Talk:Autism#Proposal to move this article to Autistic disorder

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The neutral point of view policy requires that articles "represent fairly, proportionately, and, as far as possible, without editorial bias, all the significant views that have been published by reliable sources on a topic". Does the Autism article as a whole currently overemphasize the clinical/medical model of ability viewpoint relative to the social/neurodiversity viewpoint?

Robert McClenon (talk) 14:40, 25 February 2025 (UTC)

Viewpoints on autism include a clinical/medical model of disability perspective, which sees autism as a neurodevelopmental disorder with symptoms, impairments and deficits and uses terms like "cure", "treatment", "severity", "high/low functioning", "burden", "risk", and "co-morbid"; and a social/neurodiversity perspective, which sees autism as a healthy part of human diversity rather than a disorder (though it can be disabling if the environment does not accommodate autistic people’s needs and may also involve inherently disabling features) and uses terms like "features", "characteristics", "accommodations", "likelihood", "co-occurring", and specific descriptions of support needs.

Please answer Yes or No (or the equivalent) with a brief statement in the Survey. Please do not reply to other editors in the Survey. That is what the Discussion section is for.

No; while the article uses older sources to contradict connected articles at time, I do not feel that it is spending too much time on one perspective.Abbi043 (talk) 21:31, 25 February 2025 (UTC)

:I'm changing to Yes here - @LogicalLens's survey reply makes clear that such is, at least, more dominant within the scientific community than I had thought, and that I have been holding a number of misconceptions on the exact boundary conditions of the various models of disability. Abbi043 (talk) 06:21, 26 February 2025 (UTC)

Yes. The current article on autism exhibits a significant imbalance, disproportionately reflecting the medical model and failing to adequately represent the growing body of literature supporting the neurodiversity paradigm. This is because the proportion of sources supporting the neurodiversity paradigm has increased substantially in recent years,[https://www.liebertpub.com/doi/10.1089/aut.2023.0030][https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13534][https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.13176] which is not yet appropriately accounted for in the article. The medical model and the neurodiversity model currently co-exist within the scientific literature. There is an ongoing debate over the classification of autism as a disorder.[https://www.science.org/content/article/disorder-or-difference-autism-researchers-face-over-field-s-terminology] A neurodiversity-affirming textbook for psychology students[https://www.routledge.com/Autism-A-New-Introduction-to-Psychological-Theory-and-Current-Debate/Fletcher-Watson-Happe/p/book/9781138106123] exists and two books that provide a neurodiversity-affirming approach to autism diagnosis.[https://www.routledge.com/Is-This-Autism-A-Guide-for-Clinicians-and-Everyone-Else/Henderson-Wayland-White/p/book/9781032150222][https://uk.jkp.com/products/the-adult-autism-assessment-handbook] In addition, many scholarly books have been published that deal with the paradigm shift towards neurodiversity.[https://pavpub.com/clearance/the-neurodiversity-reader][https://www.routledge.com/The-Routledge-International-Handbook-of-Critical-Autism-Studies/Milton-Ryan/p/book/9780367521011][https://www.routledge.com/Neurodiversity-Studies-A-New-Critical-Paradigm/BertilsdotterRosqvist-Chown-Stenning/p/book/9780367503253][https://www.routledge.com/Improving-Mental-Health-Therapies-for-Autistic-Children-and-Young-People-Promoting-Self-agency-Curiosity-and-Collaboration/Pavlopoulou-Crane-Hurn-Milton/p/book/9781032372525]

Increasingly, research suggests that features previously considered deficits and symptoms may also be interpreted as neutral differences within a neurodiversity framework. There is a growing body of studies indicating that the difficulties arise only when the autistic person is measured against neurotypical expectations. For example, there are many studies backing the Double empathy problem, which states that empathy difficulties between autistic and non-autistic people are two-sided.[https://journals.sagepub.com/doi/10.1177/13623613241255811][https://journals.sagepub.com/doi/full/10.1177/1362361317708287][https://journals.sagepub.com/doi/full/10.1177/13623613231211457][https://journals.sagepub.com/doi/full/10.1177/13623613231219743][https://www.nature.com/articles/srep40700][https://journals.sagepub.com/doi/full/10.1177/1362361320919286][https://www.liebertpub.com/doi/full/10.1089/aut.2018.29000.cjn][https://journals.sagepub.com/doi/full/10.1177/13623613221129123] Additionally, recent systematic reviews found that stimming (repetitive behaviors) serve a useful purpose for the autistic person.[https://www.sciencedirect.com/science/article/pii/S1750946724001338?via%3Dihub][https://www.liebertpub.com/doi/10.1089/aut.2023.0111] Furthermore, a positive autistic identity has been found by several studies to have benefits for mental health.[https://journals.sagepub.com/doi/full/10.1177/13623613221118351][https://journals.sagepub.com/doi/full/10.1177/13623613211004328][https://www.liebertpub.com/doi/abs/10.1089/aut.2020.0016]

Health authorities are increasingly adopting a neurodiversity-affirming perspective. For example, the official Autralian guidelines for autism assessment and diagnosis recommend it[https://www.autismcrc.com.au/best-practice/assessment-and-diagnosis/second-edition/micro-learning-transcript] and the UK’s health authority NHS also recommends talking about autism positively.[https://www.england.nhs.uk/learning-disabilities/about/get-involved/involving-people/making-information-and-the-words-we-use-accessible/] Moreover, many leading academic journals dedicated to autism recommend or even require neurodiversity-affirming language[https://home.liebertpub.com/publications/autism-in-adulthood/646/for-authors][https://media.springer.com/full/springer-instructions-for-authors-assets/pdf/10803_JADD%20Inclusive%20Language%20Guide.pdf][https://journals.sagepub.com/pb-assets/cmscontent/AUT/Autism-terminology-guidance-2021-1626860796.pdf] In 2023, Wiley announced a “multi-journal special issue” on neurodiversity across 38 journals,[https://onlinelibrary.wiley.com/products/call-for-papers-neurodiversity] demonstrating the growing recognition of neurodiversity across diverse academic disciplines. Similarly, Sage launched a scientific journal called Neurodiversity.[https://journals.sagepub.com/home/NDY]

While many professionals are adopting a more neurodiversity-affirming approach, diagnostic criteria and clinical interventions often still operate within a medical model framework. Therefore, the goal is not to eliminate the medical model, but to ensure that the article provides a balanced representation of both perspectives and the current state of scientific understanding and discourse. I propose that the article be revised to give more balanced weight to the neurodiversity paradigm. LogicalLens (talk) 04:47, 26 February 2025 (UTC)

No. There is an ongoing effort to present a flourishing but minority perspective on autism as having equal standing with the widely accepted mainstream medical model. This approach is often justified by citing the lead sentence of the NPoV policy. However, reducing the policy to a single sentence is a misapplication that undermines the encyclopedic tone and style, ultimately degrading both the quality of the article and its accessibility for readers. While it is essential to represent all significant viewpoints, Wikipedia policy does not suggest that every minority perspective must be presented alongside mainstream scholarship as if they were of equal validity. Recent proposals introduce excessive hedging and unencyclopedic structures, such as a persistent back-and-forth juxtaposition of models. In scientific topics where a strong consensus exists, presenting an opposing view without appropriate "due weight" can create "false balance." I deeply appreciate and value the contributions of all editors involved and fully recognize that everyone is acting in good faith. However, we must remain committed to Wikipedia’s core principles and ensure that decisions align with its mission of providing accurate and well-balanced information. There is clear evidence of Advocacy occurring in the editing history and discussions herein, which, like conflicts of interest (CoI), should be addressed with appropriate action. Contributing editors: as someone uninvolved up to this point, I would kindly and respectfully ask each of you to please consider if this is applicable to you and to determine for yourself if you should refrain from further edits and adjust your continued participation in discussions on this article due to lack of ability to do so neutrally. Tacitusmd (talk) 02:03, 27 February 2025 (UTC)

:Thank you for this. Though as well as advocacy, some editors do have potential professional CoI that they have chosen not to represent here. It would be useful if editors with these possible CoIs - for example profiting from talks and courses on the perspective they’re lobbying to have included in the article - would make them clear. 2A02:C7C:9B04:EA00:E8E7:31E6:D5B2:CC94 (talk) 09:03, 23 March 2025 (UTC)

Yes. The existing article does not come anywhere close to recognising developments in mainstream understandings of autism in the twenty-odd years since it was started, let alone the last half-decade or so.

This shows in the article's structure, tone and content.

The article as it stands is out of step with many mainstream sources in its frequent use of stigmatising language and framings, and misses out a huge amount that is actually helpful for people to know about autistic experiences.

Obviously Wikipedia is not a how-to, but it does aim to be useful to a general audience. The existing version of this entry does a poor job of benefiting readers, which I would suggest is largely because it has been written with little regard for what autistic people, our families and professionals working with us think is important for people to know about. We can absolutely fix this without compromising on our reliance on high-quality sources for claims.

Oolong (talk) 12:05, 27 February 2025 (UTC)

Comment. At the top of this talk page, there's an information section − collapsed, but with an information icon, 30px − titled "Section sizes." People responding to this RfC may find it useful to look at the relative sizes of the sections devoted to different aspects of autism. FactOrOpinion (talk) 13:22, 27 February 2025 (UTC)

:I'll paste it here for ease of reference:

{{Section sizes}}

:FactOrOpinion (talk) 17:03, 27 February 2025 (UTC)

::So that would lead me towards the answer Yes. Thanks FactOrOpinion for flagging that empirical information! If as per the table the neurodiversity-aligned approach is currently something like maybe ~10% of the wikipedia page, with the vast majority reflecting a more traditional medical lens, then that seems unbalanced as a recent systematic review of language use in the contemporary peer-reviewed academic autism literature by Bottini et al. suggests that 30% of the peer-reviewed literature language use is neurodiversity-affirming and 70% is traditional medical (https://doi.org/10.1089/aut.2023.0030). That would definitely suggest a considerable discrepancy between the wikipedia page and the contemporary peer-reviewed academic literature on this topic.

::Previously a lot of the assertions here have been based largely on the subjective opinions of a given editor, based on their appraisal of the relative importance of different sources in a pretty extensive literature. Whereas these sorts of empirical numbers at least provides some basis for more precise assertions. Of course one can still debate these numbers - one could for example discuss whether the 10% number from the table pasted by FactOrOpinion is misleading, or how to interpret the Bottini et al. review - it was based on the literature in 2021 so not 100% contemporary - I expect the 2024/2025 literature is even more neurodiversity aligned since the field is definitely heading in that direction, but I don't have 2024/2025 numbers. Or perhaps there are other ways to quantify how much of the contemporary science and research follows one approach or another. Ó.Dubhuir.of.Vulcan (talk) 23:00, 27 February 2025 (UTC)

No. Of course, there are autistic people who are never diagnosed. However, all formally autistic people have once gotten a diagnosis. The D criterium for getting this diagnosis states that symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. People who have autistic characteristics but don't have a clinically significant impairment should not have been given a diagnosis.

I have an idea though. We need to create two articles: Autism (diagnosis) and Autism (identification). File:Coin Icon.svg Lova Falk (talk) 13:22, 28 February 2025 (UTC)

no. per Lova Falk rationale--Ozzie10aaaa (talk) 13:04, 4 March 2025 (UTC)

Yes The existing article is notably unbalanced. It treats the patholigising 'medical model' of autism as being falsely definitive or sacrosanct, while marginalising the non-patholiogising 'neurodiversity model' of autism. The neurodiversity model has a great deal of published academic and scientific support. Medical thought is always behind relevant science, it is inevitable. Diagnostic manuals are often many years behind contemporary science. There are plenty of academic publications that have accepted the validity of the neurodiversity model. Even Sir Simon Baron-Cohen (originator of the 'extreme male brain' and 'systematising' theories of autism), a world expert in autism research, has accepted the validity of some aspects of the neurodiversity model in his more recent works. Urselius (talk) 11:39, 5 March 2025 (UTC)

Yes. Autistic clinical phenomena are what a biomedical paradigm seeks to explain, and autistic social phenomena are what a neurodiversity paradigm seeks to explain. These two links follow directly from the explanatory text of the RFC (associating "clinical"<->"medical model of disability," and "social"<->"neurodiversity"). In fact, on a previous version of this very Talk page I seemed to have gotten some buy-in from editors that we should primarily lean on a biomedical paradigm to explain WP:BMI, and primarily use a neurodiversity paradigm to explain WP:NOTBMI in the context of Autism.

But looking at the word count table that FactOrOpinion posted makes it clear that there's a glaring imbalance here. If we consider symptoms, causes, management, and comorbidities to be biomedical/WP:BMI, that's 66% of the entire article in just those three sections, compared to 9.6% of the article dedicated to social implications. If this were an article on, say, Carbon monoxide poisoning, it would make sense to only briefly consider the social implications of it. But this is a disorder that both current and proposed new ledes declare to be a social disorder in the very first sentence! So why do we spend only 10% or 20% on those implications?

It's strange that a page about a social disorder has a paucity of explanation on the social implications. The best way to correct this is to use more of the paradigm best suited for explaining social implications, which (following from this RFC's text) is the neurodiversity paradigm, and the existing academic articles that fall in that paradigm. Patrickpowns (talk) 20:39, 6 March 2025 (UTC)

No - At least not as how is implied here and by certain users. Though I think there is a lot of room for more nuanced and developing perspectives, however as per wikipedia's rules on how to write on medical conditions based on the mainstream medical authorities, such often in practice directly conflicts with the writing to give more space for the social/neurodiversity perspective on the condition. GigaMigaDigaChad (talk) 04:17, 7 March 2025 (UTC)

Yes - The current article is very negative and biased towards the medical model of disability. It should focus more on the social model and internal experiences, as opposed to only external observations. While the proposed lede, is better because it is less negative and less biased towards the medical model of disability, it overtly seems to also lean towards the social model of disability. Being on the spectrum myself, I believe that the proposed lede is a lot better at serving the interests of autistic and other neurodivergent people who want the world to be more understanding and accommodating of them.

Another part noted is "Research indicates that autistic people have significantly higher rates of LGBTQ+ identities and feelings than the general population." This sentence (and the research) could be biased because the people researched may not be representative of all autistic people and the people researched could have had external influences (ostracism and wanting to join a community, etc). I agree with cyberwolf that it should be ommited. If, however, this sentence is included in the lede, then I would recommend "LGBTQ+" be replaced with "LGBTQ" instead because the first term resonates with a left liberal/progressive leaning bias (with the plus + symbol) and the latter would be more neutral.

In my opinion, it would be best to start small, such as replacing terms with more neutral terms or sentences, some included in the proposed lede, using the table below:

class="wikitable" |+ Terms/Sentences to be replaced
Old Term (Biased/Negative)	New Term (Neutral)
Neurodevelopmental disorder	Neurodevelopmental condition
Sensory abnormalities	Uncommon responses to sensory stimuli
There is no known cure for autism.	There is no known method of eliminating autism.
Severity	Presentation
Deficit	Difference
Symptom	Trait or Characteristic
Comorbid	Co-occuring

Also, the use of "ASD" should be replaced with "Autism" to avoid bias towards the (almost) strictly medical model the original lede has.

Frequency (1%) is outdated (due to masking, low levels of awareness, underdiagnosis) and should be updated to 2.8% up to 5% (citation needed) to represent the most up-to-date model.

--DependableProportion (talk) 16:46, 13 March 2025 (UTC)

No per Lova Falk. That does not mean we can't improve the article, but that is another thing than disputing its neutrality. CFCF (talk) 19:16, 15 March 2025 (UTC)

Yes. The article uses frankly outdated and medicalising language that presents autism as a disease. I concur with @LogicalLens above. The article should shift away from presenting the medical model as widely accepted truth when society at large is beginning to change its attitudes to autism, even if the medical and neuroscience communities remain in a disease mindset. I agree with @DependableProportion's suggestions for how we can change the language used in the article. —Editor510 ^{drop us a line, mate} 11:37, 16 March 2025 (UTC)

No - In compliance with Wikipedia policies and guidelines, I believe the article reflects the status of the global scientific consensus. As indicated by international guidelines, national guidelines, standardised diagnostic criteria, scientific consensus statements, systematic reviews, and other secondary peer-reviewed sources, unanimously around the world, ASD is characterised as a valid neurodevelopmental disorder with symptoms and impairments, varying severity, and deficits in specific psychological traits. However, they tend to interchangeably use the terms signs and symptoms, so I am for the use of both of these terms in the article. While some of the primary literature such as editorials and advocacy papers subscribe to the Neurodiversity Movement, they are refuted by other papers and are far outweighed by the quality/reputability of the aforementioned sources.

Note that while one publication from the NHS advocates against the use of certain terms, this is continuously being cited in a selective way that omits crucial context. First, that publication is not scientific in nature; it is not evidence-based. Second, it is contradicted by its own actual evidence-based guidelines elsewhere, including by NICE which supersedes the NHS.

References

: The ICD-11 and World Health Organization (WHO), guidelines used globally, conclude that autism is a neurodevelopmental spectrum disorder and that "The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning". https://icd.who.int/browse/2024-01/mms/en#437815624 1 . The Wikipedia article also has concluded that "ICD-11 was produced by professionals from 55 countries out of the 90 involved and is the most widely used reference worldwide".

: The DSM-5 criteria, used internationally, concludes that autism is a neurodevelopmental spectrum disorder; per diagnosis that "Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning" and that "Severity is based on social communication impairments and restricted, repetitive patterns of behavior". [https://iacc.hhs.gov/about-iacc/subcommittees/resources/dsm5-diagnostic-criteria.shtml 2]

: Guidelines from the UK National Institute of Health & Care Excellence (NICE) conclude that autism is a neurodevelopmental spectrum disorder. They write "The clinical picture of autism is variable because of differences in the severity of autism itself". [https://www.nice.org.uk/guidance/cg170 3] NICE guidelines also refer to "symptoms of possible autism..." [https://www.nice.org.uk/guidance/cg128/resources/signs-and-symptoms-tables-primary-school-children-msword-183220669 4]

: National Institute of Mental Health (NIMH) Guidelines conclude that "Autism spectrum disorder (ASD) is a neurological and developmental disorder" and acknowledge the existence of "signs and symptoms of ASD". [https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd 5] Paradoxically, a different NIMH publication advocates against some of the above https://www.nih.gov/nih-style-guide/autism 6.

: The European Society for Child and Adolescent Psychiatry (ESCAP) and Autism Europe (AE) guidelines, used internationally, conclude that "autism spectrum disorder (ASD), which is now recognised not only as a childhood disorder but as a heterogeneous, neurodevelopmental condition that persists throughout life". They also state that "Earlier recognition of autism symptoms could also be improved...". [https://www.autismeurope.org/wp-content/uploads/2020/09/Fuentes2020_Article_ESCAPPracticeGuidanceForAutism.pdf 7]

: German AWMF guidelines conclude that autism is a neurodevelopmental disorder characterised by symptoms, impairments and varying severity levels in accordance with the above guidelines. [https://pubmed.ncbi.nlm.nih.gov/30326807/ 8]

: National Guidelines in France conclude that autism is a neurodevelopmental disorder, with varying severity levels, characterised by symptoms and the presence of significant impairment, endorsing the DSM-5 and ICD-11([https://www.has-sante.fr/upload/docs/application/pdf/2018-04/cpg_asd_diagnostic_assessment_child_teenager_2018.pdf 9]).

: A scientific consensus statement on the evaluation of ASD conclude that it's a neurodevelopmental disorder, with varying severity levels and is characterised by symptoms and the presence of impairments ([https://pubmed.ncbi.nlm.nih.gov/28368272/ National Consultation Meeting for Developing IAP Guidelines on Neuro Developmental Disorders under the aegis of IAP Childhood Disability Group and the Committee on Child Development and Neurodevelopmental Disorders et al., 2018)]).

: Consensus Guidelines on ASD concluded that "Autism spectrum disorder (ASD) is a neurodevelopmental disorder with an estimated lifetime prevalence of at least 1% (Baird et al., 2006; Brugha et al., 2011). Core symptoms include..." ([https://journals.sagepub.com/doi/abs/10.1177/0269881117741766 Howes et al., 2018]).

: Canada's national diagnostic guidelines from the Canadian Paediatric Society (CPS) conclude autism is a neurodevelopmental disorder; that "[children with ASD] can present with a wide range and severity of symptoms"; that "This statement proposes three ASD diagnostic approaches, the choice of which depends upon the paediatric care provider’s clinical experience and judgment, and the complexity of symptom presentation" ([https://cps.ca/en/documents/position/asd-diagnostic-assessment CPS, updated: 2024]).

: The International Consensus Statement on ADHD, authored by 80 scientists, coendorsed by 403 experts and numerous associations, across 27 countries and 6 continents ([https://pmc.ncbi.nlm.nih.gov/articles/PMC8328933/ Faraone et al., 2022]) conclude that ADHD [another neurodevelopmental disorder] "the clinical significance of the signs and symptoms of the disorder has been recognized for over two centuries". This shows that the term symptoms and signs are applicable to neurodevelopmental disorders, not merely diseases as some have suggested. Systematic reviews and meta-analyses use these terms for Autism as well, not just that specific neurodevelopmental disorder ([https://www.tandfonline.com/doi/full/10.3402/ehtj.v4i0.7111 Dietert et al., 2010]; [https://journals.lww.com/jrms/fulltext/2017/22000/Environmental_factors_influencing_the_risk_of.27.aspx Mojgan et al., 2017]; [https://journals.sagepub.com/doi/full/10.1177/13623613221133176 Belmonte et al., 2022]).

: Regarding primary literature, some blog posts, advocacy papers and textbooks advocate for a change in terms deviating from calling ASD a neurodevelopmental disorder but simply a neurodiversity with "traits" rather than symptoms and impairments.[https://www.routledge.com/Autism-A-New-Introduction-to-Psychological-Theory-and-Current-Debate/Fletcher-Watson-Happe/p/book/9781138106123?srsltid=AfmBOoohIIWKeqE8wkwP4OLzAtUWg0EjjUxpDqJxsluYBEBnl_bK410l 10],[https://scholar.google.com/scholar?cites=17243849028263424617&as_sdt=2005&sciodt=0,5&hl=en 11],[https://www.theopennotebook.com/2023/06/27/eradicating-ableist-language-yields-more-accurate-and-more-humane-journalism/ 12]. However, these are advocating for something that is not currently established. Thus, they are not sources that can overturn the global scientific consensus on how ASD is currently defined. Other textbooks do not share such views (e.g., [https://books.google.co.uk/books?hl=en&lr=&id=d0pkEAAAQBAJ&oi=fnd&pg=PR29&dq=autism+textbook&ots=dFEFSTWCHk&sig=sg2D_OIfZNOs3XnkvipbSuP9M6Q&redir_esc=y#v=onepage&q=autism%20textbook&f=false Volkmar, 2021]), and the Wikipedia articles cites other reviews that refute the Neurodiversity Movement claims ([https://onlinelibrary.wiley.com/doi/abs/10.1111/japp.12470 Neison et al., 2021]; Shields et al., 2021). Blog posts should be discounted as they are not peer-reviewed, scientific papers.

Wikipedia Guidelines/Policies

: Wikipedia:Scientific consensus concludes:

: "It is important to note that in forming its consensus it is the members of a particular scientific discipline who determine what is scientific and what is questionable science or pseudoscience. Public opinion or promoters of what is considered pseudoscience by the scientific consensus hold no sway in that determination. (See Wikipedia policy and guidelines regarding Undue weight, extraordinary claims sourcing, verifiability, reliability, and dealing with fringe theories.)"

: Wikipedia:Reliable Sources, which is an "an English Wikipedia content guideline... that editors should generally follow", concludes:

: "Material such as an article, book, monograph, or research paper that has been vetted by the scholarly community is regarded as reliable, where the material has been published in reputable peer-reviewed sources"

: Further on, they state:

: "Research that has not been peer-reviewed is akin to a blog, as anybody can post it online. Their use is generally discouraged"

: And that:

: "Many Wikipedia articles rely on scholarly material. When available, academic and peer-reviewed publications, scholarly monographs, and textbooks are usually the most reliable sources"

Димитрий Улянов Иванов (talk) 21:29, 17 March 2025 (UTC)

No. The article focus, e.g. the infobox, means the article is about Autism as a medical condition, so NPOV is limited to variations inside that boundary. It would be good to have breakaway topics as separate articles for that reason and for simple practicality of article writing not having to somehow balance dissimilar content and a resulting excessive length. Perhaps it would be good to have a top hat line describing the bounds of this article and lead to a disambiguation page, or perhaps have See Also links or sub articles - but not to try and cram every possible aspect into this one article. Cheers Markbassett (talk) 10:04, 19 March 2025 (UTC)

Yes. In reading a lot of people's !votes, it seems that they're interpreting autism as a medical condition and thus conclude that the article appropriately focuses on that topic. But people who are looking for information about autism aren't only looking for medical information, and may not primarily be looking for medical information. If you look at RS content about autism there's significant non-medical information: content from a neurodiversity perspective, content about the lived experiences of autistic people, and so forth. This is especially the case with more recent RSs. So there is a disproprotionate emphasis in this article on the medical perspective. As I said in the Discussion section, I think one solution to the significant difference of opinion is to split off a lot of the content in the current article to Autism spectrum disorder (the medical diagnosis, a page that currently redirects to Autism), and to create a more balanced article for the Autism. FactOrOpinion (talk) 15:32, 22 March 2025 (UTC)

No; as noted above, diagnosis requires clinically significant impairment. Wikipedia determines WP:WEIGHT from the most reliable sources, i.e. scientific ones, not internet discourse. The latter tends to be dominated by people with less severe symptoms and/or lack the clinically significant impairment. Although some academic sources do endorse a neurodiversity perspective, and that is represented in the article, there is not an excessive emphasis on medical views in the article. The POV tag should be removed. Crossroads ^-talk- 21:20, 9 April 2025 (UTC)

Yes -- this article approaches it completely, reading the lead, from a medical perspective. An equal focus on the neurodiversity perspective would be good, I think, although I'm not autistic. Mrfoogles (talk) 18:48, 27 April 2025 (UTC)

Yes I would love it to sound less medical. Anthony2106 (talk) 00:51, 29 April 2025 (UTC)

@Abbi043, it would be helpful to talk more about reliable sources and less about feelings. Another question: Could you agree on making some language changes even if you are on the side of those who do not think that the proportion of space dedicated to each viewpoint should change? LogicalLens (talk) 03:18, 26 February 2025 (UTC)

:Yeah, I definitely think some language changes are in order. Some of the sources could probably stand to be double checked, too - for instance, since I spotted it while checking myself again, source 153 (Hartman, L., & Hartman, B. (2024). "An ethical advantage of autistic employees in the workplace". Frontiers in Psychology, 15, [tel:1364691 1364691]. 10.3389/fpsyg.2024.1364691) is a comparison of 33 autistics and 34 neurotypicals where they found that autistics are less responsive to having bystanders, the degree of which is impacted by Moral Disengagement as defined in the study, which also reduced the odds that Autistics intervene less than it did neurotypicals. This somehow becomes "Autistic people are less likely to show cognitive or emotional biases, and usually process information more rationally." Abbi043 (talk) 04:03, 26 February 2025 (UTC)

:Also, in regards to my statement on the use of older sources to contradict connected articles - since I maybe should've been more particular about that - the sources used to establish that ABA is effective are a 2008 and a 2015 source, while the Criticisms section of the article on ABA, which is where studies of effectiveness of ABA (instead of how ABA is practiced) is covered, shows sources as late as 2022, with most of the sources being 2020 or 2021 sources, stating that there is a lot of unreported COI and low quality of evidence, and that claim is not contested in the article. I would therefor expect that that claim stands - since my earlier research into the matter had showed them just getting repeatedly, utterly rammed with things along the lines of citing their official ethical code, educational criteria, latest attempt to address criticisms, and a large study backed by the US gov, even should there be a way they could address that claim, their likely too busy on that. Abbi043 (talk) 04:46, 26 February 2025 (UTC)

@Tacitusmd, thank you for raising your concern about neutrality. I understand the importance of representing all significant viewpoints appropriately.

