Talk:Autism spectrum/Archive 6

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Neurodiversity is a more inclusive and scientifically accurate way of viewing autism.

The word "disorder" is stigmatizing and dehumanizing. It implies that people with autism are broken and need to be fixed. This is not the case. People with autism are simply different.

I believe that the word "disorder" should be removed from the Wikipedia article on autism. This would be a more inclusive and respectful way to describe this condition. GreenWolverine (talk) 15:37, 11 October 2023 (UTC)

DSM defines it as "autism spectrum disorder", thus the lead says it as such. --WikiLinuz (talk) 16:09, 11 October 2023 (UTC)

Wikipedia articles must follow the relevant scholarship, they cannot, cannot lead. If medical orthodoxy calls something a disorder this has to be reflected in Wikipedia articles. There is no useful discussion to be had about this, it is just a fact. BTW I am a diagnosed autistic and I am way, way more 'ordered' than most allistics! Urselius (talk) 16:10, 11 October 2023 (UTC)

❤️ it's a shame it's like that, is there a way to bring it to a vote or make an edit that mentioned that as Neurodiversity in addition? even in the medical community that diagnoses autistics today there is wide recognition of neurodiversity. GreenWolverine (talk) 16:36, 11 October 2023 (UTC)

I don't think you know how Wikipedia works. Please review the links on your welcome message on your talkpage. --WikiLinuz (talk) 18:00, 11 October 2023 (UTC)

and maybe update the data & statistics, in the article it says 1 in 100 where the current data(2020) about 1 in 36 children has been identified with autism spectrum condition. GreenWolverine (talk) 16:47, 11 October 2023 (UTC)

That data is all in Epidemiology of autism. --jpgordon^{𝄢𝄆𝄐𝄇} 20:29, 11 October 2023 (UTC)

but why in the article the data have to be incorrect? GreenWolverine (talk) 17:18, 3 November 2023 (UTC)

Not all scholarship relevant to autism is medical! We really ought to make sure we are taking on board scholarly insights from sociology, anthropology, and parts of psychology that do not assume medicalisation is the only appropriate lens for this sort of thing. Oolong (talk) 10:36, 9 December 2023 (UTC)

It's a disorder. It has disordering characteristics that generally cause problems for people who have it. Removing the word disorder is not only inconsistent with the literature and DSM, it's harmful.

Making people feel like they don't have a disorder, that in fact their lives are just as good and easy as others, is not helpful or accurate. Please stop this nonsense. It's not empathetic, it's just pathetic. 103.14.70.178 (talk) 09:50, 30 December 2023 (UTC)

I’m a person and student with autism and I usually try to hide the fact. It makes me very insecure because people start treating me worse, I’m pretty sure it’s a subconscious thing because many of these people think autism turns you into an aggressive, dumb, and annoying monster. I would really like it if the word “disorder” got removed. many people who are more affected by it can live happier lives than us. I’ve hear stories of people who are more affected by it are using computers to communicate instead of speaking and what they write considering how they look on the outside is ridiculous! Please change it. 82.7.61.20 (talk) 08:22, 31 December 2023 (UTC)

"because people start treating me worse" Worse as in ridiculing you or as in physically abusing you? Dimadick (talk) 16:42, 31 December 2023 (UTC)

They stop talking to me and some even start ridiculing me like you said, luckily it’s not physical though. 82.7.61.20 (talk) 20:05, 31 December 2023 (UTC)

It seems reasonable to suggest that there should be a new term specifically for verbally communicative autistic individuals. like Asperger was in the past (a new word maybe because the argue that he was involved with Nazism). The current language often fails to accurately represent the wide spectrum of experiences and abilities within the autistic community. A new term could help in better acknowledging and respecting the unique challenges and strengths of those who are verbally communicative, differentiating their experiences from those who might have different communication needs. This change could contribute significantly to reducing stigma and enhancing understanding, allowing for a more nuanced appreciation of the diversity within the autism spectrum. GreenWolverine (talk) 06:23, 4 January 2024 (UTC)

