Talk:Epidemiology of autism/Archive 1

message: Since other suggestions have been made about it, here is the true story of how this article arose.
Autism epidemic was not a good article.  I rfa'd it. It survived after a typically rancourous discussion.
user:KimvdLinde suggested in the rfa, a couple of hours later that if one stripped out the extraneous garbage there might be an article there
 "Delete if unaltered.  Otherwise, major weeding out of junk, non-verifiable stuff, 
 speculation, POV etc could make it a basic article"
she said.
So I focussed on a definite topic - what is the incidence of autism and why is it difficult - and by stripping out anything not about it, and anything else that was junk, non-verifiable stuff, speculation, POV and other bad things found that indeed, there was something that looked quite like an article.  
So then I put it up here for other people to edit further, and remarked upon it.  Saying as is below ...    12:35, 7 April 2006 (UTC)
thread_title:  Genesis 

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

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

message: I'm not quite convinced that stripping out the remark in Russia "incidence ... since 1985 when Thimerosal was abandoned..." is necessary.  COnsidering changes in incidence relative to a particular event/date/change is not unreasonable for an incidence article. I agree it is reasonable, and pure, and I personally would be inclined to oppose any amplification of thimerosal's discontinuation such as commonly gets repeated near the word (that is what links are for and that link might well be to Thimerosal controversy rather than Thimerosal (chemical), but perhaps concensus may grow to favour putting that one clause back in.  Maybe.  I however shall not do it. Midgley 21:53, 7 April 2006 (UTC)
replies: text: It is interpretation, and as such original research. No citation that links the change with the cause.KimvdLinde 21:57, 7 April 2006 (UTC)
replies: text: Read with emotional tone absent:  Hmmmm.  Those are two reasons to not do it, yes, or might they be seen as excuses to not do it.  One might consider whether it would be of assistance to the reader to be told why the date given is given, and the answer there is that I think it might well be of assistance.  I agree that a citation is essential, but I'd more require one that said that "In 1985 Russia abandoned Thimerosal" than a citation of the widespread rumour that Thimerosal is worthy of note for some reason.  I think the latter could actually be left as common knowledge, for two reasons: - firstly the references that might be cited almost all without exception simply suck; and secondly, few if any people will arrive here without having been alerted to the mentions of Thimerosal and autism in adjacent sharply indrawn breaths.  As I said, I will not add it myself, and nor will I press anyone else to do it, but like Hemingway, if we leave out an important plot point or character development we must know that we do so, and know that our readers will interpolate it themselves and not have their experience diminished thereby.  Midgley 22:34, 7 April 2006 (UTC)
replies: text: I am in extreme verifiable mode with this article, just to get that kind of shit weeded out (you are going to regret that I am here ;-). If there is a good primary or secondary source providing evidence of the link with Thimerosal, fine. If not, it has to stay out, or we have to list all possible causes (Collapse of the USSR and subsequant worsening of the mediacal system? Changed diagnostic criteria? etc) So, without a source backing that specific link, it is original reseach. KimvdLinde 15:11, 8 April 2006 (UTC)
replies: text: That is an entrirely reasonable view, and the material now presented in this article will not suffer from application of so pure a principle to it.  I'm satisfied with that and feel the presence or absence of that clause has been discussed sufficiently.  It stays out, in teh knowledge tehat there is a reason for it being out.  Thanks.  Midgley 17:07, 8 April 2006 (UTC)
thread_title:  Russia, and landmark events might be ruled in 

message: A picture to reach the GA standards.  Midgley 09:31, 8 April 2006 (UTC)
replies: text: If there is some verifyable data out there, I can make a good graph of that. KimvdLinde 15:02, 8 April 2006 (UTC)
thread_title:  It needs ... 