You mentioned the problem of back-and-forth juxtapositions between viewpoints, which is a valid point that I have already addressed in one of the discussions. We agreed on improving that paragraph of the proposed new lead section further, it is not finished yet.

To address your concern about source balance, I would like to point you to the list of citations I posted above.[https://en.wikipedia.org/wiki/Talk:Autism#c-LogicalLens-20250226044700-Survey_(on_RFC_on_focus)] It is important to note that this field is evolving rapidly, with leading autism-specific journals and health authorities increasingly moving towards the neurodiversity paradigm. The medical model continues to be a significant perspective, but the previously strong consensus to view autism as a disorder has given way to an ongoing scholarly discussion that incorporates the neurodiversity paradigm. I have focused on citing pro-neurodiversity sources here because they are currently underrepresented in the article, which historically leaned heavily towards the medical model. This is an attempt to bring the article into alignment with the current state of research and discourse.

If you believe there are specific areas where our proposals lack neutrality, please provide concrete examples and cite your sources. I am open to discussing these points and working together to ensure a balanced and accurate representation of all viewpoints. LogicalLens (talk) 04:53, 27 February 2025 (UTC)

:Thank you for your thoughtful response. I appreciate your willingness to engage in this discussion and your recognition of the importance of neutrality.

:You are correct that the field of autism research is evolving, and there is an ongoing discussion regarding the role of the neurodiversity paradigm. However, we must be cautious not to conflate the increasing presence of this perspective in academic discourse with an equivalency to the well-established medical model. While the neurodiversity paradigm is gaining traction, it does not currently hold equal standing in the broader scientific consensus, and Wikipedia's "due weight" principle requires that we reflect this appropriately.

:Regarding source balance, citing more pro-neurodiversity sources to "correct" an alleged historical bias in favor of the medical model is not a neutral approach. Wikipedia is not an advocacy platform; our role is to summarize the state of scholarship as it exists, not to rebalance perceived biases through selective weighting of sources. If the majority of high-quality, peer-reviewed literature still supports the medical model as the dominant framework, then that should be proportionally reflected in the article, even as we acknowledge the growing discussion around neurodiversity.

:I also appreciate your efforts to refine the proposed lead section. However, the concern remains that structuring the article as a constant back-and-forth between two perspectives, rather than summarizing them in a proportionate and coherent manner, risks introducing unnecessary hedging and a false equivalency. If the scholarly consensus is shifting, that shift should be demonstrated through a broad and balanced representation of the literature, not by artificially constructing a debate where none meaningfully exists at the level being implied. As it stands today, the neurodiversity paradigm should be introduced as an emerging framework primarily advocated by autistic self-advocates, certain researchers, and organizations. It should be framed as a perspective that challenges traditional pathologization, emphasizing autism as a natural variation of human neurology rather than a disorder. Due weight should be given to the fact that, while some academic and clinical sources incorporate aspects of neurodiversity, it has not replaced the medical model in mainstream clinical practice or research. We cannot conflate increased discussion and advocacy with an actual overturning of the existing consensus. We should not hedge or use language that implies a consensus of doubt that does not (yet) actually exist. Language as described in WP:WORDS in relation to the medical model should be a red flag.

:Since you asked for specific feedback, I want to be candid: inclusion of the neurodiversity paradigm in the lead section at all should be contentious, yet it has not been. This in itself is concerning. I say this despite personally supporting its inclusion. I believe the existing lead in fact already gives this perspective slightly more weight than warranted but arguably it remains within an acceptable margin of editorial discretion. However, any rewrite that further amplifies this weight is a non-starter for me. I know you've put in significant effort, and I don’t say this lightly, but I would strongly encourage you to leave the lead largely as it is and instead focus on the main body of the article, where I see clear opportunities for meaningful improvement that may, in turn, alleviate underlying concerns and lead to broader editorial consensus.

:My initial impression is that there is both room and sufficient scholarly support to:

:* improve discussion of the neurodiversity paradigm's growing prominence, tracing its evolution from self-advocacy movements to its gradual entry into academic discussions, while making clear that this perspective remains contested in most scientific and clinical circles;

:* dedicate section to summarizing the ongoing debate: presenting arguments for and against the neurodiversity paradigm specifically as it relates to autism, along with the evolving discourse on disability rights, accommodations, and ethical considerations regarding autism interventions; and

:* include a section on the sociopolitical impact of the neurodiversity paradigm, detailing how it has influenced public discourse, policy, and advocacy efforts, while ensuring it is distinguished from its scientific standing.

:Since the neurodiversity paradigm and the social model of disability extend beyond autism - applying to multiple conditions under the neurodivergent umbrella - only aspects strictly related to autism should be included in this article, with appropriate links directing readers to the broader frameworks in their own dedicated articles. Tacitusmd (talk) 07:23, 27 February 2025 (UTC)

::@Tacitusmd, you've used words/phrases like "equal standing," "equal validity," and "equivalency" your !vote and discussion comment. This makes me wonder if you're reading something into the question that isn't there. "Does the Autism article as a whole currently overemphasize the clinical/medical model of disability viewpoint relative to the social/neurodiversity viewpoint?" does not imply that a "yes" !vote means the two perspectives have to be given equal weight (though some editors may judge that to be appropriate). As a rough gauge of the current proportions in the article, the section sizes suggest that ~9/10 of the article is devoted to the medical model and ~1/10 to the neurodiversity model. Suppose (as a hypothetical), representing the two views in proportion to their discussion in RSs meant that the actual weighting should be ~7/10 and ~3/10; in this case, one would conclude that the medical view is disproportionately represented in the current article without implying that the medical and neurodiversity models should be treated equally. Also, WP:NPOV is about the appropriate representation of "all the significant views that have been published by reliable sources on a topic," but does not limit RSs to scholarship, nor do WP:SOURCETYPES and WP:BESTSOURCES. FactOrOpinion (talk) 18:07, 27 February 2025 (UTC)

::@Tacitusmd, thanks for your suggestions on what additional content could be included in the body. As this RfC runs for 30 days, we should wait for input from other editors, but your suggestions are helpful.

::I recognize the importance of adhering to Wikipedia's rules, including WP:RIGHTGREATWRONGS. By "historically leaned heavily towards the medical model" I meant that in the past, there was a strong consensus in the academic literature to view autism as a disorder and that the Wikipedia article has been written to reflect that and not been fully updated in accordance with the recent changes. My aim is to ensure the article reflects current scholarship and evolving understanding, within those guidelines.

::Determining the right balance is the central question and it is difficult because the viewpoints of researchers vary widely between countries. The fact that health authorities in the UK and Australia have already adopted a pro-neurodiversity viewpoint shows that there cannot be a consensus in these countries to use the medical model. These dramatic differences in autism conceptualization between countries is because the question whether autism should be seen as a disorder is heavily influenced by value judgements and political considerations, i.e. that, without a diagnosis, autistic people would have many problems in life and society. Currently, society is only willing to provide accommodations and services if something is wrong with a person because it has certain notions of normality and thinks that the current environments accommodate everyone who is healthy. @Ó.Dubhuir.of.Vulcan, based on this systematic review,[https://www.liebertpub.com/doi/10.1089/aut.2023.0030] estimates the proportion to be about 30% neurodiversity-affirming sources as of 2021 and says that this number has probably increased since then.

::If it is the case that the majority of reliable sources views autism as disorder, then of course, the article’s balance should reflect that. However, a viewpoint being in the majority, for example, does not justify using Wikipedia’s voice for claims such as "Autism is a disorder." (instead of "Health authorities X, Y, … classify autism as a disorder.") as this requires that something is uncontested (WP:WIKIVOICE). See this article in the magazine Science (journal) that describes the dispute in autism research.[https://www.science.org/content/article/disorder-or-difference-autism-researchers-face-over-field-s-terminology] It is important to note that Science is not a sensationalist lay newspaper or tabloid but one of the two leading scientific journals (along with Nature). I am not thereby intending to use words listed in WP:WORDS that are non-neutral. Have you encountered words like these in our proposals? If yes, please point them out so that we can replace them.

::You warned of hedging and back-and-forth juxtaposition because it can lead to both positions being presented as being equally prevalent in the literature. It has been discussed on the dispute resolution page that the current lead section describes the sources inaccurately by saying that "other scientists argue that autism is inherently disabling". This is crucial for accuracy. Especially, there is no simple dichotomy between medical and social models of disability and the neurodiversity paradigm has similarities with the social model but does not completely align with it. Much of the criticism of neurodiversity is directed towards strong social model conceptualizations. See, for example, a paper by Patrick Dwyer that explores viewpoints between the social and the medical models.[https://karger.com/hde/article/66/2/73/828432/The-Neurodiversity-Approach-es-What-Are-They-and] Kapp also says that neurodiversity advocates agree with using interventions to ameliorate aspects that inherently reduce quality of life independently from the environment, for example being unable to communicate basic needs.[https://www.mdpi.com/2227-7102/13/2/106] There is a lot of work to do in this paragraph so that it presents the different models in a way that is both accurate and balanced.

::Regardless of the extent of changes we make to the content, would you still agree on changing some of the terminology? The Manual of Style for medicine-related articles says: "Choose appropriate words when describing medical conditions and their effects on people. Words like disease, disorder, or affliction are not always appropriate." So, while it should be made clear that the medical model conceptualizes autism as a disorder, I consider it inappropriate and unnecessary to constantly repeat terms like "the disorder" or "ASD" just to avoid tedious repetitions of the word "autism". "Autism" is completely neutral and I would rather choose repetitions than value-laden terms.

::Another aspect is the use of terminology that does not have much to do with science at all. For example, using identity-first language ("autistic person"/"is autistic") is preferred by most autistic people to person-first language ("person with autism"/"has autism"). Another case is the term "risk" which is just the word "likelihood" with a negative value judgement. I think, when it comes to mere value judgements about whether being autistic is something to be afraid of, Wikipedia should use the more neutral and less stigmatizing words, especially because most of the autistic community does not view being autistic as a problem.

::In more scientific cases, a neutral ground could be chosen that is compatible with the medical model (if it is still the majority view), but not too offensive or stigmatizing. If, for example, the terms "deficit" or "symptom" are perceived as ableist by neurodiversity supporters and alternatives like "features" are seen as whitewashing by medical model supporters, we could settle for "difficulties". It should also be noted that researchers and clinicians in the medical domain are experts in their own paradigm but they are not experts on ableism and the effect words can have on people. LogicalLens (talk) 06:31, 28 February 2025 (UTC)

@Lova Falk, the question is not whether autistic people experience disability. The word 'impairment' stems from the medical model, which locates disability within the individual. However, this is not the only perspective. The neurodiversity paradigm offers an alternative, viewing autistic traits as natural variations that become disabling primarily due to societal barriers. This applies to all autistic people, including those with a diagnosis and with support needs. The list of academic sources I've provided demonstrates this perspective[https://en.wikipedia.org/wiki/Talk:Autism#c-LogicalLens-20250226044700-Survey_(on_RFC_on_focus)] and even includes two books for diagnosticians and the official Australian guidelines for autism assessment and diagnosis. Maybe you have heard some wrong information online or in the real world, but the claim that neurodiversity is limited to undiagnosed individuals is inaccurate and contradicts established neurodiversity-affirming scholarship. LogicalLens (talk) 03:28, 1 March 2025 (UTC)

::LogicalLens I don't claim, and I don't think that neurodiversity is limited to undiagnosed individuals! Quite to the contrary, I think that all diagnosed individuals also are neurodiverse neurodivergent. Lova Falk (talk) 06:53, 1 March 2025 (UTC)

:::It is not only the term "neurodivergent" that extends to all autistic people but also the neurodiversity paradigm that views disability as mostly stemming from a mismatch between person and environment.

:::By the way: The term "neurodiverse" can only refer to groups of people with different neurotypes, while the term "neurodivergent" is used describe a person whose neurocognitive functioning is different from the perceived societal norm. LogicalLens (talk) 07:19, 1 March 2025 (UTC)

::::I was not aware of the difference between the term "neurodiverse" and "neurodivergent". I'll change my comment. Lova Falk (talk) 09:06, 1 March 2025 (UTC)

:::::I'm not at all clear why you think your observations about diagnostic criteria point towards this article already being well-balanced as it stands? Could you perhaps expand on what you see as being the connection?

:::::For whatever it's worth, I was formally diagnosed as autistic 15 years ago; a strong majority of the advocates of neurodiversity who I know (of those who say they are autistic) were likewise formally diagnosed, which as you correctly observe, requires what the DSM calls 'functional impairment' in addition to the specific listed characteristics... Oolong (talk) 15:49, 1 March 2025 (UTC)

:::::@Lova Falk, it might be that I have not expressed clearly what I wanted to talk about. This RfC is about the question whether the current autism article is unbalanced towards the medical model. For this, looking at reliable sources (in Wikipedia's sense) is necessary and we have cited sources that say that there is a significant dispute in the autism research [https://www.science.org/content/article/disorder-or-difference-autism-researchers-face-over-field-s-terminology community] and that as of 2021, about 30% of sources were neurodiversity-affirming,[https://www.liebertpub.com/doi/10.1089/aut.2023.0030] which has probably increased since then. Saying that there is "the" diagnosis that calls the disabilities experienced by autistic people "impairments" is not a useful overview of reliable sources and is misleading as there are neurodiversity-affirming ways to conduct diagnoses that lead to the same group being diagnosed as autistic (when discrepancies due to a greater awareness of masking are put aside for the moment) but without the framing that being autistic is a disorder,[https://www.routledge.com/Is-This-Autism-A-Guide-for-Clinicians-and-Everyone-Else/Henderson-Wayland-White/p/book/9781032150222][https://uk.jkp.com/products/the-adult-autism-assessment-handbook] which is even recommended by the official Australian guidelines for autism assessment and diagnosis.[https://www.autismcrc.com.au/best-practice/assessment-and-diagnosis/second-edition/micro-learning-transcript] LogicalLens (talk) 23:07, 1 March 2025 (UTC)

::::::Oolong and LogicalLens I understand that this is the question. I don't think the current autism article is unbalanced towards the medical model, because autism is a psychiatric, that is, medical diagnosis. Lova Falk (talk) 06:40, 2 March 2025 (UTC)

::::::@Oolong and @LogicalLens: Please stop arguing with everyone who disagrees with you.

::::::This RFC is making a big request. Answering it requires reading (or at least skimming) a huge article. It's about 10,000 words long, so that's half an hour's reading for most native English speakers. Every time an editor stops what they're doing to read the article and give us their honest feedback, they are giving us a valuable gift. When you argue with them, you are not showing them that you value their gift.

::::::This RFC has been open for a few days now. During that time, only three (3) uninvolved editors have sacrificed their time and energy to answer the question. This is less than we would normally expect for such an important article. One or both of you have argued with all three of them and told them that you think their answers are wrong. Stop it. It's not polite, and it's not helping us get responses. WhatamIdoing (talk) 02:53, 2 March 2025 (UTC)

:::::::Thank you for that perspective. I was in no way intending to be impolite or to make people feel as if I do not value or respect their contributions and always try to use friendly language. Admittedly, these are the first two RfCs that I participate in on Wikipedia. As far as I understand it and as it says in the description („Please do not reply to other editors in the Survey. That is what the Discussion section is for.“) the discussion section was inserted precisely in order to enable replies. Can you tell me why there is a discussion section if replying is impolite? Personally, I do not feel that my time is not being valued if people argue with me (as long as it is friendly and factual) and am fine if people respond to my answers to the RfCs because that can lead to a way forward. Wikipedia has no final decision-maker who looks at the RfC responses and then decides what to do. So I thought it is better and more time-efficient to discuss now than to wait until the RfC is over and to continue discussing then. But maybe some of the respondents just want to share their perspective, which would set them apart from the other editors here on the talk page or on the dispute resolution page who tend to have stronger views on the proposed edits. I did not think about that. LogicalLens (talk) 06:18, 2 March 2025 (UTC)

::::::::I know you're trying hard and that you're very interested in this subject. That's why I wanted to be clear about the social standards.

::::::::It's okay to have a discussion. It's not okay to begin a discussion with every editor who disagrees with you.

::::::::It's okay to start a discussion if you don't understand the other person's comment. I don't mean that you can't understand how someone could be so wrong. I mean if you need more information to figure out what they meant. If someone posts something cryptic or oblique, like "Autism is like beauty; it's all in the eye of the beholder", you could ask for more information about what they meant by that simile.

::::::::But mostly, you have to let people say what they think, and say nothing. WhatamIdoing (talk) 17:40, 2 March 2025 (UTC)

:::::::::@LogicalLens, I sometimes have the same struggle when I'm interested in a topic. I end up posting too many responses, often because I want to convince someone and/or better understand someone's thinking. I'm still working on that myself. Here's a relevant essay that I've seen a number of editors refer to.

:::::::::@WhatamIdoing, in terms of eliciting more responses: there's an unbalanced tag at the top of the article right now, and it invites people to "discuss the issue on the talk page." But it links to the Dispute Resolution Request section of this page. Would it make sense / be acceptable to change that link so that it goes to this RfC instead? I realize that that's unorthodox and would probably be inappropriate with most RfCs, but perhaps this is an appropriate exception, since the RfC is about the article as a whole. FactOrOpinion (talk) 01:40, 3 March 2025 (UTC)

::::::::::I think that would be fine, if someone felt like doing it. WhatamIdoing (talk) 02:39, 3 March 2025 (UTC)

::::::::::@FactOrOpinion Thank you for sending me the link to that essay. While I intended to provide non-repetitive and useful arguments, I recognize that no editor should take up too much space. Especially the point "Wait a few days and perhaps add one comment at the bottom of the discussion that may address any or all of the concerns expressed by others." is helpful. LogicalLens (talk) 06:13, 3 March 2025 (UTC)

:::::::WhatamIdoing Thank you very much for this comment. I did doubt for a long time if I would weigh in or not, and finally I decided to do so. My hesitations were not based on uncertainty about where I stand on this issue, but just because I don't feel like engaging in a long discussion. Lova Falk (talk) 09:33, 2 March 2025 (UTC)

I'd appreciate hearing others' thoughts about the following: I see a number of editors responding "no," and my impression is that for these editors, "autism" = "autism spectrum disorder" for the most part, and therefore the article appropriately focuses on clinical information. (For those who've responded "no," please correct me if I've misunderstood your overall view.) I see a number of other editors responding "yes," and my impression is that for these editors, "autism" ≠ "autism spectrum disorder," and therefore the article overemphasizes the latter. (Again, please correct me if I'm mistaken. Also, I don't know whether there's an autism-specific term corresponding to this view, analogous to "autism spectrum disorder" but from the social/neurodiversity perspective.)

Would it resolve the concerns of both groups if there were both an Autism article and an Autism spectrum disorder article (where the latter didn't redirect to Autism), where most of the current article was moved to Autism spectrum disorder, and the Autism article:

• had a section on Autism spectrum disorder with a Main link to the Autism spectrum disorder article and perhaps some See also links to other articles with a clinical focus (e.g., Vaccines and autism);
• had a section on the social/neurodiversity perspective with a Main link (and I'm not sure whether that would be to the Neurodiversity article or the Societal and cultural aspects of autism article or something else) and perhaps some See also links to other articles with a social/neurodiversity focus (e.g., Autism rights movement);
• included text addressing/linking to other key articles (e.g., History of autism, which currently has no text, only a section header; Autistic meltdown, Sensory overload, Stimming), where those might or might not have their own section, and might or might not have Main/See also templates, depending on editors' views; and
• perhaps added more content about topics that are important but don't themselves have articles and don't have sufficient info right now?

This is related to Lova Falk's suggestion that "We need to create two articles: Autism (diagnosis) and Autism (identification)," but is a bit different, as it still envisions an Autism article, where the main article is more balanced. FactOrOpinion (talk) 16:26, 7 March 2025 (UTC)

:How nice that you picked up on my idea! I find you analysis very sharp. Yes, "autism" = "autism spectrum disorder" for the most part, and therefore the article appropriately focuses on clinical information. Exactly! Lova Falk (talk) 16:47, 7 March 2025 (UTC)

:If it turns out that we really cannot reach a consensus here even after extensive discussions then a version of what you suggest might be a solution, although it is sub-optimal. The Dutch Wikipedia seems to have followed a similar approach.

:I think the reason why some editors insist that autism simply is a medical disorder or that autistic people simply have impairments is a reification fallacy/fallacy of misplaced concreteness: The medical model, i.e., the assumed norm and the deviation from this norm that autistic people show (which is called impairment) is often taken to be the objective reality because it has been repeated so many times and in so much detail that people have forgotten that it is still a human construct and a value judgement (whether one considers this value judgement right or wrong). It is explained in relation to neurodiversity in this paper.[https://asmepublications.onlinelibrary.wiley.com/doi/full/10.1111/medu.15565]

:Also, while the Australian guidelines[https://www.autismcrc.com.au/best-practice/assessment-and-diagnosis/second-edition/micro-learning-transcript] and the UK health authority NHS[https://www.england.nhs.uk/learning-disabilities/about/get-involved/involving-people/making-information-and-the-words-we-use-accessible/][https://www.nhs.uk/conditions/autism/what-is-autism/] still use a diagnosis for access to services, they use neurodiversity-affirming language and that is the important thing. It has been pointed out even by neurodiversity advocates that abandoning the diagnosis is not the goal as of now because autistic people would lose their access to necessary supports. Instead, the goal is moving towards a non-pathologizing framework.[https://link.springer.com/chapter/10.1007/978-981-13-8437-0_13] LogicalLens (talk) 07:10, 8 March 2025 (UTC)

::LogicalLens I agree with you that we won't be able to reach consensus, and I don't want to engage in a long discussion, but I find it troubling that you dismiss all those who disagree with you as committing a fallacy, implying that you see things clearly and correctly. No. I could be wrong. You could be wrong. Lova Falk (talk) 10:42, 8 March 2025 (UTC)

:::@Lova Falk, without trying to draw you into further discussions: of course we should not dismiss others. When you wrote that autism simply is a medical diagnosis, it seemed equally dismissive of the opinions of others, as if your view is simply a fact. This was maybe not your intention and I misinterpreted it. Also, by pointing to that paper regarding the logical fallacy, I did not intend to invalidate your opinion on autism but only to show that “autism is simply a medical diagnosis” is not a helpful argument while “the majority of diagnoses is carried out using the medical model” could be.

:::Others here (not you) insisted that editors who are in favor of the changes must be activists, which is unproductive. That is taking a bad direction here and we should avoid further futile discussions, as you said.

:::No one of us has the ultimate decision making power and we should wait for further RfC responses, but if it stays that way probably that compromise is the best solution. LogicalLens (talk) 12:44, 8 March 2025 (UTC)

::::LogicalLens Thank you for that! BTW I think (or, hope) that we agree on many more things than you may think. 20px For instance, I am convinced that our society wouldn't be half as developed as it is, if it weren't for autistic people who immerse themselves in something and don’t give up until it’s done. If it may seem that I am blind for other sides of autism than the medical diagnosis, it is because I tried to avoid getting into a discussion and restricted myself to my main point. Lova Falk (talk) 13:04, 8 March 2025 (UTC)

:::::@Lova Falk I do think that the only viable alternative to a main autism article which balances biomedical and neurodiversity viewpoints is to have two or more separate articles about different aspects.

:::::It is very clear that a large proportion of autistic people, and a significant (and growing) proportion of relevant tweets and other professionals do not see the medical perspective as the only valid one, or necessarily the most valuable one. This is well-reflected in reliable sources; there are many reasons for the shift, which it may or may not be constructive to dig into here. The point, as far as Wikipedia is concerned, is simply that reliable sources reflect said shift. The article has a long history of autistic people coming and trying to edit it to better reflect this shift, and other editors coming and undoing their changes.

:::::I think @FactOrOpinion asked what a neurodiversity-affirming equivalent of 'Autism Spectrum Disorder' might be; the obvious choice would be simply autism. An alternative might be autistic people, given that many autistic researchers and activists have been at pains to emphasise that there is no autism without autistic people, and that talking about autism in the abstract seems to lend itself to dehumanising attitudes (compare 'preventing autism' with 'preventing autistic people'). We would then have one entry on the psychiatric diagnosis, and one on autistic people as human beings: what it means to be autistic, how to live and work with autistic people, challenges and supports for autistic people; that kind of thing.

:::::An article focusing on autistic people as human beings would, from my perspective at least, be far more interesting and useful than what we have now; my strong impression is that people interested in learning about autism usually want to know about autistic people.

:::::An article which both gives due weight to the human experiences of autistic people, including the many social aspects of autistic experience, and gives a sensible encyclopaedic treatment of medicalised diagnosis, would also make sense to me.

