts no meaningful content to the reader, and it's inaccurate besides. By all definitions, AS manifests by restrictive and repetitive behaviors, interests, and activities, so the "individual ways" adds nothing, says nothing, and is inaccurate. Then the article adds another similar throw-away clause in the lead, "affects people in various ways". Again, what ways? These phrases tell the reader ... nothing. SandyGeorgia (Talk) 13:36, 18 August 2007 (UTC)

Actually, you have one hell of a point there now I think of it...in it's present form it would actually slot quite neatly into Peter Sellars famous "Party Political Broadcast"! :o)

Can we boil it down to: "It can have both positive and negative effects on an individual's life" while we think about it?

But REALLY, keep it wholesome...Aspies NEVER pick their noses, that is a well autheticated NT trait *chuckles* --Zeraeph 13:44, 18 August 2007 (UTC)

"Individual ways" was CC's wording, and while I was never 100% comfortable with the clarity and flow of "individual," I understood what he was trying to say, and couldn't think of a great alternative. In one study I was reading yesterday, for example, AS patients and HFA patients were subjected to a battery of tests to try to determine whether there was any validity at all to the distinction between the two, and while they found that, overall, there was a small aggregate difference that might be used to justify the existence of 2 categories, many of the participants in both groups had scores which were completely atypical of either group, and didn't really mesh with any theory. I think this was what he was trying to convey: that aspies are a wildly disparate bunch. Can anyone think of a better word? Poindexter Propellerhead 19:45, 18 August 2007 (UTC)

Gotta do the same there as everywhere else; find a reliable source and use the words it uses. You can't get into trouble if you stick to what the sources say. And, if a source doesn't say it, don't try to bootstrap it in. SandyGeorgia (Talk) 19:53, 18 August 2007 (UTC)

Everybody happy now?

Latest comment: 17 years ago10 comments3 people in discussion

Can I ask you all, no exceptions, to come here and discuss any changes you want to make here first? AND to come here and check any changes others want to discuss? That way we are a TEAM, and a really good one, IMHO.

To start the ball rolling, how do we feel about [BBC's h2g2: "Autism and Asperger's Syndrome: The 'Little Professors'" (2006 April 19)] deleted by Admin User:Davidruben? Just because he is an admin doesn't mean we have to agree with him, so what do we all think?--Zeraeph 16:39, 17 August 2007 (UTC)

It doesn't meet WP:RS; is that some sort of a Wiki? There doesn't appear to be any editorial oversight or fact checking. SandyGeorgia (Talk) 20:50, 17 August 2007 (UTC)

Poindexter added this link back to the article, when it appears (to me at least) that it is clearly not a reliable source, thereby violating WP:EL. Please discuss and explain how this is a reliable source ? SandyGeorgia (Talk) 13:21, 18 August 2007 (UTC)

See talk page discussion here,[1] where it was established that consensus was behind keeping it, and that WP:EL does not expect external links to be RS, but rather lists under "links to consider," "Sites which fail to meet criteria for reliable sources yet still contain information about the subject of the article from knowledgeable sources." So Graham87 (who also happens to be an admin) reverted its deletion, and, aside from occasional drive-by deletions by people who don't read the talk page, it's been there ever since. Poindexter Propellerhead 16:52, 18 August 2007 (UTC)

Thanks for the link. Once again, I think the notion of there being consensus there is overstateed; there was meaningful and relevant opposition from well respected admins and editors to adding the link because it's clearly not a reliable source. It needs to go. SandyGeorgia (Talk) 17:51, 18 August 2007 (UTC)

A part of me wants to accord with the concensus and put the link back. It's good and balanced and says a lot of things that need saying...'BUT...if we do, it sets a precedent that let's in all kinds of self published...er...stuff...that is NOT so good and balanced. Do we want that in the long term? --Zeraeph 17:56, 18 August 2007 (UTC)

Possible solution, look for a reliable source that says the things worth keeping, and add them to the article. SandyGeorgia (Talk) 18:05, 18 August 2007 (UTC)

It doesn't set a precedent, WP:EL says that good, non-RS links should be considered, which was probably why 6 editors got behind keeping it, and only 1 (the one who deleted it originally, who is not a regular editor of this article, and who was recently cautioned and admonished by ArbCom for unilateral edits which disregarded the relevant talk pages) favored the deletion. Unreliable sources in the article itself are a completely different thing, with totally different rules, so creep shouldn't ever be an issue. Poindexter Propellerhead 19:58, 18 August 2007 (UTC)

I'm not going to lose sleep over it, but I'm on record as Oppose. If the article says anything worth saying, a reliable source will have said it. Example: I do include a blog on TS as an External link, and I firmly establish the Canadian author's credentials. The reason I use his blog is that no one else will say what he says about a certain medication, because US physicians are afraid of a certain litigious group I won't mention (WP:BEANS). So, I include a blog from a very credentialed and published and peer-reviewed reliable author because it contains info that no other source carries. What is there in this link that a reliable source hasn't said, and what makes the *author* of this information reliable ? SandyGeorgia (Talk) 20:17, 18 August 2007 (UTC)

The discussion of what people found desirable in that article is here.[[2]] More discussion of its merits, or lack thereof, is certainly possible, but I doubt that any of us consider it a high priority right now. Poindexter Propellerhead 05:24, 19 August 2007 (UTC)

Work needed

Latest comment: 17 years ago10 comments3 people in discussion

I've restored the cleaned up refs; what could have been accomplished yesterday by moving two paragraphs took an hour today, so that I could preserve work done since the revert war. I've flagged areas that need attention. They are some contradictions in the text, some unreliable sources, some uncited text, and some unclear text. In terms of the bigger picture:

The lead is still completely out of conformance with WP:LEAD. It makes no attempt to summarize the article, and introduces detail that is not discussed elsewhere in the article. A summary of history, treatment, causes, prognosis, epidemiology, etc. is completely lacking, and those topics aren't well developed within the article.
The article suffers from serious undue weight. It neglects completely coverage of DSM and ICD, while focusing almost exclusively on controversial aspects not reflecting overall medical consensus.
From WP:UNDUE: We should not attempt to represent a dispute as if a view held by a small minority deserved as much attention as a majority view. Views that are held by a tiny minority should not be represented except in articles devoted to those views. To give undue weight to a significant-minority view, or to include a tiny-minority view, might be misleading as to the shape of the dispute. Wikipedia aims to present competing views in proportion to their representation among experts on the subject, or among the concerned parties.
The article relies too heavily on Attwood (a 10-year-old, non-peer reviewed book), who in spite of the high esteem in which he is held by the AS community, is not an author who has significant peer reviewed publications. The article relies far too heavily on self-published sources, at the expense of referreed sources.
The article contains too much unattributed opinion (Attwood, Szatmari, etc.), and too little coverage of peer-reviewed medical consensus. For example, what one or two researchers may view as "controversy" might not be controversial at all according to the majority view. Opinions of individual researchers need to be stated as such (attributed to the author), while majority viewpoint needs to be included, at minimum.

I'll check back later to see if progress has been made, and will refrain from tagging the article now, but I have been highlighting these issues now since May. I am particularly concerned about statements not supported by the sources given, considering I've watched over the last year many unsourced text additions being made to a section with a given citation, without attention to whether that text is sourced by the reference given. Further, we've already seen multiple examples where the sources do not support the cited text; those existed in the featured version, and still exist in this version. SandyGeorgia (Talk) 17:17, 17 August 2007 (UTC)

Fair enough comment particularly on attributed comments, I just tried to tidy up a couple myself and couldn't find the refs. It's a long article, I'd say that many of those sections should probably be pulled?

I know I am not the only one who agrees with you about Attwood, he has become way too self published and self-publicizing for my tastes of late. HOWEVER, if you look, I think you will see that the actual Medical Community doesn't place too much weight on the DSM or ICD for diagnosis in AS.

I hope you KNOW that if you spot any text that got snuck in next to a citation and remove it, I will also stand over that removal.--Zeraeph 17:28, 17 August 2007 (UTC)

The current article size, per Dr pda's script is 33KB prose (readable text), which is well within WP:SIZE guidelines (30–50KB readable prose), and ideal. There is room to grow the missing areas (treatment, epidemiology, causes, etc.) a bit. SandyGeorgia (Talk) 17:55, 17 August 2007 (UTC)

That goes without saying, but if they aren't sorted by this day week shall we agree to whip out the tagged discrepancies? --Zeraeph 18:48, 17 August 2007 (UTC)

I'm not putting any deadlines; I'm waiting to see if editors intend to work on the issues, or edit war and revert. That can be determined in a day, a week, or a month. As of now, the article is far enough out of compliance with Wiki NPOV policy, attribution, undue weight, lead guidelines, and WIAFA that anyone may FAR or tag it at any time. I would have preferred the consensual approach, but edit warring seems to be the order here. SandyGeorgia (Talk) 20:48, 17 August 2007 (UTC)

Can we tone down the drama a little? Zeraeph and I missed 4 cite cleanups in the opening paragraphs, but got all of the others, and last time I checked one revert wasn't a war. Poindexter Propellerhead 21:00, 17 August 2007 (UTC)

One revert while ignoring the talk page is. I can't think of any good reason for you to disregard this: "Regarding the rest of my cleanup work, I don't know how the refs got so far out of hand; some of them had actual errors (wrong authors, dead links, etc.) The original text is still present, but now with corrected refs, so if changes are decided upon, pls move text around rather than reverting to the older versions that had messed up refs", causing me another hour of repair work unnecessarily. SandyGeorgia (Talk) 21:26, 17 August 2007 (UTC)

Sandy, you seem so unhappy editing here, though I really appreciate your thoroughness and neutrality, I am beginning to feel very selfish and guilty for asking you to come back today. --Zeraeph 21:47, 17 August 2007 (UTC)

Not at all unhappy; just genuinely bothered that someone deliberately wasted my time out of what appeared to be spite, disrespect, and something akin to machismo (I can revert, therefore I will, rather than simply move 2 paragraphs). So, now the article has a completely inaccurate lead, duplicate text, and the previous lead could have been easily fixed. <shrug> At least it has clean refs ! SandyGeorgia (Talk) 22:25, 17 August 2007 (UTC)

Sandy I am SURE it wasn't spite or disrespect...PP isn't like that. Look I tried to set it right myself and made a mess of it, ok, I was a few sheets to the wind ( :o/ ), and somewhat away with the birds, but I am usually quite good at things like that (after I clear up the typos on the second edit anyway), so maybe it wasn't that easy?

I am really bothered by this, there is a good team of editors, and really nice guys, including soulgany, here and what they need most is your neutrality and thoroughness to pull it all together and staunch any POV creep, but somehow it has all become so adversarial, instead of co-operative. Can we ALL just put it to bed for tonight than start fresh tomorrow? --Zeraeph 22:51, 17 August 2007 (UTC)

Applied Behavioral Analysis

Latest comment: 17 years ago4 comments2 people in discussion

This is the only 1982 Becker and Gersten I can find; I can't establish that it's about ABA.

Becker, W.C., & Gersten, R. (1982). A follow up of Follow Through: The later effects of the Direct Instruction Model. American Educational Research Journal, 19, 27–55.

This quote can't come from three different places:

Once certain skills have been acquired, it is possible through ABA to generalize these skills and add new skills to the "existing repertoire through various techniques of shaping, extinction, backward chaining, and prompting." (Schreibman, 1975, Sulzer & Mayer, 1972, Wolery et al, 1988)

What study is it? This text appears to have been taken from a secondary source which isn't cited. This may be a starting place for locating the sources. http://www.accessmylibrary.com/coms2/summary_0286-745676_ITM SandyGeorgia (Talk) 22:48, 17 August 2007 (UTC)

It's my opinion that the ABA part may as well be scuttled. Most of its cites are very old, and apply only to Kannerian autism (AS didn't have a name yet, let alone diagnostic criteria). I visited PubMed for replacements, and came back empty-handed, there is not a single abstract which mentions both AS and ABA. Does anyone else feel inspired to attempt a salvage, or shall we let it go? Poindexter Propellerhead 04:42, 18 August 2007 (UTC)

Scuttled entirely, no. Rewritten. As demonstrated by Eubulides in the Autism article, it's effective. See Autism#Treatment for leads on where to start (I'm not sure if what is written there applies equally to AS, or needs adaptation). I'm afraid that some of the regular AS editors forget that there are parents seeking information about effective treatments for their children; this article will not be comprehensive as long as it deprecates and demeans parents seeking to help their children by rolling them in with "curebies and parents". Children's issues need to be addressed, not overlooked by a focus on successful adults. SandyGeorgia (Talk) 12:05, 18 August 2007 (UTC)

"Curebies and parents" isn't my line, I am the parent of a kid with AS. The only issue I have with the ABA section is that there appear to be zero papers in PubMed which discuss use of ABA as a treatment for AS. My approach to it is the same as it would be for any other topic where there was no reliable sourcing. Poindexter Propellerhead 20:30, 18 August 2007 (UTC)

Proposal

Latest comment: 17 years ago17 comments4 people in discussion

Let's be methodical about this. We seem to have three points of contention :

 A)  the sources are either not RS or misrepresented here.
 B)  the emphasis is misplaced
 C)  the lede does not summarize the article.

As for C, the lede was written after the article, and the plan is to rework the article in accordance with the lede. Anyway, B and C are big issues, what is not big is A). We are all agreed that sources should be reliable and accurately represented. So can we start there?

As for Attwood, I agree. He isn't publishing for peer review. That makes two editor-objections, so let's remove references to Attwood.

Let us now go through the lede, source by source, line by line. Can we agree to this first step? CCCeilingCrash 00:23, 18 August 2007 (UTC)

OI!! I agreed on Attwood too if you don't mind, and I am agreeing to rest. :o) --Zeraeph 00:35, 18 August 2007 (UTC)

I agree about Atwood being a less desirable source than something with a PubMed number. In practice, I think that would mean throwing out much of the article. This is not because there aren't reliable sources for it, it's because you have to pay 95% of those reliable sources. If, for example, you want to cite Gillberg's Criteria, as I had to today, you have a choice of (1) someone's personal copy of them, which was tagged as iffy, (2) a copy of Gillberg's paper, which you have to pay for, because the abstract (as usual) doesn't contain the info you need, (3) the Wikipedia article on Gillberg, but that's totally forbidden, or (4) Attwood (1997), pp. 195-196, which is exactly what I ended up using. Before resolving to throw out everything by Attwood, I suggest you try the following exercise: take a heavily Attwood-dependent section, say the first 3 paragraphs of "Speech and language differences." This text is all pretty ordinary, non-controversial stuff, right? Now try fully citing it with PubMed papers (or, 95% of the time, PubMed abstracts, since the paper's not going to be free) that clearly and undeniably say the same things. When you're done tearing out your hair, come back to this thread and we can compare results. Yes, nearly all of this article could easily be sourced from peer-reviewed articles, the data are mostly quite solid. But it cannot all be sourced from freely-available abstracts without verging on OR, and we will only rarely have more than abstracts to point to.

That's not to say that we can't try it; in cases where ready replacements are found, by all means, let's use them. But I know that some of them cannot be replaced without citing offline books or paid articles, because I've already tried. Poindexter Propellerhead 04:14, 18 August 2007 (UTC)

Ok, here is a little rationale of my own I invented that might work for Attwood, can we cite Attwood ONLY where he is referring to third parties who cannot be as openly cited in their own right?

I think Sandy has a LOT of Pubmed sources already though. They should be there in the last FAR version.

Also, I don't think it is forbidden AT ALL to reference a Wikipedia article for something like Gillberg's Criteria. Isn't the whole point of Wikipedia that it is intended to interlink and constantly evolve? So that if the article or criteria is deleted and editor will spot it and change it? --Zeraeph 10:29, 18 August 2007 (UTC)

I don't have *any* full text AS sources or reviews; if I did, I'd fix the article myself :-) I do not know AS as well as I know TS (meaning, I don't know what is the topnotch medical research vs. run of the mill junk that gets published even on PubMed but doesn't enjoy wide consensus), and it makes little sense for me to be doing any writing here, so I haven't purchased an article. I'm tempted to go get a copy of Attwood, as I'm fairly certain a lot of the text sourced to Attwood is probably not verified by Attwood. No, it's never OK to link to a Wiki article as a source. Wiki is not a reliable source, and Wiki articles are rarely accurate. Some articles may incorrectly link to Wiki as a source; they shouldn't. A featured article cannot retain featured status if it doesn't conform to Wiki policies and guidelines in WP:WIAFA, which includes the use of reliable sources. SandyGeorgia (Talk) 12:20, 18 August 2007 (UTC)

I get what you are saying, but I would have thought it was ok to link to Wiki for something like the full text of Gillberg's criteria. Even if you only put the link, as illustration, under citation to the actual Gillberg publication? (Which is similar to what I am suggesting we do with Attwood). I certainly cannot find any policy against it.

Yes, it's OK to link to Gillberg for information purposes, but we still have to make sure *this* article also contains a reference to a reliable source. SandyGeorgia (Talk) 12:47, 18 August 2007 (UTC)

Here's an illustration of this issue:

INCORRECT (only links to a wiki article, which may or may not be reliable): Notable individuals with Tourette's are found in all walks of life.
CORRECT (links to a Wiki article for detail, but *also* sources the text to a reliable source, except the #$%@ing TSA has yet again altered their website, so I need to tweak): Notable individuals with Tourette's are found in all walks of life.[3]

SandyGeorgia (Talk) 12:55, 18 August 2007 (UTC)

Yep, that is EXACTLY what I meant...but maybe I didn't explain it well... or, alternatively, surely: Gillberg IC, Gillberg C. "Asperger syndrome-some epidemiological considerations: A research note." J Child Psychol Psychiatry. 1989 Jul;30(4):631–38 --Zeraeph 13:29, 18 August 2007 (UTC)

Yeah. The only problem is that the abstract doesn't contain the criteria, and cites which do nothing to demonstrate the truth of the text aren't very exciting. Poindexter Propellerhead 20:39, 18 August 2007 (UTC)

It REALLY doesn't seem very fair for others to do the writing while you have to come and fill in citations after them! Can we specify a single format for citation everybody can use (I don't mind which, as long as we all use same one), and "informal template" if you like, posted here? Save you a LOT of drudgery I am sure.