I'm autistic and I disagree. First of all, it's literally called "Autism Spectrum Disorder" and as long as that'd the official name, I think it's better if we use it. Secondly, autism can be genuinely disabling-- I know it has been for me-- and it's wrong to hide that. I've struggled a lot because I'm autistic and saying that it's not a disorder is, in its own way, invalidating. Additionally, the reason that Asperger Syndrome was removed from the DSM-V was because they realized that there is no actual difference between those with higher support needs and lower support needs other than how much support they need. Also, it's not up to Wikipedia to propose changes to the language that should be used to describe autistic people; we're here to report facts, not make them. I do, however, think that there needs to be a bit more discussion about different levels of support needs in the article because it is very important to point out that autistic people aren't a monolith and that we all struggle with different things. "Level 1 Autistic" may be the term you're looking for. Queenofconfusion (talk) 00:48, 8 January 2024 (UTC)

Intonation in autism: mmhm, uhm, silent pauses

The following findings could be integrated in the section on communication (from https://langsci-press.org/catalog/book/404 Wehrle, Simon. 2023. Conversation and intonation in autism: A multi-dimensional analysis. (Studies in Laboratory Phonology 14). Berlin: Language Science Press. DOI: 10.5281/zenodo.10069004)

In particular, length of turns and filled pauses (uh, uhm) are not different between ASD and non-ASD, but backchannels such as "okay" and "mmhm" show differences. The duration of silent pauses is different as well.

I will not edit the page myself as it is already quite long and complex. The relevant summaries of the findings are given below in case other users are interested. Jasy jatere (talk) 12:45, 17 January 2024 (UTC)

Research on turn-taking (the organisation of who speaks when in conversation) in ASD is limited, with most studies claiming a tendency for longer silent gaps in ASD. No clear overall difference in turn-timing between the ASD and the control group was found in the data under study. There was, however, a clear difference between groups specifically in the earliest stages of dialogue, where ASD dyads produced considerably longer silent gaps than controls.

Backchannels (listener signals such as mmhm or okay) have barely been investigated in ASD to date. The current analysis shows that autistic speakers produced fewer backchannels per minute (particularly in the early stages of dialogue), and that backchannels were less diverse prosodically and lexically. Filled pauses (hesitation signals such as uhm and uh) in ASD have been the subject of a handful of previous studies, most of which claim that autistic speakers produced fewer uhm tokens (specifically). It is shown that filled pauses were produced at an identical rate in both groups and that there was an equivalent preference of uhm over uh. ASD speakers differed only in the prosodic realisation of filled pauses. It is further shown that autistic speakers produced more long silent (within-speaker) pauses than controls.