:::::What we have now is bizarrely ill-balanced, largely outdated and sprawling; even leaving aside the questionable language choices, I'm struggling to imagine who would want to learn about the topics it covers from an online encyclopaedia, but wouldn't care about the many crucial aspects of autistic experience that it skims over it misses entirely (meltdowns, sensory overwhelm, masking and so on). Oolong (talk) 14:43, 9 March 2025 (UTC)

::::::Not because I said it, but the good thing about two articles is that instead of balancing and having recurring discussions about too much of this or too much of that, we can just go ahead and make the content edits that we would like to make. Lova Falk (talk) 16:05, 9 March 2025 (UTC)

:::::::@WhatamIdoing, in a previous RfC about another topic, a couple of additional options were added to the RfC after it was opened (in response to editors' comments about the original wording/options), and Raladic noted that this is OK per Wikipedia:Requests for comment#Responding to an RfC. I'm wondering if it would be good to add this as another option, and if so, whether there's any norm about how to go about that (e.g., should I check with Robert McClenon, who opened the RfC? would I note the date on which the RfC's wording changed?). The current question is worded "Does the Autism article as a whole currently overemphasize the clinical/medical model of disability viewpoint relative to the social/neurodiversity viewpoint?" Y/N. If I were to change it, I'm thinking that there would be three options along the lines of:

:::::::a) Yes, and the proportion of the article devoted to each view should be adjusted accordingly.

:::::::b) No, the proportion of the article devoted to each view does not need to be adjusted.

:::::::c) Autism spectrum disorder should become an article rather than a redirect, and most of the clinical/medical information in the Autism article should be transferred to Autism spectrum disorder, with the content/relative emphasis in the Autism article shifting as a result.

:::::::Or do you think that would be too disruptive? FactOrOpinion (talk) 17:24, 9 March 2025 (UTC)

::::::::It might be complicated to do that now. Have you found/looked over the discussions that led to the merge? WhatamIdoing (talk) 19:03, 9 March 2025 (UTC)

:::::::::I think you're probably right - or rather, I think if we were to request comments on splitting the page, it would warrant a new RfC.

:::::::::The previous merge isn't really relevant; the old autism article was nominally (and bizarrely) about 'autistic disorder' (or classic autism) in particular, except when it wasn't - while the autism spectrum article was about autism in the sense that has been standard for the last 15-20 years.

:::::::::More helpful points of reference here would be deafness/hearing loss/Deaf culture and transgender/gender dysphoria. Oolong (talk) 19:10, 9 March 2025 (UTC)

::::::::::WhatamIdoing, as best I can tell, the title Autism spectrum disorder was never involved in a merge, it was only a [https://en.wikipedia.org/w/index.php?title=Autism_spectrum_disorder&action=history series of redirects]: first to Autistic spectrum disorder, then to Autistic spectrum, then to Autism spectrum, then here. My impression is that Autism redirected to Autism spectrum; the two were swapped in May 2024, and the latter became a redirect here discussion here. If you uncollapse the "Other talk page banners" at the top of this page, it shows a combination of copied content, merging and splitting, where one of the merge tags has an error (but I haven't been able to find when it was added to see what it originally said). This is as much digging as I'm up for right now, as it's hard to keep track / hard to figure out where to look, not only because of the multiple shifts, but only some of the Talk page archives from Autism spectrum got moved when the swap occurred, so I'm uncertain whether I need to search here or there. I see that Oolong was involved in some of the relevant discussions going back a few years, and so might be able to provide more background.

::::::::::Oolong: it's possible to have two RfCs open on a single article, so in theory, nothing prevents someone from starting an RfC now about splitting the article. Do you have any key background to add about what led to the name swap with Autism spectrum and whether there was previously an Autism article (vs. only being a redirect until the article names were swapped)? WhatamIdoing, what do you think about opening a second RfC? FactOrOpinion (talk) 21:00, 9 March 2025 (UTC)

:::::::::::I briefly described the history of the earlier in my comment above; you can read some of the (often bizarre) discussion leading up to it at Talk:Autism/Archive 4.

:::::::::::That merge was much, much harder to push through than it should have been. Some very similar patterns to the discussions that were going on here when you first came in. Oolong (talk) 09:54, 10 March 2025 (UTC)

::::::::::Oolong, I was thinking of deafness/hearing loss/Deaf culture and transgender/gender dysphoria when I decided to think more about Lova Falk's suggestion. What I'm wondering is what makes most sense right now: wait until this RfC closes and see what the closer says? Or start a second RfC now with a few options? Possible options:

::::::::::* keep the Autism article mostly as is

::::::::::* have an Autism article of the sort I proposed above and move most of the content of the current article to ASD (a transgender/gender dysphoria model)

::::::::::* some other set of autism articles, where it's less clear to me what they'd be (perhaps more like the deafness/hearing loss/Deaf culture model)

::::::::::What are your thoughts? FactOrOpinion (talk) 20:52, 16 March 2025 (UTC)

:::::::::::At this point, the current RfC only has six more days to run, if I am understanding correctly; probably not much point starting another one concurrently.

:::::::::::I'm not sure 'keep the Autism article mostly as is' should be an option at all - I think it's clear from this RfC (if it wasn't already, from the endless stream of disgruntled editors arguing for change) that there is not a consensus for that - although there's obviously no consensus at all on the broad question "Does the Autism article as a whole currently overemphasize the clinical/medical model of disability viewpoint relative to the social/neurodiversity viewpoint?"

:::::::::::If people were serious about keeping the focus of the article as it is, I think they would need to propose a dramatic programme of bringing it up to date and down to size.

:::::::::::But maybe you really meant something more like 'keep Autism as the one central entry providing an overview of the topic of autism'? Oolong (talk) 08:33, 19 March 2025 (UTC)

::::::::::::There's no guarantee that an RfC is actually closed by a closer after 30 days, that's only when the bot removes the RfC tag / when it stops being listed. I'm still waiting for my RfC from January to be closed. (Here's the closure requests page.) It's certainly possible to phrase another RfC as a Y/N, something along the lines of the following, but saying more about what the Autism article would include: should most of the content of the current article be moved to ASD (removing the redirect) and the Autism article revised to provide an overview that doesn't emphasize the medical aspects (but still says a bit, and directs people to ASD for more details about that)? FactOrOpinion (talk) 12:21, 19 March 2025 (UTC)

:::::::::::::Alternatively, perhaps that could be done as a Move discussion, which doesn't typically stay open as long. FactOrOpinion (talk) 12:37, 19 March 2025 (UTC)

::::::::::::::@WhatamIdoing, seeking your input as a very experienced editor.

::::::::::::::Background: there is currently an Autism spectrum disorder → Autism redirect; the ASD page has never been an article and has a [https://en.wikipedia.org/w/index.php?title=Autism_spectrum_disorder&action=history limited history].

::::::::::::::It seems to me that there is no consensus about making the current article more balanced, and I see a couple of ways forward in resolving the conflict:

::::::::::::::* open another RfC about: ending the Autism spectrum disorder → Autism redirect, splitting/transferring most of the Autism content to Autism spectrum disorder, and then expanding what remains of Autism as a more general introduction

::::::::::::::* open a requested move discussion about moving Autism to Autism spectrum disorder over the redirect, with the expectation that we then open a redirects for discussion about ending the Autism → Autism spectrum disorder redirect, subsequently creating Autism as a more general introduction

::::::::::::::Questions: Is there another option to consider? Among the options, does one strike you as the best way forward? Are there additional things to think about as part of the process, such as first seeking agreement but working on a draft for a general Autism article before carrying anything out? Thanks, FactOrOpinion (talk) 16:41, 19 March 2025 (UTC)

:::::::::::::::An ordinary, but well-advertised, WP:SPLIT proposal would be the usual approach.

:::::::::::::::Also, whether it's a good idea is something that should become more apparent if we wait another decade or three, so I wouldn't necessarily be in a rush to do anything about this. These articles are impossible to get completely right because the real world/sources are unsettled. Nobody knows what autism is. Is it a behavior pattern? (That would explain why people with disparate conditions all have 'autism'.) Is it a change to how individual nerve fibers are organized? (That would explain the excessive rate of epilepsy.) When they agree on what autism is, we'll be able to figure out what the various pieces of this puzzle are. WhatamIdoing (talk) 20:44, 19 March 2025 (UTC)

::::::::::::::::Thank you. I'm mostly motivated by a desire to reduce the time/energy that's currently taken up by disagreements; also, I think a solution may make it easier for WP readers to find info that they're looking for. If there's consensus for splitting the article, I think that's a good move, even if editors later reconsider and move/merge/further split/... relevant articles as the field makes progress. FactOrOpinion (talk) 13:17, 20 March 2025 (UTC)

::::::Currently, the category of autism articles (Template:Autism) has Autism as its main article. Creating an article for "autistic people" and another for "autism spectrum disorder" would mean there is no main article anymore. The word "autism" is not preferring either the medical or the neurodiversity view. Would opponents of our proposed changes accept balancing medical and neurodiversity perspectives in the "autism" article if there was a separate "autism spectrum disorder" article?

::::::Maybe the article Diagnosis of autism (which currently has multiple issues and has to be rewritten anyway) could be renamed to "autism spectrum disorder" and much of the medical/clinical content from the autism article could be moved there. On the other hand, there is an entire subcategory "Diagnoses" which contains Asperger's syndrome etc. but not "autism spectrum disorder". So a new article could also be created there. LogicalLens (talk) 06:56, 10 March 2025 (UTC)

{{User:ClueBot III/DoNotArchiveUntil|1743523274}}

Should the paragraphs of the proposed revised lede shown below replace the current lede section of the Autism article?

Robert McClenon (talk) 15:28, 25 February 2025 (UTC)

Please answer Yes or No (or the equivalent) with a brief statement in the Survey. Please do not reply to other editors in the Survey. That is what the Discussion section is for.

The current lede of the article is {{tqb|

Autism spectrum disorder{{efn|name=medical term|Medical diagnosis term. See Classification.}} (ASD), or simply autism, is a neurodevelopmental disorder "characterized by persistent deficits in social communication and social interaction across multiple contexts" and "restricted, repetitive patterns of behavior, interests, or activities".{{cite book|title=Diagnostic and Statistical Manual of Mental Disorders|date=2013 |edition=5th|publisher=American Psychiatric Association|page=31|url=https://archive.org/details/diagnosticstatis0005unse}} Sensory abnormalities are also included in the diagnostic manuals. Common associated traits such as motor coordination impairment are typical of the condition but not required for diagnosis. A formal diagnosis requires that symptoms cause significant impairment in multiple functional domains; in addition, the symptoms must be atypical or excessive for the person's age and sociocultural context.(World Health Organization: International Classification of Diseases version 11 (ICD-11)): https://icd.who.int/browse/2024-01/mms/en#437815624{{Cite web |title=IACC Subcommittee Diagnostic Criteria - DSM-5 Planning Group |url=https://iacc.hhs.gov/about-iacc/subcommittees/resources/dsm5-diagnostic-criteria.shtml |access-date=1 August 2024 |website=iacc.hhs.gov}}

Autism is a spectrum, meaning it manifests in various ways, with its severity and support needs varying widely across different autistic people.{{Cite journal |last1=Waizbard-Bartov |first1=Einat |last2=Fein |first2=Deborah |last3=Lord |first3=Catherine |last4=Amaral |first4=David G. |date=2023 |title=Autism severity and its relationship to disability |journal=Autism Research |language=en |volume=16 |issue=4 |pages=685–696 |doi=10.1002/aur.2898 |issn=1939-3806 |pmc=10500663 |pmid=36786314}} For example, some autistic people are nonverbal, while others have proficient spoken language. Furthermore, the spectrum is multi-dimensional and not all dimensions have been identified {{as of|2024|lc=y}}.{{cite journal | pmid=38434761 | date=2024 | title=Autism spectrum disorder: Pathogenesis, biomarker, and intervention therapy | journal=Medcomm | volume=5 | issue=3 | pages=e497 | doi=10.1002/mco2.497 | pmc=10908366 | vauthors = Zhuang H, Liang Z, Ma G, Qureshi A, Ran X, Feng C, Liu X, Yan X, Shen L }}{{cite journal | pmc=7190887 | date=2017 | title=Multidimensional Neuroanatomical Subtyping of Autism Spectrum Disorder | journal=Cerebral Cortex (New York, NY) | volume=28 | issue=10 | pages=3578–3588 | doi=10.1093/cercor/bhx229 | pmid=28968847 | vauthors = Hong SJ, Valk SL, Di Martino A, Milham MP, Bernhardt BC }}

Public health authorities and guideline developers classify autism as a neurodevelopmental disorder,{{Cite web |date=2013-08-28 |title=Overview {{!}} Autism spectrum disorder in under 19s: support and management {{!}} Guidance |url=https://www.nice.org.uk/guidance/cg170 |access-date=2024-11-02 |website=www.nice.org.uk}}{{Cite journal |last1=National Consultation Meeting for Developing IAP Guidelines on Neuro Developmental Disorders under the aegis of IAP Childhood Disability Group and the Committee on Child Development and Neurodevelopmental Disorders |last2=Dalwai |first2=Samir |last3=Ahmed |first3=Shabina |last4=Udani |first4=Vrajesh |last5=Mundkur |first5=Nandini |last6=Kamath |first6=S. S. |last7=C Nair |first7=M. K. |date=2017-05-15 |title=Consensus Statement of the Indian Academy of Pediatrics on Evaluation and Management of Autism Spectrum Disorder |url=https://pubmed.ncbi.nlm.nih.gov/28368272/ |journal=Indian Pediatrics |volume=54 |issue=5 |pages=385–393 |doi=10.1007/s13312-017-1112-4 |issn=0974-7559 |pmid=28368272}}{{Cite journal |last1=Howes |first1=Oliver D |last2=Rogdaki |first2=Maria |last3=Findon |first3=James L |last4=Wichers |first4=Robert H |last5=Charman |first5=Tony |last6=King |first6=Bryan H |last7=Loth |first7=Eva |last8=McAlonan |first8=Gráinne M |last9=McCracken |first9=James T |last10=Parr |first10=Jeremy R |last11=Povey |first11=Carol |last12=Santosh |first12=Paramala |last13=Wallace |first13=Simon |last14=Simonoff |first14=Emily |last15=Murphy |first15=Declan G |date=2018-01-01 |title=Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology |journal=Journal of Psychopharmacology |language=en |volume=32 |issue=1 |pages=3–29 |doi=10.1177/0269881117741766 |issn=0269-8811 |pmc=5805024 |pmid=29237331}} but the autism rights movement (and some researchers) disagree with the classification. From the latter point of view, autistic people may be diagnosed with a disability, but that disability may be rooted in the structures of a society rather than the person.Kapp, Steven K. Autistic community and the neurodiversity movement: Stories from the frontline. Springer Nature, 2020.Jaarsma, Pier, and Stellan Welin. "Autism as a natural human variation: Reflections on the claims of the neurodiversity movement." Health care analysis 20 (2012): 20-30.Dwyer, Patrick, et al. "Community views of neurodiversity, models of disability and autism intervention: Mixed methods reveal shared goals and key tensions." Autism (2024): 13623613241273029. On the contrary, other scientists argue that autism impairs functioning in many ways that are inherent to the disorder itself and unrelated to society.{{cite journal | url=https://onlinelibrary.wiley.com/doi/abs/10.1111/japp.12470 | doi=10.1111/japp.12470 | title=A Critique of the Neurodiversity View | date=2021 | journal=Journal of Applied Philosophy | volume=38 | issue=2 | pages=335–347 | vauthors = Nelson RH }}{{Cite journal |last1=Shields |first1=Kenneth |last2=Beversdorf |first2=David |date=1 July 2021 |title=A Dilemma For Neurodiversity |url=https://link.springer.com/article/10.1007/s12152-020-09431-x |journal=Neuroethics |language=en |volume=14 |issue=2 |pages=125–141 |doi=10.1007/s12152-020-09431-x |issn=1874-5504}} The neurodiversity perspective has led to significant controversy among those who are autistic and advocates, practitioners, and charities.{{cite book |title=Autistic Community and the Neurodiversity Movement: Stories from the Frontline |vauthors=Robison JE |date=2020 |publisher=Springer |isbn=978-981-13-8437-0 |veditors=Kapp SK |place=Singapore |pages=221–232 |chapter=My Time with Autism Speaks |doi=10.1007/978-981-13-8437-0_16 |doi-access=free |s2cid=210496353}}{{cite journal |last=Opar |first=Alisa |date=24 April 2019 |title=In search of truce in the autism wars |url=https://www.spectrumnews.org/features/deep-dive/search-truce-autism-wars |url-status=live |journal=Spectrum |publisher=Simons Foundation |doi=10.53053/VRKL4748 |s2cid=249140855 |archive-url=https://web.archive.org/web/20220708195918/https://www.spectrumnews.org/features/deep-dive/search-truce-autism-wars/ |archive-date=8 July 2022 |access-date=9 July 2022 |doi-access=free}}

The precise causes of autism are unknown in most individual cases. Research shows that the disorder is highly heritable and polygenic, and neurobiological risks from the environment are also relevant.{{Cite journal |last1=Hodges |first1=Holly |last2=Fealko |first2=Casey |last3=Soares |first3=Neelkamal |date=February 2020 |title=Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation |journal=Translational Pediatrics |language=en |volume=9 |issue=Suppl 1 |pages=S55–S5S65 |doi=10.21037/tp.2019.09.09 |doi-access=free |pmid=32206584 |pmc=7082249 |issn=2224-4344}}{{Cite journal |last=Ratajczak |first=Helen V. |date=2011-03-01 |title=Theoretical aspects of autism: Causes—A review |url=https://www.tandfonline.com/doi/full/10.3109/1547691X.2010.545086 |journal=Journal of Immunotoxicology |volume=8 |issue=1 |pages=68–79 |doi=10.3109/1547691X.2010.545086 |issn=1547-691X |pmid=21299355}}{{cite journal |vauthors=Mandy W, Lai MC |title=Annual Research Review: The role of the environment in the developmental psychopathology of autism spectrum condition |journal=Journal of Child Psychology and Psychiatry, and Allied Disciplines |issn=0021-9630 |eissn=1469-7610 |oclc=01307942 |volume=57 |issue=3 |pages=271–292 |date=March 2016 |pmid=26782158 |doi=10.1111/jcpp.12501 |doi-access=free}} Boys are also significantly far more frequently diagnosed than girls.

Autism frequently co-occurs with attention deficit hyperactivity disorder (ADHD), epilepsy, and intellectual disability.{{Citation |last1=Bertelli |first1=Marco O. |title=Autism Spectrum Disorder |date=2022 |work=Textbook of Psychiatry for Intellectual Disability and Autism Spectrum Disorder |pages=391 |editor-last=Bertelli |editor-first=Marco O. |url=https://books.google.com/books?id=4mtvEAAAQBAJ&pg=PA391 |access-date=8 June 2022 |place=Cham |publisher=Springer International Publishing |language=en |doi=10.1007/978-3-319-95720-3_16 |isbn=978-3-319-95720-3 |quote=Persons with autism spectrum disorder and/or other neurodevelopmental problems are more likely than the general population to have transgender identity, non-heterosexual sexual orientation, and other gender non-conformities. |last2=Azeem |first2=Muhammad Waqar |last3=Underwood |first3=Lisa |last4=Scattoni |first4=Maria Luisa |last5=Persico |first5=Antonio M. |last6=Ricciardello |first6=Arianna |last7=Sappok |first7=Tanja |last8=Bergmann |first8=Thomas |last9=Keller |first9=Roberto |editor2-last=Deb |editor2-first=Shoumitro (Shoumi) |editor3-last=Munir |editor3-first=Kerim |editor4-last=Hassiotis |editor4-first=Angela |url-access=subscription}}{{Cite journal |last1=Lord |first1=Catherine |last2=Charman |first2=Tony |last3=Havdahl |first3=Alexandra |last4=Carbone |first4=Paul |last5=Anagnostou |first5=Evdokia |last6=Boyd |first6=Brian |last7=Carr |first7=Themba |last8=de Vries |first8=Petrus J |last9=Dissanayake |first9=Cheryl |author-link9=Cheryl Dissanayake |last10=Divan |first10=Gauri |last11=Freitag |first11=Christine M |display-authors=10 |date=2022 |title=The Lancet Commission on the future of care and clinical research in autism |url=https://fhi.brage.unit.no/fhi-xmlui/bitstream/handle/11250/2975811/Lancet+Commission.pdf?sequence=1 |journal=The Lancet |volume=399 |issue=10321 |pages=299–300 |doi=10.1016/s0140-6736(21)01541-5 |pmid=34883054 |s2cid=244917920 |via=Norwegian Institute of Public Health |hdl=11250/2975811}} Disagreements persist about what should be part of the diagnosis, whether there are meaningful subtypes or stages of autism,{{cite journal |vauthors=Rosen NE, Lord C, Volkmar FR |date=December 2021 |title=The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond |journal=Journal of Autism and Developmental Disorders |volume=51 |issue=12 |pages=4253–4270 |doi=10.1007/s10803-021-04904-1 |pmc=8531066 |pmid=33624215}} and the significance of autism-associated traits in the wider population.{{cite book |vauthors=Losh M, Adolphs R, Piven J |title=Autism Spectrum Disorders |chapter=The Broad Autism Phenotype |year=2011 |pages=457–476 |publisher=Oxford University Press |isbn=978-0-19-996521-2 |language=en-US |doi=10.1093/med/9780195371826.003.0031}}{{cite journal |vauthors=Chapman R, Veit W |title=Correction to: The essence of autism: fact or artefact? |journal=Molecular Psychiatry |volume=26 |issue=11 |page=7069 |date=November 2021 |pmid=34697454 |doi=10.1038/s41380-021-01057-6 |s2cid=239771302 |doi-access=free}}

The combination of broader criteria, increased awareness, and the potential increase of actual prevalence has led to considerably increased estimates of autism prevalence since the 1990s.{{cite journal |vauthors=Wazana A, Bresnahan M, Kline J |title=The autism epidemic: fact or artifact? |language=English |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=46 |issue=6 |pages=721–730 |date=June 2007 |pmid=17513984 |doi=10.1097/chi.0b013e31804a7f3b}} The World Health Organization estimates about 1 in 100 children had autism between 2012 and 2021, as that was the average estimate in studies during that period, with a trend of increasing prevalence over time.{{Efn|However, this figure may reflect an underestimate of prevalence in low- and middle-income countries.}}{{cite journal |last1=Zeidan |first1=Jinan |last2=Fombonne |first2=Eric |last3=Scorah |first3=Julie |last4=Ibrahim |first4=Alaa |last5=Durkin |first5=Maureen S. |last6=Saxena |first6=Shekhar |last7=Yusuf |first7=Afiqah |last8=Shih |first8=Andy |last9=Elsabbagh |first9=Mayada |date=15 May 2022 |title=Global prevalence of autism: A systematic review update |journal=Autism Research |volume=15 |issue=5 |pages=778–790 |doi=10.1002/aur.2696 |issn=1939-3806 |pmc=9310578 |pmid=35238171}}{{cite web |date=30 March 2022 |title=Autism |url=https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders |access-date=8 May 2022 |website=World Health Organization |language=en |archive-date=10 April 2020 |archive-url=https://web.archive.org/web/20200410103835/https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders |url-status=live}} This increasing prevalence has contributed to the myth perpetuated by anti-vaccine activists that autism is caused by vaccines.{{cite journal |vauthors=DeStefano F, Shimabukuro TT |date=September 2019 |title=The MMR Vaccine and Autism |journal=Annual Review of Virology |volume=6 |issue=1 |pages=585–600 |doi=10.1146/annurev-virology-092818-015515 |pmc=6768751 |pmid=30986133}}

There is no known cure for autism. Some advocates dispute the need to find one.{{Cite journal |date=2020-08-21 |title=Cure of Autistic Disorders: Mission Impossible is Possible in an Illustrated Pioneering Experience. |journal=SunKrist Journal of Psychiatry and Mental Health |language=en |pages=1–20 |doi=10.46940/sjpmh.01.1003|doi-broken-date=3 December 2024 |s2cid=242289975 }}{{Cite journal |last1=Eric Barnes |first1=R. |last2=McCabe |first2=Helen |date=2012 |title=Should we welcome a cure for autism? A survey of the arguments |url=http://link.springer.com/10.1007/s11019-011-9339-7 |journal=Medicine, Health Care and Philosophy |language=en |volume=15 |issue=3 |pages=255–269 |doi=10.1007/s11019-011-9339-7 |pmid=21837546 |issn=1386-7423}} Interventions such as applied behavior analysis (ABA), speech therapy, and occupational therapy can help these children gain self-care, social, and language skills.{{Cite web |last=CDC |date=2024-07-18 |title=Treatment and Intervention for Autism Spectrum Disorder |url=https://www.cdc.gov/autism/treatment/index.html |access-date=2024-11-28 |website=Autism Spectrum Disorder (ASD) |language=en-us}}{{cite journal|last1=Kasari |first1=Connie |last2=Shire |first2=Stephanie |last3=Shih |first3=Wendy |last4=Landa |first4=Rebecca |last5=Levato |first5=Lynne |last6=Smith |first6=Tristram |title=Spoken language outcomes in limited language preschoolers with autism and global developmental delay: RCT of early intervention approaches|journal=Autism Research|date=June 2023|volume=16|issue=6|pages=1236–1246|doi=10.1002/aur.2932|pmc=10460274|pmid=37070270|doi-access=free }} Guidelines from the US Centers}} for Disease Control and Prevention (CDC) and European Society for Child & Adolescent Psychiatry endorse the use of ABA on the grounds that it reduces symptoms impairing daily functioning and quality of life,{{cite journal|url=https://www.autismeurope.org/wp-content/uploads/2020/09/Fuentes2020_Article_ESCAPPracticeGuidanceForAutism.pdf|title=ESCAP practice guidance for autism: a summary of evidence‑based recommendations for diagnosis and treatment|author=Joaquin Fuentes, Amaia Hervás, Patricia Howlin, ESCAP ASD Working Party|journal=European Child & Adolescent Psychiatry |year=2020|volume=30 |issue=6 |pages=961–984 |doi=10.1007/s00787-020-01587-4|pmid=32666205 |pmc=8140956 }} but the National Institute for Health and Care Excellence cites a lack of high-quality evidence to support its use.{{Cite web |date=2011-09-28 |title=How we made the decision {{!}} Evidence {{!}} Autism spectrum disorder in under 19s: recognition, referral and diagnosis {{!}} Guidance |url=https://www.nice.org.uk/guidance/cg128/resources/surveillance-report-2016-autism-spectrum-disorder-in-under-19s-recognition-referral-and-diagnosis-2011-nice-guideline-cg128-and-autism-spectrum-disorder-in-under-19s-support-and-management-2013-nice--2660567437/chapter/How-we-made-the-decision?tab=evidence#:~:text=Consultees%20felt%20that%20applied%20behavioural,guideline%20development%20or%20surveillance%20review. |access-date=2024-11-28 |website=www.nice.org.uk}} Additionally, some in the autism rights movement oppose its application due to a perception that it emphasizes normalization.{{Cite web |date=2 April 2024 |title=EUCAP Position Statement on ABA |url=https://eucap.eu/2024/04/02/aba-statement/ |access-date=8 August 2024 |website=EUCAP |language=en-GB}}{{multiref2|{{cite web|url=https://www.spectrumnews.org/features/deep-dive/controversy-autisms-common-therapy/|title=The controversy over autism's most common therapy| vauthors = DeVita-Raeburn E |author-link=Elizabeth DeVita-Raeburn|date=10 August 2016|website=Spectrum|access-date=7 April 2019}}; republished in The Atlantic as:|{{cite magazine| vauthors = DeVita-Raeburn E |date=11 August 2016|title=Is the Most Common Therapy for Autism Cruel? |magazine=The Atlantic |url=https://www.theatlantic.com/health/archive/2016/08/aba-autism-controversy/495272/}}}}{{cite journal |vauthors=Kirkham P |date=1 April 2017 |title='The line between intervention and abuse' – autism and applied behaviour analysis |journal=History of the Human Sciences |language=en |volume=30 |issue=2 |pages=107–126 |doi=10.1177/0952695117702571 |issn=0952-6951 |s2cid=152017417}} No medication has been shown to reduce ASD's core symptoms, but some can alleviate comorbid issues.{{cite web |title=Medication Treatment for Autism |url=https://www.nichd.nih.gov/health/topics/autism/conditioninfo/treatments/medication-treatment |access-date=21 February 2023 |website=www.nichd.nih.gov/ |date=19 April 2021 |language=en |archive-date=7 February 2023 |archive-url=https://web.archive.org/web/20230207142659/https://www.nichd.nih.gov/health/topics/autism/conditioninfo/treatments/medication-treatment |url-status=live}}{{Cite journal |last1=Rzepka-Migut |first1=Beata |last2=Paprocka |first2=Justyna |date=2020 |title=Efficacy and Safety of Melatonin Treatment in Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder—A Review of the Literature |journal=Brain Sciences |language=en |volume=10 |issue=4 |pages=219 |doi=10.3390/brainsci10040219 |doi-access=free |pmid=32272607 |issn=2076-3425|pmc=7226342 }}{{Cite journal |last1=Peled |first1=Julia |last2=Cassuto |first2=Hanoch |last3=Berger |first3=Itai |date=2 April 2020 |title=Processing speed as a marker to stimulant effect in clinical sample of children with high functioning autism spectrum disorder |url=https://www.tandfonline.com/doi/full/10.1080/08039488.2019.1686063 |journal=Nordic Journal of Psychiatry |language=en |volume=74 |issue=3 |pages=163–167 |doi=10.1080/08039488.2019.1686063 |pmid=31686565 |issn=0803-9488}}

}}

The proposed revised lede of the article is {{tqb|

Autism, referred to in clinical contexts as autism spectrum disorder (ASD), is a neurodevelopmental condition characterized by difficulties in social interaction, verbal and nonverbal communication; the presence of repetitive behavior and restricted interests; and uncommon responses to sensory stimuli. Being a spectrum, autism manifests in various ways, and support needs vary widely between different autistic people. For example, some are nonspeaking, while others have proficient spoken language.