message: By the (low) standards of the genre, this is a stable article.  I propose we work toward good article (I think it is too specific to be FA) status, and make a stable version of it.  Midgley 20:56, 13 May 2006 (UTC)
replies: text: I agree. I might read over it this evening and see what I think. Kim van der Linde at venus 22:43, 13 May 2006 (UTC)
replies: text:  But ultimately, at the end of the day, a merger with frequency of autism would be necessary to avoid having two articles on the same topic.  Andrew73 00:10, 14 May 2006 (UTC)
replies: text: What is frequency of autism about though?  It isn't prevalence, it isn't incidence, and it isn't settling down - it really continues to be an assertion that there is an epidemic. Midgley 01:26, 14 May 2006 (UTC)
replies: text:  I don't think the lay person would necessarily appreciate the difference between "frequency" and "incidence."  In any event, a merger would serve to tone done the epidemic POV in the frequency of autism article.  Having two articles on the same topic seems a bit excessive, and risks orphaning the important points made in the autism (incidence) article.  Andrew73 01:47, 14 May 2006 (UTC)
replies: text: Only this article was created by leaving behind everything of Autism epidemic that was referenced, and only then adding anything else.  Merging it back in recreates the old article.  And there is a voice for not losing the old article, whatever it ends up being called.  I looked at pulling out an article on prevalence of Autism/PDD, but there isn't the material there.  Antivaccinationist might be warming up again ... they are all tied together still.  Midgley 02:05, 14 May 2006 (UTC)
replies: text: The main problem is that it is nearly impossible to change something to NPOV in autism articles due to the continued soapboxing of some editors. But I would be very much in favour. Kim van der Linde at venus 03:46, 14 May 2006 (UTC)
thread_title:  Stable article 

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

message: This article should be merged with Frequency of autism.  — Reinyday, 23:00, 13 July 2006 (UTC)
replies: text: Better, this article should replace it, that article is full of POV, and unreadable stuff. -- Kim van der Linde at venus 01:57, 14 July 2006 (UTC)

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

message: There are a couple info boxes that use the term "New Cases" in this article. That metric is not a useful metric, the way it's calculated. To be an indication of incidence, "new cases" should be the number of persons diagnosed in that period of time (quarter or year). But this information is generally unavailable from administrative data. For example, when people speak of "new cases" in the California DDS, they are referring to the difference in caseload from one quarter to the next. But unfortunately, this is not the same as the number of new clients in the system. That's because some clients leave the system every quarter, and not a negligible number of clients at that. The number of clients who leave periodically obviously must depend on the total size of the population, confounding matters further. Neurodivergent 20:08, 19 October 2006 (UTC)
replies: text: New cases is a difficult term - it appears in the literature, and the purpose of one of the boxes is to distinguish between "new cases" and "incidence", since they don't appear to be the same thing.  In an older less focussed article they are not distingushed, with results that could confuse the reader.  Midgley 21:16, 9 March 2007 (UTC)
thread_title:  New Cases 

message: Please see Talk:Frequency of autism. aLii 01:55, 14 February 2007 (UTC)
thread_title:  Proposal to redirect "[[Frequency of autism]]" to "[[Autism (incidence)]]" 

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

message: "Silicon Valley cluster
A 2002 BBC article indicated that one in 150 children in the region had an autistic spectrum disorder.[39] A 2001 article in Wired suggested that the cluster is a result of a link between autistic disorders and computer skills.[40]"
Can we find anything about incidence in that or for it?  An indication of the incidence _around_ Silicon Valley would also be useful, particularly to examine whether there is actually evidence of a cluster there.  1/150 is not higher than many of the claims that rattle around WP for prevalence in the general population.  Midgley 01:39, 16 March 2007 (UTC)
replies: text: In the paragraph below, on the Amish, for instance, there is an unsourced assertion that the surrounding incidence is 1/166 (coupled with a suggestion that that times 22000 is "dozens", but it is a figure even if not of incidence.)   A difference between 1/166 and 1/150 is less than impressive - it looks like 7% which is a rather subtle clustering. Midgley 01:53, 16 March 2007 (UTC)
thread_title:  Incidence 