Suggestions from Gizempsy

Hi, Im student from Uskudar University. I edit this article Autism spectrumas an assignment for my course Biotechnology in Neurosciences. I already completed Wikipedia training modules to be proficient in Wikipedia editing. I would appreciate any support. Best wishes, Gizempsy Gizempsy (talk) 11:45, 1 January 2024 (UTC). ASD (Autism Spectrum Disorder) is a complex neurodevelopmental disorder that emerges in early childhood and is characterized by indicators such as communication problems, repetitive behaviors, and limited areas of interest. Autism Spectrum Disorder (ASD) encompasses a complex spectrum of disorders that is linked not only to genetic but also to epigenetic factors. Essentially, it is a developmental disorder that affects the individual's neurological system. I am in favor of adding the title "Cell Therapies" to the ‘’Management’’ section of the Autism Spectrum article. It is observed that cell therapy is widely used in many neurological disorders today. Hematopoietic stem cell therapy has been indicated to extend the lifespan of children with ASD by preventing neurodegeneration. According to a study mentioned in this article, significant changes in EEG spectra were reported two months after a single intravenous autologous umbilical cord blood infusion was administered to each of the 25 children. Fetal stem cell transplantation via intravenous and subcutaneous injections in autistic patients aged 3-15 has been noted to enhance social skills in the treatment group without any adverse effects. In a group of 37 children with ASD, the transplant group showed a reduction in stereotypical and agitated behaviors and higher scores on the autism rating scale. It is stated that research is ongoing to investigate the effectiveness of mesenchymal stem cells (MSCs) and their by-products, derived from adipose tissues and umbilical cord tissues, in the treatment of neurodegenerative disorders such as Alzheimer's disease and neurodevelopmental disorders like Autism Spectrum Disorder (ASD). Stem cells with regenerative capabilities have shown positive outcome criteria in the treatment of ASD In the conducted study, it is indicated that nine out of ten clinical trials on cell therapies for individuals with Autism Spectrum Disorder (ASD) yielded positive results without significant side effects. The importance of the gap junction-mediated cell-cell interactions between cerebral endothelium and transplanted cells was observed in both BM-MNCs (bone marrow mononuclear cells) and MSC (mesenchymal stem cell) transplantation. These novel findings are stated to provide a new paradigm for cell therapy in ASD. In recent years, both preclinical and clinical evidence has been found indicating that stem cell therapy is not only safe but also improves the behaviors of individuals with autism spectrum disorder (ASD). Therefore, stem cell therapy has gained increasing support as a potential treatment option for individuals with ASD. Considering the limitations and promising sedative effects of cellular therapies in ASD treatment, it has been explained that more comprehensive research and large-scale studies will be needed to obtain conclusive results. The analysis of factors influencing the therapeutic functions of stem cells, such as stem cell types, administration route and dosage, and activity mechanism, is considered crucial in conducting clinical research.

If autism is 'cured', will that not do away with people like Elon Musk, Anthony Hopkins and Dan Ackroyd? Not to mention the probability that such luminaries as Albert Einstein, Charles Darwin, Isaac Newton, Picasso, James Joyce and Mozart were also autistic, and made huge contributions to science, culture and art. Urselius (talk) 13:42, 24 January 2024 (UTC)

References

How is this possible?

Autism was first described in 1943, but the original description isn't the same as what autism is today. Sources still state it is the same disorder we just learned more about it, but how is that possible? How can he discover a disorder that actually exist but incorrectly state what it is? What happened to the actual thing he was describing? Does it now have a different name or did it never exist? What are the odds that he came up with the actual name for a disorder but applied it to the wrong thing?

Or if the diagnosis was wrong, why was the term autism reused for a different disorder, but still treated as if it's the same disorder, just with updated findings?

Malaria has been known since ancient times, it was believed to be caused by 'miasmas', 'bad air' originating from marshy areas. In the 1890s it was discovered that malaria was the result of a parasite in the blood and that it was transmitted by the bite of anopheline mosquitoes. The disease was exactly the same through history, but its cause was wrongly attributed for centuries. Medicine changes over time, including psychiatry. This is not surprising, I fail to understand your quandary. Urselius (talk) 17:44, 4 February 2024 (UTC)

Your Malaria example isn't remotely the same. In your example malaria was the same illness in both cases the only difference was what caused it. In my case the term autism was applied to symptoms that are not the same symptoms of autism today. In 1943 Autism was the "inward self-absorbed aspects of schizophrenia in adults" The description is totally different. It's not the same thing with a newly discovered origin, nor is it different symptoms of the same cause. Like if in 1943 Autism was defined exactly as it was today but said the cause was believed to be a defect with XYZ and we know now that not to be the case, then there wouldn't be the same problem. Your comparison would be that they called completely different set of symptoms malaria, but modern doctors use the term malaria to mean what it does today, and treat it as the same thing just with a better understanding. — Preceding unsigned comment added by 2603:90C8:503:BE18:3C9F:FEC9:31EA:DC52 (talk) 05:51, 5 February 2024 (UTC)