Health authorities classify autism as a neurodevelopmental disorder, characterised by deficits.(World Health Organization: International Classification of Diseases version 11 (ICD-11)): https://icd.who.int/browse/2024-01/mms/en#437815624{{Cite web |date=2013-08-28 |title=Overview {{!}} Autism spectrum disorder in under 19s: support and management {{!}} Guidance |url=https://www.nice.org.uk/guidance/cg170 |access-date=2024-11-02 |website=www.nice.org.uk}}{{Cite web |title=IACC Subcommittee Diagnostic Criteria - DSM-5 Planning Group |url=https://iacc.hhs.gov/about-iacc/subcommittees/resources/dsm5-diagnostic-criteria.shtml |access-date=1 August 2024 |website=iacc.hhs.gov}}{{Cite journal |last1=National Consultation Meeting for Developing IAP Guidelines on Neuro Developmental Disorders under the aegis of IAP Childhood Disability Group and the Committee on Child Development and Neurodevelopmental Disorders |last2=Dalwai |first2=Samir |last3=Ahmed |first3=Shabina |last4=Udani |first4=Vrajesh |last5=Mundkur |first5=Nandini |last6=Kamath |first6=S. S. |last7=C Nair |first7=M. K. |date=2017-05-15 |title=Consensus Statement of the Indian Academy of Pediatrics on Evaluation and Management of Autism Spectrum Disorder |url=https://pubmed.ncbi.nlm.nih.gov/28368272/ |journal=Indian Pediatrics |volume=54 |issue=5 |pages=385–393 |doi=10.1007/s13312-017-1112-4 |issn=0974-7559 |pmid=28368272}}{{Cite journal |last1=Howes |first1=Oliver D |last2=Rogdaki |first2=Maria |last3=Findon |first3=James L |last4=Wichers |first4=Robert H |last5=Charman |first5=Tony |last6=King |first6=Bryan H |last7=Loth |first7=Eva |last8=McAlonan |first8=Gráinne M |last9=McCracken |first9=James T |last10=Parr |first10=Jeremy R |last11=Povey |first11=Carol |last12=Santosh |first12=Paramala |last13=Wallace |first13=Simon |last14=Simonoff |first14=Emily |last15=Murphy |first15=Declan G |date=2018-01-01 |title=Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology |journal=Journal of Psychopharmacology |language=en |volume=32 |issue=1 |pages=3–29 |doi=10.1177/0269881117741766 |issn=0269-8811 |pmc=5805024 |pmid=29237331}} An alternative perspective, arising out of autistic communities,{{Cite journal |date=2020 |editor-last=Kapp |editor-first=Steven K. |title=Autistic Community and the Neurodiversity Movement |url=https://link.springer.com/book/10.1007/978-981-13-8437-0 |journal=SpringerLink |language=en |doi=10.1007/978-981-13-8437-0}} is neurodiversity, which positions autism as a healthy part of the diversity of humankind, rather than a disorder {{Em dash}} with advantages, as well as disadvantages. This is usually associated with some version of the social model of disability,{{Cite journal |last=Dwyer |first=Patrick |last2=Gurba |first2=Ava N |last3=Kapp |first3=Steven K |last4=Kilgallon |first4=Elizabeth |last5=Hersh |first5=Lynnette H |last6=Chang |first6=David S |last7=Rivera |first7=Susan M |last8=Gillespie-Lynch |first8=Kristen |date=2024-09-18 |title=Community views of neurodiversity, models of disability and autism intervention: Mixed methods reveal shared goals and key tensions |url=https://journals.sagepub.com/doi/10.1177/13623613241273029 |journal=Autism |language=en |pages=13623613241273029 |doi=10.1177/13623613241273029 |issn=1362-3613}} suggesting that disability generally arises when a person's environment does not accommodate their needs.{{Cite book |last=Shakespeare |first=Tom |url=http://thedigitalcommons.org/docs/shakespeare_social-model-of-disability.pdf |title=The disability studies reader |date=1997 |publisher=Routledge |year=1997 |isbn=978-0-415-91470-3 |editor-last=Davis |editor-first=Lennard J. |location=New York |chapter=The Social Model of Disability}} It can also be argued that autism can be inherently disabling.{{cite journal |vauthors=Nelson RH |date=2021 |title=A Critique of the Neurodiversity View |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/japp.12470 |journal=Journal of Applied Philosophy |volume=38 |issue=2 |pages=335–347 |doi=10.1111/japp.12470}}{{Cite journal |last1=Shields |first1=Kenneth |last2=Beversdorf |first2=David |date=1 July 2021 |title=A Dilemma For Neurodiversity |url=https://link.springer.com/article/10.1007/s12152-020-09431-x |journal=Neuroethics |language=en |volume=14 |issue=2 |pages=125–141 |doi=10.1007/s12152-020-09431-x |issn=1874-5504}} There is a significant controversy between the neurodiversity perspective and the medical model of disability among autistic people, practitioners, researchers and charities.{{cite book |title=Autistic Community and the Neurodiversity Movement: Stories from the Frontline |vauthors=Robison JE |date=2020 |publisher=Springer |isbn=978-981-13-8437-0 |veditors=Kapp SK |place=Singapore |pages=221–232 |chapter=My Time with Autism Speaks |doi=10.1007/978-981-13-8437-0_16 |doi-access=free |s2cid=210496353}}{{cite journal |last=Opar |first=Alisa |date=24 April 2019 |title=In search of truce in the autism wars |url=https://www.spectrumnews.org/features/deep-dive/search-truce-autism-wars |url-status=live |journal=Spectrum |publisher=Simons Foundation |doi=10.53053/VRKL4748 |s2cid=249140855 |archive-url=https://web.archive.org/web/20220708195918/https://www.spectrumnews.org/features/deep-dive/search-truce-autism-wars/ |archive-date=8 July 2022 |access-date=9 July 2022 |doi-access=free}} Support for the neurodiversity approach has increased substantially in recent years among all of these groups.{{Cite journal |title=Moving from Disorder to Difference: A Systematic Review of Recent Language Use in Autism Research |url=https://www.liebertpub.com/doi/10.1089/aut.2023.0030 |journal=Autism in Adulthood}}{{Cite journal |title=Annual Research Review: Shifting from ‘normal science’ to neurodiversity in autism science |url=https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13534 |journal=Journal of Child Psychology and Psychiatry}}

The causes of autism are unknown in most individual cases. Research shows that autism is highly heritable and polygenic. Environmental factors are also relevant.{{Cite journal |last1=Hodges |first1=Holly |last2=Fealko |first2=Casey |last3=Soares |first3=Neelkamal |date=February 2020 |title=Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation |journal=Translational Pediatrics |language=en |volume=9 |issue=Suppl 1 |pages=S55–S5S65 |doi=10.21037/tp.2019.09.09 |issn=2224-4344 |pmc=7082249 |pmid=32206584 |doi-access=free}}{{Cite journal |last=Ratajczak |first=Helen V. |date=2011-03-01 |title=Theoretical aspects of autism: Causes—A review |url=https://www.tandfonline.com/doi/full/10.3109/1547691X.2010.545086 |journal=Journal of Immunotoxicology |volume=8 |issue=1 |pages=68–79 |doi=10.3109/1547691X.2010.545086 |issn=1547-691X |pmid=21299355}}{{cite journal |vauthors=Mandy W, Lai MC |date=March 2016 |title=Annual Research Review: The role of the environment in the developmental psychopathology of autism spectrum condition |journal=Journal of Child Psychology and Psychiatry, and Allied Disciplines |volume=57 |issue=3 |pages=271–292 |doi=10.1111/jcpp.12501 |issn=0021-9630 |eissn=1469-7610 |oclc=01307942 |pmid=26782158 |doi-access=free}} Autism frequently co-occurs with attention deficit hyperactivity disorder (ADHD), epilepsy, intellectual disability, hypermobility{{Cite journal |last=Donaghy |first=Bethany |last2=Moore |first2=David |last3=Green |first3=Jane |date=2023-01-02 |title=Co-Occurring Physical Health Challenges in Neurodivergent Children and Young People: A Topical Review and Recommendation |url=https://www.tandfonline.com/doi/full/10.1080/13575279.2022.2149471 |journal=Child Care in Practice |volume=29 |issue=1 |pages=3–21 |doi=10.1080/13575279.2022.2149471 |issn=1357-5279}} and gastrointestinal problems.{{Cite journal |last=Leader |first=Geraldine |last2=Abberton |first2=Cathal |last3=Cunningham |first3=Stephen |last4=Gilmartin |first4=Katie |last5=Grudzien |first5=Margo |last6=Higgins |first6=Emily |last7=Joshi |first7=Lokesh |last8=Whelan |first8=Sally |last9=Mannion |first9=Arlene |date=January 2022 |title=Gastrointestinal Symptoms in Autism Spectrum Disorder: A Systematic Review |url=https://www.mdpi.com/2072-6643/14/7/1471 |journal=Nutrients |language=en |volume=14 |issue=7 |pages=1471 |doi=10.3390/nu14071471 |issn=2072-6643}} Research indicates that autistic people have significantly higher rates of LGBTQ+ identities and feelings than the general population.{{Citation |last1=Bertelli |first1=Marco O. |title=Autism Spectrum Disorder |date=2022 |work=Textbook of Psychiatry for Intellectual Disability and Autism Spectrum Disorder |pages=391 |editor-last=Bertelli |editor-first=Marco O. |url=https://books.google.com/books?id=4mtvEAAAQBAJ&pg=PA391 |access-date=8 June 2022 |place=Cham |publisher=Springer International Publishing |language=en |doi=10.1007/978-3-319-95720-3_16 |isbn=978-3-319-95720-3 |quote=Persons with autism spectrum disorder and/or other neurodevelopmental problems are more likely than the general population to have transgender identity, non-heterosexual sexual orientation, and other gender non-conformities. |last2=Azeem |first2=Muhammad Waqar |last3=Underwood |first3=Lisa |last4=Scattoni |first4=Maria Luisa |last5=Persico |first5=Antonio M. |last6=Ricciardello |first6=Arianna |last7=Sappok |first7=Tanja |last8=Bergmann |first8=Thomas |last9=Keller |first9=Roberto |editor2-last=Deb |editor2-first=Shoumitro (Shoumi) |editor3-last=Munir |editor3-first=Kerim |editor4-last=Hassiotis |editor4-first=Angela |url-access=subscription}}{{Cite journal |last1=Lord |first1=Catherine |last2=Charman |first2=Tony |last3=Havdahl |first3=Alexandra |last4=Carbone |first4=Paul |last5=Anagnostou |first5=Evdokia |last6=Boyd |first6=Brian |last7=Carr |first7=Themba |last8=de Vries |first8=Petrus J |last9=Dissanayake |first9=Cheryl |author-link9=Cheryl Dissanayake |last10=Divan |first10=Gauri |last11=Freitag |first11=Christine M |display-authors=10 |date=2022 |title=The Lancet Commission on the future of care and clinical research in autism |url=https://fhi.brage.unit.no/fhi-xmlui/bitstream/handle/11250/2975811/Lancet+Commission.pdf?sequence=1 |journal=The Lancet |volume=399 |issue=10321 |pages=299–300 |doi=10.1016/s0140-6736(21)01541-5 |pmid=34883054 |s2cid=244917920 |via=Norwegian Institute of Public Health |hdl=11250/2975811}}{{cite journal |last1=Graham Holmes |first1=Laura |last2=Ames |first2=Jennifer L. |last3=Massolo |first3=Maria L. |last4=Nunez |first4=Denise M. |last5=Croen |first5=Lisa A. |date=1 April 2022 |title=Improving the Sexual and Reproductive Health and Health Care of Autistic People |journal=Pediatrics |publisher=American Academy of Pediatrics |volume=149 |issue=Supplement 4 |pages=e2020049437J |doi=10.1542/peds.2020-049437J |issn=0031-4005 |pmid=35363286 |quote=A substantial proportion of autistic adolescents and adults are LGBTQIA+. Autistic people are more likely to be transgender or gender nonconforming compared with non-autistic people, and findings from a recent autism registry study suggest that among autistic people able to self-report on a survey, up to 18% of men and 43% of women may be sexual minorities. |doi-access=free}} Autistic people are also significantly more likely to experience anxiety and depression, especially if they feel the need to mask their autism.{{Cite journal |title=Camouflaging in autism: A systematic review |url=https://www.sciencedirect.com/science/article/abs/pii/S0272735821001239 |journal=Clinical Psychology Review}}

There is ongoing debate within the autism community and among researchers regarding diagnostic criteria, whether there are meaningful subtypes or stages of autism,{{cite journal |vauthors=Rosen NE, Lord C, Volkmar FR |date=December 2021 |title=The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond |journal=Journal of Autism and Developmental Disorders |volume=51 |issue=12 |pages=4253–4270 |doi=10.1007/s10803-021-04904-1 |pmc=8531066 |pmid=33624215}}fix this citation and the significance of autism-associated traits in the wider population.{{cite book |title=Autism Spectrum Disorders |vauthors=Losh M, Adolphs R, Piven J |publisher=Oxford University Press |year=2011 |isbn=978-0-19-996521-2 |pages=457–476 |language=en-US |chapter=The Broad Autism Phenotype |doi=10.1093/med/9780195371826.003.0031}}{{cite journal |vauthors=Chapman R, Veit W |date=November 2021 |title=Correction to: The essence of autism: fact or artefact? |journal=Molecular Psychiatry |volume=26 |issue=11 |page=7069 |doi=10.1038/s41380-021-01057-6 |pmid=34697454 |s2cid=239771302 |doi-access=free}} Estimates of autism prevalence have increased considerably since the 1990s, mainly due to the combination of broader criteria and increased awareness; there is disagreement on whether the actual prevalence has increased.{{cite journal |vauthors=Wazana A, Bresnahan M, Kline J |date=June 2007 |title=The autism epidemic: fact or artifact? |journal=Journal of the American Academy of Child and Adolescent Psychiatry |language=English |volume=46 |issue=6 |pages=721–730 |doi=10.1097/chi.0b013e31804a7f3b |pmid=17513984}}{{cite journal |display-authors=6 |vauthors=Russell G, Stapley S, Newlove-Delgado T, Salmon A, White R, Warren F, Pearson A, Ford T |date=August 2021 |title=Time trends in autism diagnosis over 20 years: a UK population-based cohort study |journal=Journal of Child Psychology and Psychiatry, and Allied Disciplines |volume=63 |issue=6 |pages=674–682 |doi=10.1111/jcpp.13505 |issn=0021-9630 |eissn=1469-7610 |oclc=01307942 |pmid=34414570 |s2cid=237242123 |quote=The figure starkly illustrates an overall 787% increase in recorded incidence of autism diagnosis over 20 years. |doi-access=free |hdl-access=free |hdl=10871/126929}}{{Cite journal |title=Autism phenotype versus registered diagnosis in Swedish children: prevalence trends over 10 years in general population samples |url=https://www.bmj.com/content/350/bmj.h1961 |journal=The BMJ}} The increase in reported prevalence has reinforced the completely debunked pseudo-scientific conspiracy theory perpetuated by anti-vaccine activists that autism is caused by vaccines.{{cite journal |vauthors=DeStefano F, Shimabukuro TT |date=September 2019 |title=The MMR Vaccine and Autism |journal=Annual Review of Virology |volume=6 |issue=1 |pages=585–600 |doi=10.1146/annurev-virology-092818-015515 |pmc=6768751 |pmid=30986133}} Boys are more frequently diagnosed than girls,{{cite journal |display-authors=6 |vauthors=Maenner MJ, Shaw KA, Baio J, Washington A, Patrick M, DiRienzo M, Christensen DL, Wiggins LD, Pettygrove S, Andrews JG, Lopez M, Hudson A, Baroud T, Schwenk Y, White T, Rosenberg CR, Lee LC, Harrington RA, Huston M, Hewitt A, Esler A, Hall-Lande J, Poynter JN, Hallas-Muchow L, Constantino JN, Fitzgerald RT, Zahorodny W, Shenouda J, Daniels JL, Warren Z, Vehorn A, Salinas A, Durkin MS, Dietz PM |date=March 2020 |title=Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016 |journal=MMWR. Surveillance Summaries |language=en-us |volume=69 |issue=4 |pages=1–12 |doi=10.15585/mmwr.ss6904a1 |pmc=7119644 |pmid=32214087}} although this gap has been narrowing.{{Cite journal |title=What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis |url=https://www.jaacap.org/article/S0890-8567(17)30152-1/abstract |journal=Journal of the American Academy of Child and Adolescent Psychiatry}}

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No. The clear shift from spending time covering symptom matters to talk of discussions around that is sufficient, and the proposed version comes across more clearly as non-neutral.Abbi043 (talk) 21:37, 25 February 2025 (UTC)

:In connection to my reply in the other recent RFC opened by Robert McClenon, I think I may be out of my depth and hadn't realized it. I no longer feel confident in my ability to judge the exact text difference. Abbi043 (talk) 06:25, 26 February 2025 (UTC)

Yes. There are three main changes that we have proposed. Two are related to the balancing and the third is related to reducing the number of words.

The first is that we do not use Wikipedia’s voice anymore for the assertion that autism is a disorder. The neutral point of view policy (WP:WIKIVOICE) says that opinions must not be stated as facts. Only in cases where something is either objective or uncontroversial is it appropriate to write something like „Autism is a disorder.“ instead of „Health authorities X, Y, ... classify autism as a disorder.“ This consensus existed until a few years ago but it does not exist anymore, as has been shown by many reliable sources that different editors have cited here on the talk page and on the dispute resolution pages. [https://en.wikipedia.org/wiki/Wikipedia:Dispute_resolution_noticeboard/Autism][https://en.wikipedia.org/wiki/Wikipedia:Dispute_resolution_noticeboard/Autism_discussion] and in my comment to the other RfC.[https://en.wikipedia.org/wiki/Talk:Autism#c-LogicalLens-20250226044700-Survey_(on_RFC_on_focus)]

The second point is that we have clarified the section on the controversy about the autism classification as it is wrong and contradicts the given sources to say that the neurodiversity viewpoint means not viewing autism as a disability (it is only not a disorder to be treated according to this perspective, but can still be disabling).

Thirdly, the last paragraph has been omitted mainly because the lede is too long. The old lede has 524 words and the new has 366 words (if my text program counted them correctly). The Manual of Style ([https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Lead_section|Manual of Style]) considers 250 to 400 words optimal. We thought the other parts in the lede are more important and especially the controversy about ABA is so intricate that it is very challenging to summarize in a few sentences. LogicalLens (talk) 04:52, 26 February 2025 (UTC)

Yes. The existing lead is far too long, poorly-focused, and comes off as dismissive of - and muddled about - the neurodiversity perspective.

Given the well-evidenced popularity of this perspective among stakeholders (especially autistic people, but also families and relevant professionals[https://journals.sagepub.com/doi/full/10.1177/13623613241273029]) and its position as (at least) a very substantial minority view among researchers in the field[https://www.liebertpub.com/doi/10.1089/aut.2023.0030], it is important that this should be reflected fairly in the lead, as well as in the body of the entry.

Speaking as someone involved in drafting it, the proposed replacement lead represents an attempt at a careful compromise between two fundamentally differing understandings of autism, each well-represented in reliable sources. It continues to give the medical perspective substantially more space than the neurodiversity approach - which, to be transparent, is not my personal preference, but is the result of a sincere effort to assign weight to viewpoints 'in proportion to their prominence in reliable sources'.

- Oolong (talk) 12:29, 27 February 2025 (UTC)

:I just want to emphasise here that there is not a scientific consensus that autism is a disorder, and there is certainly no scientific consensus that neurodiversity is an incorrect or unhelpful perspective.

:I keep hoping to get to a point where we can work towards some kind of Wikipedia consensus based on a shared understanding of basic facts, but any responses made on the basis of a 'scientific consensus' against the neurodiversity approach are, I'm afraid, unambiguously incorrect.

:@LogicalLens has carefully laid out plentiful references directly addressing these questions above, as well evidence that shows the large number of relevant scientists and other researchers who take a neuro-affirming view, and the much higher proportion of other stakeholders who do so. Wikipedia rightly demands a high standard of evidence for claims of academic consensus for articles, and I would suggest that it would be appropriate to hold out for something similar before making such claims in a discussion of this sort: "A statement that all or most scientists or scholars hold a certain view requires reliable sourcing that directly says that all or most scientists or scholars hold that view."

:I understand that this is a demanding discussion in many ways, but I would strongly encourage anybody contributing to it to ensure they are at least familiar with the overall trends in the academic literature[https://www.liebertpub.com/doi/10.1089/aut.2023.0030]. Oolong (talk) 17:43, 16 March 2025 (UTC)

Yes. The existing version is unbalanced. It emphasises the purely medical viewpoint of autism to the detriment, and frankly marginalisation, of other valid approaches to autism, to be found in recent research in genetics, neurology, psychology and sociology, and in disability rights, autism advocacy and the neurodiversity paradigm. Urselius (talk) 19:58, 28 February 2025 (UTC)

No The current version is excellent because it accurately reflects current mainstream medical opinion. It appropriately includes concerns from advocacy organizations. The proposed version is not acceptable because it does not adequately address severe forms of autism.T g7 (talk) 05:58, 2 March 2025 (UTC)

No The current lede is stronger in terms of neutrality, balance, and accuracy. While the proposed lede introduces some valuable refinements, it leans heavily into advocacy for neurodiversity perspective, misrepresenting the current scientific and clinical consensus. The medical model remains the dominant framework in diagnosis, intervention, policy, and research, and should therefore be presented as the default and baseline perspective in the lede. Discussion here on this talk page fail to sufficiently acknowledge that the majority of autism research is still conducted within the medical paradigm and the revised lede creates the misleading impression that the medical model is being broadly challenged or replaced, when in fact - despite claims to the contrary also here on this talk page - no country has discarded the medical diagnostic framework for autism in favor of any other model. While some countries have embraced neurodiversity principles in their autism strategies and programs (primarily in education, social support, and advocacy contexts), the medical model remains the dominant and official paradigm globally. The neurodiversity perspective is influential in advocacy and social discussions and that should influence where in the article we afford more discussion to it, but it is not a wholesale replacement or alternative to the medical model and care should be taken to avoid presenting it as such intentionally or accidentally. The original lead correctly frames neurodiversity as a perspective originating from autistic communities and advocacy movements.

A close analysis of the proposed changes reveals a significant shift that compromises neutrality:

• Subtle undermining of the medical model, introducing doubt and uncertainty only in relation to it.
• Complete removal of discussion on treatment, aligning with neurodiversity perspective that shifts the burden away from clinical intervention and onto broader societal accommodations.
• Omission of the formal diagnostic requirement that symptoms cause “significant impairment” in multiple functional domains - a critical omission, as diagnosis requires functional impairment, distinguishing autism from personality traits that resemble it.
• Introduction of vague reference to prevalence of LGBTQ+ identity and "feelings" - while some research suggests a link between autism and gender diversity (not necessarily same-sex orientation), this is not a core trait of autism nor central to its definition. Its inclusion notably strengthens the neurodiversity framing without sufficient justification for inclusion in lede or sufficiently strong sourcing.
• Escalation of language in reference to the vaccine myth, which is not part of medical model, shifting from neutral fact to polemical tone not appropriate for encyclopedia. "This increasing prevalence has contributed to the myth perpetuated by anti-vaccine activists that autism is caused by vaccines." -> "The increase in reported prevalence has reinforced the completely debunked pseudo-scientific conspiracy theory perpetuated by anti-vaccine activists that autism is caused by vaccines." (emphasis added to highlight problematic language). This change was entirely unnecessary and unrelated to creating a more balanced lede. It is a great example of why advocacy editing is as problematic as COI.
• Creating unnecessary ambiguity about whether autism rates have increased or simply been recognized more and subtle attempts to separate autism from medical risk factors and reject the idea that autism prevalence is influenced by environmental or genetic causes. "neurobiological risks from the environment are also relevant." -> "Environmental factors are also relevant." On the surface, the edit may not seem inherently problematic, but when examined in context we see there is sufficient reason to believe its an attempt to subtly shift the article’s framing.