See my link to Diberri's tool below. (Also see WP:MEDMOS and WP:MEDRS for additional guidance.) If editors will use it for pmids, it will return consistent and accurate results. I don't mind repairing refs as long as other editors here are respectful of the work. From my own experience on Tourette syndrome, I can tell you it makes me nuts when someone who doesn't have a full working knowledge of the entire body of research starts tweaking the text, introducing subtle inaccuracies. I don't feel qualified to tweak AS text. SandyGeorgia (Talk) 12:47, 18 August 2007 (UTC)

Do we actually HAVE anyone around anymore with a copy of Attwood to verify? --Zeraeph 12:43, 18 August 2007 (UTC)

I have a copy of Attwood, and 90% of what I've been doing (aside from struggling to keep up with the talk page) has been citing stuff. I haven't been including quotes in the citations, but will start doing so, where good, terse "text bites" exist. Poindexter Propellerhead 20:39, 18 August 2007 (UTC)

OK, in the lede we mention positive characteristics of AS and give four sources. The reason we give four is we are aware this fact is suprising given the popular conception and the DSM description of AS. Extraordinary claims, sources, etc.

The most important source, to my way of thinking, is [2], Simon Baron Cohen. First, it is important to know who he is. He was Lorna Wing's graduate student when she first proposed AS; he created and field-tested the AQ screening tool; he originated 'Theory of Mind'. he has since produced study after study, http://en.wikipedia.org/wiki/Simon_Baron_Cohen . He is by any measure almost certainly the world's single most established authority.

The reference we give is to a suprise result he reported when field-testing his AQ test at Cambridge university. He found that,

"scientists (including mathematicians) scored significantly higher than both humanities and social sciences students, confirming an earlier study that autistic conditions are associated with scientific skills"

He goes on. The Mathematical Olympiad is the UK's most prestigious competition of creative mathematical talent. He tested 11 winners of the Olympiad. These are mathematical geniuses. He found ALL ELEVEN met at least three of the DSM criteria for AS, and 7 of them met the threshold for AS/HFA.

So the correlation between AS and mathematical talent is astonishingly strong for an otherwise rare condition.

It's here, peer reviewed in the Journal of Autism and Developmental Disorders. This article, by the way, is the magna carta of AS testing.

http://www.springerlink.com/content/k872618310261272/

As for mathematical talent, it doesn't get any more RS than this, to my way of thinking anyway. Are we agreed this far? CeilingCrash 00:57, 18 August 2007 (UTC)

I'm sorry to have missed this comment, which was stuck in the middle of another conversation, breaking it up. Now I see the problem, and the text is far more wrong than I originally thought. You are mistaking casuality and drawing completely erroneous conclusions based on confusion over sampling issues and correlation. Testing a lot of scientists and finding they have AS is NOT THE SAME as testing a lot of people with AS and finding they have scientific ability. This is a completely erroneous conclusion and error in logic. That text really needs to be fixed to reflect what the source says. A study of a lot of people with AS, compared to a lot of "normal" controls, showing that the AS group has statistically more scientific, mathmatic, whatever ability than the "normal" controls and more than expected by chance is needed to establish correlation. Is there such a study ? What the study you cite may have shown is that people with AS are more likely to pick a particular profession, but it doesn't establish that all people with AS are more likely to be mathmatically or scientifically inclined. Is there such a study, is it on a large sample, and is compared to "normal" controls? SandyGeorgia (Talk) 21:28, 18 August 2007 (UTC)

I don't mean to sound repetitious, since I already said this above, but I believe the problem is precisely because of a focus on writing the lead rather than writing the article, and I suggest this approach is backwards. I suggest the opposite; fix and finish the article, writing it comprehensively, balanced, and based on reliable sources, and then figure out what one or two sentences can best summarize each fully developed section back to the lead. Right now, the lead is the biggest problem because it doesn't flow from a well constructed, comprehensive, well sourced article. If the article is correct, it will be easier to do the lead at the end, and then the lead will truly be a summary (it's not a summary now). SandyGeorgia (Talk) 04:04, 18 August 2007 (UTC)

Forget that the sentence is in the lede. We cannot write a balanced and comprehensive article until we come to accord on what it is we are attempting to balance and comprehend. That will be a collection of facts. About 50 of them, and we are on #1. I am asking if you think it is fairly represented as a 'positive trait' and if it is RS. How, where, and if it is used in the article is another matter which is entirely moot if it's not RS in the first place. So what is it? Accept, Reject, or Abstain?

Will you work with us on this, one issue at a time, despite your dissenting view as to what we should be doing first ?

CeilingCrash 05:16, 18 August 2007 (UTC)05:14, 18 August 2007 (UTC)

Sorry, but no, I don't think that's the best approach. Working one sentence at a time in the lead, when the entire article needs major surgery, will not get the job done. I'm answering here at the bottom to cover a lot of what was written (overnight) above: patching up the lead, covering over the Attwood sources, finding better reliable sources, and finishing up the missing sections in terms of comprehensiveness *all* need to be done by someone getting their hands on the best, recent journal-published review of AS (as an example, see my use of 4 papers/books in Tourette syndrome— Zinner, Bagheri, and Robertson papers and the Advances in Neurology book—then complementing and updating the basics in those reviews with individual PubMed abstracts as needed). Trying to retroactively cite an incomplete article, and trying to retroactively cite a lead that doesn't summarize an incomplete article, won't do the job effectively. The article was patched up in the last featured article review by using Attwood (a book written when AS was still in its infancy, and now 10 years old), and Eubulides' analysis of some of that text shows how far off most of the article still is; it needs major surgery. Going to PubMed to try to individually cite statements is the wrong approach; some of those statements are outdated or poorly written to begin with. There must be a good recent overview that can be used to update and cite the entire article. Eubulides probably has access to one or can recommend one. Yes, someone may need to purchase one review; not a lot of PubMed studies. The review will reference studies which can then be accessed as needed. I'm sorry you may disagree, CC, but the lead is a wreck and the entire thing needs to be rewritten. Most of the current content there needs to be expanded, corrected for accuracy, and included within the text, and then the lead needs to be a summary of the entire article, per WP:LEAD. The entire second, third and fourth paragraphs do not belong in the lead; they provide excess detail for the lead, and text which is not covered in the article. Those topics need to be included and explored completely within the article, and summarized back to the lead with a sentence or two. The lead is not a WP:LEAD—that it has 26 citations is the first tipoff that it's trying to be an article, not a summary. To see what a lead is supposed to be, see Autism, Schizophrenia or Tourette syndrome. Working on individual sentences within the lead is the wrong focus, and will take forever. SandyGeorgia (Talk) 12:40, 18 August 2007 (UTC)

Recent reviews

Latest comment: 17 years ago1 comment1 person in discussion

A section for things I've found in PubMed, no idea if they're good or not, perhaps Eubulides will advise:

PMID 16639107 Current trends in psychological research on children with high-functioning autism and Asperger disorder (Sep 2005). SandyGeorgia (Talk) 11:20, 18 August 2007 (UTC)

Ref repair

Latest comment: 17 years ago19 comments5 people in discussion

This edit did the following:

Page ranges are separated by endashes, not hyphens (see WP:DASH)
pmids and dois don't need last accessdates, I filled in missing dois. Last accessdates are used for other URLs
The ref named DSM merely pointed to a website with the DSM definition, which is the same as BehaveNet; I replaced it with BehaveNet.
Accurate cite journal data can be had from Diberri's tool by merely plugging in the PMID.
The Treffert and Att1 named refs were dropped when subsequent text that defined them was deleted, leaving missing refs; I put them back.
I changed the MedScape link to the printable version, which includes the entire text rather than just the first page.
I deleted the Sagepub url on Leekam because it is replaced by the doi, which is an automatic link in the cite journal template generated by Diberri's tool.
... that delayed onset of speech favors a diagnosis of AS.ref name=dsm/ Removed DSM, since it doesn't verify that text, left Attwood.
Named ref for Attwood 150–151, since it's repeated.
Added citequote and failed verification on "and too vague." PMID 9519632 The abstract says "The current DSM-IV criteria show good to excellent reliability for the diagnosis of PDD, Asperger's disorder (AsD), and autism, but they show poor reliability for the diagnosis of atypical autism." This abstract seems to be saying exactly the opposite of what is alleged in the Wiki article.

SandyGeorgia (Talk) 11:55, 18 August 2007 (UTC)

Ongoing problems with citations

Another ongoing problem in this article is the lack of specificity and sourcing which simply and accurately backs the statement. I added a fact tag on the "often" part of

These characteristics can often[11][4] lead to fulfilling careers in mathematics, engineering, the sciences,

We now have two more citations in the lead, but neither of them supports the word "often". This is a similar situation for all of the statements in the lead which have two, three and four citations, yet not a single one of those citations supports the text. This is synthesis and original research, camoflauged by a string of references. When the {{citequote}} template is added, it means the reader is requesting a quote that specifically verifies the text. The lead is overburdened with citations, most of which don't accurately source the text cited. Where is a quote that says AS characteristics "often" lead to fulfilling careers? That statement implies that most people with AS have fulfilling careers; where's the evidence? Linking to a speculative article about Einstein and Cavendish give me no information at all about the career prognosis for *most* people with AS. SandyGeorgia (Talk) 14:03, 18 August 2007 (UTC)

I pulled *often* instead...it really IS a "POV keyword" if ever I saw one! "Often" is SUCH a subjective, context independent, concept it is meaningless anyway...--Zeraeph 14:41, 18 August 2007 (UTC)

That helps; I pulled the refs that went along with it, since one was already used to cite the sentence, and the other was Attwood. Next example:

Some positive characteristics include enhanced mental focus, excellent memory abilities,[9] superior spatial skills, and an intuitive understanding of logical systems.[10]

Where is the evidence in those sources that these are truly "characteristic"; that is, a study which shows this is typical for most people with AS? The sources cited, again, are anecdote about a few people, and provide no evidence of these traits being characteristic of most people with AS. If there's evidence that these traits are characteristic of most people with AS, put it forward, by all means !! Anecdote isn't evidence just because it's published, and anecdote doesn't belong in the lead (it can be explored in the text). The ongoing problem with this article is that it's POV and inaccurate, but rather than rewriting it to reflect accurate sources, editors are now trying to retrofit sources to what they want the article to say. In every case I've looked at, the sources don't support the text and don't provide comprehensive info about the condition that will help the mom whose kid was misdiagnosed for five years with everything from ADHD to OCD to TS and just got an AS diagnosis and wants to know how she's supposed to get from the suicidal, obsessive, raging, explosive, bullied, unhappy middle-schooler to the next successful adult and next Einstein. (NO, Wiki isn't a support group, but it does need to provide accurate info about treatment and prognosis.) Does she fill the risperdal prescription? Is there evidence that it works? How come the Dr. told her the kid had OCD, but kiddo doesn't excessively wash his hands, which is what *she* thinks is OCD? Are obsessions in AS different than those in classic OCD? (I know the answers to those queries, but this article doesn't tell me.) Does she use ABA? Does she hire someone for CBT, or use medication alone? This article pretends kiddo is going to be Einstein, but sure doesn't give any info about how he's going to get from here (miserable bullied unhappy middle schooler) to there (successful mathmatical genius adult). The article needs to be rewritten comprehensively from accurate sources; trying to retrofit sources to POV text isn't going to work, and is horribly unfair to that kiddo who might be the next Einstein. The last time this article was reviewed, the active editors then refused to even write a treatment section, so I cribbed that section from the NIH public domain text. That's pathetic. People need to know what works. Biased, POV medical articles are the worst kind, because they harm real people—mostly innocent children and well-meaning parents. If you think I'm unhappy working on this article, that's why. SandyGeorgia (Talk) 15:11, 18 August 2007 (UTC)

A Couple of POV Creep Points

This is a Wikipedia article, it is not supposed to be aimed at "parents of Aspies", "partners of Aspies", "Goldfish of Aspies" or "Adult Aspies", it is supposed to be aimed at what the French call "Le Monde".

Having said that, in terms of "what works" trawl every reputable source you can find and ALL you will find is a lot of polysyllabic verbiage that loosely translates as "it might have worked on a few but we aren't really sure".

Literally the ONLY thing I know of that works, or in any way helps Aspies is being treated as equal sentient human beings, and (at the appropriate age) as the autonomous adults they should be. So the article should really place a priority on sustaining that attitude throughout.

Beyond that, not all high function Aspies have the slightest interest in "mathematics, engineering, the sciences". There IS a creep that suggests that those areas are the only route to high function. There is lot of documented evidence of a special (sometimes prodigious) relationship to music, it has been considered an actual symptom, but it isn't even mentioned here. Only anecdotal, but most of the HF Aspies I know tend towards the Arts, writing, film etc, there must be some sources for similar? --Zeraeph 17:43, 18 August 2007 (UTC)

It strikes me that, right now, the article is written for, aimed at, and contains exclusively one POV: successful scientific adults. There's a good deal of undue weight. I still say someone needs to locate the most recent review and rewrite the whole thing to be accurate, reliably sourced, and comprehensive. SandyGeorgia (Talk) 18:09, 18 August 2007 (UTC)

I suppose that IS the short version of what I was saying! It's great to have the positive view of AS, but that CAN be a double edged sword...it can make lifestyle losers, like me, feel VERY inadequate by comparison. In a way, just as bad as an article based on the assumption that Aspies require lifelong parental supervision. :o) --Zeraeph 18:17, 18 August 2007 (UTC)

PS, if I ask everybody to take a look at the form and format of the Tourette syndrome article do you feel I will be showing then an example of the kind of form you feel this artricle should be considering? --Zeraeph 18:34, 18 August 2007 (UTC)

Autism (written by Eubulides) passed FAC more recently, and had a strenuous peer review with a lot of input from many editors, and is in great shape. Tourette syndrome garnered record support (20 Supports within two days), passing FAC without a single Oppose; both TS and autism conform to WP:MEDMOS. Schizophrenia recently squeaked by FAR, but it only got the input of a few editors, and I feel it could still use some work. But I've already offered all 3 of them as examples of the improvements needed here. SandyGeorgia (Talk) 19:00, 18 August 2007 (UTC)

I don't think Schizophrenia (like Bipolar or ADHD) would be a great parallel anyway, as it is a medication dependent neurochemical condition, which is quite different. Autism is brilliantly presented, and the closest vin epidemiology, treatment and prognosis but it is definitely describing a lower range of functionality, and, as such, must be largely pitched at parents and carers. I still feel Tourette syndrome is the closest parallel overall in tone and coverage, I particularly like the cultural references. --Zeraeph 19:18, 18 August 2007 (UTC)

That's an area that frustrates me about this article. To my knowledge, AS is far more studied than TS. If I can find reliably sourced peer-reviewed information about the optimistic prognosis for most people with TS, why can't this article do that? It shouldn't be necessary to stretch what the sources say; it should be possible to find sources and accurately reflect them. I just get the sense every time I visit this article that none of the regular editors are thoroughly steeped in all of the recent literature, and are trying to bootstrap the article together based on Attwood. Surely there's better info than Attwood's 10-yo book. By the way, the regular editors of schizophrenia completely disagree with you; the argument there is exactly the same as the argument here. They argue that schizophrenia is not an illness and should be viewed as a variant of the normal human condition, and they aren't much interested in exploring sections like treatment and causes, so there is something to be garnered from that article's structure and progress. SandyGeorgia (Talk) 19:36, 18 August 2007 (UTC)

I don't know the TS field well enough to be 100% certain, but when I go to entrez PubMed and search for "Asperger" I get 931 matches, while "Tourette" gives me 2,869, so I suspect that TS is quite a bit better researched at this point. Poindexter Propellerhead 03:01, 19 August 2007 (UTC)

A lot of AS research may get published under broader autism articles. SandyGeorgia (Talk) 14:24, 19 August 2007 (UTC)

Ok, you caught me bang to rights stigmatising others there *deep purple shame*. MOST sorry for that...though I think we should also take a look as some of the structure of Gay, Michael Fitzgerald often parallels the two (though that information MIGHT be OR). Took a scan though Amazon, and there isn't much recent that even squeaks into WP:RS except this: Asperger's Disorder (Medical Psychiatry) (Hardcover) by Jeffrey L. Rausch (Editor), Maria E. Johnson (Editor), Manuel F. Casanova (Editor) - and something tells me that, at $200, that is totally prohibited by WP:AFFORD. Maybe there just ISN'T any new, cutting edge research? That does sometimes happen...--Zeraeph 20:45, 18 August 2007 (UTC)

(rem indent) - much of the milder side of Asperger blends into normal human behaviour and there are huge issues as to where you put the fence posts. Schizophrenia and Tourettes are much more easily demarkated..hey I was a regualr editor on schizophrenia and didn't have that view....cheers, Casliber (talk · contribs) 23:16, 18 August 2007 (UTC)

I know, but I didn't want to name names :-) (You disappoint me, the same can be said about Tourette's. It's not the plaque, you know–there are also huge controversies there about where to put the fence posts :-) SandyGeorgia (Talk) 23:21, 18 August 2007 (UTC)

== Changes discussed first ==

Latest comment: 17 years ago7 comments5 people in discussion

I would like to express my strenuous conviction that changes should be introduced in Talk first; that changes made unilaterally to the article shd be reverted regardless of their merit.

How do others feel about this?

CeilingCrash 15:16, 18 August 2007 (UTC)

Well, if people don't get cracking and start fixing this article, which right now should be tagged as factually inaccurate and POV, it's ridiculous to expect others to sit around and do nothing. Further, if you start reverting good faith, well-sourced, accurate edits, I intend to call it to admin attention. And, if you want to move at a snail's pace on every word here, I'll agree; let's put the factual inaccurate, POV tags on the article, and then take all the time in the world to fix it, as long as the article is tagged, reader beware. Let's see now; the textual changes this morning have been 1) the deletion of one word (often), 2) the deletion of the redundant words "such things as", and 3) the reorganization of the order of two sentences. You have a problem with those edits? Was there a substantive change there? Furthermore, I raised the problems with the lead in May, and Eubulides agrees with them; don't you think 3 months is enough patience? SandyGeorgia (Talk) 15:50, 18 August 2007 (UTC)

Ok...I am going to sit on the fence on this...

YES, OF COURSE minor tweaking of existing problems and citations (eg, unnecessary "often" plus it's dodgey overcite to Attwood or this [4] which was just a bit of nasty syntax) should just be GOT ON WITH, and reverting that would be silly.