message: There are 74,000 Pennsylvanians diagnosed with autism spectrum disorders.
China
"There are 1.8 million reported cases of autism in China with over 10,000 known cases in ShanghaiSHanghai Daily News reported in China View - www.chinaview.cn 2005-11-29  viewed April 2006. This gives a prevalence of 1 in 720 for the country (based on a population of 1.3 billion people U.S. Central Intelligence Agency World Factbook) and 1 in 1600 for Shanghai (based on  16 million population).  
"
as for US, embedded previous redacted content
California is considered to have the best reporting system for autism in the USA because of its promise of educational services to handicapped children with a diagnosis of autism.http://www.sacunion.com/pages/california/articles/5424 Sacramento Union press article viewed March 2007 According to data released in late 2005 by the California Department of Developmental Services (DDS), new cases — of professionally diagnosed full syndrome DSM IV autism — entering the DDS system indicated a decline, from 734 new cases during the second quarter of 2005 to 678 new cases during the third quarter of 2005, a 7.5% decline in one quarter.
As of August 1993, a total of only 4,911 cases of autism had been logged in DDS's client-management system, a number excluding milder autism spectrum disorders such as Asperger's syndrome. By April 29, 1999, the DDS reported a State-wide incidence rate of about 15 to 20 per 10,000, triggering alarms about the increase.
As of 2005, the DDS reported 28,046 cases, but that the rate of increase peaked in 2002 and has dropped slightly since. According to data released by DDS in January, 2006, the number of new cases of professionally diagnosed full syndrome autism entering California's developmental services system in 2005 was the lowest since 2001. The DDS year end report documents that, in 2005, California added 2,848 new cases of autism to its system. Not since 2001, when 2,725 new cases were added, has California added fewer new cases of full syndrome autism to its system. Ever since the record year of 2002, there has been a slow, steady decline in the number of new autism cases entering the 37-year old DDS system, even though levels have still not yet reached the 1 in 166 reported by population-based studies.
The use of the term "New Cases" has come into question and DDS has written that "New Cases" should not be calculated as the difference in the numbers between quarters
.  Concerns have been raised that "New Cases" could reasonably include older people newly diagnosed, and immigrants. 
The total caseload handled by the state continues to increase much faster than population growth, but the recent trend points to a decrease in the caseload increase per quarter. 
. The awareness curve might be levelling off. 
It has also been pointed out that the caseload does not yet meet the levels found in population studies.
According to a report by the DDS Autistic Spectrum Disorders, Changes in the California Caseload:  1999-2002 http://www.google.co.uk/url?sa=t&ct=res&cd=1&url=http%3A%2F%2Fwww.dds.ca.gov%2Fautism%2Fpdf%2FAutismReport2003.pdf&ei=n_75RcquHY2a0wTB6OnqDQ&usg=__DYYm0MKRGnQJV4TvIP92nuC1ugs=&sig2=upb_rPnDa3FlO2nfM_Wjvg the prevalence of children diagnosed with full-syndrome autism in California nearly doubled between 1999 and 2002, from 10,360 to 20,377. The report stated, "(B)etween Dec. 31, 1987, and Dec. 31, 2002, the population of persons with full-syndrome autism has increased by 634 percent."
California's increase in childhood autism was not due to flawed diagnosis, according to a 2002 study led by University of California, Davis pediatric epidemiologist Robert Byrd. 
1,685 newly diagnosed autistic children had entered the state's regional center system the previous year, making a 273 percent increase over an 11-year period from 1988 to 1999 during which period the state's population increased by approximately 20%http://www.dds.ca.gov/autism/pdf/2background.pdf. The data again included only children with classic autism, discounting those with PDD-NOS, Asperger's etc. "The sheer complexity of this phenomenon prevents any clear conclusions," the report stated. "What we do know is that the number of young children coming into the system each year is significantly greater than in the past." However, a reanalysis of this report's data showed that the observed increase in autism was canceled out by an observed decrease in mental retardation, indicating that diagnostic substitution had occurred.
The above looks good (except phrasing definitions of numbers as "concerns have been raised" wich really doesn't do the job.  But none of it is incidence.  
Midgley 00:36, 16 July 2007 (UTC)
thread_title: Pennsylvania

message: "While the causes for this trend remain uncertain and difficult to ascertain, factors such as environmental shocks, changing diagnostic criteria, and greater awareness of autism are cited."
The trend isn't really made out in the article, although the lead has been rewritten to assert it.  Causes are more topics for autism (aetiology) than the question of what we know about the incidence.  The latter two clauses are relevant to difficulties in measuring incidence, but they seem rather deeper than the lead need be.   Midgley 00:43, 25 July 2007 (UTC)
thread_title:  Header/Lead 