These changes, taken together, fundamentally alter the framing of the article, shifting it away from a neutral, fact-based summary toward a viewpoint-driven narrative. The current lede is far better at maintaining the appropriate balance between the scientific consensus and alternative perspectives, and should not be replaced with a version that overstates the prominence of neurodiversity at the expense of accuracy. The medical model should retain primacy in the lede with acknowledgement of the existence of the neurodiversity perspective but discussion beyond that should be reserved for appropriate sections in the body. Someone who reads just the lede should understand the broad strokes of the medical model and be aware that there is a sufficiently prominent movement to warrant acknowledgement in the lede who believe that autism is a natural part of human neurodiversity and resist pathologizing their difficulties and differences. The lede must not become a summary of the controversy/dispute/difference between the models as this isn't an article about that even if it is one of the important parts of it. Tacitusmd (talk) 11:15, 2 March 2025 (UTC)

:I agree it may be useful to include some discussion on supports and accommodations, but if so, surely this would need to be a balanced discussion meaning accommodations would need to be discussed as well as interventions aiming to change the individual. The original article's intervention section is notably unbalanced and covers only the latter.

:I agree it may be useful to note in paragraph 2 something like "Health authorities classify autism as a neurodevelopmental disorder, characterised by deficits. In this approach, a diagnosis of autism requires identifying impairments internal to the individual." However this is a minor addition and can easily be made within the context of the proposed new text.

:The LGBTQ+ mention seems very relevant since there is plenty of research now documenting it, and why mention co-occurring neurodevelopmental disabilities and mental and physical health conditions but selectively leave out other things co-occurring with autism? That seems unbalanced and odd.

:I would assume since the various scientific authorities have totally debunked the vaccine myth that we all agree it should not be endorsed. I think the specific language used to reject it can be discussed separately from the global changes here.

:As for shifting the framing of environmental factors influencing likelihood, the previous version's use of the subjective word "risk" was notably unbalanced and aligned only with a controversial medical perspective, whereas the term "likelihood" is neutral, compatible with either medical or neurodiversity perspectives, and more reflective of a Wikipedia-appropriate balance.

:So it seems like rather than proposing a balanced view, you are proposing again to provide unbalanced coverage in favour of the medical model, which you actually call the "scientific consensus" even though it is not - as I noted in other posts, even a few years ago 30% of the peer-reviewed literature used neurodiversity-aligned language - 70% vs 30% is not a consensus. Somewhere like the International Society for Autism Research one sees a mixture of medicalized and neurodiversity-affirming approaches - not a consensus in favour of medicalized - for example as one crude metric, of the keynotes this year, 2 are medicalized and 1 is neuro-affirming. Meanwhile the Australasian Society for Autism Research is almost exclusively neuro-affirming. The neurodiversity perspective is far from marginal, and there is definitely no scientific consensus in favour of the medical view these days. Ó.Dubhuir.of.Vulcan (talk) 00:31, 7 March 2025 (UTC)

No I agree with Tacitusmd. Lova Falk (talk) 18:41, 3 March 2025 (UTC)

Yes. The existing lead is unbalanced. Ó.Dubhuir.of.Vulcan (talk) 00:32, 7 March 2025 (UTC)

No As per Tacitusmd. As an autistic, this seems to be far less nuanced despite how much I was under the assumption that the intent was to provide far more nuance, though in practice seems to merely wants to replace suspected "bias" the article because it goes against the own personal bias of certain activist editors. I think there is potential to show a rise in different perspectives, but how it's introduced here goes against the overwhelming medical consensus of current medical authorities, which IMO seems to prefer writing based more on vague and subjective "autistic lived experience" to depict pro-neurodiversity views as deserving of more weight against the viewpoints of mainstream medical authorities, even despite such being the rules for writing about medical conditions on wikipedia. [[User:GigaMigaDigaChad|

GigaMigaDigaChad]] 04:14, 7 March 2025 (UTC)

No. The revised proposal gives undue weight to the opinions of the Neurodiversity Movement and discounts the mountains of references demonstrating a global scientific consensus on the validity of ASD as a neurodevelopmental disorder (cited in prior discussions) and of the application of other terminology. Furthermore, it's biased against the perspective of scientists about how ASD impairs functioning inherently in ways unrelated to society. It reduces this statement to just "inherently impairing", while leaving the opposing statement with far more elaboration. The proposal also erroneously suggests there has been a "substantial increase" in support for the aforementioned movement's assertions, and redacts key details regarding the treatment of ASD with interventions approved by various guideline developers. Overall, the proposal should not be admissible and lacks careful consideration. Димитрий Улянов Иванов (talk) 15:10, 8 March 2025 (UTC)

• No As indicated below, this badly fails WP:RFCBRIEF. If successful it would only provide an avenue to lock the lead on the Right Version™, and provide an avenue for proponents to discourage any further changes. This runs counter to the spirit of Wikipedia and part of why we do not generally have RfCs on sweeping rewrites to several paragraphs. If the proposal is rejected, it's not abundantly clear that everyone will reject it for the same reasons, rendering it effectively a non-con result where anyone could come back in a while with a largely cosmetic rewrite and try again with an equally broad proposal.{{pb}}Narrow this down to something specific and concise and try again. GMG^talk 15:04, 10 March 2025 (UTC)

Yes because, although I would personally write the lede with more emphasis on the medical model, this revised lede resulted from a long, detailed discussion by many editors with different perspectives. In addition, adopting the revised (new) lede does not mean that its exact text must persist forever. In other words, we can (and should) continue to debate the issues and revise as needed according to the usual Wikipedia guidelines, policies, and procedures. Mark D Worthen PsyD (talk) [he/him] 17:45, 14 March 2025 (UTC)

Procedural oppose this use of an RfC - I am not averse to shortening the lede or to the gist of the suggested changes, including bringing the mention of neurodevelopmental disorder down to the second paragraph. However, I feel we are losing important context by removing reference to age, sociocultural context, interventions and the evidence-base behind interventions. I realize we do not want to speak of there not being a "cure" for autism, however I think a non-negligible proportion of readers may need this context. Imagine someone who has a child recently diagnosed with autism, or someone who has recently been diagnosed - and at a point where they may be quite distressed - they go to the lede of this page as a first point of reference. I think they need that information. Maybe it could be put in different words, and it is not entirely true to say that "autism doesn't go away" - but I don't think throwing this out of the lede is helpful.

Anyway, I commend this effort, but I believe what would be best is to use parts of this discussion to iteratively rewrite the existing lede. I'm quite against the idea of an RfC for the whole lede, because that cements it in a way that it shouldn't be cemented. CFCF (talk) 18:56, 15 March 2025 (UTC)

:P.S. I'm also not sure we have support to say "especially" regarding vulnerability due to masking. I think we can say that it contributes, but especially makes it sound like the exact degree of increased depression etc. caused by masking is known. We don't know it, and we certainly can't say it is the major part based off of this lack of evidence. CFCF (talk) 19:01, 15 March 2025 (UTC)

::@CFCF – Thanks for engaging in good faith. But I want to challenge a few core assumptions here—because what you’re describing as “context” often reflects a specific worldview, not a neutral baseline.

::Your point about readers coming to the article in distress is valid. But what exactly do we think comforts them? A framing that subtly reinforces deficit models? Or one that situates autism within a broader landscape of diversity, possibility, and grounded support?

::You mentioned that the proposed lede “throws out” references to age, intervention, or evidence. But those are still in the article—just not in the opening. That’s not omission; it’s structural clarity. The job of the lede is to lay out the conceptual frame. Not to front-load clinical messaging or offer emotional hand-holding via deficit language.

::Regarding your “procedural oppose” to the RfC: it’s a tool, not a verdict. Community input isn’t “cement.” It’s calibration. The current lede has resisted major revision for years precisely because these informal, incremental rewrites haven’t led to durable consensus. An RfC—properly framed—can clarify what the community is actually aligned on.

::Lastly, on the “especially due to masking” phrase: you’re right to be cautious about weighting. But the literature does support a significant association between camouflaging and mental health distress in autistic people, particularly women and gender minorities. If the word “especially” feels too strong, we can amend that. But the entire point is to reflect what autistic people themselves report—not just what external observers feel confident quantifying.

::Let’s not confuse “comfort” with “familiar framing.” Readers in distress don’t need autism described as a tragedy—they need to not feel alone. And that starts with language that doesn’t flatten their identity into pathology.

::Recursiva (talk) 10:41, 7 May 2025 (UTC)

No - I think that the proposal is well written, but it is an advocacy statement that does not reflect the article content and is a bad match per WP:LEAD. The first paragraph seems an improvement to readability, but the rest just seems too much like soapboxing. At the end it’s getting a bit ranting with side topic content and sensationalized phrasing “completely debunked pseudo-scientific conspiracy theory perpetuated by anti-vaccine activists “ Cheers Markbassett (talk) 10:17, 19 March 2025 (UTC)

• Bad RfC. Per WP:RFCBRIEF: {{tq|"The initial RfC statement (and heading) should be neutrally worded and brief."}} There's an RfC on the scope and wording of the article right now. I don't think it makes sense to have what are essentially the same discussion in two places at the same time. TurboSuperA+ (☏) 10:47, 20 March 2025 (UTC)

• Yes overall but there are some ways in which the first section is better. For example, the statement "mainly due to the combination of broader criteria and increased awareness" looks like it should be sourced. I concur with Turbo that this RfC is not as well structured as it ought to be but not because of lack of neutrality. It would be more efficient to say what the main upshot of the intent behind the change is. Darkfrog24 (talk) 14:54, 20 March 2025 (UTC)

• No. The above comments rejecting this explain this in detail and I don't have much to add; it gives far too much WP:WEIGHT to the neurodiversity movement over the still-mainstream medical view, creating a false balance. Crossroads ^-talk- 21:24, 9 April 2025 (UTC)

Yes Per my comments on the other RfC, the lead doesn't mention the "neurodiversity" view at all. I don't know the details of all this, but I do think that Wikipedia shouldn't be talking about a "cure" for autism any more than it should be talking about a "cure" for ADHD, despite the fact that both conditions can cause problems. Mrfoogles (talk) 18:50, 27 April 2025 (UTC)

:@Robert McClenon why has the cure part been ommitted. “It can also be argued that autism is inherently disabling” is pretty damaging since majority of the autistic population can function similarly to others and saying “it can be argued” is basically saying its a valid arguement and simply underminds the fact that autism is a spectrum this should be changed to “some argue…”. I also in my opinion the lgbtq correlation should be ommited from the opening paragraph as i feel it could add fuel to the already blazing fire that is the current world we live in today it should be relegated to an different section until further research solidifies more about the correlation •Cyberwolf•. talk? 19:19, 25 February 2025 (UTC)

::The cure part has been omitted mainly because the lede is too long. The old lede has 524 words and the new has 366 words (if my text program counted them correctly). The Manual of Style ([https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Lead_section]) considers 250 to 400 words optimal. We thought the other parts in the lede are more important and especially the controversy about ABA is so intricate that it is very challenging to summarize in a few sentences. LogicalLens (talk) 03:05, 26 February 2025 (UTC)

::The previous version was "on the contrary, other scientists argue..." which was misleading because there are many pro-neurodiversity researchers who acknowledge that there can be aspects of autism that are inherently disabling (for example, not being able to communicate basic needs, not even trough alternative means of communication). That part of the lead section is not optimal and we agreed on refining it further. LogicalLens (talk) 04:31, 27 February 2025 (UTC)

:::I agree that’s my stance with those scientists and imo the right approach. This approach should be documented in the article if it isn’t already. I was concerned with the lack of the word “can” and who said it
{{tq|1= there are many pro-neurodiversity researchers who acknowledge that there can be aspects of autism that are inherently disabling (for example, not being able to communicate basic needs, not even through alternative means of communication)}}
is a perfect solution •Cyberwolf•. talk? 16:51, 27 February 2025 (UTC)

::::This is a very complicated section of the article. Your phrasing is factually more accurate and I personally would normally agree with that. But then sources by actual pro-neurodiversity researchers would have to be used and before that, it should be stated that other researchers have criticized neurodiversity on the grounds of the assumption that neurodiversity would say there cannot be inherently disabling features. This would then be a back-and-forth juxtaposition that is very suboptimal in an encyclopedia. I think this paragraph will require a lot of work to provide a neutral, accurate, and encyclopedic summary of the models. LogicalLens (talk) 05:04, 28 February 2025 (UTC)

:::::I agree •Cyberwolf•. talk? 05:17, 28 February 2025 (UTC)

::::::Realistically, there is no way to convey the nuance of this debate (or several others) within the kind of word-count that is appropriate for a lead. There are researchers and non-researchers on all sides of this particular debate, for example, and we should not be reporting only the views of researchers, as if they are the only ones that matter.

::::::There are many subtle distictions to be made within the social model of disability, and the neurodiversity approach(es). Our goal for the lead should, I think, be to summarise only the most important points about all of this. Meanwhile, we probably ought to start thinking about how best to give an encyclopaedic account of these disagreements (and indeed disagreements) within the body of the article... Oolong (talk) 15:42, 1 March 2025 (UTC)

:::::::I am currently working on a re-draft for this paragraph of the lede. The current body mischaracterizes the neurodiversity paradigm by, for example, stating that critics object to it because they think autism is a disability, as if any serious pro-neurodiversity researcher had said the opposite. LogicalLens (talk) 23:21, 1 March 2025 (UTC)

::::::::Thank you for all your work on this LogicalLens, including your current work to improve that paragraph. I had stated earlier (although I cannot find it now) that we should omit or revise that sentence (“It can also be argued that autism is inherently disabling”) because of its ambiguity. I agree that it is a challenge to find concise, accurate phrasing to explain the issue. Mark D Worthen PsyD (talk) [he/him] 17:53, 14 March 2025 (UTC)

• Pretty sure this fails WP:RFCBRIEF. You can't really expect uninvolved editors to spend an hour trying to figure out exactly what changed between these two versions. GMG^talk 19:39, 25 February 2025 (UTC)
• :Which is what i did lol •Cyberwolf•. talk? 20:30, 25 February 2025 (UTC)
• :The topic we are discussing here is very complicated and it does not lead anywhere to resort to oversimplifications. The RfC runs for 30 days so there is enough time. LogicalLens (talk) 03:07, 26 February 2025 (UTC)
• ::RFCBRIEF is concerned about the part that appears on Wikipedia:Requests for comment/All, which is only 19 words long ("Should the paragraphs of the proposed revised lede shown below replace the current lede section of the Autism article?"). WhatamIdoing (talk) 23:32, 26 February 2025 (UTC)
• :::Where in the world did you get that idea? GMG^talk 15:19, 4 March 2025 (UTC)
• ::::These statistics will probably answer your current question. WhatamIdoing (talk) 01:42, 6 March 2025 (UTC)
• :::::Congratulations I guess. But no. The point of brevity and specificity is to hopefully arrive at an actionable outcome. Suggesting 50 different changes in one go is just offering 50 different ways for people to disagree. GMG^talk 13:42, 9 March 2025 (UTC)
• ::::::And having 50 different RFCs is just offering 50 different times for people to disagree. WhatamIdoing (talk) 19:10, 9 March 2025 (UTC)
• :::::::To disagree on something specific. If an overly broad RfC fails, it doesn't really establish an underlying consensus if participants are dissenting for vastly different reasons. GMG^talk 12:55, 10 March 2025 (UTC)
• ::::::::GMG: Since you chose to not participate in the Dispute Resolution Process, I'm having a hard time giving a lot of credence to your arguments now that we have an RfC. Mark D Worthen PsyD (talk) [he/him] 18:03, 14 March 2025 (UTC)
• :::::::::If the price for entry is wading through 250k+ of meandering text that results in...one clearly malformed RfC and another that's so broad that it at best justifies more RfCs, then think what you will. DRN is a bad format that pretends to be pseudo ArbCom. I have not and will not be a party to it. GMG^talk 19:31, 14 March 2025 (UTC)
• ::::::::::There is clearly a significant dispute here about this article's content, and editors have not been able to make progress despite expending a lot of time and energy. Do you have a suggestion for making progress? For example, can you identify what you think would be a more effective RfC? FactOrOpinion (talk) 20:28, 14 March 2025 (UTC)
• :::::::::::That would require those involved to focus on a specific change rather than debating autism writ large. At this point in this war of attrition, it's a small victory if someone posts a response that's less than a half page long. GMG^talk 21:02, 14 March 2025 (UTC)

@Abbi043, it would be productive to hear what exactly you perceive as non-neutral. There are two major changes influencing the balancing between the viewpoints that we made to this proposed lead section.

The first is that we do not use Wikipedia’s voice anymore for the assertion that autism is a disorder. The neutral point of view policy (WP:WIKIVOICE) says that opinions must not be stated as facts. Only in cases where something is either objective or uncontroversial is it appropriate to write something like „Autism is a disorder.“ instead of „Health authorities X, Y, ... classify autism as a disorder.“ This consensus existed until a few years ago but it does not exist anymore, as has been shown by many reliable sources that different editors have cited here on the talk page and on the dispute resolution pages. [https://en.wikipedia.org/wiki/Wikipedia:Dispute_resolution_noticeboard/Autism][https://en.wikipedia.org/wiki/Wikipedia:Dispute_resolution_noticeboard/Autism_discussion]

The second point is that we have clarified the section on the controversy about the autism classification as it is wrong and contradicts the given sources to say that the neurodiversity viewpoint means not viewing autism as a disability (it is only not a disorder to be treated according to this perspective, but can still be disabling). LogicalLens (talk) 02:59, 26 February 2025 (UTC)

:So, firstly, the proposed lede spends a lot of time on the neurodiversity position, which is not really the topic of the article - since neurodiversity does not just refer to autism, such belongs in articles on neurodiversity and/or the neurodiversity movement.

:Secondly, the proposed lede has removed the quotation from the symptomology part of the lede, and as near as I can tell that has only really served to remove a citation from there.

:Thirdly, the mention of the positions of various health organizations has been removed from the new lede, implying a greater level of unification in their positions than the old lede did.

:Fourthly, "It can also be argued that autism can be inherently disabling", as the sum of the coverage of that issue, in combination with the time spent on the neurodiversity position, is rather clearly dismissive of that position; while I haven't encountered a great deal of material over the years regarding it, what I have seen has suggested that it's more popular amongst the most severely disabled autistics. I'll see if I can get back to you with a source on this last one, since it feels like it should have one - I've been hovering nearer the sections of neurodiversity advocates focusing on DID, Psychosis and PDs lately, so that may take me a bit, and I feel you deserve a quicker reply than that. Abbi043 (talk) 03:42, 26 February 2025 (UTC)

::There is much more to autism than can be found in any diagnostic manual. The existing lead gives too much emphasis to the medical diagnosis manuals and their definitions. Plus, speaking as an autistic biomedical researcher (retired), it does so using unnecessarily insulting language. It is not fit for purpose as it marginalises all the many perfectly valid non-medical approaches to defining and studying autism, these being supported by many high quality academic sources.

::Your first point. Autism falls within neurodiversity, so neurodiversity is relevant. There are two competing models of autism operating at present, the medical model and the neurodiversity model. Both need to have as close to equal treatment in anything claiming to be encyclopedic.

::Your second point makes little sense to me. If a quotation is removed its supporting citation should be removed. Of course the quotation may be incorporated in a section outside of the lead later, when the body of the article is overhauled.

::Your third point. Again the material can be reinstated in the body of the article. Your implication of medical unity due to a lack of information is rather strained.

::Your fourth point. The most important word in the quote is 'CAN', which is not 'inevitably, or 'always'. I think that the social disability model, inherent in the neurodiversity paradigm for autism, does not claim that all disability, at all times, is wholly caused by the environment. A person with quadriplegia is never going to play table tennis.Urselius (talk) 20:09, 28 February 2025 (UTC)

:::I believe that Abbi043 was emphasizing the "It can also be argued that" part of that sentence, whereas you seem to be focused on the "autism can be inherently disabling" part. Perhaps it should be shortened to "autism can be inherently disabling"? Or "Sometimes autism is inherently disabling, and sometimes it is not"? WhatamIdoing (talk) 20:59, 28 February 2025 (UTC)

::::"Autism can be inherently disabling" can sound either out-of-context and confusing or a bit dismissive of the neurodiversity position because it could be interpreted in a way that neurodiversity supporters deny this and then critics come along and point out the obvious dismissal. As I have written already in these discussions, it is very hard to phrase this paragraph in a way that is both balanced and accurate because the debate between the models is very intricate. LogicalLens (talk) 03:39, 1 March 2025 (UTC)

@T_g7, @WhatamIdoing said that it can put editors who provide valuable contributions off to involve them in long arguments. I still have a question and would appreciate an answer although I do not expect you to take part in lengthy discussions. Do you think that information could be included to our proposed lede to reflect autistic people with higher support needs better or do you disagree entirely with our proposed changes? LogicalLens (talk) 06:22, 2 March 2025 (UTC)

:Thank you. I would not remove any of the information in the existing lead section. However, the definition of autism has been shifting in recent years, so I think it would be reasonable to add text taking into account this shift. That text can include much of the proposed text. I would advocate that instead of deleting the existing lead section and replacing it with a new section, you might wish to identify the important points you wish to communicate, and add them in to the existing lead. T g7 (talk) 06:47, 2 March 2025 (UTC)

::There are different legitimate positions on this topic. The main reason why some content in this proposed lead section was removed is that the current lead section is already far longer than what is recommended in MOS:LEADLENGTH and adding more content makes it even longer. Both the current and the proposed new lead section mention that support needs vary widely between autistic people, that some autistic people are nonverbal and that autism frequently co-occurs with intellectual disability. So, it would be helpful for our efforts to improve the article if you clarified in which ways you think the proposal addresses autistic people with higher supports needs in a less adequate way than the current lead section. LogicalLens (talk) 00:37, 3 March 2025 (UTC)

::There are two competing, but overlapping, models of autism in the real world at present, the pathologising 'medical model' and the non-pathologising 'neurodiversity model'. Any encyclopedic treatment HAS to cover both and, in my opinion, should cover them equally. There has been a tendency by editors here to treat the medical model as sacrosanct and the neurodiversity model as fringe and merely an expression of autistic community activism. This is entirely biased and wrong. There are plenty of academic publications that have accepted the validity of the neurodiversity model. Even Sir Simon Baron-Cohen (originator of the 'extreme male brain' and 'systematising' theories of autism), a world expert on autism research, has accepted the validity of some aspects of the neurodiversity model in his more recent works. Urselius (talk) 10:31, 3 March 2025 (UTC)

:::@Urselius, there are two RfCs on this page, and this comment strikes me as relevant to the RfC on the overall focus of the article, where you haven't !voted or otherwise commented. Just a heads up in case you missed that. FactOrOpinion (talk) 23:46, 4 March 2025 (UTC)

::::Thanks. Urselius (talk) 11:36, 5 March 2025 (UTC)

::There is some preliminary genetic evidence that autism is caused in two differing ways. Is it really one condition? For most autistics autism is caused by a higher than average incidence of a plethora of small variants in DNA (such as point mutations - single nucleotide changes) found within the general population, that have been associated with autism. Some of these variants are also associated with higher than average academic attainment. For a smaller, though still significant, number of autistic people, autism is caused by much larger changes in DNA (deletions, transpositions and duplications). These are often de novo mutation events, not inherited, occurring during ovum and sperm development. The former is associated with autism without intellectual disability, the latter associated with autism with intellectual disability and more 'profound' autism. Urselius (talk) 22:39, 4 March 2025 (UTC)

:::Yes, but probably it would be better to say these are two classes of differing ways. After all there are many different specific variants that have influences on autism likelihood (and on the likelihood of many other things!!) within each of these two categories. And leading to different things - autism in Fragile X syndrome is quite different from CHD8 autism... There's also some blurry boundaries here since the "common variants" still influence outcomes in those with the genetic syndromes, modulating likelihood that the person with the genetic syndrome will be autistic - since for a given syndrome it might often be say 30%, or 70% - higher than average but not deterministic. Ultimately the genetics is such a mess that autism just isn't a genetically defined category, or even one defined on the basis of biology. It's a socially constructed category referring to real phenomena but with fuzzy boundaries. Clinicians define it behaviourally, though arguably people in the neurodiversity movement might tend to conceptualize it as more of a mental/cognitive experience. Ó.Dubhuir.of.Vulcan (talk) 00:12, 7 March 2025 (UTC)

:::A comment here to {{U|Ó.Dubhuir.of.Vulcan}} - I think this is what you're saying, but I also think we need to be more clear when we are discussing this. We can not say that autism is caused by SNPs in DNA or Fragile X or CHD8. We are unsure what precise mechanism underlies the increase in autism among these individuals, but even among those with these diagnoses, autism is not universal or even present in the majority of cases - and other factors must therefore also be in play - meaning we can't say they "cause autism". CFCF (talk) 15:01, 16 March 2025 (UTC)

This is a small point in the scheme of things, perhaps, but {{User|Ó.Dubhuir.of.Vulcan}} in a reply to {{User|Tacitusmd}} [https://en.wikipedia.org/wiki/Talk:Autism#c-%C3%93.Dubhuir.of.Vulcan-20250307003100-Tacitusmd-20250302111500 suggested adding something like] "Health authorities classify autism as a neurodevelopmental disorder, characterised by deficits. In this approach, a diagnosis of autism requires identifying impairments internal to the individual."

I don't think this is an accurate reflection of what is required by diagnostic manuals like the DSM - am I missing something? The characteristics needed for a diagnosis are mainly determined by behaviour, and are largely social. In the DSM, as I understand it, impairment is used only to talk about functioning, in contexts which are primarily social in nature: "Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning". There is, as far as I can see, nothing about whether "impairments internal to the individual" are present at all; indeed, the kind of impairment referred to is, by definition, contextual.