BUT...major changes really should be discussed here with everybody, it's only courtesy to all to do that, isn't it?

Let's hail the admin ppl now. I will be back to work on this article when it is agreed that we shall discuss and agree on substantive changes. Sandy, you charge factual inaccuracy yet refuse to comment on the sources themselves. You charge POV yet refuse to enter a discussion as to the state of knowledge on this topic with the group prior to editing.

Most of all, you simply refuse to respect the uconsensus of EVERY OTHER editor here, that we post a draft in Talk, discuss it, modify it, when consensus is reached we place it in the article. This keeps the article from changing hour-to-hour, as it's doing now. I, for one, will revert any text that hasn't been discussed from this point forward, and I welcome admin mediation in this matter.

I am in favor of getting consensus before making major changes, and favor avoiding even minor changes where there is clearly no consensus for them. I see no reason to delay tagging the article, and am considering doing so myself. If you'd like to ask for mediation, or other administrative remedies, I'm 100% fine with that. Poindexter Propellerhead 21:24, 18 August 2007 (UTC)

If you tag the article, someone may submit it to FAR, and then we'll be working under a time deadline. I was hoping we could do without that. SandyGeorgia (Talk) 21:38, 18 August 2007 (UTC)

Zaraeph, I'd ask we hold off on archiving this discussion for a while as I think it will help admin discern how best to move forward.24.34.190.34 20:08, 18 August 2007 (UTC) CeilingCrash 20:13, 18 August 2007 (UTC)

Oh SCR*W, why you not ask BEFORE I do it? It's all still THERE in Archive 12, and actually easier to read. --Zeraeph 20:29, 18 August 2007 (UTC)

That's rubbish, and you're displaying ownership issues. First, the article has not substantially changed (although it needs to). Second, I've detailed the POV, the factual inaccuracy (as has Eubulides), and problems with the lead several times (ad nauseum, in fact). Third, this is Wiki; articles change. Fourth, you can hardly say these issues aren't being discussed. As I said, it's your choice if you want to improve the article by working together, or let it be tagged and FAR'd. I'd prefer the former. Regards, SandyGeorgia (Talk) 20:23, 18 August 2007 (UTC)

Can we Archive?

Latest comment: 17 years ago3 comments2 people in discussion

This is a bit of a dial-in no fly zone again...anyone mind archiving down to "Major New Research"? --Zeraeph 17:00, 18 August 2007 (UTC)

OK with me. SandyGeorgia (Talk) 17:29, 18 August 2007 (UTC)

Oh well, no one else has objected, let's do it. --Zeraeph 18:35, 18 August 2007 (UTC)

Two comments

Latest comment: 17 years ago7 comments4 people in discussion

Nobody can demand that all edits are approved on a talk page, one person cannot own an article. Controversial material may be removed to talk pages for discussion, but pre-approval of edits is not an option.
If you need access to sources, list them below and put your signature in the e-mail list. I will see what I can get access to at work on Monday and e-mail the PDFs I gather to everybody listed in the "E-mail list" section below - remember to activate e-mail in your account! Tim Vickers 21:07, 18 August 2007 (UTC)

Requests

PMID 16639107 Current trends in psychological research on children with high-functioning autism and Asperger disorder (Sep 2005).
PMID 11439754 The autism-spectrum quotient (AQ): evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians" Dec 2001
- (repeat) DOI 10.1023/A:1005653411471 The Autism-Spectrum Quotient (AQ): Evidence from Asperger Syndrome/High-Functioning Autism, Malesand Females, Scientists and Mathematicians (2001)
PMID 10789283 'Obsessions' in children with autism or Asperger syndrome. Content analysis in terms of core domains of cognition.
PMID 16682171 Determining treatment outcome in early intervention programs for autism spectrum disorders: a critical analysis of measurement issues in learning based interventions 2006
PMID 17641962 Social skills interventions for children with Asperger's syndrome or high-functioning autism: a review and recommendations 2007?
PMID 9519632 Reliability and accuracy of differentiating pervasive developmental disorder subtypes (March '98)
PMID 17450055 An epidemiological and diagnostic study of Asperger syndrome according to four sets of diagnostic criteria. (The 4 different sets of diagnostic criteria, we need that).
PMID 17030291 FOUND, Asperger's syndrome. A recent review from Yale, 2006. It looks quite complete. Tim this is my first priority, in case we're overwhelming you. SandyGeorgia (Talk) 03:13, 19 August 2007 (UTC)
PMID 16596080 Asperger syndrome revisited. A Harvard 2006 review that covers history, diagnosis, treatment, incidence, prevalence, and etiologies!! SandyGeorgia (Talk) 03:16, 19 August 2007 (UTC)

E-mail list

Thanks so much. If you are able to locate a recent comprehensive review of AS, that's what we really need (as well as the one above). SandyGeorgia (Talk) 21:09, 18 August 2007 (UTC)
Tim you are an ABSOLUTE STAR, please email me any relevant PDFs --Zeraeph 21:15, 18 August 2007 (UTC)
Yes, thanks very much! And please add me to the list. Poindexter Propellerhead 22:03, 18 August 2007 (UTC)

E-mails now sent, anybody else wanting these Pdfs, please ask on my talk page. Tim Vickers 15:59, 20 August 2007 (UTC)

Mediation

Latest comment: 17 years ago17 comments6 people in discussion

I have never made a direct edit to this article, besides a single word change. It is precisely ownership that we have been trying to avoid. This article will now enter a state of constant flux as text is entered and removed, in this single most controversial issue in neuropsych. Rather than a single editor (me) demanding all changes be posted here, if you review the archived discussion, it is the stated, unanimous view of everyone but Sandy. I shall request mediation. CeilingCrash 21:25, 18 August 2007 (UTC)

You're welcome to waste our time on that rather than working towards consensus to repair the article, which is demonstrably deficient. Mediation is not binding, and not often effective. At any rate, I'm much more concerned about the inaccuracy of this article right now, and I strongly suggest that you reconsider that you are showing all the signs of ownership. Would you like to mediate the fact that Zeraeph and I together decided to delete the word "often"? Or the fact that I've spent now about four hours cleaning up references? What exactly is the change that has occurred in this article that has you so worried? Can you point to a single textual change you're concerned about ? SandyGeorgia (Talk) 21:44, 18 August 2007 (UTC)

CC, regarding your comments on Tim's talk page, do you think 3 months is charging ahead? Do you think there's been no consensual discussion here? Do you think my moving two paragraphs between sections while leaving the (inaccurate) text completely intact—text that could have been easily moved back to the lead rather than reverting and losing the work I also put into cleaning up the refs—is so drastic as to warrant mediation and intervention? I still don't know of a single change in the text that should trouble you, which is why this looks like ownership. My read of this talk page is that other editors are understanding that these issues should be addressed, and that you're the only one resisting. Am I wrong? SandyGeorgia (Talk) 22:00, 18 August 2007 (UTC)

Trying to be objective here, wouldn't a little non-hostile mediation just to get everybody on the same page save more time than it wasted? Because unless something changes it will all just go on like this and get nowhere. The way I see it, at present, both side would have to make MASSIVE concessions against what they feel is right just to co-operate. (I can see both sides, and that leaves me feeling liable to get lynched any minute.) Maybe just a little informal mediation would help close that gap a little? I am SURE it can all be ironed out, because the harder I look the more I see that everybody, ultimately has the same goal, just vastly different ways of going about it. --Zeraeph 22:07, 18 August 2007 (UTC)

What troubles me is you didn't seek consensus for these changes first. This led to the reversion of the lede - not by me. Edit-first and Discuss-later is a recipe for chaos in a field this controversial and evolving.

We are all agreed the references need fixing. We are all agreed the article needs work.

I do not object to, nor do i think other editors object to - repairing references or single world changes, especially those arrived at in discussion with at least one other editor. It is substantive changes in content, going forward, that i am concerned with, as i indicated in my proposal. There are warring and shifting schools of thought in this topic; edit-wars have been avoided thus far by introducing new material or substantively reworking old material in Talk first. This is not my idea, rather i was introduced to it by other editors when i first began working on this article. I do not like to speak for others; it is the weekend, as the new week begins I am sure they will speak for themselves. I would suggest that if you wish to collaborate with others, you yield to their consensus mode of collaboration as it is likely to have developed for good cause. (Added by ceilingcrash - Z's proposal of informal, disinterested mediation seems a good idea to me.)CeilingCrash 22:13, 18 August 2007 (UTC)

I'd recommend as a start that everybody familiarise themselves with Wikipedia:Resolving disputes, particularly the first few sections. Tim Vickers 22:14, 18 August 2007 (UTC)

Thanks, Tim! Poindexter Propellerhead 22:25, 18 August 2007 (UTC)

(edit conflict) CC, those edits you so objected to, once again, were moving two paragraphs from one section to another. If such a small and easily changed edit troubles you so much, this article will be indefinitely stalled, needs to be tagged and FAR'd, and isn't worth working on. The article is massively deficient, and you want to pick away one word at a time. Will mediation be worthwhile, to answer Zeraeph's question? Not in my experience. Mediation is only as good as the volunteer mediator who happens to take the case, and it often turns out to be someone who joined Wiki two weeks ago, and makes things worse. A better idea is to cool off for a few days, and think things over. Here, right on the heels of Tim making an incredibly generous offer that could resolve a lot of problems, you come asking for mediation? Again, this looks like ownership. Think it over; it was very nice of Tim to make that offer so that we can cut through the problems in the article and get the work done. SandyGeorgia (Talk) 22:19, 18 August 2007 (UTC)

We will resolve these issues here, or by undoing each other's work on the Article. Speed is not our mandate, accuracy and NPOV are. The foregone conclusion that an impartial mediator is likely to make things worse strikes me as an intensely non collaborative sentiment. I shall wait to see what other editors say, I won't revert simple corrections. CeilingCrash 22:32, 18 August 2007 (UTC)

I am a bit put out that Tim's kind offer got overwhelmed by other stuff myself...people aren't that nice very often. I just hope you haven't put him off.

Sandy...ME NO DAFT :o) ...I know RIGHT well the inherent flaws in mediation, which is why I remembered User:Francis Tyers and sneaked over to ask him if he would consider informally mediating this. He seems exactly the right sort of person to defuse this and get us on the same page and working together. --Zeraeph 22:38, 18 August 2007 (UTC)

Oh - and Tim, your offer is enormously generous and I suggest we make good use of it. Thanks. CeilingCrash

That's nice :o) --Zeraeph 22:45, 18 August 2007 (UTC)

Recently, Francis hasn't been as active as before; not sure he's still around, but yes, he's a good mediator, and mediated Schizophrenia several times in addition to TS, so understands some of the issues. On the other hand, Tim is also one of Wiki's best diplomats, so what more could we want? I think he offered a perfect solution; we really just need some reliable sources. CC, perhaps I moved too fast for your comfort zone. When I see a job that needs to be done, I dig in, and I work fast so I can move on. I don't want this article to still be in bad shape in another 3 months, but I'm certainly willing to back off for several days if that will make you more comfortable, and then we can all see what Tim can come up with for sources. Would that help? Problem is, then my end of summer travel plans get underway, and I won't be around for either mediation or working on the article, which is why I was trying to get some work done. I 'spose lots of people will be off-Wiki at the end of August. SandyGeorgia (Talk) 22:56, 18 August 2007 (UTC)

Well then, between Tim (who seems a total angel) and hopefully Francis (who is definately around, but whether he wants to get into this is another matter), I have it in my mind that we can sort this out in a few days...and a little easing up on each other and communicating, we should be FINE...

Isn't anybody else, but me, just a TINY bit excited to see what Tim digs up for us (I have VISITORS on Monday too, DRAT!)? --Zeraeph 23:06, 18 August 2007 (UTC)

Clean slate

Hi all - I've semi-protected the page so that all edits can be attributed so everybody can see who is doing what as this would be a headache of a time for anon IPs to start complicating things, well intentioned or otherwise. Would it be worth generating a list of 'Bones of contention' to navigate below? cheers, Casliber (talk · contribs) 23:11, 18 August 2007 (UTC)

Are you the Cavalry? :o) If so permit me. --Zeraeph 23:30, 18 August 2007 (UTC)

Tra..traaa (sound of trumpet blast and horses hooves) -yep. heeheehee. cheers, Casliber (talk · contribs) 23:36, 18 August 2007 (UTC)

Good idea; bad time for IP vandalism, etc. SandyGeorgia (Talk) 23:32, 18 August 2007 (UTC)

Bones of Contention

Latest comment: 17 years ago52 comments6 people in discussion

Content Issues

(Everyone please add thoughts under each)

Casliber

Shift in view section - this para is highly relevant to treatment and I feel should go there. I feel it would gell better in treatment section almost as first or second para (whole cure --> management paradigm needs to be up top of treatment). Culture bit is also then more cohesive.cheers, Casliber (talk · contribs) 23:24, 18 August 2007 (UTC)

Epidemiology -section is pretty controversial and important; in Schizophrenia we had it up under diagnosis and I think it should be there here too. Then prognosis, treatment and culture are all closer together.cheers, Casliber (talk · contribs) 23:28, 18 August 2007 (UTC)

Characteristics section before Diagnosis - allows a more descriptive bit, then the nitty gritty of the criteria.cheers, Casliber (talk · contribs) 23:33, 18 August 2007 (UTC)

It was argued in the last FAR that Diagnosis had to come first, to explain the differences between DSM/ICD/Szatmari/Gillberg, since some of Characteristics depends on what definition you're using. Not sure I agree, but that was the logic. SandyGeorgia (Talk) 23:37, 18 August 2007 (UTC)

(groan) - realistically the differences between diagnostic systems are pretty minor. I wasn't around for the FAR, maybe a better have a read...cheers, Casliber (talk · contribs) 23:50, 18 August 2007 (UTC)

Personally I think that perhaps the BEST way is to cite the characteristics common to ALL diagnostic definitions, THEN expand into diagnosis? It's sorta logical. --Zeraeph 23:55, 18 August 2007 (UTC)

Yep. that's what I felt...cheers, Casliber (talk · contribs) 07:14, 19 August 2007 (UTC)

SandyGeorgia

My list
- POV, towards successful adults and controversial opinions, away from children and away from medical consensus, which are underdeveloped.
- Lead is not a WP:LEAD; that content needs to be corrected, incorporated to correct sections, and lead needs to be written.
- Not comprehensive in areas of treatment, causes, prognosis, epidemiology, etc.
- Overreliance on one outdated source (Attwood book, not peer reviewed), and reliance on non-peer reviewed os self-published sources (Kirby, Myles, others; I believe Myles or her husband owns her press)
  - (YIKES!! That can SO BEGONE *shudders*--Zeraeph 00:51, 19 August 2007 (UTC)
- Concern that text isn't supported by cited sources
- Concern that POV text is original research, editors now trying to retrofit sources to match, entire article should be revamped from updated peer reviewed sources, assuring that text is actually supported by sources and not "successful adult" POV SandyGeorgia (Talk) 23:31, 18 August 2007 (UTC)

(I'll look in detail later - gotta be off-keyboard for a while..)cheers, Casliber (talk · contribs) 23:39, 18 August 2007 (UTC)

Comments I don't have any serious issues with any of the above so far. Except to note that "medical consensus" is underdeveloped on LOT larger scale than this article, and that really DOES need to be taken note of.—Preceding unsigned comment added by Zeraeph (talk • contribs) 23:53, 18 August 2007 (UTC)

Zeraeph

My list
- I don't think the article should be POV to successful adults, but I really DO feel that the tone of the article should at all times acknowledge adults with AS as autonomous and equal, and should NEVER devolve into an atmosphere where AS appears to be about the parents (it's not)
- I would be very uncomfortable with too much assertion of treatments and managements. So far nothing has been effective on a significant scale, some modalities have done as much harm as good and I don't think we should take responsibility for in any way promoting specific treatments (which would be POV ANYWAY).
- I absolutely NEVER want to see any of the small community of amateur self appointed "parents and partners" groups appear in the article. They are just a tiny non-WP:RS and non-WP:NOTE cottage industry seeking publicity. They do keep trying, and I think that has contributed to the defensiveness of the editors and created a reactionary "POV creep".
- It is very important to me that all text should be impeccably and unassailably cited (not least to keep the self appointed amateurs OUT of it!)

I'll add more as I think of it. --Zeraeph 23:53, 18 August 2007 (UTC)

Strongly agree with you on parents and other support group info, but that applies to adult groups as well as parent groups (and is covered by WP:NOT, WP:EL). Only reliable sources should be in External links, they should be minimal, every external link needs a strong justification, and everything else is covered by DMOZ and shouldn't be there (they can submit it to DMOZ). On treatment and management, though, I think we have to at least offer whatever info reliable sources have. SandyGeorgia (Talk) 00:00, 19 August 2007 (UTC)

No groups AT ALL goes without saying (equality goes both ways after all!). DMOZ (and minimal links) is fine with me too these days, things changed and there is no longer the same risk of arbitrary, POV, editorial control there (it was under the editorial control of a banned Wikipedia editor with a grudge, but it isn't any more, thankfully). Absolutely, any reliable information on treatment and management must be offered, but perhaps conservatively? --Zeraeph 00:26, 19 August 2007 (UTC)

As a former DMOZ editor, I would point out that DMOZ is not at all reliable, but that it's acceptable as an external link, because external links don't have to be. Poindexter Propellerhead 00:29, 19 August 2007 (UTC)

No matter HOW unreliable it is now, at least it isn't conducting a personal vendetta any more :o) Do you have a better suggestion though? --Zeraeph 00:36, 19 August 2007 (UTC)

No, I think that DMOZ is fine on most subjects, and external links is where good and useful, but non-RS, material rightfully belongs. Poindexter Propellerhead 01:19, 19 August 2007 (UTC)

I've added an invisible tag in the External Links section that should help slow cruft accumulation. Tim Vickers 00:34, 19 August 2007 (UTC)

NEAT TAG, I have just copied it to Bullying an article that usually has a bumper harvest of links over time. --Zeraeph 00:40, 19 August 2007 (UTC)

CeilingCrash

My quick take is this - the NPOV balance between disability/difference is a tough issue and inherently subjective to some extent. What we tried to do in the initial lede was balance the two equally, list abilities with impairments. This probably leans too much to the 'difference' pole and away from the 'disability'. It is my rough sense that around 25% of the text should focus on abilities; and the introductory sentences in the lede shd be compound statements which mention them together. My reasons are not political, they have to do with sources : Baron Cohen found an astonishing correspondence between mathematical talent and AS; which he reported in his seminal paper establishing the AQ. In Hans Asperger's initial paper describing what was later termed AS, he states over and over again that these are unusually talented people who tend to achieve professional success in areas of abstract content. He actually went so far as to claim that "it seems that, for success in the arts and sciences, a dash of autism is required." I could go on, and will later. My point is the world-class heavy-weight authorities on this subject are making this assertion in a non-peripheral way. It is easy to see how this information would be ommitted in medical manuals - talents are not problems a doctor needs to worry about. But our goal here is comprehensive coverage. On a technically irrelevant note, this is critical information to care-givers, educators and patients who are trying to guide AS folks to productive lives. But we shd make this central point because the sources do, first and foremost. (This is a very interesting situation, as i know of no other disorder that is directly correlated to certain talents. We find ourselves unable to follow typical templates for medical disorders.)