message: I noticed that the current version of the article has some green boxes floating next to the text; I was wondering where they came from....
*The first is located smack-dab at the top of the article, right next to the lede.  It provides definitions for incidence (epidemiology) and prevalence.
*The second contains a table of data showing new cases of autism in the United States from 2001 to 2005.
*The third one provides a definition/distinction between "new cases" and "incidence".
As far as I know, no other Wikipedia article breaks out specific definitions into little boxes floating next to text.  Where technical language or terms of art need explanation, we provide a brief definition in the body text.  For longer or more thorough definitions, we rely on wikilinks to detailed articles.  (This is an advantage of wikimarkup and HTML over paper—we don't need to have the little breakout boxes which might be found in a child's textbook or magazine article.)  I'll be removing the first and third boxes and merging them back into the text as appropriate.
With respect to the second box, I'll probably fold it back into a standard wikitable, using the appropriate syntax.  In general, we don't use custom style and formatting for tables because a) custom formatting breaks the consistent Wikipedia style and b) we have CSS to save us from all that gruntwork. TenOfAllTrades(talk) 12:42, 5 July 2007 (UTC)
replies: text: I'll leave this to others, but it is quite clear that incidence is in this context a specific and fairly technical term, and that many people inclined to contribute to articles don't know the difference between prevalence, incidence and frequency.  I think that a definition of the term, and for convenience and education of the reader a definition of the term most likely to be confused with it should be near the top of the page.  In another wiki aimed at qualified people we use boxes of many types all over the place, but that doesn't have to be how it is done.  I've seen many articles which define their title in the opening paragraph, but I see that if it was folded into the narrative, it isn't there now.  Back to you for a solution, please.  Midgley 00:00, 16 July 2007 (UTC)
thread_title:  What's with the boxes? 

message: The incidence in (presumably children conceived in) the valley would be interesting.
The material remaining in the article was however about prevalence.
I've parked it here.
"See Silicon Valley cluster below.
====Silicon Valley cluster====
A 2002 BBC article indicated that one in 150 children in the region had an autistic spectrum disorder and asserted this was many times the prevalence in the surrounding area (see California below) A 2001 article in Wired suggested that the cluster is a result of a link between autistic disorders and computer skills.
"
Incidence anyone?  Midgley 23:53, 15 July 2007 (UTC)
thread_title:  Silicon Valley Incidence 

message: A 2002 BBC article indicated that one in 150 children in the region had an autistic spectrum disorder and asserted this was many times the prevalence in the surrounding area (see California below) A 2001 article in Wired suggested that the cluster is a result of a link between autistic disorders and computer skills.
"
Incidence anyone?  Midgley 23:53, 15 July 2007 (UTC)
thread_title: Silicon Valley cluster

message: "Further, there was with no discernable rate of change in incidence before and after the criteria change. "  The spelling would be easy enough, but it isn't clear what this originally was intended to mean.  Second integral perhaps?  Midgley 00:36, 25 July 2007 (UTC)
thread_title:  Redacted from Denmark: integral to article? 

message: "Many of the most well-funded public health systems in the world note a significant increase in the incidence of autism."
Unsupported by the article. Midgley 23:29, 24 August 2007 (UTC)
thread_title:  Introduction 

message: I've taken this out, not becuase there is anything wrong with it, but because it is in the wrong article.
 ---
There has been public concern that the MMR vaccine or the vaccine preservative thiomersal have contributed to an increase in the incidence of autism; the consensus of the medical and scientific community is that there is no scientific evidence to support these hypotheses, but decreasing uptake of vaccines has led to outbreaks of serious childhood diseases.
 ---
It is in several articles where it is the right article, but here it is entirely subsumed within one of the possible explanations for changes in reported incidence - that incidence has changed.  Once one decides that incidence has changed - which is not supported by the article in its present state, I think - one might start considering what the cause of that was.  But not till then, and it is a very different piece of epicemiology.  Curing the condition is of course entirely absent from this article, and the suggestion of bias was quite surprising.  Midgley (talk) 13:51, 7 December 2007 (UTC)
thread_title:  If it had changed, why it might have 

message: The first and last sentences in this are clearly in the right place, the rest I suspect should be removed for the moment, unless there are actual incidence figures or discussions that can usefully be quoted. Midgley (talk) 20:05, 9 December 2007 (UTC)
thread_title:  Incidence in sub-groups 

message: *The incidence rate of a condition is the rate at which new cases occurred per person-year, for example, "2 new cases per 1000 person-years".
Er, no...  Not here.  Midgley (talk) 16:32, 10 December 2007 (UTC)
replies: text: The quoted definition is the standard one used in epidemiology. See the cited textbook reference, which says incidence is defined by "relating the numbers of new cases to the person years at risk, calculated by adding together the periods during which each individual member of the population is at risk during the measurement period". A definition related to how many babies eventually have autism is equivalent to the standard definition if we assume that all cases of autism begin at birth, but such an assumption is controversial, as some theories hypothesize that cases of autism are caused by postnatal environmental factors, and a careful article should not make such an assumption without stating it. After all, this article started out as Autism epidemic and was based on environmental theories that are widely popular; we cannot simply ignore them merely because they lack scientific support. Infant mortality also messes up the proposed nonstandard definition. Eubulides (talk) 18:11, 10 December 2007 (UTC)
thread_title:  Wrong definition 