The USA's CDC [https://www.cdc.gov/autism/hcp/diagnosis/index.html follows the DSM], of course (and helpfully lists its full criteria) and I can't see any sign that they deviate from its apparent agnosticism about where any impairment is located.

It may well be the case that clinicians widely assume that some impairment is present in the individual, but if this view is going to be attributed to health authorities, or as any kind of requirement, I would appreciate a more specific reference to back that up. Thanks!

--Oolong (talk) 18:29, 9 March 2025 (UTC)

:{{U|Oolong}} - This is precisely right. For autism to be diagnosed there much be a) a persistant deficit present from a young age, and b) some degree of symptoms causing clinically significant impairment in social, occupational, or other important areas of current functioning.

:The only possible way to diagnose this is based off of behavior, and thus the diagnosis is a behavioral diagnosis.

:You are also entirely correct that this impairment is always contextual - that is why I believe it is important to describe the sociocultural environment in the lede. A theory that has some traction in explaining part of the increase in autism (beyond increased awareness), is that: modern society is structured in such a way that certain situations - that individuals with autism tend to struggle with - are becoming more common.

:Just for a very gratuitous example - just 50 years ago - factory jobs were more common and might have meant limited need for social interaction in the workplace. Whereas today, with collaborative work and taking in social nuances to clarify what needs to be done, is more common. Taken at the population level - this might just tip some individuals over to the side that fulfills clinically significant impairment - when they would previously have not. I neither think we should speak about deficits being "inherent" - nor is this strictly the medical view. Rather, the relevant question is whether deficits are persistent. CFCF (talk) 15:01, 16 March 2025 (UTC)

• Note that the established definition of lede is the first sentence in a news article. https://en.m.wiktionary.org/wiki/lede#English (apologies for the pedantry Dw31415 (talk) 12:31, 15 March 2025 (UTC)
• :The source you linked to defines it as "The introductory paragraph or paragraphs of a newspaper, or a news or other type of article; the lead or lead-in."
• :I personally much prefer the standard English spelling of 'lead', and Wikipedia guidelines mainly only use 'lede' by way of contrast with news articles, but there's nothing wrong with the way it's been used here - certainly not according to your own source! Oolong (talk) 17:49, 16 March 2025 (UTC)

:I feel emboldened to pile pedantry atop pedantry. 'Lede' as a spelling was introduced to the printing of newspapers and other periodicals to avoid confusion with 'lead', which could refer to metallic lead used in type setting. Now that printing no longer uses metallic lead, the spelling 'lede' is redundant (it only dates the the late 1940's anyway). Urselius (talk) 14:30, 15 March 2025 (UTC)

::Lede has been used on Wikipedia for the past 20 years to describe the text that precedes the TOC. CFCF (talk) 15:01, 16 March 2025 (UTC)

:::Wikipedia usage should follow, not lead usage in the real world. If something is archaic and no longer relevant it should go. Urselius (talk) 06:53, 19 March 2025 (UTC)

{{User|CFCF}}, regarding your procedural objection, I don't know if you're aware that this RfC has come out of a long dispute resolution process.

I am more and more thinking I should have lodged a conduct complaint instead (a combination of dismissing good sources and going well beyond what other sources say, adding up to status quo stonewalling) but I thought maybe dispute resolution might help lead us towards some kind of consensus. 😐

I wonder what your preferred approach would have been?

For what it's worth, my biggest problem with the page is essentially that it seems to have been written with no regard at all for likely readers such as "someone who has a child recently diagnosed with autism, or someone who has recently been diagnosed". We should be thinking carefully about what information might be valuable for such readers (and what is likely to be actively unhelpful), as they are likely to constitute a large and important fraction of visitors to this page (along with people who are just at the stage of considering seeking such a diagnosis). The existing entry reads as if it's aimed at someone taking a first-year undergraduate course on autism, or something - tonnes of stuff on (mostly outdated) scientific research and technical details, with a systematic failure to cover essential information of general interest. It's bizarre.

I'm a little bit surprised by your comments about masking and mental health, by the way; you don't think [https://www.sciencedirect.com/science/article/abs/pii/S0272735821001239 this review paper] and [https://www.mdpi.com/2076-3425/13/3/469 this one] for example confirm what is written in the draft?

--Oolong (talk) 18:11, 16 March 2025 (UTC)

:I was not aware, and I would prefer to remain neutral.

:To elaborate on my objection, it stems from how damaging it is when an RfC decides what an entire lede should read, or even just part of a lede. It discourages editing, and articles tend to get stale. I believe it runs counter to the iterative refinement process that Wikipedia excels at. For instance COVID-19 pandemic ran into these issues, perhaps by necessity (due to massive trolling), but it was very detrimental to editing of the article, and much of it is still in bad shape and not up to snuff with WP:MEDRS. However controversial autism may be, it is not that controversial, and we should avoid putting unnecessary barriers against improvement. Because what do we do when we want to change the lede after an RfC sets it in stone? Well we need a new RfC, and then a new one, and then one whether we want to overturn the need for RfCs.

:Instead, I think one could have a pretty broad discussion on what the current gripes are, and lower the stakes. I think the table above by DependableProportion is interesting, even though I don't agree with all of it (in part not with the need to replace all of it - in part because it is useful to distinguish and clarify both perspectives). I think by rewriting the entire lede in one go, we are trying to do too much. I like the first two sentences of the new suggestions, but then you lose me when so much relevant information is removed, and the part about deficits (in italics) is not very good. It does not explain what they are, which the old lede does better.

:Some parts of the old lede are however really bad, like the part about "not all dimensions have been identified". I think something actionable would be try to agree on: 1) what is superfluous in the current lede, 2) what is missing, 3) should be move the mention of neurodevelopmental disorder and diagnostic criteria to the second paragraph.

:If I were to start:

:1) a. I think mention of dimensions is entirely redundant - that is not lede-material. Perhaps it is for the body, perhaps it is too in-depth for an encyclopedic entry all-together. b. I don't think we should write the autism "frequently" co-occurs with those other conditions - as if you remove ADHD from the list - it more frequently does not co-occur. I don't like the word frequently and find it a WP:WEASEL, and we would to better to replace with "can co-occur", and then get into the exact numbers in the article. c. We should probably not link to causes of autism in the lede. It is sufficient to say it is largely hereditary. d. The current read leads almost as if there were an antagonism between the autism community and researchers/clinicians. This isn't really the case - I think this is overemphasizing a quite limited debate on the internet.

:2) I think the new lede is missing quite a few things, relating to sociocultural context, prognosis, and what is meant by deficits.

:3) I think it could be moved down. We aren't going to get away with not mentioning it, but there isn't any need to have it in the first sentence.

:CFCF (talk) 20:18, 16 March 2025 (UTC)

::P.S. Forgot to explain on masking. I don't think it is incorrect to say that masking contributes - but both of those studies fail to quantify the size of any relationship. This is the problem, not the mention itself. I think the problem is the word "especially", which would be better if replace with "including". CFCF (talk) 21:23, 16 March 2025 (UTC)

:::The statement is that "Autistic people are also significantly more likely to experience anxiety and depression, especially if they feel the need to mask their autism."

:::That is surely literally true if masking contributes to anxiety and depression, which we agree the studies demonstrate? I guess your position is that it makes it sound like their contribution is known to be large...? Oolong (talk) 07:50, 19 March 2025 (UTC)

::::My position is that the word "especially" makes it sound like the contribution is known to be large. CFCF (talk) 19:46, 20 March 2025 (UTC)

:I am following this developing story closely and may have more to say about the accusations of misconduct being made here. For now, despite the repeated accusations, the most worrying things I have seen out of our discussions is the occasional innuendo a user or two have directed towards holders of a particular position, which I don't think persisted to compromise the discussion process.

:As one of the people to which Oolong's accusations have been directed towards, to give my own perspective, we have not been "dismissing good sources" nor "going well beyond what other sources say", or other sych assertions. In actuality, we have been showing how the Neurodiversity Movement has contributed very little to the scientific understanding of neurodevelopmental disorders, which is why its claims (e.g., that ASD is not a neurodevelopmental disorder, doesn't have symptoms or impairments, isn't subject to varying severity, etc) are contradicted in virtually all national and international guidelines, diagnostic criteria, scientific consensus statements, systematic reviews, and other secondary sources on the topic of ASD. I have pointed out that the quality of such sources far outweighs the references to (some) of the primary literature, advocacy papers, and editorials, that may claim otherwise. These sources have been individually accounted for in replies, and so haven't been dismissed. In contrast, I have seen one publication from the NHS repeatedly presented as an authority on the matter to not use specific terminology. However, it's been pointed out that its not scientific in nature, and is contradicted by its own guidelines elsewhere, including by NICE which supersedes the NHS.

:In this case, citing references to substantiate a scientific consensus is just that, a review of the literature, and not signs of some attack worthy of censorship. I do not think there has been any intentional misrepresentations of people's viewpoints, though I do think the draft proposed here is misrepresenting the literature and is strongly biased towards inaccurate viewpoints. Nonetheless, I wouldn't want to pursue misconduct accusations against the people who contributed to or support the proposal. Not only would that be unfounded, as the discussion process has not been compromised, but also because you're supposed to challenge what you think is wrong speech through more speech, not by trying to silence the authors. Димитрий Улянов Иванов (talk) 15:41, 17 March 2025 (UTC)

::@Димитрий Улянов Иванов, there are two RfCs on this page; the other one is an RfC on the overall focus of the article, where you haven't !voted or otherwise commented. Just a heads up in case you missed that. FactOrOpinion (talk) 15:49, 17 March 2025 (UTC)

:::Thank you! Димитрий Улянов Иванов (talk) 15:52, 17 March 2025 (UTC)

::I stand by my description of status quo stonewalling, and I am prepared to shift this to Wikipedia:Arbitration if necessary. I have put enormous effort into challenging wrong speech through more speech, and there are good reasons why this is not the only avenue available. Procedurally, Wikipedia maintains a division between disputes over content and conduct, but in practical terms it is understood that many disagreements involve both.

::As I described above, I entered into a dispute resolution process - in good faith - in the hopes of bringing us towards some kind of consensus.

::I remain sure that we have significant common ground, despite our substantial disagreements about a number of basic facts as well as genuinely contentious questions, but so far we have made little to no progress in establishing that.

::I am strongly disinclined to enter into further discussion with you without strong mediation in place - we have spent enough time going in circles around this - so I will not get into your claims about the relationship between neurodiversity and science here, but I will direct interested readers to [https://oolong.medium.com/neurodiversity-and-science-41fc303a1782 a piece I wrote about this in January,] sparked by earlier discussions on these pages. Oolong (talk) 08:18, 19 March 2025 (UTC)

:::Disagreements aside, I don't mean to imply that you haven't been engaging diplomatically. I agree that the discussions were getting circular, though I do not see that as a reason to pursue misconduct hearings, unless there is something I have missed. The subject is ultimately always going to be contentious. Disagreements will likely persist, and people's views on things do get misrepresented or misinterpreted at times, but with the involvement of other editors, I believe that in due time, debate and discussion will be the path of achieving more of a common ground. Димитрий Улянов Иванов (talk) 13:00, 20 March 2025 (UTC)

::::Of course circular discussions in themselves are not grounds for misconduct hearings. Circularity is not the fundamental issue here: as you say, 'things do get misrepresented or misinterpreted at times'.

::::I had hoped that Dispute Resolution would allow us to move on from persistent misrepresentations and misinterpretations, but that has not, so far, happened. Oolong (talk) 15:26, 24 March 2025 (UTC)

• Comment. I have not yet !voted in the Survey. I agree with editors who say the RfC is too long. This isn't an RfC on the lede, this is an RfC on the whole article.

:First of all, there isn't consensus among MEDRS that autism should be called a "disorder" [https://www.science.org/content/article/disorder-or-difference-autism-researchers-face-over-field-s-terminology], so rather than take sides, the article needs to explain the debate in prose.

:I understand that some people might have a desire to classify and categorise. It would be nice if we could say "Autism is " and be done with it, but the world is a messy place and not everything fits neatly into boxes.

:Autism isn't any one thing. That's why the first sentence of the lede should start with {{tq|"Autism describes..."}} or even {{tq|"Autism is the word for..."}} because that's what "autism" really is -- it is a label/descriptor of certain behaviours and traits (or symptoms, depending how you look at it).

:Stop thinking about Wikipedia as a textbook and think of it as a store of knowledge (yes, there is a difference between the two). Are we trying to impart knowledge humans have so far accumulated about autism or are we simply giving people the textbook definition from DSM-V? If the latter, then there's no point to Wikipedia, people can just go look at the DSM-V. TurboSuperA+ (☏) 10:41, 20 March 2025 (UTC)

::{{tqq|the first sentence of the lede should start with "Autism describes..." or even "Autism is the word for..." }} {{mdash}} MOS:REFERS says No. If you are correct in that autism {{tqq|is a label/descriptor of certain behaviours and traits }}, then the first sentence should be (for example) "Autism is a set of certain behaviours and traits ...". All words are labels; this article is about the subject, not the word/label. Mitch Ames (talk) 01:46, 21 March 2025 (UTC)

@CFCF, thank you for the time you put into improving this particle, but, while for most conditions, person-first language is preferred, this does not apply to autistic people. The Manual of Style (WP:SUFFER) says: "Some groups view their condition as part of their identity and prefer identity-first language (for example, many autistic or culturally Deaf people) and reject person-first terminology." See also these studies.[https://journals.sagepub.com/doi/abs/10.1177/13623613221142383][https://onlinelibrary.wiley.com/doi/full/10.1002/aur.2864][https://www.liebertpub.com/doi/abs/10.1089/aut.2023.0175] LogicalLens (talk) 02:34, 2 April 2025 (UTC)

:{{U|LogicalLens}} - Thank you. I was not aware of those amendments to WP:SUFFER. However, I think it should be noted that the view to use identity-first language is not a subject of consensus neither among activists nor within the medical establishment. For instance, the NHS goes even further, and suggests also the alternative "people on the autism spectrum", and directly says that one should not say "autistic children", but "children on the autism spectrum". [https://www.england.nhs.uk/learning-disabilities/about/get-involved/involving-people/making-information-and-the-words-we-use-accessible/]

:Regardless, it is a potentially worthwhile discussion to have here - and one which I did not find upon looking at the archives here.

:My view comes from the perspective of having treated many patients with the condition - mainly in child and adolescent psychiatry - but also among adults. It would never occur to me to label someone as "autistic" unless they themselves were comfortable with that language. (And even then I have a hard time envisioning a situation where I would express myself using "autistic" as an adjective, as discussing the condition writ large is less useful than speaking about specific expressions and difficulties).

:I am open to amending or reverting this edit, but I think this should be done following informed discussion - because it's not clear cut. The APA for instance suggests choosing the preferred approach of the person you are speaking with - and suggests that mixing between "people with autism" and "autistic people" to "avoid cumbersome repetition".[https://apastyle.apa.org/style-grammar-guidelines/bias-free-language/disability] This mix is something that some of the bigger advocacy groups and organizations employ: [https://www.autismspeaks.org/what-autism], [https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders]

:There are also studies to support both sides [https://pmc.ncbi.nlm.nih.gov/articles/PMC10074744/]

:There are many nuances here, and we should consider how not everyone may be comfortable with identity-first language - which pervaded the entire article prior to my edit.

:Perhaps there is room for middle ground - what do others think? CFCF (talk) 08:24, 2 April 2025 (UTC)

::@CFCF

::gay people

::lesbian people

::transgender people

::lebinese people

::Indian people

::old people

::disabled people

::No that last one is rude for some reason. but it does depend, like I think with anorexia its person first.

::Also "on the spectrum" doesn't seem to be a middle ground, as per this. Anthony2106 (talk) 01:58, 3 April 2025 (UTC)

:::It's also worth noting that some like cripple is being reclaimed: crip (disability term) and is now like the N-word I guess. So I guess we can't always talk like the person dose. Anthony2106 (talk) 02:25, 3 April 2025 (UTC)

::::Some people dislike "old people". The usual recommendation in the US is "older people".

::::Previous discussions on wiki have generally ended with a compromise that children will usually be called "children with autism" or "children on the autism spectrum", and adults will usually be referred to as "autistic adults" or "autistic people". There is quite wide variety in how people self-identify, so I don't think we need a one-size-fits-some rule imposed on the whole article. WhatamIdoing (talk) 04:12, 3 April 2025 (UTC)

:::::@WhatamIdoing is it because kids may not know the difference between indenty first/person first? Anthony2106 (talk) 05:06, 3 April 2025 (UTC)

::::::I think the rationale is that they may not have the appropriate background or cognitive capacity to make an informed choice as to self-identification, and one ought therefore default to not prescribe a label. So, I guess to some extent yes, but without it being purely about "knowing", but rather about being mature or independent enough to choose. While a mature or informed child might be able to do so, collectively as a group, children would not have this capacity. CFCF (talk) 05:30, 3 April 2025 (UTC)

:::::::@CFCF Regarding children vs. adults, there shouldn't be a language distinction here on Wikipedia or out in the real world. Unfortunately, it is often the case that those with authority over Autistic children see the autistic neurotype as akin to disease and either teach said children to refer to themselves using person-first language or, even more grotesquely, to use euphemisms-turned-dysphemisms (e.g., "special needs," "differently abled," etc.).

:::::::It's also worth noting that, unless an Autistic child's parent is also openly Autistic, they are rarely exposed to Autistic culture more widely until they become old enough to question their parents' preferences and begin exploring the wider Autistic community online or in person. DoItFastDoItUrgent (talk) 04:27, 4 April 2025 (UTC)

::::::::This is a personal preference that is not in line with the literature or guidelines. CFCF (talk) 15:13, 4 April 2025 (UTC)

:::None of the examples listed above, except for "disabled people", can be compared with autism because they are not based on the presence of impairment. Unlike those, the diagnosis of autism is contingent on symptoms causing significant impairment in major life domains, and hence the disparity in the terminology. Димитрий Улянов Иванов (talk) 17:30, 6 April 2025 (UTC)

::::@Димитрий Улянов Иванов so people think autism is bad? Anthony2106 (talk) 05:45, 23 April 2025 (UTC)

:::::The answer to that question is mostly "yes". It's a little more complicated than that, because people might want specific, isolated features, or they might value the particular combination of autistic traits in a particular famous person (who wouldn't want their child to be the next Einstein?), but overall, the answer is that most people think autism is an undesirable trait.

:::::For example, I've never spoken with a pregnant woman who says she really hopes her child will be autistic. Plenty of them tell me that they want their child to be smart, pretty (for the girls), or sociable. They tell me that they're looking forward to playing ball games or baking cookies or going hiking. But I've never heard "I really hope this child turns out to be autistic", even among the parents whose older child is autistic and who think the older child is amazing and the world is a better place because of them. It is a bit like saying "I really hope this child has a two-thirds chance of being incapable of driving a car when they're 20 years old, and ten times the usual risk of developing a potentially deadly epilepsy". Who would actually wish that for anyone?

:::::Speaking of which: It would be interesting to see if there is any research on family planning choices. For example, do parents frequently decide against having more children if their first has autism? WhatamIdoing (talk) 17:26, 23 April 2025 (UTC)

::::::Please remember that when you ask about what people believe, that "people" are frequently wrong! Half of "people" have below-median IQ. Half of "people" have below-median knowledge about autism. At some level, "what do people think?" means "what do people, most of whom are badly informed and/or not very smart to begin with, think?" WhatamIdoing (talk) 17:29, 23 April 2025 (UTC)

::::::@WhatamIdoing Well now we gotta use identy first to reinforce the idea its fine. Well person first was never gonna win for this page. In fact its slightly annoying no one undid the edit right away, because it takes longer to undo after other edits have been made. Anthony2106 (talk) 00:00, 24 April 2025 (UTC)

:::::::Deaf people and blind people have used person-first language for decades. Has that made you think that losing your hearing or your sight would be fine? WhatamIdoing (talk) 00:37, 24 April 2025 (UTC)

::::::::@WhatamIdoing I would haft to learn O&M and braille and get better at use Apples screen reader (I only tried it a handful of times out of cerosity) I think I would haft to give up on Linux because Orca says random stuff (maybe its just broken for me or I'm doing it wrong). So I can only imagen how hard it must be for someone to lose there sight. And if I lost my hearing I would learn Auslan (maybe I should learn it anyway just in case I meet a deaf person). So maybe not "fine" but identy first defiantly makes it sound less like a illness and more like an important part of the persons identy. Anthony2106 (talk) 01:00, 24 April 2025 (UTC)

:::::::::Or perhaps it makes it sound very much like an illness/impairment, and more important than the fact that they're still people. WhatamIdoing (talk) 01:05, 24 April 2025 (UTC)

::::::::::@WhatamIdoing no the person was gonna be a person either way. Also "fine" was the wrong word. Its not good or bad. [https://www.youtube.com/watch?v=K7CL-1sgQGM&t=769] I don't need a better source this is probably correct. Don't worry I don't use that mantality when adding sources to pages (but I often don't add sources). Anthony2106 (talk) 01:11, 24 April 2025 (UTC)

:::::::::::When people feel like person identity-first language is unkind, it's because they think it sounds like they're not being recognized as people. They interpret it like you're saying "DISORDER person", and they want you to think of them as "Person! (with a disorder)". WhatamIdoing (talk) 02:14, 24 April 2025 (UTC)

::::::::::::@WhatamIdoing that makes sense, but in my option I feel its more important to use identy first, as we do with everything else. Anthony2106 (talk) 02:18, 24 April 2025 (UTC)

::::::::::::@WhatamIdoing:

::::::::::::“They.” As if there aren’t multiple autistic people speaking here (whether you like it or not).

::::::::::::Suggesting that identity-first language stems from a need to be “seen as a person” misrepresents the entire discourse. It reduces a deliberate epistemological stance to an emotional misunderstanding. The comment isn’t just condescending—it’s gatekeeping through simplification, or worse, through imposed benevolence that masks imposed authority as kindness

::::::::::::Autistic people who use identity-first language aren’t seeking validation. They’re rejecting a framework that externalizes their neurology—treating autism as an add-on, a flaw to be linguistically distanced from.

::::::::::::Recasting that rejection as confusion or sentimentality doesn’t clarify anything—it reinforces the idea that only one worldview gets to set the terms. That’s not neutrality. It’s about maintaining control over how autism is described—whether through simplification, or worse, through imposed benevolence that masks authority as kindness.

::::::::::::If we’re operating under Wikipedia’s core policies—like WP:NPOV (https://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_view ), WP:VERIFY (https://en.wikipedia.org/wiki/Wikipedia:Verifiability ), and MOS:DISABILITY (https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Disability/Style_advice )—then the expectation is clear: Wikipedia should represent all significant viewpoints proportionally, cite reliable sources, and reflect how language is used by the people being written about—not just how institutions have historically framed them.

::::::::::::So let’s clarify: what’s informing your position here? Are you drawing from lived experience, peer-reviewed sources, or community-endorsed language guides? Because without that, this reads less like a policy-aligned contribution and more like a personal preference filtered through a clinical legacy Wikipedia no longer treats as default. Recursiva (talk) 08:46, 7 May 2025 (UTC)

:::::::::::::I apologize; I had a critical typo in my comment above, which I have just fixed. Fortunately for me, Anthony readily glorked my meaning from context. I'd like to give you the opportunity to check your comment to see whether it is still relevant. WhatamIdoing (talk) 18:15, 7 May 2025 (UTC)

::::::::Being deaf or blind is seen as significantly less bad than other disabilities. The switch to identity-first language alone does not completely shift the narrative but it has an impact. See this paper, which argues that person-first language can accentuate stigma.[https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.12706] LogicalLens (talk) 04:47, 24 April 2025 (UTC)

:::::::::I wonder why you believe that being blind is "significantly less bad than other disabilities". Research shows that it is considered one of the most feared disabilities.[https://www.nytimes.com/2017/02/20/well/the-worst-that-could-happen-going-blind-people-say.html][https://www.aafp.org/pubs/afp/issues/2008/0515/p1431.html#afp20080515p1431-b1]

:::::::::(I'm not very impressed by the opinion piece. It complains that "person-first language is used more frequently to refer to children with disabilities than to refer to children without disabilities", as a statistical matter, but does not take the context into account. People do not usually need to be reminded that gifted children are valuable humans; people unfortunately do need to be reminded that children with highly stigmatized conditions are valuable humans. This is true outside of the medical world, too: we do not need to talk about [https://www.theguardian.com/commentisfree/2023/apr/11/comfort-sad-scared-billionaire-call-them-person-of-wealth "people of wealth"]; we do need to be reminded that "children affected by poverty" are children first and their circumstances second.) WhatamIdoing (talk) 05:43, 24 April 2025 (UTC)

::::::::::@WhatamIdoing maybe LogicalLens spoke backwards. Also LogicalLens who do you think will be the first person to put a welcome message on your talk page? I could of asked you on your talk page but then it would of been me. Anthony2106 (talk) 05:52, 24 April 2025 (UTC)

:::::::::::I didn't even know that welcome messages exist and don't know who will do it. LogicalLens (talk) 01:30, 25 April 2025 (UTC)

:::::::::::@Anthony2106

:::::::::::What’s with the power play disguised as a welcome?

:::::::::::LogicalLens raised a legitimate point. You responded with a joke about who gets to post on their talk page—like belonging here is a reward for compliance.

:::::::::::Is that how you treat all new editors whose opinions challenge your status quo?

:::::::::::#WP:CIVIL #WP:EQ #WP:NPOV

:::::::::::Recursiva (talk) 08:55, 7 May 2025 (UTC)

::::::::::::Well I didn't want to be the first one on their page so I had to ask them here. I could of asked them elsewhere I guess. And I'm not trying to reward them for joining in, they can do what they want. Was the "power play" me saying LogicalLens made a speaking mistake? Because I thought they might of. Anthony2106 (talk) 09:38, 7 May 2025 (UTC)

:::::::::::::Fair enough if that wasn’t your intent. But commenting on someone’s phrasing and linking it to who gets to welcome them can land as a bit of a status move. In autistic spaces, it’s often more constructive to lead with logic rather than social cues. What feels playful to one person can quietly influence whose voice is treated as legitimate. Recursiva (talk) 10:10, 7 May 2025 (UTC)

::::::::::::::Status move? I also enjoy not caring about body language and say what I mean. Anthony2106 (talk) 14:16, 7 May 2025 (UTC)

:::::::::::::::My meaning was: if someone comments on phrasing while also referencing who gets to welcome whom, it can appear hierarchical—even unintentionally. In autistic spaces especially, where many of us are hyper-attuned to power dynamics (even while disliking them), that kind of framing can trigger concern about whose voice is being implicitly validated or moderated. You’ve already clarified your intent, and I appreciate that. Recursiva (talk) 15:00, 7 May 2025 (UTC)

::::::::::I was talking more about congenital disabilities. If one already lives a life seeing and hearing, then their life plans are disrupted by becoming blind or deaf, which is not the case for those born that way.