You have just said that the definition of the causes of autism in 1943 were misascribed to "inward self-absorbed aspects of schizophrenia in adults". That is an attributed cause, not the symptoms. The symptoms noted in 1943 were largely the same as the symptoms noted in today's diagnostic manuals - difficulties in communication and restricted/repetitive interests. Therefore, the 'disorder' of autism is the same and has remained the same, but the ascribed cause - then schizophrenia, now neurodevelopmental - is different. My malaria paradigm is therefore exactly apposite and cogent. Urselius (talk) 09:52, 5 February 2024 (UTC)

Grandfathered in?

According to an article by Ferris Jabr The new DSM-5 criteria for ASD will make it more difficult for people to be diagnosed with ASD to receive treatment, but people that are already diagnosed will continue to receive treatment. Basically saying that you're grandfathered into a disorder instead of being previously wrongly diagnosed? If DSMs are updated to the most current and accurate knowledge of a disorder, why would people that were previously wrongly diagnosed still receive treatment for something they don't have?

There is no treatment for autism as such. Urselius (talk) 17:46, 4 February 2024 (UTC)

The DSM-5 is not new, it dates to 2013. It did away with Asperger's Syndrome as a formal diagnosis. The DSM-5 has definitely not reversed the increase in the rate of autism diagnosis and there has been no evidence that it has affected the rates of treatment for comorbidities of autism - as I said above, autism itself is untreatable. Urselius (talk) 10:00, 5 February 2024 (UTC)

Prosody

I find the statement in this article "At least half of autistic children have unusual prosody" inaccurate and should either be removed or the source replaced with an accurate one. I reviewed the article sourced in full. It states that while research in this area is promising, there is no clear single indicator of ASD in speech yet. I should mention that my bachelor's is in Linguistics and prosody is one of my areas of particular interest. While I personally believe we will eventually find or may have already found and defined an indicator of ASD in speech, the article being sourced (which is a meta analysis) does not provide sufficient evidence on its own to support this.

Possible suggested edit?

Recent research has investigated a possible link between ASD and non-standard prosody.

I can't think of what I would put after that right now. Maybe something about the state of current research and that it's promising. I'd like to do some more research myself in the interim first.

https://pure.au.dk/ws/files/101709535/046565.full.pdf Alderius (talk) 12:56, 24 January 2024 (UTC)

The source seems to me to support the current wording (emphasis mine):

From its earliest characterizations, ASD has been associated with peculiar tones of voice and disturbances of prosody (Asperger, 1944; Goldfarb, Braunstein, & Lorge, 1956; Kanner, 1943; Pronovost, Wakstein, & Wakstein, 1966; Simmons & Baltaxe, 1975). Although 70-80% of individuals with ASD develop functional spoken language, at least half of the ASD population displays early atypical acoustic patterns (Paul et al., 2005a; Rogers et al., 2006; Shriberg et al., 2001), which persist while other aspects of language improve (Baltaxe & Simmons, 1985; Depape, Chen, Hall, & Trainor, 2012). These atypical acoustic patterns have been qualitatively described as flat, monotonous, variable, sing-songy, pedantic, robot- or machine-like, hollow, stilted or exaggerated and inappropriate (Amorosa, 1992; Baltaxe, 1981; Depape, et al., 2012; Järvinen-Pasley, Peppé, King-Smith, & Heaton, 2008; Lord, Rutter, & Le Couteur, 1994). Such distinctive vocal characteristics are one of the earliest-appearing markers of a possible ASD diagnosis (Oller et al., 2010; Paul, Fuerst, Ramsay, Chawarska, & Klin, 2011; Warlaumont, Richards, Gilkerson, & Oller, 2014).