message: I agree with much of what you say about incidence and prevalance and so forth, but I'm afraid that with autism things are a bit different than with influenza. Almost all the cited data in this article is about prevalence, not incidence. The article's discussion may be about incidence, but when you follow the references and see what actually is being measured, it's prevalance. And there are some good reasons for this. To quote Autism#Epidemiology, "Autism's incidence, despite its advantages for assessing risk, is less useful in autism epidemiology, as the disorder starts long before it is diagnosed, and the gap between initiation and diagnosis is influenced by many factors unrelated to risk. Attention is focused mostly on whether prevalence is increasing with time." This quote is backed by Newschaffer et al. 2007 (), the most-recent high-quality review of autism epidemiology that I know of. Eubulides (talk) 20:12, 9 December 2007 (UTC)
replies: text: I'm surprised and a little perplexed.  I've looked at the references.  The word incidence occurs in the titles of several of them.  The title of the article is "incidence".  I wrote the first go of it by deliberately setting out to remove everything that did not relate to incidence.  The last change made was to remove a chunk that doesn't clearly enough relate to incidence rather than prevalence, frequency or "service" in the USA and reinstate a piece specifically on the incidence in Olmstedt county.   I'd be fascinated to read the article that I thnk we both agree is not without merit, on autism prevalence, with that being a good name for it.  Attention may well be focussed upon prevalence, but I suggest applying a little ray of it to incidence.  Midgley (talk) 16:28, 10 December 2007 (UTC)
replies: text:  The word incidence does appear in some titles, notably Honda et al. 2005 () and Barbaresi et al. 2005 (), but if you read the sources you'll see that they are talking about cumulative incidence, not incidence rate. In a disorder where the cure rate is essentially zero, there is little practical difference between cumulative incidence and prevalence. For example, Honda et al. 2005 reported cumulative incidence up to age 7; under the reasonable assumption that death and cure rates were negligible, this is equivalent to the point prevalence at age 7. Eubulides (talk) 18:35, 10 December 2007 (UTC)

text:  This may help to explain why it would be a mistake to have separate articles on autism incidence and prevalence. There should be just one article, which talks about the frequency of autism, and which discusses both incidence and prevalence and clarifies the relation between the two. The vast majority of our audience doesn't care about the fine distinctions between cumulative incidence and point prevalence; what they care about is the risk that their child will be autistic, and whether that risk is increasing or decreasing with time. This audience will be far better served by one article rather than having two dueling articles on essentially the same subject. Eubulides (talk) 18:35, 10 December 2007 (UTC)

text: I'd also suggest looking for the source of the quoted paragraph.  Midgley (talk) 16:30, 10 December 2007 (UTC)
replies: text: Sorry, I've lost context. Which quoted paragraph is that? Eubulides (talk) 18:35, 10 December 2007 (UTC)
thread_title:  This article is actually about prevalence 

message: To not mention possible environmental factors and to question whether it is uncertain that actual prevalence has increased; is grossly misleading. And who deleted the Talk page? --Leifern (talk) 21:17, 19 December 2007 (UTC)
replies: text: Nobody deleted the talk page, as far as I know. I think Epidemiology of autism got renamed to some other page (sorry, I don't know which; it was before my time), so the old talk page probably moved with it. As for environmental factors, good point, I'll add something. Eubulides (talk) 21:30, 19 December 2007 (UTC)

text: Your edits are improvements over the first version, but the article still reads like a crude propaganda piece. The controversy should be mentioned, and though several people find support for the changing diagnostic criteria view, the support for this is tenuous at best. I appreciate your effort, but suggest that you read up on all sides of the controversies rather than accepting one side uncritically. --Leifern (talk) 22:20, 19 December 2007 (UTC)
replies: text: I added a new section Epidemiology of autism#Autism and its causes which mentions the controversy. No doubt further improvements could be made; suggestions are welcome. The article does not say that all the changes are due to diagnostic criteria, only that some of the changes are. I don't know of any reliable sources that disagree; if you know of any, please let us know. Eubulides (talk) 22:30, 19 December 2007 (UTC)
thread_title:  NPOV and deletion of talk page 