::::::::::The notion that autism is a bad thing that has to be separated from the person in order to remind people that autistic people are people is exactly the thing that autistic advocates fight against. LogicalLens (talk) 01:24, 25 April 2025 (UTC)

::::::@WhatamIdoing

::::::This line of reasoning is eugenic in nature, even when delivered politely.

::::::Suggesting that no one would wish for an autistic child because they might not drive or might have a co-occurring condition reinforces the idea that autistic existence is inherently lesser. That’s not objectivity—it’s live social prejudice.

::::::WP:NPOV WP:BIAS

::::::Let’s flip the question: what kind of world assumes a child is only worth hoping for if they can drive, hike, or match a neurotypical script?

::::::Many of the world’s most impactful thinkers weren’t just coincidentally autistic—they were powerful because of their divergence. Autism is associated with pattern recognition, emotional depth, innovation, and radical truth-telling.

::::::If a parent says they hope for a child who is brilliant, precise, deeply feeling, and honest to the core—they might not realize they’re describing autistic traits.

::::::The issue isn’t autism. It’s a society that punishes difference. And if Wikipedia is committed to representing significant viewpoints and avoiding systemic bias, that needs to be reflected in how we frame neurodivergence.

::::::WP:UNDUE WP:EQUITY

::::::We’re not just talking about abstract traits here.

::::::We’re talking—possibly—about minds like Newton’s, Einstein’s, and Tesla’s.

::::::Minds so divergent, history didn’t just tolerate them—it bent around them. Recursiva (talk) 09:24, 7 May 2025 (UTC)

::@CFCF Switching back and forth between identity-first, person-first and/or euphemistic language in an attempt to please everyone pleases no one. The majority preference of a group should always be respected and defaulted to. It's fine to use person-first or euphemistic language when speaking with an Autistic person who tells you that's what they prefer, but that individual doesn't get a veto over the language preferences of the larger community. At a certain point, majority preference wins out and those who cling to the minority position get left behind. Further, from an encyclopedic perspective, we should value consistency and brevity. DoItFastDoItUrgent (talk) 04:11, 4 April 2025 (UTC)

:::Going from "respecting a view" to "defaulting to or abiding by this view" is a logical leap that is inappropriate. The appropriate language for an encyclopedic entry depends on who is the potential reader. This very general overview article on the topic is likely to be read by those undergoing evaluation, those newly diagnosed, those who have embraced identification as autistic, those who have not, as well as a generally interested lay-public. The appropriate language use must take this into account. The language use that is least likely to be challenged is that which abides by international guidelines and recommendations, such as by the NIH or the NHS - and is respectful. People with autism is not a euphemism. I have no strong opinion on mixing or allowing a choice for individual editors, but I strongly reject your position. I think the only actionable outcome here is to describe the issue in detail under the classification section as a separate subheader on terminology. CFCF (talk) 15:20, 4 April 2025 (UTC)

::::@CFCF So you believe that the NIH should determine what language is most respectful and not the Autistic community itself? Duly noted. DoItFastDoItUrgent (talk) 16:27, 4 April 2025 (UTC)

::::@CFCF Also, to be brutally frank, if you are not Autistic yourself, I couldn't care less if you "strongly reject [my] position" on what language is or isn't respectful. Your experience as some sort of medical professional doesn't give your opinion equal weight to those of Autistic individuals. DoItFastDoItUrgent (talk) 16:29, 4 April 2025 (UTC)

:::::Yeah...that's not how this works, not least of which because asking for somebody on the internet to show their group identity membership card is kinda dumb. GMG^talk 16:50, 4 April 2025 (UTC)

{{od}}I think we must be very mindful of how what are acceptable self-referrential terms are not the same as terms being accepted for use to describe a group from a potentially external vantagepoint. For all its legitimacy, reclaiming previously derogatory terms, as described by Anthony2106, is by definition not widely accepted. While some movements are thought-provoking (not a direct analogy: Mad pride), they are not always generally accepted, and certainly do not always speak for the majority (and are to some minority still hurtful).

Further, and quite notably, WP:WIKIVOICE is not self-referrential. This is not so much about a medical or biomedical vantage point - as it is in finding an acceptable terminology for an encyclopedia written by the general public for the general public. CFCF (talk) 05:03, 3 April 2025 (UTC)

:The reason why identity-first language is preferred by most autistic people is not that it was used in a derogatory way in the past but because "person with autism" implies a separation between the person and being autistic, which is rejected by most autistic people. We could use “on the autism spectrum” for children, but we should not use “person with autism”. The NHS language guide you cited says one should say “children on the autism spectrum” instead of “children with autism” and not instead of “autistic children”. The other study you cited is about preference in the Dutch language, which is relevant for the Dutch but not for the English Wikipedia because the connotations of expressions are not identical in different languages. All the English-language studies show a clear preference for identity-first language. LogicalLens (talk) 05:48, 3 April 2025 (UTC)

::I'm not going to disagree with you, but I would prefer if we could discuss those studies, because I have not been able to find that clear preference when I go looking for it, nor does it pan out in the links given above by LogicalLens. Instead the NHS and WHO sources linked above, which summarize a fair few of those studies urge moderation or using terms interchangeably without clear preference.

::If for no other reason, it would make sense to write a section of this article on the preferred terminology. It could fit quite neatly under ==Classification== : ===Terminology===. CFCF (talk) 06:03, 3 April 2025 (UTC)

:::Hi @CFCF, here are some recent studies.

:::Autism-related language preferences of English-speaking individuals across the globe: "across all countries, there was a majority preference for identity-first language. The most popular terms for self-identifying were ‘autistic person’ (75.9%–88.1% endorsement across countries), ‘neurodivergent person’ (65.2%–75.9%), and ‘autistic’ (65.6%–72.6%). In contrast, there was considerably lower endorsement of person-first language (e.g., ‘person with autism’; 18.5%–28.6%)."

:::[https://journals.sagepub.com/doi/abs/10.1177/13623613221130845 Preferences for identity-first versus person-first language in a US sample of autism stakeholders] : "Autistic adults preferred to self-identify using identity-first language (87%); however, a sizable minority of adults with autism prefer to self-identify with person-first language (13%)." ... "As the language we use shapes our conscious and unconscious perceptions and beliefs of individuals with autism, it is critical to identify the terminology that is preferred by individuals within the community."

:::[https://journals.sagepub.com/doi/full/10.1177/27546330231216548 Words matter: Language preferences in a sample of autistic adults] found strikingly different results: "no consistent trends in language preference, indicating best practice may be to alter language use based on individual preferences when interacting with autistic individuals." Participants were recruited (and compensated) using the Pollfish online survey platform; I don't know if that's relevant to these results, but a quick scan didn't suggest any other obvious factors that might help explain the discrepancy.

:::I don't believe there are any stuidies that suggest a majority preference for person-first language among autistic people, and an 80%+ preference for identity-first is not unusual.

:::I'm just not seeing the case for using person-first in this article. Like many other sources, the NHS article clearly recommends avoiding "with autism", and makes a strong case for it.

:::As for the rationales, Jim Sinclair's [https://blogs.exeter.ac.uk/exploringdiagnosis/files/2017/03/Sinclair-Why-I-Dislike-First-Person-Language.pdf Why I dislike “Person First” language] famously made the case in 1999; [https://autisticadvocacy.org/about-asan/identity-first-language/ ASAN discusses IFL here], courtesy of Lydia X. Z. Brown. Oolong (talk) 14:29, 3 April 2025 (UTC)

:::::Thank you. CFCF (talk) 06:52, 4 April 2025 (UTC)

::::Can we write this down somewere so we don't gotta explain it every time? That's why I made MOS:AUTISTIC but now that goes no where. Infect maybe it should of been WP instead of MOS. Anthony2106 (talk) 01:08, 4 April 2025 (UTC)

:::::It was my suggestion to include this in the article, just FYI. I can't see this as it being explained, rather this is being reasoned around. It is not so simple as writing down, because guidelines are not saying the same thing. CFCF (talk) 06:55, 4 April 2025 (UTC)

:::Professionals are often hesitant to switch to identity-first language because they were trained to use person-first language and to view autism as a negative thing instead of an identity. It is important, however, to be open to new perspectives and to listen to what the majority of the community prefers. LogicalLens (talk) 04:41, 4 April 2025 (UTC)

::::LogicalLens, I think this is a false statement for many reasons. The reason to avoid identity-first language is that a sizeable proportion of patients will take offence at being labled or having an identity thrust upon them.

::::It is quite a complex field, where the preferences of a majority may not be the only thing that matters. It is one thing to state what terminology should be used among those who have over time embraced a diagnosis or condition, and those who are newly diagnosed or for various reasons struggle with the identity. If I may speculate, one of the reasons that guidelines take a less strict identity-first approach is 1) that even among the sources above there are conclusions such as {{tq|Despite relative consensus across groups, both our quantitative and qualitative data demonstrate that there is no universally accepted way to talk about autism.[https://onlinelibrary.wiley.com/doi/10.1002/aur.2864 Keating et al.]}} (linked by Oolong). 2) In part one much acknowledge that these studies are performed on participants that have already accepted their status, with sampling bias leading to lower response rates among those who may be diagnosed but do not accept autism as an identity.

::::I think it is quite telling that the articles on the topic refrain from strong conclusions on preferred language, with guidelines being similarly nuanced.

::::Further, why your point is false LogicalLens, is that what you say about professionals being trained on person-first language is false. What they are trained to be is compassionate. There is a trend where while most professionals are not trained in person-first language, acknowledgement of stigma and patient perceptions are quite recently being introduced into guidelines - coming from the research perspective where there have been strong movements on this in the past 5 years (e.g. new 2021-2022 UNAIDS guidelines on HIV language and a Lancet HIV position, just for analogy). Rather the wish to avoid lables comes from experience of reactions among patients.

::::Most of my experience is with children, specifically teenagers who are recently diagnosed or under evaluation for autism. Regardless of the views of the physician, the interpretation taken by children of the diagnosis is often negative - with the doctor being the one to have a less negative view, based on knowledge of strategies and adaptation of the environment around the children that can help them flourish, despite the situation they currently see themselves in that prompted evaluation. CFCF (talk) 06:51, 4 April 2025 (UTC)

:::::A short piece from the NIH ([https://www.nih.gov/about-nih/what-we-do/science-health-public-trust/perspectives/writing-respectfully-person-first-identity-first-language Writing Respectfully: Person-First and Identity-First Language]) reads:

:::::{{tq|Many people in the autism community also prefer identity-first language. They view autism as a central and important part of their identity and take pride in it. Some autistic people feel that identity-first language better reflects and respects neurodiversity. Some are firmly against person-first language. Others in the autism community, however, prefer person-first language—including many parents of children with autism.
Again, because of the diversity of perspectives, consider asking an individual’s preference when writing a story about one person. If writing generally, experts suggest defaulting to person-first language when writing about children and using a mix of person-first and identity-first language when writing about adults or autistic individuals generally. Examples of this mixed approach include President Biden’s Proclamation on World Autism Awareness Day 2022(link is external) and a recent blog post, Research Along the Autism Spectrum: Diverse Research to Meet Diverse Needs, from Dr. Joshua Gordon, Director of NIH’s National Institute of Mental Health.
[...]
Be creative: You don’t always need to use a single word or term. For example, you can switch back and forth between “people on the autism spectrum” and “autistic Americans.”}}

:::::CFCF (talk) 07:01, 4 April 2025 (UTC)

::::::@CFCF "switch it back and forth" how can that be good? Every time I hear "people with autism" or "on the spectrum" (random one) I lose 20 health points. Anthony2106 (talk) 07:51, 4 April 2025 (UTC)

:::::::We must account for who the potential reader is, and not personal preferences. CFCF (talk) 15:20, 4 April 2025 (UTC)

::::::::One person may lose 20 hp when reading "children on the autism spectrum". The next may lose 20 hp when reading "autistic children".

::::::::One way to accommodate both of them is to minimize the number of times any formulation is needed. For example, whenever it's not ambiguous, we can use words like "they". WhatamIdoing (talk) 16:11, 4 April 2025 (UTC)

:::::::::I think it'd be better to interchangeably use both to reflect the variation in individual preferences. They factually refer to the same concept, as I understand it, and I don't see the relevance of political correctness for an encyclopaedia. People's justification for which one the article should be allowed to exclusively use, or even to not use any at all, seems to be based on collectivism. That is, viewing what is acceptable or politically correct through the average or majority of a group. However, the collective doesn't truly exist in reality, it's an abstract concept, for which you cannot attribute a "preference" to, nor can it express one itself. Although individual people may hold a preference, which differs between people. So, I think the variation itself is more important. Димитрий Улянов Иванов (talk) 17:44, 6 April 2025 (UTC)

:::::::::Right, but most surveys suggest that somewhere in the region of 80% of autistic people prefer identity-first language. From what I've seen, the minority who prefer person-first are also less likely to have strong feelings about it, though that's harder to quantify.

:::::::::We're not going to be able to please everyone, and that's fine, but we can minimise the number of people who are significantly bothered by our language choices. I'm not sure that avoiding talking about autistic people in an entry about autism is a viable route to that! Oolong (talk) 10:38, 7 April 2025 (UTC)

::::::::::Wrong.

::::::::::It would be fairer to say that most surveys – of (1) a thoroughly biased population of (2) people who self-identify as having autism with (3) no ability to find out whether their self-identification is actually correct, and (4) no effort to sample an unbiased population, or an effort so inadequate that they have to report it as a 'limitation' of the survey – find that even in a population biased towards the Right™ answer, a significant minority don't prefer person-first language.

::::::::::{{pmid|37074176}} says 15% of 8-year-old kids with autism are nonverbal or minimally verbal. What's their preference? Do they even have a preference? Excluding 15% of the supposed target population right off the bat is the kind of survey design that would make a pharma company's marketing team proud, but it's not the kind of survey design that helps you find the actual answer that applies to everyone. WhatamIdoing (talk) 19:24, 7 April 2025 (UTC)

:::::About {{xt|the doctor being the one to have a less negative view}}: I think this is largely true in those initial stages.

:::::I've seen both the labeled child (if old enough to understand) and their family members, and even friends, reject the diagnosis. "How could they say that? There's nothing wrong with him", or "He doesn't have autism; it's only ADHD". I know a family that divorced over whether to have their son assessed for autism. I know two families that probably have a teen with autism, but they refuse the assessments because they're afraid of the label.

:::::If you are that under-informed, half-panicked family member or friend, then coming to an article that emphasizes the "AUTISTIC!!!!!1!!" part is not going to sound like a joyful expression of Autistic pride. It's going to sound like the authors have forgotten that all children are children. WhatamIdoing (talk) 23:31, 4 April 2025 (UTC)

::::::I think this an extremely important perspective that we need to take in account. CFCF (talk) 11:32, 5 April 2025 (UTC)

:::::::I've never understood why anyone would think that [https://janinebooth.com/im-autistic-its-an-adjective-not-an-accessory/ using an adjective] would suggest that anyone has 'forgotten that all children are children'. Nobody thinks this about other adjectives, like 'tall' or 'gay' or 'Scottish', right? Oolong (talk) 10:43, 7 April 2025 (UTC)

::::::::There is no need to understand why people think this, only to acknowledge that they do. Further, it's not about the adjective, but about the label, which is not accepted by everyone as as an essential feature of their being. The noun form is generally rejected when we talk about people, and the fact that the adjective form is preferred by some seems to mostly be a cultural perspective in certain groups. This mirrors quite close debates on other conditions, and the guidelines are quite clear here. CFCF (talk) 17:29, 7 April 2025 (UTC)

::About "{{xt|identity-first language is preferred...is...because "person with autism" implies a separation between the person and being autistic, which is rejected by most autistic people}}":

::This argument claims that we should prefer identity-first language because identity-first language pushes the Right™ POV about what autism is. That's the opposite of a policy-based reason for making this kind of stylistic choice. WhatamIdoing (talk) 16:09, 4 April 2025 (UTC)

:::It is a good idea to reduce the number of times these expressions have to be used by writing "they" instead. Although "children on the autism spectrum" is also person-first language, it is at least perceived as less offensive by many autistic people than "with autism". So I could agree as a compromise on using mainly this expression for children while using "autistic person" for adults.

:::The question whether autism is perceived as separate from the person is determined by autistic people and the studies cited above show a clear preference for identity-first language. This is different from the academic disorder/neurodivergence debate where we mainly have to take into account the views of scientists in order to follow the rules on reliable sources. LogicalLens (talk) 04:27, 5 April 2025 (UTC)

::::On what basis do you assert that "The question whether autism is perceived as separate from the person is determined by autistic people"? There is no scientific law that says autistic people alone get to determine whether autism is "separate from the person". There isn't even a scientific law telling is what "separate" and "person" mean. Mind–body dualism says that the mind (e.g., your beliefs about yourself) is separate from (and usually more important than) your body (e.g., your brain's wiring pattern) – but that's philosophy, not science, and it's a viewpoint, not a fact.

::::Whether autism is "separate from the person" is a matter of viewpoints, and every significant viewpoint (attested to by reliable sources) belongs in this (and any) article. The viewpoint of autistic people is not automatically elevated above any other viewpoint. WhatamIdoing (talk) 04:41, 5 April 2025 (UTC)

:::::The Manual of Style (WP:SUFFER) recommends following the preferences of the groups themselves for person-first/identity-first language. My explanation about autism being inherent to/separate from the person was to explain why many autistic people dislike person-first language, which helps in understanding but does not change the fact that the Manual of Style advises us to follow the group's preference.

:::::Do you as well as @CFCF agree with my above suggestion for a compromise? LogicalLens (talk) 06:08, 5 April 2025 (UTC)

::::::I do agree with you {{U|LogicalLens}} that shifting towards more use of "they" and "those on the spectrum" is a very valid compromise. However I also think we should not have a blanket ban on either "autistic people" or "people with autism" - accepting that both are valid descriptions that can be used in the article. I am happy to have learned more of the debate through this discussion, and believe it merits a reasonably prominent section on ==Classification==/===Terminology===.

::::::I also agree with {{U|WhatamIdoing}} that the appropriate language choice and whether to accept the essentialist view of "autistic" identities is not something to be dictated solely by self-identified surveys. The conclusions in all of the articles seems to be that there is no agreed upon perfect terminology - that a sizable minority strongly prefers person-first language - and that there is a preference in guidelines to adapt and choose depending on context. I think we must also accept that the types of surveys that we discuss above have a general limitation that by definition can't be avoided - in that they are mostly responded to by those who accept and identify as autistic.

::::::We must be mindful that autism stigma exists, and that the language choices we make can influence how different readers perceive the information that is given - and that readers of a high-level overview article like this one are likely to include a sizable number of people who do not (yet or who never will) accept identification. They will be less likely to (and may never) respond to such surveys. CFCF (talk) 10:48, 5 April 2025 (UTC)

:::::::Diagnostically, autism cannot be "self-identified". It requires the involvement of external assessors to prevent over- and under-diagnosis, and a diagnostician is also needed to determine its presence or absence. Therefore, surveys that rely entirely on self-report are problematic as they are not representative of the population they claim to assess. Self-identification also tends not to be based on impairment but merely traits of the disorder, which confounds the survey further because it's far more likely to be the people who are significantly impaired (as required for a diagnosis) to prefer person first language. Димитрий Улянов Иванов (talk) 17:22, 6 April 2025 (UTC)

::::::::Who told you that "significantly impaired" people use PFL?

::::::::Self diagnosis dose exist but I fell like you should still ask an expert afterwards, so maybe being self diagnosed is like being bi-curious, you will eventually figure it out. Anthony2106 (talk) 12:53, 7 April 2025 (UTC)

::::::::::{{U|Anthony2106}} - There is actually quite a bit of literature to support that statement. I'm not saying it is conclusive, but it's certainly not pulled out of nowhere. CFCF (talk) 17:28, 7 April 2025 (UTC)

:::::::::Being bi-curious isn't a diagnosis. GMG^talk 13:09, 7 April 2025 (UTC)

::::::::::But I was saying its common for people to first self diagnose first, then ask an expert. So maybe a self diagnosis is temporary. Isn't being bi-curious temporary? Anthony2106 (talk) 13:14, 7 April 2025 (UTC)

:::::::::::Being bi-curious isn't a diagnosis any more than self-diagnosing myself with being interested in rock music or wanting to try more Japanese food. Please don't normalize pathologies to the point where you pathologize normalcy. GMG^talk 13:19, 7 April 2025 (UTC)

::::::::::::I don't think self-diagnosis preceding medical diagnosis is as common as you take it {{U|Anthony2106}}. I would look forward to being proven otherwise, but it would seem to be a very specific subset of those who receive an autism diagnosis, and is certainly not common among children, who make up the majority of those diagnosed. Having a suspicion, or that people around one have a suspicion is not self-diagnosis. CFCF (talk) 17:37, 7 April 2025 (UTC)

:::Anyone writing about what the group or community or even themselves thinks wrt autism is already making an error. Those who can write articles or blogs or engage on Wikipedia are a subset of those with autism. The size of that subset has changed as autism has changed in scope. Our article currently says 40% are non verbal. I don't see what portion are unable to read or write, so there's something this article could mention. Such severely disabled people aren't writing blogs or responding to questionnaires or participating on Wikipedia. What their identity is is unknown and imposing the identity of a vocal activists upon them would be wrong. Imagine if you took the cliché of highly promiscuous gay men who parade with rainbow flags and assumed that's how everyone who is gay thinks and behaves. With lots of groups, there's a highly visible minority who get attention.

:::We think about deaf people and think of Rose Ayling-Ellis who was deaf from birth and who signs. Our thoughts about blind people are similarly cliched with ideas of people reading braille and needing a stick or a helping hand to get around. And then your cliched idea is bust with Chris McCausland who went blind aged 22, doesn't read braille but can learn to ballroom dance. Most people who are deaf or blind (or who's hearing or vision are seriously impaired) got that way from being old or illness. Someone who goes blind from their diabetes or onchocerciasis is not a happy member of a new identity group, but is extremely likely to be living in poverty, even in developed countries. The portion of people who are deaf or blind who proudly hold that identity is small, and yet we elevate that as some example of identity-first grouping. Your great gran who seldom leaves her home because she cannot see well enough, and has the TV blaring because she cannot hear well enough, finds these aspects of growing old just as shitty as their incontinence and their arthritis. Let's not pretend otherwise.

:::Questionnaires about identity self select for those who feel that identity is important to them. Countless others identify primarily as a mum or a dad or a teacher or a schoolchild, or just as a unique individual with a name who doesn't want to belong to any group and would like to be left alone to get on as best they can. They are not online filling in activist surveys. Filling in their PIP application is way way more important.

:::Wikipedia article like this are written about a general group meeting a diagnostic criteria, and we should be conscious that not all that group identify the same or even understand what identity even is. Similarly we do not know our audience is someone with autism, a parent or relative or friend of someone with autism, or just someone reading about it for knowledge. Just as we don't want our readers to think people with autism are savants like Rain Man, nor do we want readers to think people with autism is are all internet bloggers, Wikipedians or Chris Packham. -- Colin°^Talk 10:04, 25 April 2025 (UTC)

::::@Colin Of course a significant minority of autistic people is unable to communicate an own opinion on the matter but there is no obvious reason to believe that they would prefer person-first language other than an imposed narrative of autism as a problem. LogicalLens (talk) 10:17, 25 April 2025 (UTC)

:::::The entire concept that "they would prefer" is incorrect. If you have no language then being fussy about word order is irrelevant. In fact this whole argument is nonsense in some other European languages which just don't have the two variant orders we do.

:::::Person first makes no assumptions about identity and no assumptions about the attribute being good or bad. Everyone is a person and the attributes they have are always secondary to that. There isn't an "imposed narrative of autism as a problem" any more than "people with brown hair" has an imposed narrative of brown hair as a problem. It is the neutral form. I get that those advocating identity first are doing so to declare a narrative that autism is not a problem. It is the non-neutral form. It says that one is comfortable in that identity, proud even. Whereas people first says nothing. If talking to or writing about or for someone who wants to advocate that position, it is absolutely fine to adopt that form. But we are not generally doing that in Wikipedia medical articles.

:::::The identity first form came about in medicine when doctors reduced patients to their illness. Hence the response that a person is not their illness. The fact that identity first is often problematic doesn't imply that people first is always a response to a problematic identity first form.

:::::Let's leave identity first for when Wikipedia is writing about people we know have autism as an important and declared aspect of their identity. -- Colin°^Talk 18:43, 25 April 2025 (UTC)

::::::Person-first language is not more neutral than identity-first language. LogicalLens (talk) 00:08, 26 April 2025 (UTC)

::::::Perhaps we should stop thinking about "person first" and "identity first", and just use normal English grammar: "in English ... adjectives almost always go before nouns", eg "brown-haired person", "tall person", "autistic person". None of those adjectives are implied to be "good" or "bad" characteristics because they appear before the noun. They are descriptors not identifiers. Mitch Ames (talk) 01:27, 26 April 2025 (UTC)

:::::::Excellent point. In the vast majority of cases, person-first language is unnatural to those who speak, read or write English natively. The fact that some people will tie themselves in linguistic knots for no reason other than they've been told by a teacher or employer at some point in their lives it's "more respectful" when referring to the disabled community is irrelevant. As I said previously, brevity is something that should be valued here on Wikipedia. Anyone who wants to go out of their way to clog lengthy articles, like this one, with an endless parade of person-first (or euphemistic) language would probably be better off applying their editing expertise to less controversial topics. DoItFastDoItUrgent (talk) 02:49, 26 April 2025 (UTC)

::::::::Wikipedian's personal preferences for certain grammatical rules do not refute guidelines. CFCF (talk) 18:58, 7 May 2025 (UTC)

:::::::::@CFCF most people use identy first when mentioning autism, so its not just Wikipedians. Anthony2106 (talk) 02:35, 8 May 2025 (UTC)

::::::::::I don't think it's as clear-cut as that:

::::::::::* "autistic children": 6.4 million Ghits

::::::::::* "children with autism": 18.6 million Ghits

::::::::::* "autistic adults": 1.6 million Ghits

::::::::::* "adults with autism": 5.5 million Ghits

::::::::::* "autistic individuals": 2.6 million Ghits

::::::::::* "individuals with autism": 9.8 million Ghits

::::::::::* "autistic person": 1.7 million Ghits

::::::::::* "person with autism": 1.3 million Ghits

::::::::::I didn't check every possible variation (e.g., plural/singular; student/worker/girl/woman), and hopefully I didn't mix up any of the phrase/number pairings, but overall I'm seeing a mix of uses. WhatamIdoing (talk) 03:40, 8 May 2025 (UTC)

:::::::::::Okay so what happened last time? We used identity-first. What else is there to talk about? Anthony2106 (talk) 09:40, 8 May 2025 (UTC)

::::::::::::No, at the MOS discussion, we determined that "many" people prefer identity-first, and that many others – "most", in fact – don't.