Secondly, and i think someone else just suggested this too, the controversy over the DSM is no mere footnote. To some extent, I expect every DSM category has detractors. But the current DSMV-TR is under blistering and near-universal attack. Baron Cohen asserts that 2/3's of people thus diagnosed are misdiagnosed, and has suggested a new set of dx criteria altogether. Five independent field tests of the DSM-TR criteria have shown it is untenable for various reasons. Between the DSMV and the DSMV-TR virtually all the text was replaced. ( Folklore in the subject - which i can't substantiate but could try - is the category was put together in order to attract the research money necessary to develop workable criteria.) I think we should consider introducing this 'state-of-the-DSM-category' first; it is very unusual for a DSM category to be in such a state. I'm not sure we should do this, but i think it's worth considering. Let me post this comment, then add some links ...

Lastly, I think we should endeavor to go with recent sources. Larger studies have been conducted in the last 5 years, and certain theories (like Theory of Mind) have been overturned, whilst new data have emerged - such as the systematic underestimation of IQ among autistic children. New studies have appeared from the field of neurology or cognitive psychology, especially regarding differences in visual and auditory processing. This is very much part of the current state of knowledge, and sources even 10 years old must be suspect of being overturned or incomplete. CeilingCrash 01:01, 19 August 2007 (UTC)

Two things, first see my comments at Talk:Asperger_syndrome#Proposal: If I'm reading correctly what you've reported about the math/science/AS connection, it appears to be an erroneous interpretation of that result and an overextension of the conclusions. Re, This is a very interesting situation, as i know of no other disorder that is directly correlated to certain talents. We find ourselves unable to follow typical templates for medical disorders. <sigh> Hello, TS. Second, this is not a unique situation and can well be handled by reliable sources. There is a good deal of evidence that Tourette syndrome is truly correlated with specific advantages, discussed in the text in proper context to the strength of the studies, so AS is not blazing some new territory that Wiki can't handle. There's DSM controversy about lots of condtions; we deal with that in the text of each article with no problem. SandyGeorgia (Talk) 01:02, 19 August 2007 (UTC)

Let's see the math/science/AS connection thing in full before we decide it?

I thought I'd leave it to Sandy, who actually knows what she is talking about, not me, who just read it today, to tear you a new one over TS and correlation with specific advantages (you wanna start praying there aren't any low fly Schizophrenics or Bipolars around)...but though AS is NOT unique, I feel the principle remains the same? --Zeraeph 01:12, 19 August 2007 (UTC)

Glad someone appreciates that TS has taken two hits here in the last few hours; that's OK, better chopped liver than headline news :-) SandyGeorgia (Talk) 01:16, 19 August 2007 (UTC)

~~CC, you are NUDE again...please log in? *rolling eyes* You won't be ABLE to edit in that state right now. --Zeraeph 00:53, 19 August 2007 (UTC)~~

Apart from which I think you have put many important matters, close to my heart, very eloquently above. The only thing I don't wholeheartedly agree with is that I REALLY don't think we should let the article get too bogged down in DSM controversy, it isn't so very important to the overall topic...and can we get this stuff PROPERLY CITED? --Zeraeph 01:01, 19 August 2007 (UTC)

The math/science connection is due to Baron Cohen, http://www.springerlink.com/content/k872618310261272/. He states,

" scientists (including mathematicians) scored significantly higher than both humanities and social sciences students, confirming an earlier study that autistic conditions are associated with scientific skills

and

[in reference to the winners of the Mathematical Olympiad] On interview, 11 out of 11 of these met three or more DSM-IV criteria for AS/HFA, and all were studying sciences/mathematics, and 7 of the 11 met threshold on these criteria."

(these numbers are nothing short of amazing.) I don't believe there is any room for misinterpretation here, pls correct me if i misread somehow.

As an aside, a long-standing Millenium problem posed in 1900, the Poincare Conjecture, was solved by a man named Perelman, whom Baron Cohen also dx'd as AS.

OK, now let me insert the remaining links as Z asked ... CeilingCrash 01:15, 19 August 2007 (UTC)

I think what worries Sandy (correct me if I am wrong) is that SO far, all that proves is that people with AS and HFA are more likely to CHOOSE sciences and mathematics, it doesn't really say anything definate about whether they are especially talented at them. The full text may do so though, so stay on the right side of Tim so he gets it. --Zeraeph 01:20, 19 August 2007 (UTC)

Without seeing the full journal study, I'm not sure ... but ... Repeating what I asked above, is there a large study of people with AS establishing that they have a greater than chance statistically significant difference in math/science ability over "normal" controls? That's how you establish correlation. The observation that a lot of math/scientists have AS isn't the same as saying most people with AS have math/science ability. Two different things. Is there a controlled study comparing people with AS to non-AS peers, and establishing a math/science correlation? It's, again, an issue of sticking true to what the sources say and not overextending the results. I invite you to read the Prognosis and Cultural aspects sections of Tourette syndrome and Sociological and cultural aspects of Tourette syndrome (see Latent advantages section) to see that this kind of information can be handled neutrally and accurately without overextending the conclusions of the studies. SandyGeorgia (Talk) 01:22, 19 August 2007 (UTC)

In that study, Baron-Cohen tested over 1,000 people. He arrived at the correlation precisely as you indicate. This is clear from his summary. If you are having trouble accessing the summary, i can paste it here. —The preceding unsigned comment was added by CeilingCrash (talk • contribs) 01:32:12, August 19, 2007 (UTC).

Tiny problem cc, according to the summary, he took 3 groups, one of Aspies, one randon control and one from Cambridge, then tested them for AQ not mathematical ability, he just cross referenced it with their course choices :o( But the full text may explain far more and fix that. --Zeraeph 01:43, 19 August 2007 (UTC)

Another problem with making this conclusion is that correlation does not imply causation. If you find a group of mathematicians that have Asperger's, is it the fact that they have Asperger's that causes them to be good at maths, or is it that fact that they find it difficult to interact with people and express emotion the reason that they are more likely to enter fields where abstraction and logic are highly valued? Finding this correlation does not prove that A causes B, only that A and B are associated. We will have to read the article carefully to see if the authors propose causation. Tim Vickers 01:46, 19 August 2007 (UTC)

I think Z makes a valid criticism; it is almost certain that math and science students entered university with higher math and science scores, but this is a sticky point.

As for causation, I propose it is a non issue. When it comes to an inborn condition like autism (no credible evidence i know of indicates a sudden 'onset' of AS), there is only correlation and not causation. To say A caused B, we must establish that B would not have likely have occurred without A. We cannot sensibly imagine the same person who somehow is not autistic. It's inherent.

The negative aspects of autism are all similarly correlations; causative hypothesese are unverifiable. Correlation is all we got. I've got to tend to other things for a while, but find this discussion intensely interesting and productive and shall return soon .... CeilingCrash 01:56, 19 August 2007 (UTC)

The Asperger's phenotype is the personality and mental abilities of the person. How this phenotype interacts with the world - career choices, professional successes/failures, marriage/divorce rate etc. - is not a direct outcome of the biological state of the individual. We both agree that making any statement that Asperger's causes any of these higher-order effects directly is unwise. Instead people will apply Occam's razor and attempt to first explain these effects using the phenotypes we know, rather than hypothesising new aspects of the phenotype for each correlation discovered. As an example, if you were to breed albino mice with no eye pigment they would find bright light painful - a direct phenotype. The observation that these mice spent a lot of time in shadows could either be explained with the basic phenotype, or a new aspect of the phenotype cold be hypothesised - "they like the dark". Similarly, the observation that people comfortable with abstraction and uncomfortable with emotion gravitate towards professions that fit their personalities can either be explained with the basic phenotype, or a new aspect of the phenotype could be hypothesised - "they are better at these professions". Do not needlessly multiply entities - apply the razor. Tim Vickers 03:17, 19 August 2007 (UTC)

The razor cuts both ways. As you say, the phenotype has two traits, "comfortable with abstraction and uncomfortable with emotion," and the causality of either one is an equally simple proposition. The causality of both together isn't terribly complex, and seems quite plausible -- although we are unlikely to have any proof of causality at any point, precisely because the phenotype does have both traits, and there's no way to bifurcate them. But I doubt that CC demands any statement of causality. The abstract says that the findings are "confirming an earlier study that autistic conditions are associated with scientific skills," and my guess is that he'd be fine with simply stating that the association exists. No need to speculate about causality at all. Poindexter Propellerhead 05:55, 19 August 2007 (UTC)

I think that, if you want a statement which is concise and directly addresses the matter, Asperger's quote, "It seems that, for success in the arts and sciences, a dash of autism is required," does that pretty well. Any medical/psych type, in the last 50 years, who wanted to a lifetime's worth of academic laurels could do so by proving a monumental figure like Asperger wrong, but I've never heard of anyone contesting it, only (like Baron-Cohen) working out the details. Poindexter Propellerhead 02:01, 19 August 2007 (UTC)

No, that's anecdote and hyperbole and just plain silly and not based on science. And I have a graduate degree in math/sciences and a successful career, with no autism, so it's not even useful. SandyGeorgia (Talk) 02:07, 19 August 2007 (UTC)

Maybe someone else can explain this better than I can (I wish Eubulidies would pop in). That study (I think, based only on reading the abstract) shows that people with AS rate higher on the Autism-Spectrum Quotient (AQ) instrument than controls. That may tell us something about the ASQ rather than people with AS. The question is (for example), if you look at 1,000 people with AS and 1,000 people without AS, are you going to find higher mathmatic ability and talent in the group with AS than expected by chance, independently of this ASQ instrument? The next question is how strong is the medical consensus in support of these results. And the next question is whether that conclusion is so earth shattering that it frames our entire approach to the condition (I don't think so -- just because kids with TS are smarter than expected and faster than kids without tics and have better cognitive control, do I wish for everyone to have TS and do I pretend the difficulties don't exist and do I frame an entire article around the latent advantages, ignoring the rest of the story? No, we balance this info in the context of everything else we need to say.) We need to see what other researchers say about this conclusion and how it is framed in the overall context of AS. That's why we also use secondary sources to evaluate primary sources, and need an overall review of AS. We just can't overlook the difficulties associated with "growing up different" even though there are latent advantages. SandyGeorgia (Talk) 01:47, 19 August 2007 (UTC)

Again, not much time, briefly, and i'll return to support these statements : the AQ test has since been demonstrated to be predict a DSM diagnosis 80% of the time. I'll make that more precise later. Further studies confirm : people with AS have higher math scores, people with higher math scores are more likely to be AS and - astonishingly, people at the very highest level of talent about 50x as likely to be AS as the general population.

This information has been absorbed into secondary sources, and has not been refuted to my knowledge. Again, you won't find it in medical manuals because talent is not a medical issue. We are not writing a medical manual, however.

It's not just math; further studies show people with AS have more accurate visual memories, and *vastly* superior verbal skills by age five.

I am as astounded by this information as I suspect you are, and I look forward to discussing the RS's for it.

CeilingCrash 03:19, 19 August 2007 (UTC) 03:17, 19 August 2007 (UTC)

Stealing a few minutes here, Baron-Cohen got straight to this issue in this more recent study,

Mathematical Talent is Linked to Autism : http://www.springerlink.com/content/21t03377610752g0/

Again, Baron Cohen is director of the world-famous Autism Research Centre at Cambridge University. Of course, some non Baron references shd be provided, and I'll be back. Interestingly, Baron is first cousin to Sasha Baron-Cohen, otherwise known as Borat. How cool is that?

PP is right, the authors of these studies avoid implying causation, and i am content to do the same. I'd point out, however, the same reasoning applies to negative aspects as well. Until/Unless AS can be turned off, or at least the internal mechanism understood to the point we can hypothesize a non-autistic 'double', causation has no empirical meaning. I like the word 'manifests' rather than 'causes'.

The occum's razor argument is interesting, but I believe it begs the question. Let us take the simplest possible definition of Asperger's : it is a characteristic of the brain - rather a set of characteristics that tend to co-occur, in a subgroup of the population. These characteristics are in variance with the norm of the population.

In nature, variance from the norm is almost always pathology. Each species arrives at a carefully struck equilibrium. Change the system, it malfunctions and dies prematurely. What is different is what is *wrong*.

But not always. Rarely there are critical improvements, which have led our race from living in trees to discussing neurology on laptops. When we assume that the "simplest explanation" for talent is that it is a mere side effect of deeper pathology, we have made the unspoken assumption that no improvement over the current norm of the species is possible. Nature has left us a million years of fossilized counter-examples to this assumption. Most of them affecting the brain.

The Asperger phenotype, to use your term, as described in the DSM makes virtually no assertion about the person in and of themselves. It is not a phenotype at all, rather it describes their higher-order interactions with other members of their culture (social impairments, etc) and the subjective reaction of those members (odd parasody of speech.) Very little is asserted about the person themselves. They are mostly higher-order effects, again to use your terminology.

There is no reason to consider 'social impairments' a more fundamental attribute of a person than a mathematics degree. Both are higher order interactions with the environment, and the math degree is considerably more objectively determined.

If we argue not from complexity but from precedence, that is : we 'know' that social impairment is part of AS, therefore this appearance of mathematical ability is most simply explained as a side effect of social impairment, we have our head planted firmly in the sand, insisting that new data is an illusory consequence of existing theory - with no more justification than "it's simpler to think that way."

The flat earth theory was simple, but had to be radically altered in view of emerging evidence.

In order to objectively assess the characteristics of this subgroup we have identified, we must not hasten to unproven pathological explanations to talents we may observe. Occum's razor dictates we simply observe the talent with the same dispassion as the deficits.

I think it was Heidegger who said, "In order to know a thing, first ask : what is it, in and of itself?"

CeilingCrash 06:56, 19 August 2007 (UTC)

Updated, CeilingCrash 09:36, 19 August 2007 (UTC)

I know how to put this really simply. So far, all you have is another test that establishes a connection between Autism and a preference for maths/sciences among those of a certain ability range. In order to test for enhanced ability, you need to have two otherwise random (or similar) groups, one that tests high on the AQ scale, and one that tests low, then you need give BOTH the same test to establish mathematical reasoning skills. If the Aspies score significantly higher than the others you have established a connection.

This statistical analysis stuff is really convoluted, I once had a book called "Playing games with statistics" as required reading, and I would recommend it to ANYONE. --Zeraeph 11:03, 19 August 2007 (UTC)

Your point is well taken, but I would add :

a) we shd let Baron Cohen speak for himself, criticizing his conclusions is OR on our part and a

b) these students didn't just choose math as a major, they were *accepted* into a math program by Cambridge U, which (can any brits chime in here) i expect sets an extremely high standard for mathematical ability.

c) cohen reports not only that mathematicians tend to be more aspie, but that a majority of the most talented are aspie. The fact that only 11 people were interviewed - winners of the mathematical olympiad - is due to the fact that of ninety nations participating it takes a decade for this distinction to be achieved by 10 people. There are less than fifty in the entire world ! This competition is at the high school level, incidentally, before they get to university. This result cannot be ignored by any reasonable person, it is absolutely astonishing.

Let me illustrate with some rough calculations. Suppose 1% of the population is AS. The fact that 7/11 olympiad winners are aspie means that a randomly selected Aspie child is sixty times more likely than a randomly chosen NT child to grow up to win the olympiad. Sixty.

Put differently, 2 random Aspies have a better chance that one of them wins than do 100 NT children.

These results are not dismissed easily, and aren't for us to dismiss.

I too would like to see more research on this, in fact Baron Cohen is now directly searching for an Autism/Mathematics gene. But this correlation is more firmly established in these studies than any of the DSM characteristics have been (or could be.) I think it is safe to say that AS is associated with at least one positive trait - above normal ability in mathematics. At least they are a helluva lot more likely to win the olympiad. Since our goal is to determine credibility, accuracy and verifiability - not truth (we are not the subject matter experts, just a tertiary source), i submit that this far exceeds encyclopedic standards for inclusion. As for accurate representation of his findings, let's quote Baron Cohen directly and remove that concern.

CeilingCrash 11:56, 19 August 2007 (UTC)

I get your take on the Cambridge thing, I was educated in an Oxbridge feeder myself *pause for fellow editors to get standing ovation out of their systems* and know the system and the logistics inside out and WHATEVER the standards set, there are too many objective factors involved. BESIDES, you could only get the very most subjective read by comparing statistics for Aspies studying maths at Oxbridge with Aspies studying maths elsewhere, at which point you would get lynched by the combined forces of the OTHER uk Unis for undermining the intergrity of their maths programs...then there is the TINY WEENY POINT that Cambridge is renowned for classics, medicine and law and tends to lag behind on maths...

In other words, no, CC, snob value is NOT a valid scientific tool for statistical analysis, nor is it THE ASPIE WAY...for shame...*rolling eyes* --Zeraeph 12:05, 19 August 2007 (UTC)

PS. BE PATIENT, we will soon have the WHOLE study to read and analyse, then the picture may change completely. BTW I HATE maths and border on dyscalcula...no kidding...and I know a lot of others who do. —The preceding unsigned comment was added by Zeraeph (talk • contribs) 12:19:02, August 19, 2007 (UTC).