message: Currently Epidemiology of autism#Frequency of autism lists Autism (incidence) as a subpage. There is considerable duplication, and Autism (incidence) is small enough that it should be merged into Epidemiology of autism. Eubulides (talk) 21:19, 19 December 2007 (UTC)
replies: text: No objection, so I did the merge. Eubulides (talk) 02:26, 24 December 2007 (UTC)
thread_title:  Merge from "Autism (incidence)" 

message: Maleness is a comorbid condition? I know some conservatives have argued that our society is at war with the masculine, but is being male really a disorder now? 128.164.107.161 (talk) 17:02, 3 November 2008 (UTC)
replies: text: The article says maleness is a comorbid condition, not a comorbid disorder. Eubulides (talk) 18:12, 3 November 2008 (UTC)
replies: text:  Such a statement is not supported by the reference . Risk factor yes; Comorbid conditon no.  Furthermore, disease/disorder is implicit when using the term comorbidity.128.192.84.143 (talk) 23:10, 4 November 2008 (UTC)
replies: text:  Ah, right you are of course. What was I thinking? Also, the exact same material is already in Epidemiology of autism #Risk factors. I fixed the problem by removing the bogus duplication. Thanks. Eubulides (talk) 00:47, 5 November 2008 (UTC)
thread_title:  Comorbid Conditions 

message: "Several contributing environmental risk factors have been proposed  ..."
It is aetiology rather than epidemiology, and is muddled.  Difficult, I know...  Midgley (talk) 13:20, 6 July 2009 (UTC)
replies: text: Thanks for catching that. The simplest fix is to remove the word "contributing", which I did here as well as on a couple of other autism-related articles. Eubulides (talk) 16:28, 6 July 2009 (UTC)
thread_title:  paragraph makes poor sense 

message: There is no mention of specific percentage rates, or x per 1000 people.  —Preceding unsigned comment added by 67.166.122.57 (talk) 07:57, 28 December 2009 (UTC)
replies: text: Thanks for pointing out the problem. I  it. Eubulides (talk) 09:12, 28 December 2009 (UTC)
thread_title:  Rates for U.S. need to be more clearly defined 

message: My name is Stephen Arnold and I got Autism Speaks to fund a study (it should be completed in about a year) to either prove or disprove my theory on what is behind the current rise in autism rates.  I have written two papers on the subject but due to the complexity of this topic and abundance of evidence they are both quite long. I was hoping that one of you could give me feed back on the first paper which is 28 pages long not including references. I apologize if I have violated Wikipedia etiquette, but I did not know how else to ask my question.  —Preceding unsigned comment added by Arnold5404 (talk • contribs) 16:00, 20 January 2010 (UTC)
thread_title:  A Request 

message: This page takes a long time to load, and part of this is due to the use of the standard Wikipedia citation templates such as . Recently developed faster & smaller templates (such as ) make the page smaller and faster to load. Let's use them here; they're already in use in Heritability of autism. I just tried it out here, and the  generates 145,617 bytes of HTML, 57% bigger than the  (which generates 92,591 bytes of HTML); in one test the current version takes about 6.6 seconds of server time to generate more than twice as long as the 3.1 seconds of the proposed version (the timings are variable but this sort of improvement is common). Eubulides (talk) 02:56, 25 January 2010 (UTC)
replies: text: There is a message at the top of the template documentation saying that the template is not yet ready for use -- that's a little bit intimidating. Looie496 (talk) 16:40, 28 January 2010 (UTC)
replies: text:  Yes, I know. This is part of the experiment (using the template on a few real-world pages). I wouldn't worry about that part: I'm watching this page and the template closely, and can fix any problems that arise (possibly even reverting back to the existing templates). Eubulides (talk) 20:38, 28 January 2010 (UTC)
thread_title:  Page loading efficiency and style 

message: According to a study done May 9 2011 the autism rate in South Korea is 1/38: http://www.autismspeaks.org/about-us/press-releases/new-study-reveals-autism-prevalence-south-korea-estimated-be-26-or-1-38-chil  — Preceding unsigned comment added by Slartibartfastibast (talk • contribs) 13:50, 23 July 2011 (UTC)
thread_title:  South Korea 