While the source does state "We could not identify any single feature that could yet serve the role of a marker", that isn't what the text of the article suggests either, no? Tollens (talk) 06:54, 26 January 2024 (UTC)

 Not done: According to the page's protection level you should be able to edit the page yourself. If you seem to be unable to, please reopen the request with further details. Zippybonzo | talk | contribs (they/them) 11:25, 18 February 2024 (UTC)

Differences vs. Deficits

Recent changes included language to highlight that autistic people show differences in "reciprocal social communication [...,] social interaction, verbal and nonverbal communication", though this change was reverted because it was "POV writing". Personally, I would argue that "differences" has a lesser perspective than "deficits", which places a judgment on how people should communicate, indicating that autistic people communicate poorly. Proponents of the neurodiversity paradigm have argued against such deficit language for multiple reasons. On the other hand, nobody is arguing that there are differences in communication styles between autistic and non-autistic people. As such, wouldn't using the word "deficit" instead of "difference" have more POV issues than vice versa? (ping @ATC) Significa liberdade (she/her) (talk) 16:31, 6 March 2024 (UTC)

Autism is mainly characterized by difficulties with social interaction (and communication and by restricted or repetitive patterns of thought and behavior). In DSM-5 it is,

Diagnostic Criteria for 299.00 Autism Spectrum Disorder

To meet diagnostic criteria for ASD according to DSM-5, a child must have persistent deficits in each of three areas of social communication and interaction (see A.1. through A.3. below) plus at least two of four types of restricted, repetitive behaviors (see B.1. through B.4. below).

• Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
  • Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
  • Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
  • Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

— https://www.cdc.gov/ncbddd/autism/hcp-dsm.html

While I generally sympathize with the proponents of neurodiversity, I think we should adhere to WP:NPOV in Wikipedia and state what the medical literature actually characterizes autism as. Changing definitions for perceived judgment or stigmatization is not a valid reason. --WikiLinuz (talk) 20:20, 6 March 2024 (UTC)

WikiLinuz: The DSM is utilized specifically to identify disorders and medical conditions. If this page were titled "Autism spectrum disorder", then it would be understandable to state, "The DSM utilizes the following criteria to diagnose ASD".

However, this is a general page to describe autism, which many people do not see as a medical diagnosis but rather as a way of being. For instance, one autistic scholar defines autism as "a genetically-based human neurological variant" that is "characterized by particularly high levels of synaptic connectivity and responsiveness", which "tends to make the autistic individual’s subjective experience more intense and chaotic than that of non-autistic individuals". She further states, "Autism is a developmental phenomenon, meaning that it begins in utero and has a pervasive influence on development, on multiple levels, throughout the lifespan. Autism produces distinctive, atypical ways of thinking, moving, interaction, and sensory and cognitive processing" (Walker, 2021, "What is Autism?").

I'm not indicating that the entire page needs to be written from the perspective of the neurodiversity paradigm; that would, after all, be a POV problem. However, the first paragraph is currently written in alignment with pathology paradigms that purely view autism as a medical diagnosis. If we're trying to be neutral, I think it would be beneficial to use a more neutral, less judgmental term when describing what autism is. Significa liberdade (she/her) (talk) 21:41, 6 March 2024 (UTC)

Basically, as Walker concludes, "To describe autism as a disorder represents a value judgment rather than a scientific fact." Significa liberdade (she/her) (talk) 22:09, 6 March 2024 (UTC)

Difficulties = deficits. The core features (psychological phenotypes) of an individual on the autism spectrum are still social challenges (aka deficits). It's not as if autistic individuals would have no difficulty communicating with other autistic individuals and only have difficulty when communicating with non-autistic individuals (some argue maybe to a lesser extent, but that's not relevant here). [...] view autism as a medical diagnosis - Autism is still a diagnosed condition, meaning only a trained medical professional can "tell" (that is, diagnose) whether a person is autistic or not, which makes it, a medical diagnosis. After the diagnosis, they can view their condition/difficulties/traits as a difference (as in, part of neurodiversity and self-acceptance) or deficit (seek accommodations and therapies (Autism therapies) on areas that affect their functioning) - but that doesn't affect the fact that the condition itself is diagnosed using certain parameters of social deficits (mainly) and other traits. WP:SUBJECT of this article is about a neurodevelopmental disorder. It is recognized as a developmental disability in many countries (such as Canada, United States, UK, etc.). And why exactly should Walker's opinion be given undue weight here? Are you quoting from a peer-reviewed publication? --WikiLinuz (talk) 00:12, 7 March 2024 (UTC)