Anyway, back on topic; regardless of the conclusions of this discusion, the entire thing should not be debated in the lead of the article. We still need to write a summarizing WP:LEAD and move all of this debate to the appropriate part of the article, once we have the full studies, summarizing it back to the lead in one or two sentences. The entire lead right now is controversy, speculation, hypothesis and inaccuracy, and there is still an article to be written and summarized back to the lead. SandyGeorgia (Talk) 14:20, 19 August 2007 (UTC)

I agree with Sandy(!), i think we've got a candidate RS for the statement, "a link between AS and mathematical skill has been reported.", pending review of the complete studies (thanx again, Tim). I know PMID hasn't indexed these, is that a uk/usa thing?

I disagree with Sandy's assessment of the lede, and as she challenged the assertion of 'positive traits' - leading to this discussion, i hope she continues to register specific concerns that we can address. I know this is slow-going, but i think it will improve the article, and i hope some other editors are finding this discussion as informative as I am.

Again, i think majority of the article (and lede) shd be deficits, i am focussing on alleged abilities because i was requested to (way back).

Shall we shelve the mathematical talent for now? there are two other areas i want to provide support for, Memory and Language.

Once we have the credibility (or lack thereof) laid bare, we can then discuss their relative importance and position in the text of the article.

CeilingCrash 17:10, 19 August 2007 (UTC)

Poindexter Propellerhead

My list can be boiled down to one item, although it's awfully broad. The article is a patchwork of edits, representing different viewpoints, levels of expertise, and writing styles. If you look at the "treatment" section, for example, it's obviously the work of at least 3 people; one who wrote the first, general section, one who inserted some mention of ABA, and one who tacked on a sentence about ethics. That has been my complaint about the article from the first time I set eyes on it, and that was what led me to be content with a collaborative, comprehensive rewrite on the talk page. It was difficult and time consuming, but we arrived at a product which was coherent, flowed pretty well, and had enough collective support that editors would be inclined to defend it from deteriorating into a hodgepodge again. (That, in my opinion, is what makes Britannica a historically great encyclopedia; sure, it's full of POV articles, but every article is consistent and coherent. By collaborating closely we emulated a single author, and, until the last day or so's worth of edits, had an opening which showed that.)

Yes, there are other things wrong with the article; as has been pointed out, the opening should mention some areas more than it does. The criteria section probably does need to be moved towards the top; that would also facilitate splitting off the discussion of AS vs HFA into a subheading, something which has been discussed before, which would eliminate a lot of the criticism of the opening. The rest of it is of highly variable quality; some sections are nearly acceptable as-is, others are riddled with contradictions and probably need to be rewritten from scratch. We can keep doing what we've been doing in recent days, and turn this article from a piece of crap into a better sourced, more balanced piece of crap which will satisfy the FAR criteria. But, unless we take the time to work collaboratively, it will never be more than that, and I really hoped for more. Poindexter Propellerhead 18:09, 19 August 2007 (UTC)

Now that everyone has sort of had a chance to weigh in, and we all seem to be approaching a broader understanding ... without being alarmist, and without intending to offend anyone (because it is a patchwork—some of the really bad text survived the last FAR when it shouldn't have), IMO this is currently Wiki's worst featured article. It is alarmingly bad, and an embarrassment to the star it's wearing, and we simply cannot take our time in fixing it. Tim, Cas, and Tony have all looked in here now. Including Eubulides, that means that collectively, some of Wiki's best FA writing talent is on board here to some extent. It is a shame that the last featured version was copyedited by Tony (who many consider to be Wiki's best copyeditor, and who doesn't have time to offer his talents to many articles) and what we have now is barely recognizable as FA quality. There is no need to dally in fixing this article; we just need the sources, and it needs to be urgently and immediately rewritten, top to bottom. The lead must be dealt with "yesterday", even if that means temporarily putting something in its place while we work on something better. Anyone can grab a basic summary of AS from NIH, emed, whatever and put something in there while we take the time to hammer out the rest. We just can't have thousands of readers daily hitting on this article as a representation on Wiki's finest when it isn't neutral, isn't comprehensive, and isn't accurate. Let's please not underestimate at all the deteriorated shape this article is in, or delude ourselves into believing that we can dally in repairing it. That's my four cents; we need to get cracking as soon as we get the sources, or we need to tag this article and remove the star. SandyGeorgia (Talk) 19:11, 19 August 2007 (UTC) Adding on. My original hope was that we could avoid FAR, by moving all of that debate and controversy out of the lead and into the body of the article, so that the problems would be less dramatic and we could take more time to do the necessary work. That idea was rejected and reverted, so I hope we don't dally and I just don't want the severity of the problems with this article to be underestimated. SandyGeorgia (Talk) 19:35, 19 August 2007 (UTC)

I think there is a difference in perspective here. You clearly want to get this article patched up quickly, avert FAR issues, and move on. The people who watch over this article every day, attempt to slow its deterioration, and make gradual improvements, tend to have the long term in mind. And, in the long term, if we are not truly proud of this article, it will not remain as it is. Repairs to unsatisfactory sections will be tried, and stupid little edits by visiting dabblers will go unreverted, because they won't be obviously worse than what was there before. I'd like to see this article become static, something which everyone concerned will be happy to revert to, because all are satisfied that it really can't be improved upon. Instead we're rushing through piecemeal changes to satisfy FA requirements, which don't even matter to everyone in this discussion. I think they matter to Z, but CC has expressed utter lack of interest in them before, and I sit somewhere in the middle; it seems nice, but I'd rather have a great article that isn't featured, than a mediocre one which nevertheless meets enough criteria to get an occasional day of extra publicity. You are very focused on the battle, but I am concerned about direction of the war. CC isn't asserting ownership, he's showing pride in something he helped craft, which has now been largely replaced by numerous quickie edits. After another few barrages of friendly fire, will he try to turn it into a great article, or will he abandon it to clueless edits by wandering novices? I have no idea, I have no idea which of those I may do, either. I'm just pointing out that either result is likely to leave you wondering what the hell happened when you look at this article a few months down the road. It may be a lot better, or it may be a lot worse, but there's no way that this article's going to be stable without strong and broad consensus, and we definitely don't have that right now. Poindexter Propellerhead 22:44, 19 August 2007 (UTC)

You clearly want to get this article patched up quickly, avert FAR issues, and move on. Not so. I want to get the lead patched up in the interim, and settle in for the sustained amount of work necessary to repair this article once and for all. And by sustained work, I don't mean three months of debating every sentence. The road to hell is paved with good intentions; it shouldn't take 3 months to rewrite this article with reliable sources and conforming to Wiki policies and guidelines. In the last year, editors who had the long term in mind have not improved this article from the dismal state it was in when it survived the last FAR. Whether it is featured or not featured, if it remains in the state it's in, it needs to be tagged as factually inaccurate and POV, so there's no reason to sacrifice featured status if the article can be repaired. All wiki articles strive for the same level; featured articles attain it, but defeaturing this article will not let it off the hook as far as conforming to guidelines and policies. Anyone with Wiki's best interest in mind will strive to fix the article, and if they don't have Wiki's best interests in mind and leave, so be it. If the article deteriorates, a tag will be needed to warn off unsuspecting readers; I doubt that will happen, as there are editors who can repair the article. And it is still inaccurate for you to say that CC's content has been replaced; it hasn't. It was moved from the lead, and then moved back. SandyGeorgia (Talk) 22:58, 19 August 2007 (UTC)

"Anyone with Wiki's best interest in mind will strive to fix the article..." Many thousands of good Wikipedians are busy contributing elsewhere.

For those who care to see (it's not exactly riveting), here are diffs of the changes between the time FARC finished with it and the time Sandy dropped by the talk page to discuss the state of the article.[[5]]

Here are changes between then and the start of the recent editing spree.[[6]]

No predigested conclusions offered, people can draw their own.

I said that the opening had "been largely replaced by numerous quickie edits." Here are the diffs, with new text in italic and deleted text stricken through. Once again, people can draw their own conclusions.

Asperger syndrome (also referred to as Asperger's syndrome, Asperger's disorder, Aspergers, or AS) is a condition on the autistic spectrum. Like other autistic spectrum disorders, Asperger's includes "restrictive, repetitive, and stereotyped patterns of behavior, interests, and activities." However, Asperger's differs from 'classic' autism in that there is no significant delay in non-social aspects of intellectual development. ~~It manifests in individual ways and~~ AS can have both positive and negative effects on ~~a person~~ an individual's life. Like other autistic spectrum disorders, Asperger's includes repetitive behavior patterns and impairment in social interaction. However, Asperger's differs from 'classic' autism in that non-social aspects of intellectual development generally proceed at a normal or accelerated rate.

~~The disorder affects~~ AS does not always affect people in ~~various ways,~~ the same way, but individuals ~~with Asperger's commonly share characteristics~~ tend to have aspects in common, such as ~~an ability~~ a tendency to focus intensely on areas of interest, hyposensitivity or hypersensitivity to certain stimuli and sensory integration problems, self-stimulating ('stimming') behaviors such as rocking back and forth, and difficulty interpreting facial expressions and other social cues. ~~Some~~ The more positive ~~characteristics~~ aspects can include things such as enhanced mental focus, excellent memory abilities, superior spatial skills, and an intuitive understanding of logical systems. ~~These characteristics~~ and can ~~often~~ lead to fulfilling careers in mathematics, engineering, the sciences, ~~music, art, or language~~ or other fields which utilize these strengths.

There is significant ~~controversy~~ debate over the difference between AS and the broader category of high-functioning autism (HFA). While ~~neither AS nor~~ HFA ~~have universally accepted~~ has no standardized definition, and AS has several distinct definitions, ~~most diagnostic manuals~~ disgnosticians often distinguish the two according to speech development. Delayed speech indicates HFA; normal onset of speech indicates Asperger's. However, at least one diagnostic guide takes the ~~opposite~~ position; that delayed ~~onset of~~ speech ~~favors~~ may be a ~~diagnosis~~ sign of AS.

Poindexter Propellerhead 01:59, 20 August 2007 (UTC)

I am opposed to making changes based on urgency alone. We do not have consensus that any sort of reversion is an improvement. We need to work through these issues and reach consensus. It is not easy and it is not quick. This issue is deeply complex, evolving, and controversial, as all the activity on this page indicates. To seek shortcuts is to underestimate our task and to attempt to subvert consensus. Let's keep working. CeilingCrash 02:17, 20 August 2007 (UTC)

Like I said earlier, no pre-set deadlines, it wouldn't take long to determine if editors here intended to fix the article or not. I think the message is clear. This article cannot stand in this condition. I'll tag it now. SandyGeorgia (Talk) 02:20, 20 August 2007 (UTC)

Hey, I have a suggestion! Let's try civility! Poindexter Propellerhead 03:43, 20 August 2007 (UTC)

Important Point to Consider

Latest comment: 17 years ago1 comment1 person in discussion

I'm taking this out of brackets (where all the REALLY important things always seem to wind up) and transcribing it a little because I think we all need to consider it seriously and with an open mind:

just because kids with AS are smarter than expected and faster than kids without AS and have better logical, musical and mathematical ability, do I wish for everyone to have AS and do I pretend the difficulties don't exist and do I frame an entire article around the latent advantages, ignoring the rest of the story?

I think the answer is No; this is the sin of the opposite extreme. We need to balance the two, and roughly speaking, my guess is the abilities shd be about 25% or so. —The preceding unsigned comment was added by CeilingCrash (talk • contribs) 04:19:47, August 19, 2007 (UTC).

--Zeraeph 01:53, 19 August 2007 (UTC)

Removing sources

Latest comment: 17 years ago9 comments2 people in discussion

Ack, Poindexter, don't just remove sources. As long as the text is there, we need to know where it came from. We can source similar text to other reliable sources later, but for now, it's better to leave the sources so we know the origin of the info at least. You should only remove the source if you also remove the text, or flag the text as uncited. SandyGeorgia (Talk) 02:10, 19 August 2007 (UTC)

Yeah, I should have tagged them as uncited before, I'll go do that now. Poindexter Propellerhead 02:51, 19 August 2007 (UTC)

But I'd rather keep the sources; even if they're not reliable, sometimes they have a bibliography that gives an idea where they got the info, and we can use that to find reliable sources. SandyGeorgia (Talk) 02:52, 19 August 2007 (UTC)

If I may make a suggestion, it seems to me that we all have pretty full plates already... rather than going out and acquiring copies of 2 non-RS books so that we can look at their bibliographies, how about we provide better cites instead? They were used as cites for 3 statements, but one already had an additional cite, and at least one other could be cited very easily. I'd hate to see someone waste $50 on questionable books over one cite. So how about I put a better cite on one statement, and leave the other one tagged for now? Reasonable compromise? Poindexter Propellerhead 03:23, 19 August 2007 (UTC)

Good point, makes sense; I just hate to lose a citation. I get attached to those ref tags too easily :-) SandyGeorgia (Talk) 03:24, 19 August 2007 (UTC)

Well, that was an exercise in frustration. No peer-reviewed article has taken special notice of Myles' coining of the catchphrase "hidden curriculum," so while sourcing the other facts in the sentence is very easy, citing her use of that expression is not. I have restored the cite, reluctantly, and will tear it out by the roots shortly, rewriting the sentence to eliminate use of Myles' particular jargon. Poindexter Propellerhead 04:08, 19 August 2007 (UTC)

It's kind of a disguised book advert, I guess :-) SandyGeorgia (Talk) 04:13, 19 August 2007 (UTC)

The New York Times mentioned the hidden curriculum if that helps:PDF Answer, but No Cure, for a Social Disorder That Isolates Many April 29, 2004 By AMY HARMON The New York Times SandyGeorgia (Talk) 04:27, 19 August 2007 (UTC)

Thanks... yeah, I saw that one, but figured that the NY Times wouldn't really cut it as a cite in a medically-based article. Poindexter Propellerhead 05:03, 19 August 2007 (UTC)

Inaccuracy in History section ?

Latest comment: 17 years ago57 comments3 people in discussion

The History section says the term was first used by Wing; PMID 17354550 says Bosch. I don't want to abuse of Tim's generosity by asking for another article, but ~~it looks like this article could be useful to anyone who wants to write the History section.~~ Oops, the article is in Japanese. SandyGeorgia (Talk) 14:52, 19 August 2007 (UTC)

No worries, one or two of us can learn japanese while the lede is hammered out :o) --Zeraeph 23:53, 19 August 2007 (UTC)

It looks like Bosch was supposed to have used it in 1970, and Wing in 1981, but I don't find evidence for Wing. More faulty fact checking, original research here. SandyGeorgia (Talk) 00:01, 20 August 2007 (UTC)

Perhaps PMID 4077818 can verify. SandyGeorgia (Talk) 00:13, 20 August 2007 (UTC)

Here's Lorna Wing's account [7] (not sure if we can use it for citations AS SUCH but it's a great crib sheet also http://www.mugsy.org/wing.htm )--Zeraeph 00:20, 20 August 2007 (UTC)

Right, looks like original research. Someone said Lorna Wing was the first to use the term, and then linked to Lorna Wing to prove it. Not verified by a secondary reliable source. Another example of why I think every sentence in this article is suspect and it needs to be rewritten from scratch, verifying everything written. SandyGeorgia (Talk) 00:24, 20 August 2007 (UTC)

No, I meant look at the details she gives on Bosch, dates AND publishers. There are a LOT of other details and bibliography too. --Zeraeph 00:31, 20 August 2007 (UTC)

Take a look at THIS:

http://www.springerlink.com/content/q578u57501671854/ D. Arn Van Krevelen Early infantile autism and autistic psychopathy (Maybe the real first person to publish on AS in English)
http://www.elsevier.com/authored_subject_sections/S05/S05_360/pdf/klin.pdf Baron-cohen on the origins of AS "What’s so special about Asperger Syndrome?"

--Zeraeph 00:42, 20 August 2007 (UTC)

Right; that's what I meant. I can't verify any source claiming Wing was first except Wikipedia, while there are plenty of indications that the Japanese article is correct about Bosch. The info was added by AlexPlank, aka Perl (talk · contribs) aka Wrong Planet. It illustrates the problems with this article; original research rather than reliably sourced statements. I don't much care who used it first; I care that we start from scratch and not assume anything in this article is accurate. SandyGeorgia (Talk) 00:49, 20 August 2007 (UTC)

Even scarier is that I didn't even go looking for that info; I chanced upon it while looking for a good review for Tim. SandyGeorgia (Talk) 01:04, 20 August 2007 (UTC)

It does look as though Lorna Wing may well have been the first person to use the term "Asperger Syndrome" in English AS SUCH...also, Simon Baron-Cohen does say:

Lorna Wing is recognized as having drawn the English-speaking medical community to the existence of AS by summarizing Asperger’s observations and providing clinical illustrations in what became an influential journal article (Wing, 1981). and that the "Influential Journal Article" he cites is in fact Asperger syndrome: a clinical account the article that I just posted above. (after "Here's Lorna Wing's account.." a bit more significant than just "original research" in this context??).

I do, seriously, see what you mean about the sources needing close review, but I think we need to be equally careful not too channel our attention towards seeing sources only in terms of disproving existing text. Some of them will largely substantiated it. Still on this one I think the text definately needs changing immediately to reflect the fact that Lorna Wing was, so far, only the first person to use the term widely, in English (Bosch wrote in German, Van Krevelen did not use the term "Asperger Syndrome" as such) --Zeraeph 01:20, 20 August 2007 (UTC)

PS. I think it was probably me who cited Lorna Wing's article, and it does seems an appropriate enough citation where the article is referred to in the para beginning "Asperger’s observations, published in German" (whst else would we cite, but the article itself?) but not in the first line, I agree. --Zeraeph 01:28, 20 August 2007 (UTC)

Mystery solved; it appears to have been a misstatement inserted into the article here in 2003 (4 years ago !!) The source is NIH, but it says "not widely known until" (it does *not* say she first described it),

Asperger’s observations, published in German, were not widely known until 1981, when an English doctor named Lorna Wing published a series of case studies of children showing similar symptoms, which she called “Asperger’s” syndrome. Wing’s writings were widely published and popularized. AS became a distinct disease and diagnosis in 1992, when it was included in the tenth published edition of the World Health Organization’s diagnostic manual, International Classification of Diseases (ICD-10), and in 1994 it was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the American Psychiatric Association’s diagnostic reference book.

while the article said:

Asperger syndrome was named in honour of Hans Asperger by the English psychiatrist Lorna Wing, who first used the term in a 1981 paper

and the Japanese article says:

Bosch (1970) was the first author who used "Asperger's syndrome" in English literature.