message: The study mentioned is out of date and has been discredited
"Dr. Poul Thorsen, one of the co-authors and "scientist in residence" at the CDC 2000-2002, subsequently was terminated by Aarhus University and indicted in Atlanta for embezzlement this year in relation to his $11 million grant from the CDC.
http://www.prnewswire.com/news-releases/scandal-exposed-in-major-study-of-autism-and-mercury-132519518.html  — Preceding unsigned comment added by 124.180.175.26 (talk) 12:29, 17 December 2011 (UTC)
thread_title:  Denmark data innacurate 

message: http://www.psychiatry.org/practice/dsm/practice-relevant-changes-to-the-dsm-iv-tr
Quote below from the source linked above from the American Psychiatry Association indicates an editorial error was made in the description of the PDD NOS category of Autism Spectrum Disorders in the 1994 publication of the DSM-IV.  Research sourced in the quote below conducted by Dr. Fred Volkmar and colleagues, in 2000, provided results that "about 75% of cases identified by the clinician as not having PDDNOS (true negatives), were incorrectly identified as having PDDNOS according to the DSM-IV."  These results provided support both to the concern that the DSM-IV wording inappropriately broadened the PDDNOS construct and for a correction that reversed the criteria for PDD NOS back to the DSM-III-R criteria construct for PDD NOS, in the 2000 text revision for the DSM-IV (DSM-IV-TR). 
"Major changes were made the PDD category in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) based, in part, on a large, multi-site, international field trial. However, an editorial change was made in the description of PDDNOS during the final phase of production that had an unintended effect on the definition of PDDNOS.   Instead of requiring “impairment in social interaction and in verbal or nonverbal communication skills” (DSM-III-R, p. 39), DSM-IV states that the “category should be used where there is a severe and pervasive impairment of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and activities are present” (DSM-IV, pp. 77-78).   Thus, a child with an impairment in only one area (e.g., a child with stereotyped behavior, interests and activities but without evidence of disturbed social interactions could theoretically qualify for a diagnosis of PDDNOS. 
To assess the impact of the DSM-IV wording, Volkmar and colleagues performed a series of reanalyses of the DSM-IV autism/PDD field trial data (Volkmar FR, Shaffer D, First M.  PDD-NOS in DSM-IV.  J Autism Dev Disord 2000 Feb;30(1):74-75).  A series of comparisons were conducted to evaluate sensitivity/specificity.  Using clinicians' judgment of the presence or absence of PDDNOS as the standard,  the DSM-IV wording  had an excellent sensitivity of .98.    However, the specificity was only .26, i.e., about 75% of cases identified by the clinician as not having PDDNOS (true negatives), were incorrectly identified as having PDDNOS according to the DSM-IV.  These results lend support to the concern that the DSM-IV wording inappropriately broadened the PDDNOS construct.  If problems are required in the social area and either communication or restricted interest (i.e., at least 2 criteria present one of which must be from the social area) the sensitivity was .89 and specificity .56.   
These results supported a change in the wording of PDDNOS to revert to the original construct.  The new wording in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) is as follows:
“This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction associated with impairment in either verbal and nonverbal communication skills, or with the presence of stereotyped behavior, interests, and activities, but the criteria are not met for a specific Pervasive Developmental Disorder, Schizophrenia, Schizotypal Personality Disorder, or Avoidant Personality Disorder.”" Yellowboy70 (talk) 23:37, 4 November 2012 (UTC)
thread_title:  An editorial error in the description of the PDD NOS category of Autism Spectrum Disorders, published in the 1994 DSM-IV, inappropriately broadened the PDD NOS construct. 