Walker's definition has been provided as a definition of autism that does not view it through the medical model. This definition has been used in peer-reviewed sources (e.g., [1], [2]). To address some of your points:

1. It's not as if autistic individuals would have no difficulty communicating with other autistic individuals and only have difficulty when communicating with non-autistic individuals. On this Wikipedia page, we have provided evidence that "autistic–autistic interactions are as effective in information transfer as interactions between non-autistics are, and that communication breaks down only between autistics and non-autistics". That is, autistic individuals communicate with other autistic individuals fine. Autistic individuals can also have great conversations with non-autistic people.

2. Only a trained medical professional can "tell" (that is, diagnose) whether a person is autistic or not. Even the American Psychiatric Association recognizes that medical practitioners often fail to diagnose people, particularly women and people of color (see also [3], [4]). They're still autistic regardless of whether a doctor can figure it out. This is of particular issue for individuals who can function in a society and thus, don't display the typical "deficits". It doesn't change how they process sensory inputs. This feels on par with saying someone is "cured" if therapies make it possible for someone to thrive. They're still autistic.

3. Once again, everyone agrees there are differences in communication, etc. Not everyone agrees about the language of deficit. "Difference" can mean deficit; it can also just mean doing things differently. As such, it feels to me like it would be more neutral to use the word "difference" than "deficit". Significa liberdade (she/her) (talk) 04:48, 7 March 2024 (UTC)

Studies (like the one cited) focus specifically on "information transfer", which is a narrow aspect of communication. Autism is characterized by broader social communication deficits that go beyond mere exchanging information. Even if autistic individuals can share information more effectively with each other, they may still have difficulties with other aspects of social interactions, like for example, (1) reading and responding to non-verbal cues, (2) understanding and expressing emotions, (3) reciprocating in back-and-forth conversations, (4) maintaining appropriate eye contact and body language, etc. And autism is also a spectrum disorder, so while some autistic individuals may find communication easier with other autistic individuals, those with more severe social impairments may still struggle significantly, regardless of the communication partner's neurotype.

Again, the subject of the article is about a neurodevelopmental disorder which is clinically defined as deficits (as explained previosuly). Humanities or social sciences sources cannot be used to override medical definitions in these articles, as sources must meet WP:MEDRS (medical claims, that is, diagnostic criteria or presentation of a condition, must be sourced from medical sources). --WikiLinuz (talk) 17:02, 7 March 2024 (UTC)

To further add to this point, most neurodevelopmental and mental disorders, and learning disabilities, could be considered a "difference". For example, ADHD is a deficit in executive function. You could say that it's just differences in executive functioning, but on an objective scale, these impairments go beyond mere differences in executive functioning and represent deficits in abilities that are considered essential for adaptive functioning in the environment/modern society.

This applies to pretty much everything, anxiety disorders (differences in how individuals perceive threat), bipolar disorder (differences in how individuals experience and regulate their moods and energy levels), schizophrenia (differences in how individuals perceive and process reality), OCD (differences in how individuals experience intrusive thoughts and the urges to perform repetitive behaviors), etc.

These are of course differences, but these differences arise from a deficit (maladaptation). Which is why it is more accurate (and in-line with current medical literature) to use the word "deficit" instead of "difference". --WikiLinuz (talk) 20:34, 7 March 2024 (UTC)