Now it can all be put together into an accurate statement. Bosch first used the word in English literature in 1970, Wing popularized the term in a widely published 1981 paper. SandyGeorgia (Talk) 06:30, 20 August 2007 (UTC)

On the other hand, I should add that the NIH information about the history of Tourette syndrome is completely wrong, so I'm not sure we should add anything back until we can verify to another source. SandyGeorgia (Talk) 06:33, 20 August 2007 (UTC)

Ah but it pretty much matches (copy and paste from maybe? :o) ) what Baron-Cohen says here too [8] so we could use him or both? Citing from the Japanese? Now THERE's fancy! :o) --Zeraeph 13:20, 20 August 2007 (UTC)

Adding the Baron-Cohen reference here:

Baron-Cohen S, Klin A (2006). "What's so special about Asperger Syndrome?" (PDF). Brain and cognition. 61 (1): 1–4. doi:10.1016/j.bandc.2006.02.002. PMID 16563588.

Now that I have this source, I'll be rewriting my proposal (below). SandyGeorgia (Talk) 15:45, 20 August 2007 (UTC)

History proposal

For the top section of History (first 3 paras). The last two paragraphs deviate from true "History", but I propose we leave them as is and deal with them later—this is only to correct the Bosch/Wing issue. Some of this is direct from NIH, but it's public domain. They've corrected the 1995 to 1994 error in their DSM date, so we can lose that footnote. The first sentence of the Kanner paragraph needs to be verified to Attwood pg. 15 if Poindexter doesn't mind checking (that is, we need to know that Attwood specifically said that Kanner characterized them as "perhaps less socially functional". SandyGeorgia (Talk) 07:27, 20 August 2007 (UTC)

Asperger syndrome was named in honour of Hans Asperger (1906–1980), an Austrian psychiatrist and pediatrician. In 1944, Asperger observed four children in his practice who had difficulty integrating socially. Although their intelligence appeared normal, the children lacked nonverbal communication skills, failed to demonstrate empathy with their peers, and were physically clumsy. Their way of speaking was either disjointed or overly formal, and their all-absorbing interest in a single topic dominated their conversations. Asperger called the condition "autistic psychopathy" and described it as a condition primarily marked by social isolation.^[1]

The Austrian-American child psychiatrist Leo Kanner identified a similar syndrome in 1943, although the population characterized by Kanner was perhaps less "socially functional" than Asperger's.^[2] Kannerian autism is characterized by significant cognitive and communicative deficiencies, including delays in language development or complete lack of language.^[3]

Asperger’s observations were published in German and were not widely known.^[1] The first author to use the term "Asperger's syndrome" in English literature was the German physician Gerhard Bosch in a 1970 paper;^[4] the term was first widely popularized in 1981, when an English psychiatrist named Lorna Wing published a series of case studies of children showing similar symptoms^[5] which she called Asperger’s syndrome.^[1] AS became a distinct diagnosis in 1992, when it was included in the tenth published edition of the World Health Organization’s diagnostic manual, International Classification of Diseases (ICD-10), and in 1994 it was added to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as Asperger's Disorder.^[1]

The rest of history needs more work. The final two paragraphs don't really provide a cohesive History narrative, and there's a strange sentence in the Asperger paragraph which isn't well related to History either:

He also stated that "exceptional human beings must be given exceptional educational treatment, treatment which takes into account their special difficulties. Further, we can show that despite abnormality, human beings can fulfill their social role within the community, especially if they find understanding, love and guidance."

I don't see a way to relate that or the final two paragraphs to history, but perhaps will find more sources so that we can fix and expand those. SandyGeorgia (Talk) 07:50, 20 August 2007 (UTC)

To answer the original question, I would have to say that page 15 of Attwood does not say that. "Leo Kanner described children with a more severe expression of autism, while Hans Asperger described more able children" is about as close as page 15 gets. Poindexter Propellerhead 16:26, 20 August 2007 (UTC)

Thanks Prop; I'm reworking the whole thing in my Sandbox now, using the sources Zeraeph found, and I'll repost it in a bit. SandyGeorgia (Talk) 16:48, 20 August 2007 (UTC)

Zeraeph's proposal

Asperger syndrome was named in honour of Hans Asperger (1906–1980), an Austrian psychiatrist and pediatrician. In 1944, Asperger observed four children in his practice who had difficulty integrating socially. Although their intelligence appeared normal, the children lacked nonverbal communication skills, failed to demonstrate empathy with their peers, and were physically clumsy. Their way of speaking was either disjointed or overly formal, and their all-absorbing interest in a single topic dominated their conversations. Asperger called the condition "autistic psychopathy" and described it as a condition primarily marked by social isolation.^[1]

The Austrian-American child psychiatrist Leo Kanner identified a similar syndrome in 1943, although the population characterized by Kanner was perhaps less "socially functional" than Asperger's.^[6] Kannerian autism is characterized by significant cognitive and communicative deficiencies, including delays in language development or complete lack of language.^[7]

Asperger’s observations were published in German and were not widely known.^[1] The first author to use the term "Asperger's syndrome" in English literature was the German physician Gerhard Bosch in a 1970 paper (probably Infantile Autism, 1962^[8] translated into English by D. Jordan and I. Jordan in 1970);^[9] the term was first widely popularized in 1981, when an English psychiatrist named Lorna Wing published a series of case studies of children showing similar symptoms^[5] which she called Asperger’s syndrome.^[1] AS became a distinct diagnosis in 1992, when it was included in the tenth published edition of the World Health Organization’s diagnostic manual, International Classification of Diseases (ICD-10), and in 1994 it was added to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as Asperger's Disorder.^[1]

Super...except that I Bosch's paper really DOES seem to have been written in '62 and translated into English in 1970 so to say "The first author to use the term "Asperger's syndrome" in English literature was the German physician Gerhard Bosch in a 1970 paper;" is a bit misleading? Can I tweak that? --Zeraeph 13:20, 20 August 2007 (UTC)

We don't know that as fact, so we need to say what the source says. I'm seeing the text above as a temporary patch until we get more thorough sources; it will need more tweaking later, and we need to do something about the later history (the current Frith etc. paragraphs aren't really giving us history). I don't want to say it was written in 62 and translate in 70; I want to say exactly what the source says (first to appear in English literature). SandyGeorgia (Talk) 13:24, 20 August 2007 (UTC)

Oh that is VERY much a fact...there are loads of sources for the date and translation of the paper, at present only uses in bibliographies (bit silly to cite them? Yes? No?), won't take a minute to pin it down, the only thing we don't have a definate source for is the use of Asperger syndrome as a term in that, or any other paper by Bosch...YET...can we GET the paper? Also, remember, that is not "what the source say" it is what an ABSTRCT says translated from Japanese. --Zeraeph 13:31, 20 August 2007 (UTC)

We don't even have the name of the original Bosch paper to be able to prove it was published in 62 and translated in 70 (I haven't yet gotten to your Baron-Cohen link above because it keeps hanging my computer; I guess I'm going to have to switch computers to look at it). SandyGeorgia (Talk) 13:34, 20 August 2007 (UTC)

Zeraeph, you added "in a paper (Infantile Autism, 1962) translated into English by D. Jordan and I. Jordan in 1972"; what is the source for that so I can cite it? (Is it in Baron-Cohen, which I haven't been able to access yet?) SandyGeorgia (Talk) 13:46, 20 August 2007 (UTC)

AHA! I SEE NOW...you are on slow connection right now? Ok, let me give you a dial in treat (very short) to read from google's cache [9] (I KNOW we can't use this, but we need to run down an alternative source for it and it is a TREASURE trove on Bosch, the article seems to have been inadvertantly overwritten by a "letter to the editor" of same name [10] can anyone do something about that? I am trying to get webarchive open right now, but I have guest on way) and I will see EXACTLY where that is best sourced. --Zeraeph 13:53, 20 August 2007 (UTC)

Wonderful; I'll work on that after I switch computers, and look for it in the internet archive. SandyGeorgia (Talk) 13:58, 20 August 2007 (UTC)

No, Baron-Cohen is citation for Lorna Wing (instead of NIH? Same words, better source) , but Lorna Wing is citation for Bosch (http://www.mugsy.org/wing2.htm which is fine because that is NAS Surrey site, and article appears by permission of Cambridge University Press) BUT, there are LOADS of mention of this article (Infantile Autism, Gerhard Bosch) in the bibliographies of other articles, HOWEVER, the google cache I gave you, is a "40 years after" follow up, that SPECIFICALLY differentiate between autism and AS in subjects :o) (Webarchive only has the same miss-link, can we try and get the right article? SOMEHOW?) but it WOULD be good to get Bosch, G, Infantile Autism, in the original, if not in the Jordan trans. --Zeraeph 14:05, 20 August 2007 (UTC)

I'm not explaining myself well; we're not trying to source the article. We're trying to source someone saying that specific paper was the first mention. Maybe I haven't yet found that passage because I need to switch computers. The Japanese ~~article~~ abstract says Bosch was the first mention in the English literature; the ~~article~~ abstract doesn't say what paper it was. That's what we need to source. SandyGeorgia (Talk) 14:08, 20 August 2007 (UTC)

I have GOT IT [11]. I DO know what you mean, but I think that article is important and I am against the clock here now. Surely identify the exact article is important thought? I reckon all it takes is a bibliography that refers to it or a list of Bosch's articles, let me try another tweak? --Zeraeph 14:23, 20 August 2007 (UTC)

THERE is an abstract of the 1970 paper, (I popped it in the "ref" spot but there MUST be a tidier way) http://www.eric.ed.gov/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED049567&ERICExtSearch_SearchType_0=eric_accno&accno=ED049567. Sadly there is no ref to translation detals, can somebody run all that down? BUT the reference to Asperger is clear as day...surely the Japanese paper, plus Lorna Wing are enough to confirm it as first ref to Asperger in English? --Zeraeph 14:31, 20 August 2007 (UTC)

PS here are publication details http://medcat.wustl.edu/catflat/BIN/B467035.html --Zeraeph 14:32, 20 August 2007 (UTC)

No, we can't speculate or guess. We shouldn't introduce the word "probably", and we can't use the Japanese abstract to cite that it was translated. The abstract doesn't say that. All we have is an abstract saying it was first used in the English literature. Perhaps you're seeing something I'm not seeing yet since I haven't accessed the PDF, but we can't connect the dots ourselves (that's synthesis). I suggest going back to my original passage, which was true to the sources. We really don't need to track down the original paper. SandyGeorgia (Talk) 14:41, 20 August 2007 (UTC)

Then you cannot speculate or guess either, which mean you cannot possibly refer to a 1970 par by Bosch, youn can only refer to the source referring to it. the most you can say is "It is claimed by X that the first author to use the term "Asperger's syndrome" in English literature was the German physician Gerhard Bosch in a 1970 paper". --Zeraeph 19:50, 20 August 2007 (UTC)

When we have a reliable, undisputed source that says something (which we've been able to independently determine is likely accurate and is not challenged), why would we need to attribute it as opinion? SandyGeorgia (Talk) 19:59, 20 August 2007 (UTC)

Because the source (not "undisputed" it is in Japanese, and none of us really have a clue what it says), and your text, implies the paper was written in English in 1970 by Bosch, however, the only paper we can locate by Bosch in reference to AS is a 1970 translation of a German paper. That is "speculation" on identical terms to which you dismiss me. Now either BOTH speculations (based on WP:RS in both cases) are acceptable, or neither. --Zeraeph 23:15, 20 August 2007 (UTC)

The abstract upon which we're basing it is in English. Where is it disputed; you validated it with your own research? I'm sorry, but I'm completely confused about what your objection is. Is it just that you want it attributed to the Japanese authors? SandyGeorgia (Talk) 23:20, 20 August 2007 (UTC)

My objection is to saying "The first author to use the term "Asperger's syndrome" in English literature was the German physician Gerhard Bosch in a 1970 paper" when, in fact Gerhard Bosch did not produce a paper on AS in English in 1970, though he did have a 1962 paper translated. If you attribute the statement "The first author to use the term "Asperger's syndrome" in English literature was the German physician Gerhard Bosch in a 1970 paper" directly TO the Japanese authors, that is FINE, the inaccuracey does not matter, but if you present it as narrative, it does matter.

I agree with you about purging inaccuracies 100%, but I cannot agree with you on creating them in this way. --Zeraeph 23:37, 20 August 2007 (UTC)

How's this:

The source (PMID 17354550) says: Bosch (1970) was the first author who used "Asperger's syndrome" in English literature.
We say: According to the Japanese Journal of Clinical Medicine, the first author to use the term "Asperger's syndrome" in English literature was the German physician Gerhard Bosch. (PMID 17354550)

And, if it's still a problem, why don't we just delete the paragraph, because at any rate we've resolved the original problem of the incorrect statement about Wing, and the new wording about her is correct. SandyGeorgia (Talk) 23:52, 20 August 2007 (UTC)

Here's the PDF you're trying to reference:

Bölte S, Bosch G. "Bosch's Cases: a 40 years Follow-up of Patients with Infantile Autism and Asperger Syndrome" (PDF). Journal of Psychiatry. Retrieved 2007-08-20.

It says:

Between 1951 and 1962 Gerhard Bosch worked as junior and senior psychiatrist at the department of child and adolescent psychiatry at Frankfurt University, Germany. During this period, he discovered his interest in autism and associated disorders. Later he published five detailed casuistries of individuals affected by a PDD in a monograph (Bosch, 1962) and thus became one of the first scientists to establish research on autism in Germany. Because of the attention his monograph also raised outside the German speaking audience, an English translation was made available eight years later (Bosch, 1970).

It doesn't use the word "Asperger's" and we don't have a reliable source saying this refers to the first paper to use the term as mentioned by the Japanese, and we can't say "probably" (that's original research and speculation), but we can add text that discusses this work without saying it's *the* work referred to by the Japanese. SandyGeorgia (Talk) 15:25, 20 August 2007 (UTC)

In response to the original question, I think that passage looks very good, and the only question I'd raise is whether we should say that Asperger "observed four children in his practice" as the background for his paper. He did four case studies, but I'm sure that I've read a comment from one of his colleagues that he had interviewed hundreds of people on the subject, both those with AS and family members. I don't know that the time frame is definite (hundreds prior to the paper? 50 prior to the paper and the rest later? etc.), but it might be best to omit reference to numbers, unless it is to specify "four case studies." Poindexter Propellerhead 16:53, 20 August 2007 (UTC)

The "observed four children" is taken directly from the NIH, and I've had problems with their factsheets wrt accuracy on TS. Can we solve it by just dropping the number four, saying observed children? SandyGeorgia (Talk) 17:06, 20 August 2007 (UTC)

This is resolved in some of the new studies we've got; I'll rework the History proposal in my Sandbox to reflect the new sources. SandyGeorgia (Talk) 20:52, 20 August 2007 (UTC)

Let's try it this way

Asperger syndrome was named in honour of Hans Asperger (1906–1980), an Austrian psychiatrist and pediatrician. In 1944, Asperger observed four children in his practice who had difficulty integrating socially. Although their intelligence appeared normal, the children lacked nonverbal communication skills, failed to demonstrate empathy with their peers, and were physically clumsy. Their way of speaking was either disjointed or overly formal, and their all-absorbing interest in a single topic dominated their conversations. Asperger called the condition "autistic psychopathy" and described it as a condition primarily marked by social isolation.^[1]

The Austrian-American child psychiatrist Leo Kanner identified a similar syndrome in 1943, although the population characterized by Kanner was perhaps less "socially functional" than Asperger's.^[10] Kannerian autism is characterized by significant cognitive and communicative deficiencies, including delays in language development or complete lack of language.^[11]

Asperger’s observations were published in German and were not widely known.^[1] Ishikawa and Ichihashi^[12]assert that the first author to use the term "Asperger's syndrome" in English literature was the German physician Gerhard Bosch in a 1970 paper (probably Infantile Autism, 1962^[13] translated into English by D. Jordan and I. Jordan in 1970); the term was first widely popularized in 1981, when an English psychiatrist named Lorna Wing published a series of case studies of children showing similar symptoms^[5] which she called Asperger’s syndrome.^[1] AS became a distinct diagnosis in 1992, when it was included in the tenth published edition of the World Health Organization’s diagnostic manual, International Classification of Diseases (ICD-10), and in 1994 it was added to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as Asperger's Disorder.^[1] --Zeraeph 23:23, 20 August 2007 (UTC)

I don't know where to start with this; it's several iterations behind the current text, which I've expanded based on the new sources. SandyGeorgia (Talk) 23:57, 20 August 2007 (UTC)

This version is now fine [12], except I think the word "ironically" is too POV and should be pulled. Perhaps we should just archive all outdated versions to prevent further misunderstandings? --Zeraeph 00:15, 21 August 2007 (UTC)

Ironically is taken straight from the cited source; knowing the full history of Tourette syndrome, the word doesn't trouble me. World War II really messed with medical science; the irony is two Austrian researchers separated by a war. No one has objected to the content yet, so if you're OK with it now, why don't I just pop it in so we can move on? SandyGeorgia (Talk) 00:20, 21 August 2007 (UTC) PS, it's now a version in which I can vouch for almost every word there being true to the source. The only pre-existing statement I haven't verified is "Frith wrote that people with AS seem to have more than a touch of autism." SandyGeorgia (Talk) 00:23, 21 August 2007 (UTC) Another PS: for example, you'll see the "POV" word "influential" in there, also taken directly from the source. SandyGeorgia (Talk) 00:31, 21 August 2007 (UTC)

Personally I would be a lot more comfortable if you took out ironically AND "influential" (which I missed), they are totally superfluous words that add nothing. --Zeraeph 00:37, 21 August 2007 (UTC)

That's fine; then is it good to go to the article (I know there will still be tweaks, but would like to move on from that section). SandyGeorgia (Talk) 00:39, 21 August 2007 (UTC)

No problem, as far as I am concerned you can archive this bit now. --Zeraeph 00:54, 21 August 2007 (UTC)

I'd rather leave it so others can review. I'm moving on to work on Comorbidities in my Sandbox next, since the new sources cover it well. SandyGeorgia (Talk) 01:08, 21 August 2007 (UTC)

Third, consolidating proposal

I've now incorporated the sources Zeraeph found, and re-worded to avoid saying whether the 1970 paper was *the* paper. I've updated the entire section to reflect the info in the Baron-Cohen paper. The only portions (from the previous text) I haven't verified are the final statements about Frith, Ozonoff and Baron-Cohen. If someone can check into those, it would be great. SandyGeorgia (Talk) 17:02, 20 August 2007 (UTC)

There's more detail in the new sources to finish this up, so I'll rework in in my sandbox. SandyGeorgia (Talk) 21:10, 20 August 2007 (UTC)

Earlier draft removed, replaced with later draft in my sandbox. SandyGeorgia (Talk) 22:44, 20 August 2007 (UTC)

This history is lacking a sentence describing how the term "autistic psychopathy" got dropped in favor of AS. SandyGeorgia (Talk) 17:21, 20 August 2007 (UTC)

Found in one of the new sources, will add later in my sandbox. SandyGeorgia (Talk) 21:45, 20 August 2007 (UTC)

Next draft

Instead of taking of space here again, I'll leave it in my sandbox. Can you all tell me if it's close? If so, I'll ask Tony to copyedit before putting it into the article. SandyGeorgia (Talk) 22:35, 20 August 2007 (UTC)

DSM criticism (Diagnosis section)

Latest comment: 17 years ago2 comments2 people in discussion

For our sourced statement about the DSM being too narrow, we use PMID 11411788 Mayes as a source. PMID 15909409 Woodbury-Smith present another view that we might incorporate or use as a reference. SandyGeorgia (Talk) 15:25, 19 August 2007 (UTC)

Works for me. Isn't the definition of communication impairment quite an AS related issue in it's own right, or am I imagining stuff? --Zeraeph 04:27, 20 August 2007 (UTC)

New Game Plan

Latest comment: 17 years ago14 comments5 people in discussion

Dear all - I suspect my start above was too unstructured:

How about a structured plan to deal with everything systematically:

.Order
.Review each section and finally the LEAD.
.Continue to get sources as we go along and add but each will be analyzed in detail when that section is done.