message: Per the subject titled study, from 2010, linked below, all children, ages 3 to 21, in two Amish dominant counties were screened for the presence of an ASD.
https://imfar.confex.com/imfar/2010/webprogram/Paper7336.html
Quoted from the paper:
"Results:
From September 2008 to October 2009, 1899 Amish children were screened in the two Amish communities.  A total of 25 children screened positive for ASD on either the SCQ or the DSM-IV-TR checklist.  A total of 14 screened positive for ASD on both screeners.  Of those 25 children, 14 were evaluated and seven children were confirmed as having a diagnosis of ASD using the ADI and/or ADOS, and clinical judgment.  Interestingly, four of the seven only met ASD criteria on the ADOS but not the ADI.  Three of the four who were not diagnosed by the ADI only missed criteria on the Behavioral Domain, which may be attributable to the reporting style of Amish caregivers.
Conclusions:
Preliminary data have identified the presence of ASD in the Amish community at a rate of approximately 1 in 271 children using standard ASD screening and diagnostic tools although some modifications may be in order.   Further studies are underway to address the cultural norms and customs that may be playing a role in the reporting style of caregivers, as observed by the ADI.  Accurate determination of the ASD phenotype in the Amish is a first step in the design of genetic studies of ASD in this population." 
The Amish study mentions Kogan's study in 2009, linked below, that determined a 1 in 91 ASD prevalence from a national survey of parents answering whether or not they had been told that their children, ages 3 to 17, were diagnosed with an ASD.  While the data released in this study on the Amish is preliminary, the door to door methodology of screening children is one of the most comprehensive methods of reaching a general community population of children.
http://pediatrics.aappublications.org/content/124/5/1395.abstract  
It was interesting in Kogan's study, that among the parents who reported that they were told their children had an Autism Spectrum Disorder at an earlier age, 40% of those children were no longer identified by the parents as having an Autism Spectrum Disorder. These children no longer identified with an ASD, were not included in Kogan's 1 in 91 statistic.  It is possible that the editorial mistake in the DSM-IV, in 1994, that inappropriately broadened the diagnostic construct of PDD NOS, resulted in some of those children being re-assessed as not diagnosable with PDD NOS, after that error was corrected in the DSM-IV-TR, in 2000.
The methodology used in the Amish study is more comprehensive in reaching a community wide demographic of children, ages 3 to 21, than the methodology in the South Korea study, referenced and cited above in another section of this talk page, and below is limited to a more restricted age bracket of children scanned in the school system in South Korea for ASD's.  Similar methodology used in the most recent CDC prevalence study in the US, of previously recognized diagnosed cases of ASD's in South Korea, yielded a .75% prevalence in comparison to the CDC's current reported prevalence rate of 1.13%. Those identified with ASD's determined in South Korea from the fuller scan of children in mainstreamed classes, yielded an additional 1.89% prevalence of ASD's.  So out of the 1 in 38 statistic, provided in the referenced South Korea study, two-thirds of the children were previously undiagnosed.
http://www.ncbi.nlm.nih.gov/pubmed/21558103
Vaccines as a potential causal factor underlying the Autism subgroup of regressive autism most often in the subject of that controversy has been refuted by the most current scientific findings.  Regressive Autism is a form of autism severe enough that it would not likely be significantly identified in further Community wide analysis of children among the Amish or in South Korea, as it is not an issue that can reasonably be overlooked by most parents, physicians, or educators in either society.  
While vaccines as evidenced in the most current scientific research, have not been shown to be the culprit of the disparity in the prevalence statistics in the South Korean and Amish larger community scans of children, there appears to be substantial elements of heredity and/or environment/culture associated with that disparity beyond diagnostic methodology.  Those factors of disparity further studied may lend greater insight in both the causal factors and/or extent of a prevalence increase, over time, in the full spectrum of ASD's.Yellowboy70 (talk) 05:29, 5 November 2012 (UTC)
thread_title:  "Prevalence Rates of Autism Spectrum Disorders Among the Old Order Amish" 

message: The article talks about the thoroughly disproven hypothesis that autism is caused by vaccines as if there was still uncertainty in the matter. It needs to be made more clear that the idea that vaccines cause autism has been completely disproven.  — Preceding unsigned comment added by 70.192.135.114 (talk) 15:54, 31 May 2016 (UTC)
replies: text: I noticed that too. There are numerous references in the article which are out of date or discredited, regarding the possibility that vaccines (or thimerasol in the minute or non-existent quantities present in vaccines) are a cause of autism. It is grossly misleading to perpetuate the COMPLETELY DISPROVEN idea that vaccines cause autism. I don't know enough about the subject matter to feel confident in removing some of the inappropriate references, although I can try. For any editors who follow or notice: Please be aware that this is my motive.--FeralOink (talk) 22:31, 31 July 2016 (UTC)
thread_title:  Bias 

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thread_title:  External links modified 

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message: The section in Denmark has significant issues.  It refers to a study from Aarhus University, but provides no references for that specific study.  It then does cite a study which shows the opposite finding, but claims it is discredited because one of the authors was charged with fraud and embezzlement, but if you follow the reference the fraud was related to the acquisition of grant money, not the study.  Someone should address this.  — Preceding unsigned comment added by 2601:601:8280:5D7C:CCDC:C648:DF85:2731 (talk) 21:14, 29 January 2019 (UTC)
thread_title:  Issue in Section on Denmark