I can't see any other way of doing it without it being amazingly labour intensive. I have limited time - I chipped in as I am a psychiatrist but I don't do too much with child psychiatry these days. If you're all happy to go along with this plan above then sign below otherwise if you've developed a momentum and are happy I'll leave you to it..cheers, Casliber (talk · contribs) 21:36, 19 August 2007 (UTC)

I'm concerned that we can't leave this lead up while we work, and that many people may have restricted time during August. SandyGeorgia (Talk) 21:45, 19 August 2007 (UTC)

I would expand Casliber's proposal by adding one more step: get the lead from the last featured version, correct the few errors in it that Eubulides pointed out, move the current lead content to within the article, and then proceed with Casliber's plan of working section by section, prioritizing to working on the most troubled sections first (not necessarily going in order, that is). Then rewrite the lead last. We simply cannot leave this lead up while we work, and we need time to work. SandyGeorgia (Talk) 23:09, 19 August 2007 (UTC)

I agree with Caliber. I disagree with Sandy's expansion. CeilingCrash 02:04, 20 August 2007 (UTC)

The lead and the multiple problems in this article can't stand in this condition as an example of Wiki's finest work: I've tagged the article as the clear message is that editors here do not see the urgency to repair these issues, and aren't willing to compromise on interim fixes. SandyGeorgia (Talk) 02:25, 20 August 2007 (UTC)

Order: Looking it over yet again, I guess I'd go with: Lead, History, Classification/Characteristics (merge), Diagnosis, Treatment, Prognosis, Research, Epidemiology, Cultural Aspects, See Also/References/etc. I'll save section and sourcing critiques until I know we're all on the same page. Poindexter Propellerhead 02:30, 20 August 2007 (UTC)

I see no need to deviate from WP:MEDMOS. SandyGeorgia (Talk) 02:35, 20 August 2007 (UTC)

I do - guidelines are just that, as opposed to rules or policies, they are intended as starting points from which to deviate. Specifically, medical science studies pathology. Asperger's has non pathological aspects. CeilingCrash 02:50, 20 August 2007 (UTC)

Sorry Sandy, I feel issues with the lead are the lesser of two evils at the moment - hopefully we'll get to it in a matter of days. We need to start somewhere so can everyone list preferred order below? I'll cut and paste PPs and mine and we can at least make a constructive start. cheers, Casliber (talk · contribs) 03:18, 20 August 2007 (UTC)

Revert tags, lock article, request mediation

I support reverting the various tags, locking this article against further edits, and seeking formal mediation in order to proceed in a manner where disputes are resolved in Talk, not the Article, and no single editor asserts their will over the consensus of group working on this article. CeilingCrash 02:59, 20 August 2007 (UTC)

I have reverted them myself. Let's get an admin who can help us to proceed in a less contentious way. CeilingCrash 03:07, 20 August 2007 (UTC)

CC that's what I am rtying to do - can you give your preferred order of sections? :)cheers, Casliber (talk · contribs) 03:11, 20 August 2007 (UTC)

I disagree with the implication that a single editor (SandyGeorgia) is asserting their will over the group consensus. This article has severe problems that cannot be solved by a few minor edits. I just now reread the lead, and its current version is nowhere near Featured Article quality, for reasons similar to those I gave in my earlier review. Eubulides 03:20, 20 August 2007 (UTC)

Given how this talk page is going I was just trying to start teh ball rolling somewhere and at least get a bit of collaboarative spirit back into the thing by focussing on something less contentious first (i.e. order)...cheers, Casliber (talk · contribs) 04:51, 20 August 2007 (UTC)

Orders Please ;)

Latest comment: 17 years ago17 comments5 people in discussion

Lead, History, Classification/Characteristics (merge), Diagnosis, Treatment, Prognosis, Research, Epidemiology, Cultural Aspects, See Also/References/etc. -Poindexter Propellerhead

Lead, Classification, Characteristics (3.1 Social differences/3.2 Speech and language differences/3.3 Narrow, intense interests/ 3.4 Other differences (may need tweaking), Diagnosis, Epidemiology, Causes (incl. Research as subsec), Treatment ( incl. Shift in view), Prognosis (Comorbidities), History (incl. Cultural aspects, Autistic culture), See also, References, External links - cheers, Casliber (talk · contribs)

I am good with both of these lists, with the proviso that under Characteristics we consider inclusion of extra-pathologically, highly RS'd features such as talents, differences in visual and auditory processing that are neither talent nor deficit. (my concern is that certain aspects are not of primary interest to medical care-givers, but should be considered for inclusion in an comprehensive article.)

I regret that the talk page itself is a bit too active for me to remain engaged in it; but i am quite eager to continue contributing. If any editor wishes me to provide support for a topic, chime in on a specific issue, or offer a general opinion, just shoot me a message and i'll snap to it. I have to be a bit cautious in allocating mental energy, and could easily get myself tied up in each and every thread here 24 hours a day. I'll be back watching this page when the dust has settled a bit. Let's roll ... CeilingCrash 04:16, 20 August 2007 (UTC)

I agree with CC in differentiating characteristics and diagnosis as we have done this in other medical FAs.cheers, Casliber (talk · contribs) 04:23, 20 August 2007 (UTC)

Me too, they are really seperate I think. At least in that diagnosis strives to identify a condition while characteristics define and describe it?

No pro-active suggestions from me, I am just TERRIBLE at organising ANYTHING...so why try? Just about ANYTHING anyone else suggests is liable to be an improvement on any attempt I might make --Zeraeph 04:33, 20 August 2007 (UTC)

Sandy has stated the MEDMOS order is OK, which gives us: Classification/ Signs and symptoms or Characteristics/ Causes or Genetics /Pathophysiology or Mechanism/ Diagnosis (including Characteristic biopsy findings and differential diagnosis)/Prevention or Screening /Treatment or Management /Prognosis /Epidemiology/History (not patient history)/Cultural references/ See also (avoid if possible, use wikilinks in the main article)/ Notes/References/ Further reading or Bibliography (paper resources such as books, not web sites)/External links (avoid if possible).

To Sandy - I would put diagnosis under characteristics because (like schizophrenia) the two are more intimately related than they may be in other illnesses as the diagnoses are in essence descriptive. MEDMOS allows for changing order if it makes more sense flow-wise.cheers, Casliber (talk · contribs) 04:37, 20 August 2007 (UTC)

I can go with your list, Cas, except one concern; why roll Cultural aspects into History? No other FA has done that, and I'm not clear on the purpose. (Also, it wasn't clear to me in the conversations above if you were asking for order of sections in the article or order of sections for prioritizing work here, confused.) SandyGeorgia (Talk) 04:46, 20 August 2007 (UTC)

Well spotted! I totally agree. Where AS is concerned I don't think cultural aspects and Autistic culture have a lot to do with history. --Zeraeph 04:49, 20 August 2007 (UTC)

OK - this is about order of sections in article as it is. Regarding cultural aspects in history...I did it somewhere else but my pages are loading really slowly. Whether a section or subsection an extra two '='s are easy to insert (or delete) when the time comes. My plan was that once order is settled, then work on each section. cheers, Casliber (talk · contribs) 04:53, 20 August 2007 (UTC)

I'm thinking in terms of daughter article templates at the top of sections: Cultural aspects is really a different animal than History, with its own sets of daughter articles. SandyGeorgia (Talk) 04:55, 20 August 2007 (UTC)

OK - it's not astrong one with me and the defualt has been for them to be separate. As teh contents evolve we'll get a flavour for it anyway.cheers, Casliber (talk · contribs) 05:17, 20 August 2007 (UTC)

OK first change done. It's a start anyway. cheers, Casliber (talk · contribs) 05:17, 20 August 2007 (UTC)

So, now you can see the problem left after the last FAR. Characteristics contains:

This section mainly reflects the views of Attwood, Gillberg, and Wing on the most important characteristics of AS; the DSM-IV criteria represent a slightly different view.

but those concepts are defined later, in Diagnosis. SandyGeorgia (Talk) 05:23, 20 August 2007 (UTC)

I think that the exisitence of a characteristics section is straightforward, but what it contains is another matter. We'll get to that once we've ironed out what goes where (I spoke too soon re research though). —The preceding unsigned comment was added by Casliber (talk • contribs) 05:28, August 20, 2007 (UTC).

Happy with Shift in View subsection to go into treatment?

Are we happy with this? Once this is done the gross order is largely settled (I'm not too fussed where epidemiology goes) and we can go section by section.cheers, Casliber (talk · contribs) 06:38, 20 August 2007 (UTC)

Concur. SandyGeorgia (Talk) 06:40, 20 August 2007 (UTC)
Hmmm... I lean towards other placement, because, while treatment comes into it, I see that as being peripheral to the issue of whether or not AS is considered a disorder. "Classification," maybe? Poindexter Propellerhead 07:26, 20 August 2007 (UTC)

PP - The treatment section needs something right up front about the crux being management of symptoms rather than cure. This sits rather nicely as a counterargument to go there rather than floating where it is (or that was my take on it anyway) - what are we treating anyway/what are we aiming for etc. i.e. ethical counterbalance nad all that.... cheers, Casliber (talk · contribs) 07:57, 20 August 2007 (UTC)

Oh! OK, with that plan in mind, sure. Poindexter Propellerhead 08:49, 20 August 2007 (UTC)

Thanks (I'm glad I sounded convincing... :) ) - right now onto sections.....cheers, Casliber (talk · contribs) 09:27, 20 August 2007 (UTC)

First problem -research section

Latest comment: 17 years ago4 comments3 people in discussion

OK - I spoke to soon; I was musing on order and feeling good when I noticed that currently causes is a subheading of research. Now research is fairly ubiquitous and vague and I'm not sure where and how it is in hte article is useful - surely research into particular aspects would go under those headings (causes/treatments etc). The first para is extremely general and the article would lose nothing by its deletion, while the second para pertains to diagnosis and would be good to go in that section. i propose we lose the headnig and first para and place 2nd para in Dx and make causes a section. thoughts?cheers, Casliber (talk · contribs) 05:26, 20 August 2007 (UTC)

Concur. SandyGeorgia (Talk) 05:31, 20 August 2007 (UTC)
I'm OK with that, there's little more than speculation about causes at this point; genetics and brains seem to be involved, and it pretty much ends there. It can be touched on, under various headings, as appropriate. Poindexter Propellerhead 05:41, 20 August 2007 (UTC)

Done right...onto next point of 'order' (heehee) cheers, Casliber (talk · contribs) 06:32, 20 August 2007 (UTC)

needs serious work

Latest comment: 17 years ago5 comments3 people in discussion

May I add my voice to the move to improve this article? I had a look yesterday and was disturbed to find a general degradation in the quality of the writing, a degradation that can't help have a negative effect on the scientific aspects of the article. It was much better at the time of promotion to FA. What on earth has been happening? Tony 06:29, 20 August 2007 (UTC)

Erm..thanks, I'm trying to do this step-by-step and once order, content and lead are sorted I'm sure there'll be ample copyediting.. :) cheers, Casliber (talk · contribs) 06:32, 20 August 2007 (UTC)

It's throughout, but maybe we can just pick up what we can as we go, and leave a final ce til the factual issues are resolved. I was just reworking an error in the History section, and found this 1a redundancy example ...

The Austrian-American child psychiatrist Leo Kanner identified a very similar syndrome ...

SandyGeorgia (Talk) 07:47, 20 August 2007 (UTC)

Oh yeah - agree. fix obvious stuff and it makes the final CE easier...cheers, Casliber (talk · contribs) 09:28, 20 August 2007 (UTC)

Well, I can see massive copyedit changes needed throughout that even I (not a prose guru like Tony or Tim) am capable of doing, but since CC and PP have reverted everything I've done and made allegations about my participation here, it's best I not do that editing. It's hard to look at so much obvious text redundancy, but I think I'll cover my eyes for now. SandyGeorgia (Talk) 13:38, 20 August 2007 (UTC)

Begin Section-by-section analysis - 1 - Classification

Latest comment: 17 years ago16 comments4 people in discussion

OK - here. Please limit comments to this section only. A nice straightforward one to start (...or am I sadly mistaken...).cheers, Casliber (talk · contribs) 09:30, 20 August 2007 (UTC)

...actually before we go any further how do we all feel about acronyms here (HFA, AS and PDD) - they are half way between being gloablly recognised and a de facto made up term/acronym. Do we feel they are global enough to be littered through the article? (Has this come up before?) cheers, Casliber (talk · contribs) 09:35, 20 August 2007 (UTC)

We need to ask Eubulides; he;s dealt with that at autism and we may as well be consistent. I'll ping him because he said recently he was busy and might not be following closely. SandyGeorgia (Talk) 13:39, 20 August 2007 (UTC)

Those abbreviations are all used in the literature, so the only question is readability of the article. Abbreviations are jargon that turn off the reader, but they can also make the article more readable if they abbreviate sufficiently. If an acronym is used throughout the article (e.g., ASD in Autism), I think it's OK to define it once in the lead. If it's used in two widely separated sections, it's better to define it separately in each section. In intermediate cases one must use one's best judgment. The idea is to cater to casual readers, who may read just the lead and one part of the body. For Autism, I felt that Asperger's was better than AS because there are already too many abbreviations in that article and Asperger's is short and didn't appear often enough to be worth the hassle of introducing the abbreviation; also there was the danger of the reader getting confused by AS versus ASD. For Asperger's the calculations will be different but I suggest choosing one shorthand, either AS or Asperger's, and using that consistently in the article. HFA is a more-controversial term and abbreviation, but it's common enough in the literature. While we're on the subject, Autism uses both ASD and PDD but prefers ASD; the two terms describe the same set of syndromes, but ASD is more common in the literature that I read. Eubulides 14:13, 20 August 2007 (UTC)

Let's not reinvent the wheel; autism has this sentence, which can be cribbed (changed autism to AS): SandyGeorgia (Talk) 14:27, 20 August 2007 (UTC)

Asperger's is one of the five pervasive developmental disorders (PDD) or autism spectrum disorders (ASD), which are characterized by widespread abnormalities of social interactions and communication, and severely restricted interests and highly repetitive behavior.^[14]

The grammar here needs to be tweaked; it's awkward: SandyGeorgia (Talk) 14:30, 20 August 2007 (UTC)

and is characterized by deficiencies in social interaction and normal to above normal intelligence,[5][10] undelayed language development, and repetitive or restrictive patterns of thought and behavior. This sentence could start or end with a clause that explains how AS differs from other ASDs.

This passage is unintelligible to a layperson unfamiliar with autism (me :-) and not excellent prose. Also, whenever we say things like "others feel", it needs to be better defined and attributed. Who feels this? How common is it? How widespread is the consensus, etc? "apply the early onset of the regressive pattern" is coming at the reader out of nowhere here. No, this section is no easier than the rest: it needs a rewrite :-)) The "others feel that the speech delay associated with HFA is significant" gets into territory of how the word "significant" is being used (statistically significant or otherwise?) SandyGeorgia (Talk) 14:35, 20 August 2007 (UTC)

Many experienced clinicians apply the early onset of high-functioning autism or the regressive pattern of development as the distinguishing factor in differentiating between AS and HFA. Others feel that the speech delay associated with HFA is significant.[26]

As for "significant," I can answer that. Asperger included kids who had delayed speech in his studies, and Wing also noted that over half of the kids she felt fit the description had delayed speech. Gilberg continued along these lines, saying that delayed speech was a diagnostic sign of AS. Then someone got the bright idea to specify that there could be no delay of speech, and it was written into DSM and ICD, and suddenly kids who had been firmly in the AS camp for decades had to be shuffled into the (now defined in DSM) category of PDD-NOS, or into (undefined) HFA. Since then, various authorities have disagreed with the change, whether it was to assert that they could not reliably distinguish between the groups using non-speech tests, or that they saw no objective reason for having multiple categories, or that kids with delayed speech tended to test as being the same as a later age, or to say that, in practice, the distinction is ignored, and diagnosis made based on what will get insurance coverage. So there are all sorts of different takes on how the difference in speech development may not be significant (statistically, clinically, or otherwise). Some have tried to champion the cause of 2 categories, and have not completely failed in the effort; there have been tests which showed some differences in specific abilities between the groups (just as others have shown that there were not), and there have been some studies on the brains of those concerned which showed some differences between the groups. While the Asperger/Wing/Gilberg/Attwood/etc/etc perspective seems to have the upper hand, until the day comes that DSM and ICD are both rewritten to eliminate the distinction, the issue cannot be considered resolved. Poindexter Propellerhead 17:42, 20 August 2007 (UTC)

So, is the answer statistically significant (as in, demonstrated greater than chance by studies) or significant in the common sense of the word? We have to be careful with the word "significant" (see WP:MEDMOS). Also, it seems to me that we need a source for some of this so that a sentence or two can be added to History (unless we intend to cover it more thoroughly in Classification or Diagnosis—where should we cover it?). SandyGeorgia (Talk) 17:52, 20 August 2007 (UTC)

Some have mounted arguments based on statistical results of particular studies, such as in cites 18 and 19. Attwood, on the other hand, surveys the literature, saying "At present, the results suggest there seems to be no meaningful differences between them," and that diagnosis tends to be based on insurance and government benefits: "...one may use a practical approach: use the diagnosis that provides the services." So statistical significance, clinical significance and practical significance have all been disputed. Poindexter Propellerhead 18:19, 20 August 2007 (UTC)

As for other matters you brought up, (1) I'm not sure whether we can cite the history very well, unless we want to take the unsatisfying, ORish route of pointing to statements in papers of Asperber, Wing, and so on. I've never looked for a peer-reviewed paper which discussed the history of the dispute, one may or may not exist. I'll look around... (2) As for where to cover it, "Classification" is where it seems most natural to me, and since that comes before "Diagnosis" (and most everything else), if the topic comes up later, they will already know what we're talking about. Sound reasonable, or am I overlooking something? Poindexter Propellerhead 18:42, 20 August 2007 (UTC)

I'm going to read all this delightful package that just came in my e-mail, and maybe I'll find something. Classification works for me, unless it's truly something "historical" that can be added to History. SandyGeorgia (Talk) 18:46, 20 August 2007 (UTC)

Next we get into a Szatmari sentence, but we need to give the reader an idea of how widespread this belief is (we need to establish context and consensus): SandyGeorgia (Talk) 14:35, 20 August 2007 (UTC)

According to Peter Szatmari, a Canadian PDD researcher, the current classification of the pervasive developmental disorders (PDDs) is unsatisfying to many parents, clinicians, and researchers, and may not reflect the true nature of the conditions.[27]

I assume you mean whether Szatmari's view is widespread in the academic/research community, rather than whether he's correct about it being widespread among parents, clinicians and researchers? Poindexter Propellerhead 18:49, 20 August 2007 (UTC)

Right, just how much general consensus/acceptance there is, is it mostly known in Canada, etc. But since I now have two excellent reviews to pour through (I paid the $20 to download the Baskin MGH review and also now have the McPartland Yale review), these answers should become more clear. SandyGeorgia (Talk) 18:56, 20 August 2007 (UTC)

I think the consensus is fairly broad. I haven't been able to see the survey pdfs yet, but as the abstract for Foster says, "clinical research has produced mixed results that do not clearly discriminate Asperger syndrome from high-functioning autism," and that seems to extend somewhat to PDD-NOS and other related diagnoses as well. The crux of the matter is figuring out whether natural categories exist, or whether some in the psych community have created artificial distinctions where no natural ones exist. Because neither the causes or mechanisms involved in PDDs are understood yet, the reality of the categories, and what their borders might be, is still up in the air. Poindexter Propellerhead 21:34, 20 August 2007 (UTC)

Reviews

Latest comment: 17 years ago19 comments3 people in discussion

I've read both recent reviews, PMID 17030291 McPartland, Asperger's syndrome, Yale 2006 and PMID 16596080 Baskin, Asperger Syndrome Revisited, MGH Harvard 2006. They provide ample detail—in fact pages—of info for a useful start on diagnosis, treatment, causes, genetics, prognosis, characteristics, epidemiology, etc.

The info is there to comprehensively cover neuroanatomical findings; can Eubulides or Tim or Cas be enticed to write that section? I don't speak brain/fMRI findings.
There is excellent detail on the AS/HFA controversy, which shouldn't be hard to cover.
Between the sources Zeraeph found and the additional info here, I should be able to finish up History; my remaining questions are answered here.
There is specific mention that none of the diagnostic instruments have proven reliable and accurate, and that the gold standard is the Autism Diagnostic Interview-Revised, so it appears that the ASQ has been given undue weight in our article; since reliable secondary sources discount it, I'm not going to spend much time on the ASQ paper. Next, the paper on the four sets of diagnostic criteria.

Question on how to cite. If we read in a review (secondary source) about finding X with a primary source given, should we cite to the review where we read it, or the primary source where the original finding was made, even if we haven't seen the original study? When I wrote TS, I didn't have this dilemma, as I tend to have the original (primary source) studies; what do we do when we haven't seen the primary source, and are citing a secondary source report of the primary source? We report the review, secondary source, right? SandyGeorgia (Talk) 20:13, 20 August 2007 (UTC) SandyGeorgia (Talk) 20:13, 20 August 2007 (UTC)

Vaughan preferred citing a single Review article rather than several assorted primary ones in schizophrenia, which I think was a good move; most illnesses have comprehensive review articles here and there.cheers, Casliber (talk · contribs) 20:40, 20 August 2007 (UTC)

OK, makes sense. (On TS, I often cited the primary source because 1) I had the original studies, and 2) I only used them because I knew they enjoyed consensus from the secondary sources and reviews.) SandyGeorgia (Talk) 20:56, 20 August 2007 (UTC)

I've gotten through the rest.

Found little of use in Foster, PMID 14508298; anyone else ? SandyGeorgia (Talk) 20:49, 20 August 2007 (UTC)

No opinion as yet, I seem to be unable to download the papers without using IE, and I'm using an operating system which does not have IE. I'll have to get a copy of the pdfs via another route. Poindexter Propellerhead 21:21, 20 August 2007 (UTC)

I'm not able to discern an easily summarized paragraph on the differences/similarities or importance/relevance of the four sets of diagnostic criteria from Matilla, PMID 17450055 ; maybe someone with better focus can generate that. I've not gotten any sense if Szatmari and Gillberg are even relevant. SandyGeorgia (Talk) 20:49, 20 August 2007 (UTC)

I'll give it a go. Poindexter Propellerhead 21:21, 20 August 2007 (UTC)

OK, I'm kind of running out of time, having spent quite a while on this article over the last several days, but here's a summary of

the main variances between the 4 major diagnostic criteria. Anyone who wishes to may try turning it into text, I may or may not feel able to do so as soon as would be liked.

criteria**no speech delay**speech delay**clumsy**odd communication**social**stereotypy/obsessions
ICD-10--------Y-----------------------N------------------(y)---------------(n)---------------------Y--------------Y
DSM-IV-TR-Y-----------------------N-------------------N-----------------N----------------------Y--------------Y
Szatmari----N-----------------------N-------------------N-----------------Y----------------------Y--------------N
Gillberg------N-----------------------Y-------------------Y-----------------Y----------------------Y--------------Y

Y=yes, it is a criterion, although not mandatory in all cases.
N=not listed as a criterion.
(y)=mentioned as common, but not listed as a criterion.
(n)="there may or may not be problems in communication similar to those associated with autism."

Additional differences: DSM requires distinction from other PDDs and schizophrenia. Szatmari
requires distinction from Autistic Disorder. ICD-10 requires distinction from anakastic
personality disorder, attachment disorders of childhood, obsessive-compulsive disorder,
schizotypical disorder, and simple schizophrenia. Emphases may differ considerably, e.g.
Gillberg requires an obsessive interest, DSM has a stereotypy requirement which MAY be met
by an obsessive interest, ICD basically follows DSM, Szatmari makes no mention of obsessive
interests at all. As a social impairment, Szatmari requires that the patient lead a solitary
lifestyle. Gillberg would accept it as "lack of desire to interact with peers," but would
not require it, DSM would accept it as "failure to develop peer relationships appropriate to
developmental level" but would not require it. And so forth. ICD-10 and DSM also require no
delay in cognitive development outside the social area, Gillberg and Szatmari don't discuss
it.

Poindexter Propellerhead 01:34, 21 August 2007 (UTC)

That's very helpful. If I can source it to Mattila, I'll turn it into a table. SandyGeorgia (Talk) 02:16, 21 August 2007 (UTC)

Here's what I put together based on the chart in Mattila. I don't think it disagrees with yours anywhere, but it's structured a bit differently. What do you all think? SandyGeorgia (Talk) 03:26, 21 August 2007 (UTC)

Poindexter, can you give me the exact wording on the exclusion criterion for Szatmari, so I can add that footnote to the table? Thanks, SandyGeorgia (Talk) 18:17, 21 August 2007 (UTC)

I think that table looks great, it includes details that mine didn't (structuring a properly aligned table as pure text is just too much of a PITA for me to have wanted to include many entries), and I have no problem with the contents. Szatmari's exclusion criterion was worded "E. Does not meet criteria for Autistic Disorder." Poindexter Propellerhead 19:55, 21 August 2007 (UTC)

Thanks, Poindexter; I'll incorporate. I'm waiting to get more input elsewhere about whether it violates copyright or can be used under Fair Use. If I get copyright clearance, is everyone OK with adding it to the Diagnosis section? SandyGeorgia (Talk) 20:40, 21 August 2007 (UTC)

Baron-Cohen's paper on the ASQ PMID 11439754 seems clear. It's not a diagnostic tool and it's not even measuring AS. It's measuring "autistic-like traits", and 80% of those scoring high on ASQ did not merit a diagnosis, so previous notions of correlation seem to have been overstated, and we need to reword those sections to reflect what the source says if we are to include them at all. SandyGeorgia (Talk) 20:49, 20 August 2007 (UTC)

Are you looking at the full text, or the abstract? The abstract says 80% of those already diagnosed as having AS or HFA scored high, as opposed to 2% who were not so diagnosed, which would seem like a pretty strong correlation. Poindexter Propellerhead 21:21, 20 August 2007 (UTC)

I'm looking at both (the full text, as well as the abstact at the top of the full text. I'd put a chunk of the text in here for you, but it's on my other computer; I've got this Adobe Acrobat problem ... did you check your popup controls? I had problems at first ... ) Typing what I can easily, the abstract says 80% of adults with AS scored high vs. 2% of controls, while the text reveals a more complete story, p. 15, "A score of 32+ appears to be a useful cutoff for dsitinguishig individuals who have clinically significant levels of autistic traits. Such a high score on the AQ however does not mean an individual has AS or HFA, since a diagnosis is only merited if the individual is suffering a clinical level of distress as a result of their autistic traits. As shown in the subsample of students in Group 3 above, 80% of those scoring 32+ met DSM-IV criteria for HFA, but did not merit a diagnosis as they were not suffering any significant distress." So, it sounds like he's measuring the ability of the instrument to detect *traits* rather than *diagnosis* and (although I only skimmed the article) I don't find the strong conclusions in the text to support the extensions made in our article. If he's measuring autistic traits in non-distressed adults, he's not measuring people who meet diagnostic criterion. As I suspected earlier, and in relation to the body of research about the prognosis in AS, I think we're mixing up what the instrument is measuring and overextending the conclusions. Maybe Tim or Cas or Eubulides can clarify; I'm just a layperson with a math/stat background :-) By the way, am I on the right track on History above, and should I finish it up, or does it have problems? SandyGeorgia (Talk) 21:41, 20 August 2007 (UTC)

I see. Interesting. Welcome to the world of diagnoses of incurable conditions which come and go on their own. Allow me to give an anecdotal, non-RS example. My AQ score is (I forget exactly) somewhere in the 32-34 range, putting me into potentially diagnosable territory. When I was growing up, my aspie traits really bothered me a LOT, and I would easily have been diagnosable, but nobody was aware of AS at the time, so no such thing happened. By the time I hit my 20s, I was doing great at university, got married, got good jobs, and was generally content with my life, which would have made me undiagnosable. And I remained undiagnosable for decades; I've had a great career in a scientific field, and a generally very happy life. But some of those traits are really starting to bother me again. For example, is Wikipedia eating so much of my time that it's become an unhealthy obsession which distracts me from other things I should be doing? Quite possibly. So I am approaching diagnosability again, and some diagnosticians might say I'm there already. A lot of DSM is that way -- the paraphilias, for example. If you're sexually attracted to X, and it bothers you a lot that you are, you may be diagnosed as an Xophile, but if it doesn't bother you much, or at all, you're undiagnosable. So diagnosability not only deals with measurable traits, it deals with the circumstances of a person's life, which may have little relationship to anything medical or psychological. At 10 I was an aspie, at 35 I wasn't, but at 60 I might be again. Bill Gates is probably not an aspie now, despite the way he rocks and stims under pressure, needs a consultant to tell him how to dress, and is so shy that he has his wife introduce him to people. Take away his money and he might be an instant aspie.

That is the sort of fuzziness that exists in the field, primarily as a result of classification as a disorder. Baron-Cohen's AQ can tell autistics from non-autistics, but it does not determine how satisfied they are with their lives, so many may be undiagnosable, happy autistics. As DSM-IV said (pp. 1162-1163), "DSM-IV criteria remain a consensus without clear empirical data supporting the number of items required for the diagnosis... Furthermore, the behavioral characteristics specified in DSM-IV, despite efforts to standardize them, remain subjective." And so it goes. Poindexter Propellerhead 22:46, 20 August 2007 (UTC)

Welcome to the world of diagnoses of incurable conditions which come and go on their own. I really must get you to read Tourette syndrome, where you can have the condition one day, and not have it the next, depending on a committee decision. (And please do read Roger Freeman's blog at the bottom of the Tourette syndrome article; he has a lot to say about these committee diagnoses of these "things" that you can have one day and not the next.) I know these issues as well as you do; you're preaching to the choir. At least aspies get services in schools. SandyGeorgia (Talk) 22:59, 20 August 2007 (UTC) And if you have time, please read this as well; the situation is not unique to AS. In an encyclopedia, we still can only report what reliable sources say; we can't be an advocacy group. SandyGeorgia (Talk) 23:02, 20 August 2007 (UTC)

For anyone who is going to write from these sources, in the History section I named (so far) refs for "Baskin", "McPartland" and "Mattila". SandyGeorgia (Talk) 01:16, 21 August 2007 (UTC)

^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l Cite error: The named reference NINDS was invoked but never defined (see the help page).
^ Attwood(1997), p. 15
^ Kanner, L (1943). "Autistic Disturbances of Affective Contact". Nervous Child, 2;217–250.
^ Ishikawa G, Ichihashi K (2007). "[Autistic psychopathy or pervasive developmental disorder: how has Asperger's syndrome changed in the past sixty years?]". Nippon Rinsho (in Japanese). 65 (3): 409–18. PMID 17354550.
^ ^a ^b ^c Wing, Lorna. "Asperger syndrome: a clinical account". Psychological Medicine. 11:115–129 . Available at mugsy.org. Retrieved on 2007-08-15.
^ Attwood(1997), p. 15
^ Kanner, L (1943). "Autistic Disturbances of Affective Contact". Nervous Child, 2;217–250.
^ Bosch Gerhard [http://www.eric.ed.gov/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED049567&ERICExtSearch_SearchType_0=eric_accno&accno=ED049567 Infantile Autism. A Clinical and Phenomenological-Anthropological Investigation Taking Language as the Guide.
^ Ishikawa G, Ichihashi K (2007). "[Autistic psychopathy or pervasive developmental disorder: how has Asperger's syndrome changed in the past sixty years?]". Nippon Rinsho (in Japanese). 65 (3): 409–18. PMID 17354550.
^ Attwood(1997), p. 15
^ Kanner, L (1943). "Autistic Disturbances of Affective Contact". Nervous Child, 2;217–250.
^ Ishikawa G, Ichihashi K (2007). "[Autistic psychopathy or pervasive developmental disorder: how has Asperger's syndrome changed in the past sixty years?]". Nippon Rinsho (in Japanese). 65 (3): 409–18. PMID 17354550.
^ Bosch Gerhard [http://www.eric.ed.gov/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED049567&ERICExtSearch_SearchType_0=eric_accno&accno=ED049567 Infantile Autism. A Clinical and Phenomenological-Anthropological Investigation Taking Language as the Guide.
^ World Health Organization (2006). "F84. Pervasive developmental disorders". International Statistical Classification of Diseases and Related Health Problems (10th ed. (ICD-10) ed.). {{cite book}}: |access-date= requires |url= (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)

[NINDS-1] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l Cite error: The named reference NINDS was invoked but never defined (see the help page).

[2] Attwood(1997), p. 15

[3] Kanner, L (1943). "Autistic Disturbances of Affective Contact". Nervous Child, 2;217–250.

[4] Ishikawa G, Ichihashi K (2007). "[Autistic psychopathy or pervasive developmental disorder: how has Asperger's syndrome changed in the past sixty years?]". Nippon Rinsho (in Japanese). 65 (3): 409–18. PMID 17354550.

[lw-5] Wing, Lorna. "Asperger syndrome: a clinical account". Psychological Medicine. 11:115–129 . Available at mugsy.org. Retrieved on 2007-08-15.

[6] Attwood(1997), p. 15

[7] Kanner, L (1943). "Autistic Disturbances of Affective Contact". Nervous Child, 2;217–250.

[8] Bosch Gerhard [http://www.eric.ed.gov/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED049567&ERICExtSearch_SearchType_0=eric_accno&accno=ED049567 Infantile Autism. A Clinical and Phenomenological-Anthropological Investigation Taking Language as the Guide.

[9] Ishikawa G, Ichihashi K (2007). "[Autistic psychopathy or pervasive developmental disorder: how has Asperger's syndrome changed in the past sixty years?]". Nippon Rinsho (in Japanese). 65 (3): 409–18. PMID 17354550.

[10] Attwood(1997), p. 15

[11] Kanner, L (1943). "Autistic Disturbances of Affective Contact". Nervous Child, 2;217–250.

[12] Ishikawa G, Ichihashi K (2007). "[Autistic psychopathy or pervasive developmental disorder: how has Asperger's syndrome changed in the past sixty years?]". Nippon Rinsho (in Japanese). 65 (3): 409–18. PMID 17354550.

[13] Bosch Gerhard [http://www.eric.ed.gov/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED049567&ERICExtSearch_SearchType_0=eric_accno&accno=ED049567 Infantile Autism. A Clinical and Phenomenological-Anthropological Investigation Taking Language as the Guide.

[ICD-10-F84.0-14] World Health Organization (2006). "F84. Pervasive developmental disorders". International Statistical Classification of Diseases and Related Health Problems (10th ed. (ICD-10) ed.). {{cite book}}: |access-date= requires |url= (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)

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