::::::::::::The traditional compromise for this page has been to use a mix of language: "children with autism" and "autistic people" (but not "autistics"). I think the key thing to remember is that while some people (including most of the editors on this page) see autism as a core feature of their identity, this is not universally true. Toddlers don't have "an identity". People with very severe intellectual disabilities don't have "an identity". People with no language can't prefer one term over another. These groups cannot prefer "identity-first language".

::::::::::::There are also people with little interest in autism. As you said last autumn, people with no interest in their autism diagnosis tend not to care about which terms are used. There are also people who claim they're misdiagnosed ("I don't have autism; I just have ADHD") and won't accept any label (except maybe neurodivergent). WhatamIdoing (talk) 15:56, 8 May 2025 (UTC)

:::::::::::::What is autumn? But are lots of sources for identity-first when it comes to autism so that is probably what will be used. And that's pretty much all there is to say. Anthony2106 (talk) 16:20, 8 May 2025 (UTC)

:::::::::::::Why should person-first be the default for people who have no identity? I also agree with @Mitch Ames that adjectives are descriptors and not automatically identifiers.

:::::::::::::People who are not interested in autism do not often care about the language choice but that is an abstention that does not change the group preference. LogicalLens (talk) 00:57, 9 May 2025 (UTC)

::::::::::::::How to count abstentions varies by voting system. Sometimes abstentions are uncounted; other times, they're counted as 'no' votes. I've heard that our articles about voting systems are quite good, if anyone's interested in learning more.

::::::::::::::Person-first is the default for people with no identity because disability rights activists say that's the appropriate and least de-humanizing default. The general principle is: If you know nothing about the individual's personal preference, or if the person is so impaired as to be unable to have a preference, then start by recognizing that this individual is also a human. WhatamIdoing (talk) 04:49, 9 May 2025 (UTC)

:::::::::::::::While person-first language is generally preferred by many disability rights advocates, applying this preference to the autistic community without regard for its own stated norms is arbitrary. Numerous surveys and studies—while not without limitations—consistently show a preference among autistic people for identity-first language. Dismissing these findings may reflect personal discomfort with autistic identity more than a substantive critique of the data. It is worth noting that autistic individuals who do not have a strong preference typically accept both forms, and those who have limited understanding of language are not affected by terminology in the same way. If an individual prefers person-first language, that choice should be respected. However, as a general rule, identity-first language is widely recognized as the preferred standard within the autistic community itself. LogicalLens (talk) 10:24, 11 May 2025 (UTC)

::::::::::::::::I agree that those who have limited understanding of language are not directly affected by terminology, but they are indirectly affected by it. The historical record shows that the language affects how other (e.g., neurotypical, temporarily abled) people treat them.

::::::::::::::::It is true that autistic people with university degrees and a desire to advocate for autistic people mostly prefer identity-first language. But when we're talking about a three year old who is having an epic meltdown, it might be more important for everyone to remember that this is a little child. While you may want to celebrate autism as "difference, not disorder", that can easily result in othering, and being thought of as "different" is particularly risky for those who are most severely impaired. WhatamIdoing (talk) 21:00, 11 May 2025 (UTC)

:::::::::::::::::Regarding the concern about "difference" leading to othering: Othering comes not from acknowledging difference, but from devaluing it. We do not other people by recognizing that they are autistic; we other them by treating autism as something shameful or pitiable, which person-first language is associated with. By embracing identity-first language, we align with the voices of a growing majority of autistic adults — including those who were once that three-year-old child — who now say: "Autism is not something I carry. It is who I am." LogicalLens (talk) 05:44, 12 May 2025 (UTC)

::::::::::::::::::I have to strongly object to the assertion that person-first language is associated with treating something as shameful or pitiable. CFCF (talk) 07:50, 12 May 2025 (UTC)

:::::::::::::::::::@CFCF I referred to the view as a disorder, "shameful or pitiable" is indeed an inaccurate phrasing. The view of autistic people as disordered others them, which is associated with person-first language. LogicalLens (talk) 08:04, 12 May 2025 (UTC)

::::::::::::::::::::And no, disorder is not associated with person-first language, that assertion is false. Person-first language is solely associated with rejection of essentialism, and that some accept autism as an essential characteristic does not imply that all do, or that a non-essentialist view is othering. I know there are even those who prefer to call themselves autists [https://www.collinsdictionary.com/dictionary/english/autist] [https://www.merriam-webster.com/dictionary/autist], but this term is widely rejected. We are not making up negative views on person-first language based off personal preference, and the guidelines strongly favor that person-first, as well as identity-first language are allowed with regards to autism. CFCF (talk) 11:02, 12 May 2025 (UTC)

:::::::::::::::::::::This study says: "Considering autism to be a disorder was associated with preference for the term “doctors with autism,” and with having attempted suicide."[https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1160994/full] LogicalLens (talk) 01:30, 13 May 2025 (UTC)

::::::::::::::::::The antonyms for pity ("A feeling of sympathy at the misfortune or suffering of someone or something") are hard-heartedness and indifference. If you see a young child expressing how much they're suffering, do you honestly think that hard-heartedness and indifference are preferable to pity? I doubt it. "Autism" might not be "pitiable", but that overwhelmed child's experience certainly is. WhatamIdoing (talk) 17:37, 12 May 2025 (UTC)

:::::::::::::::::::Who recommended hard-heartedness and indifference for an autistic child who has a meltdown? LogicalLens (talk) 02:20, 13 May 2025 (UTC)

::::::::::::::::::::Possibly the person who said we shouldn't have pity on people with autism, though I doubt they meant it.

::::::::::::::::::::Consider:

::::::::::::::::::::* Don't treat "autism as something shameful or pitiable".

::::::::::::::::::::* Autism is "who I am".

::::::::::::::::::::* Don't pity me for being autistic. I don't want you to have feelings of sympathy over any autism-related suffering, such as when I'm overwhelmed and melting down.

::::::::::::::::::::If that's what you really want, then I'll try to accommodate you. But the alternative to feeling sympathy for your suffering is not celebrating your autism; it's being indifferent to your suffering. Do you really want people to be indifferent to the suffering of autistic people? If you don't, then maybe you do want to reconsider the value of pity. WhatamIdoing (talk) 17:19, 13 May 2025 (UTC)

:::::::::::::::::::::There is a difference between genuine empathy among equals and pity, which is condescending and patronizing (and thereby othering). See the Wikipedia articles on Models of disability and Piss On Pity and also these texts.[https://www.abc.net.au/rampup/articles/2013/07/11/3800619.htm][https://themighty.com/topic/multiple-sclerosis/patronizing-attitudes-towards-disabled-people/] LogicalLens (talk) 02:16, 14 May 2025 (UTC)

::::::::::::::::::::::Do you consider yourself to be the equal of a three year old? I don't. WhatamIdoing (talk) 05:18, 14 May 2025 (UTC)

::::::::::::::::@LogicalLens so why are we still talking? Anthony2106 (talk) 00:12, 13 May 2025 (UTC)

:::::::::::::::::Because some people think identity-first language leads to othering, although it is the other way around. LogicalLens (talk) 03:48, 13 May 2025 (UTC)

::::::::::::::::::No it's not. CFCF (talk) 08:01, 13 May 2025 (UTC)

:::::::::::::::::::Yes it is. Why do we gotta speak differently just because its a disability? Identity-first is used for everything else. Well not everything, but lots. Anthony2106 (talk) 13:38, 13 May 2025 (UTC)

:::::::::::::::::::If something is highly stigmatized, people who have that thing sometimes prefer person-first language as a means to distance themselves from the stigmatized feature. But autistic people, as multiple surveys cited several times here show, prefer identity-first language. This preference reflects a desire for full acceptance, not conditional inclusion based on separating the person from their neurology. Unfortunately, some professionals and non-disabled individuals struggle to grasp this perspective. They often believe they are being kind or respectful by using person-first language, without realizing it comes across as patronizing or dismissive of autistic voices. This reflects a broader issue: well-meaning but imposed forms of "kindness" can end up silencing the very people they intend to support. Respect means listening, especially when the community has made its preference clear. LogicalLens (talk) 03:24, 14 May 2025 (UTC)

::::::::::::::::::::This really isn't it. Many stigmatized conditions have seen movements to "reclaim language", back and forth. Autism is certainly not unique in this sense. The issue is rather that there are authoritative guidelines that say that using both types of language are appropriate, and should be done so contextually. The insistance of using only one is not neutral in the face of these guidelines, and may reflect a personal preference, but it is not what we abide by. CFCF (talk) 22:07, 14 May 2025 (UTC)

::::::::::::::::::Even though the consensus here seems to be to call it "identity-first", I disagree with the notion that putting a characteristic first means that it is an identity. What is true though is that in the wording "autistic person", the person between these quotation marks is essentially an idea of an NPC, with the only discernible characteristic being autism.

::::::::::::::::::I guess that it may be more problematic in mental descriptions than in other cases, as people ore often seen as being their mind, and defining it with a label may thus be seen as problematic. Ethnicities are for example especially nowadays seen as just being there, randomly and very separately from the person. In psychopathy, on the other hand, the person is a psychopath, which is someone many would see as inherently wicked and evil.

::::::::::::::::::Thus, mental diagnoses were in the past also put first, as in "schizophrenic person" or "anorexic person", regardless of their status as identities. There was subsequently a strong push to not define entire persons only by what they lack in terms of mental functioning, as the person can first of all be seen as merely a "person", but also as a "kind and talented person", who happens to have obtained a diagnosis of schizophrenia, for instance.

::::::::::::::::::However, in the case of autism, many "autistic people with autism" have decided that autism is in fact something they see as a major factor in who they are, and they also see it as something which should not be suppressed, but possibly even rather embraced. I would only guess that if autism were to be seen as something much worse, the tone would be different. BlockArranger (talk) 17:40, 13 May 2025 (UTC)

:::::::::::::::::::Yes, but putting an adjective before the noun does not mean it is the defining or main feature. I think if people say "white ball" they still consider the thing being a ball the main part and not the whiteness. LogicalLens (talk) 02:18, 14 May 2025 (UTC)

:::::::::::::::::::Indeed, 'identity-first' is the standard terminology, but I kind of wish it wasn't.

:::::::::::::::::::I prefer Janine Booth's framing, '[https://janinebooth.com/im-autistic-its-an-adjective-not-an-accessory/ I’m Autistic: It’s an Adjective not an Accessory]'. Oolong (talk) 13:36, 14 May 2025 (UTC)

:::::::@DoItFastDoItUrgent and @Mitch Ames, it would be an "excellent point" if it was in any way relevant. Nobody is arguing to write "person autistic". The form "person with autism" has autism as a noun, not an adjective. Both forms are standard English and frequency counts don't mean a whole lot other than to say both occur regularly.

:::::::I agree somewhat with 'we should stop thinking about "person first" and "identity first"' in that those terms have baggage. The historical baggage that doctors viewed their patients as illnesses on legs, or tumours in beds, and the reaction to that which says if we use a different word order, that mindset is diminished and we remember these are people first and foremost. And the reaction to that which comes from those advocating autism isn't a medical condition at all, who maybe should stop overthinking it.

:::::::Aside from that baggage, in English, prefacing with the adjective always has the effect of enforcing and dominating the adjective over the person. And it is one step along the path to "identity only" language, where a person or people group are reduced to their attribute. It is no coincidence that when people describe a group hatefully or dismissively, this always occurs. It loses force the other way around.

:::::::I remember a news story about using the term "The French" was nearly always wrong. Or something like that. Whenever you start saying "The French do X" or even "French people believe X" you are likely to be overstating the universality of that grouping doing or believing X. As soon as you put it the other way round, "People who are French believe X", it starts sounding a little ridiculous. You start thinking, so having the attribute "French" made all these people the same? Maybe not. So I think it is a healthy writing style to consider using, to keep being reminded that maybe your assertion isn't as universal as it appears.

:::::::Both forms appear in professional writing. It is probably a good idea that the article is fairly consistent. But neither form is completely wrong. Writing about autism very often falls into the trap of thinking about one group of people with autism, and over stating the views of activists. Many neurodevelopmental disorders have a huge amount written about children, because that's where the issues first appear and might be addressed, and are lacking in writing about adults in comparison. On the other hand, writing about adults with autism is dominated by highly capable activists, like Greta Thunberg. This article notes that a large number with autism do not develop language or speech in childhood. It says nothing more about their adult life. It would appear they don't exist. -- Colin°^Talk 11:29, 9 May 2025 (UTC)

::::::::{{tqq|Nobody is arguing to write "person autistic". The form "person with autism" [is] standard English}} {{mdash}} You are correct, but the second paragraph of WP:MOS says "write articles using straightforward, succinct ... language". Why use three words ("person with autism") when two words ("autistic person") more succinctly denotes exactly the same thing? Mitch Ames (talk) 12:06, 9 May 2025 (UTC)

:::::::::If that's your rule, why not "autists" everywhere. And on the epilepsy article, we'll refer to those with the condition as "epileptics". Why use two words when one will do. In case it isn't clear, I am not proposing that at all.

:::::::::The arguments on both sides clearly disagree with your claim that they "denote[] exactly the same thing". We do not, ever, in professional respectful prose, refer to people with epilepsy as "epileptics" or "epileptic people" despite those being more concise than "people with epilepsy". So clearly people's feelings on how to identify our fellow human beings is more important that word count.

:::::::::As I noted above in my comments on our imagination of people groups, when one writes "deaf people" or "the deaf" then one immediately assumes a certain group with that identity, and it turns out that group is a small minority of "people who are deaf" or "people with significant hearing impairment" or however else you might define it. Naturally, autistic activists and many autistic writers (see what I did there) will be writing about and for their identity group. But that group isn't "all people with autism". Which is what this article is about. Maybe if we had an article on autistic Wikipedians or autistic bloggers, identity first language would be entirely in scope. -- Colin°^Talk 17:15, 9 May 2025 (UTC)

:::::::::Correct, @Mitch Ames. If we were to accept the argument that both forms of language are value-neutral (which I personally don't), then there would be no reason to default to person-first language or go out of our way to "balance" articles by using both person-first and identity-first language, as that would make said articles unnecessarily long and clunky.

:::::::::The long and short of the formal arguments made on this talk page in favor of always or sometimes using person-first language appear to be either that the autistic neurotype is a terrible, horrible, no good, very bad thing that should be spoken about as such (which is a nakedly ableist argument that weakly attempts to relitigate the previously reached site-wide consensus) or that we should default to language traditionally used in medical literature (which ignores the fact that Wikipedia is not a medical journal and is tailored to a general audience).

:::::::::There also appears to be a rather sinister third argument being made by some here that identity-first language being a majority preference amongst the Autistic community and certain other disabled groups (e.g., the Deaf and Blind) is an illusion promoted by a loud minority. This ignores the fact that many people traditionally deemed incapable of expressing an opinion can do so via alternative means of communication. This also promotes the wildly ableist idea that all input from the Autistic community is invalid, because (in the opinion of some) one is either not disabled enough or too disabled to have a valid opinion, and, thus, we should just defer to caregivers and medical experts on all matters. It's the polar opposite view of "nothing about us without us" and treats all Autistic people as voiceless children incapable of any measure of self-determination, a viewpoint that I do not believe it's controversial to state that Wikipedia should not embrace or even tolerate. DoItFastDoItUrgent (talk) 17:55, 9 May 2025 (UTC)

::::::::::Nobody has said that {{!xt|all input from the Autistic community is invalid}}. People have said that [https://onlinelibrary.wiley.com/doi/full/10.1002/aur.2886 a survey such of this one], of a hopelessly non-representative group of people (e.g., 170% as many university graduates as expected for autistic adults), in which only 40% of the self-identified autistic respondents say that "autistic person" is their first choice, is not proof that a mathematical majority prefers "autistic person". WhatamIdoing (talk) 19:36, 9 May 2025 (UTC)

:::::::::::Sure, nobody has said that all input from the Autistic community is invalid, but it's hardly as if that survey is the only line of evidence towards the widely held conclusion that most autistic people with a preference prefer identity-first language, is it? There are many surveys that almost all point in the same direction, as well as statements from autistic-led organisations and so on.

:::::::::::What reason is there to think that all of these surveys, studies etc., taken collectively, fail to pick up on a hidden community preference that runs counter to their conclusions? Oolong (talk) 13:41, 14 May 2025 (UTC)

::::::::::::The question isn't whether the surveys are failing to pick up on a hidden community preference.

::::::::::::The question is whether "first choice for only 40% of a biased sample" should be understood as "most autistic people", or even "most autistic people with a preference".

::::::::::::Imagine that someone ran a similar survey in "the cancer community". The survey starts by excluding almost everyone with the most common type of cancer (i.e., non-melanoma skin cancers), and inadvertently excluded people who have the condition but either aren't diagnosed or it's so clinically insignificant that they don't think of themselves as being part of that community (e.g., a majority of people with prostate and thyroid cancers). For practical reasons, they received almost no responses from people who were very ill or dying. They specially sought out women who self-identify as having survived breast cancer through breast cancer advocacy and fundraising groups.

::::::::::::Imagine that this survey of a biased sample set found that 40% choose "cancer survivor" as their first choice, and that they thought "cancer dier" was always offensive and wrong. Would you say that "most" people affected by cancer prefer cancer survivor and that all Wikipedia articles should use only this language?

::::::::::::Or would you first say something like, "Wait, just how many people were excluded from this survey?"

::::::::::::When I look at the surveys about language preferences, I see a lot of stakeholders being excluded, and even among the people who are included, I see a lot of language choices that are acceptable. But somehow that diversity gets simplified down to people saying that there is only one acceptable choice. I would rather have this article reflect the diversity of choices. WhatamIdoing (talk) 17:20, 14 May 2025 (UTC)

:::::::::::::Precisely. CFCF (talk) 22:08, 14 May 2025 (UTC)

:::::::::::::{{tq|"They specially sought out women who self-identify as having survived breast cancer through breast cancer advocacy and fundraising groups."}} This is a very inaccurate comparison. Those who prefer identity-first language have not “survived” autism and autistic adults can get meltdowns too. To combine this with my answer to your other comment where you asked whether I consider myself the equal of a three-year old child: By “equals” I meant accepting autistic people as equals alongside non-autistic people and autistic children alongside non-autistic children.

:::::::::::::A possible solution for the dispute is to settle for "autistic person" and "child on the autism spectrum". The latter is person-first ("child" comes before "autism") but is less polarizing. LogicalLens (talk) 04:48, 15 May 2025 (UTC)

::::::::::::::I think that having some variety in the language, and preferring "child-first" (but not necessarily "adult-first") is appropriate.

::::::::::::::(I think that comparison is very apt, since some of these surveys recruited from autism advocacy and fundraising groups that publicly promote identity-first language for people on the autism spectrum, just like some cancer groups publicly promote the use of the word survivor for people who have/had cancer.) WhatamIdoing (talk) 17:52, 15 May 2025 (UTC)

::::::::::When I find that nearly every sentence someone writes is misconstruing what other editors have written, particularly when done to paint them in a "sinister" light, it isn't productive to continue. -- Colin°^Talk 09:44, 14 May 2025 (UTC)

:::::::::::It would be most unfortunate if the end-product is that painting the views of others as "sinister" wins? How would one solve that? CFCF (talk) 22:10, 14 May 2025 (UTC)

::::::The idea that “person-first” language is neutral doesn’t hold up linguistically or politically. Language always encodes narrative. In this case, “person with autism” reflects a clinical distancing convention rooted in models that treated autism as something to be separated from the self.

::::::Comparing it to “person with brown hair” is a false equivalence. Brown hair hasn’t been pathologized, institutionalized, or used to justify exclusion. Autism has. To claim they carry equal semantic weight is to ignore both context and history.

::::::Identity-first language is not a casual preference—it’s an epistemic stance. It arose because autistic people were consistently spoken over, corrected, or redefined by external authorities.

::::::More importantly, defaulting to person-first language across this article perpetuates the very imbalance it has been flagged for. If the goal is neutrality, then the article must reflect the diversity of linguistic and epistemic positions within the autistic community—not erase one in favor of institutional comfort.

::::::Wikipedia’s tone guidelines support clarity, not erasure. If we respect self-identification in other domains, we should do the same here—especially when writing about autistic people, not just about autism.

::::::Recursiva (talk) 08:00, 7 May 2025 (UTC)

:::::::None of this is relevant, the guidelines say what the guidelines say - and your personal preference is irrelevant. As much as person-first stems from one ideological view, so does identity-first language - and the guidelines are not in favor of prescribing only identity-first language, frankly they reject it.

:::::::Please stop trying to push your personal arguments and rationales as something that is immutable. There are different views on this, and yours are not the only ones that are correct. CFCF (talk) 18:56, 7 May 2025 (UTC)

:::::::{{tqq|Brown hair hasn’t been ... used to justify exclusion}} {{mdash}} "Blonde versus brunette rivalry" says that it has. Mitch Ames (talk) 12:13, 9 May 2025 (UTC)

::::::::Not really. People with disabilities are literally excluded by force from some places: Sorry, your wheelchair can't go on this trail. Sorry, your child isn't allowed in this classroom. Sorry, he is too old to play at this playground.

::::::::By comparison, the modern tropes about women's hair color are mostly fictional rather than real life, and they can usually be summed up in a single sexist question: "Will the man pick the blonde or the brunette?" WhatamIdoing (talk) 17:40, 9 May 2025 (UTC)

{{collapse top|title=Ad hominem}}

While reading through this talk page, I noticed some persistent patterns in the arguments advanced by WhatamIdoing and CFCF that deserve explicit clarification:

The claim by WhatamIdoing that “there’s no scientific law” granting autistic people authority to describe their own condition misrepresents both policy and ethics. Wikipedia does not require metaphysical consensus—it asks for verifiable, relevant perspectives. Framing this as a matter of abstract philosophy sidesteps the real issue: epistemic exclusion.

CFCF repeatedly casts doubt on survey data showing identity-first language preference by arguing that self-identified autistic respondents are inherently biased or unrepresentative. But that logic would discredit nearly all identity-based community data. Invoking the absence of non-verbal voices to dismiss the stated preferences of verbal ones is not neutral. It’s rhetorical erasure.

Both editors suggest that person-first language is somehow more objective or “neutral,” despite WP:LABEL and the Manual of Style explicitly advising deference to group preference where it exists. The refusal to apply that guidance in this case doesn’t reflect policy—it reflects discomfort with the perspective itself.

None of this amounts to a legitimate, policy-based reason to resist a clearly sourced, proportionate sentence in the lead. These objections have circulated in various forms for years, but repetition is not validation. They remain arguments—not consensus, and not policy.

Autism may not be the loudest voice in this thread, but it’s the one actually following the argument.Recursiva (talk) 04:07, 7 May 2025 (UTC)

:{{U|Recursiva}} - You are being WP:TENDITIOUS, mischaracterizing other's views, and frankly actively lying if you state that others are not following arguments. Please stop it, it does not strengthen your position, and you are not discussing any of the points raised above, beyond saying that others are wrong without clarification. CFCF (talk) 18:51, 7 May 2025 (UTC)

::@CFCF

::Worthwhile to clarify what WP:TENDENTIOUS actually means.

::It applies to patterns of editing that:

::* Reject consensus without policy basis,

::* Repeatedly ignore counter-evidence,

::* Refuse to engage good-faith arguments.

::That doesn’t describe my conduct — but it increasingly maps onto your own pattern of engagement.

::I’ve cited multiple Wikipedia policies (WP:NPOV, WP:DUE, WP:VERIFY, WP:CONSENSUS) in nearly every post.

::I’ve directly responded to points raised — including yours.

::I’ve grounded arguments in peer-reviewed sources, official guidelines, and recent studies.

::Meanwhile, you’ve:

::* Framed sourced positions as “personal preference,”

::* Dismissed survey data from the autistic community as biased,

::* Resisted proportionate inclusion of a documented viewpoint already present in the article body,

::* And now resorted to labeling policy-aligned critique as "tendentious."

::

::That’s not a defense of neutrality. It is deploying rhetorics instead of argument.

::Strong disagreement is not tendentiousness.

::Following policy to challenge legacy bias is not disruption.

::And suggesting that autistic contributors are “lying” for advancing sourced arguments is a far more serious breach of WP:CIVIL than anything you’ve accused me of.

::This is not personal, it is procedural.

::You don’t have to agree with me. But if you want to invoke policy, you need to follow it.

::Recursiva (talk) 03:42, 8 May 2025 (UTC)

:::Recursiva, I think you will find this conversation will become more productive if you focus on winning friends and influencing people. Declaring that you're right and everyone who has a different view is wrong is not helpful. Acting like you're the only autistic person here (or one of few) is not helpful. A majority of editors in this thread are autistic, and you've treated some of them poorly – as if you are trying to teach your grandmother how to suck eggs (or mansplaining, for the modern slang). The other people in this discussion know more about Wikipedia and its rules than you.

:::We haven't formed a consensus about when and how to use which language options. This needs open discussion, flexibility, compromise, and tolerance. It does not need you throwing around WP:UPPERCASE shortcuts or being mean to other editors. WhatamIdoing (talk) 04:06, 8 May 2025 (UTC)

::::Appreciate the advice, @WhatamIdoing. For the record—my shelves tilt Machiavelli, not Carnegie. Less Win Friends, more reshape consensus. The Prince sits right next to Neuroqueer Heresies and a few outlawed fairytales annotated in WP:NPOV ink.

::::

::::So kindly leave grandma out of the metaphor.

::::Pop culture references will do.

::::I’m not here to suck eggs or settle old scores.

::::I’m here for friction, not correction—

::::Not WP:REHASH or softened deflection.

::::I cite from deep stacks, not just PubMed stats.

::::From policy—not paternal projection.

::::All the world’s a page, and some of us just edit better—

::::like Shakespeare, but with sources from science.

::::Please don’t file for moderation protection. I’m not going to.

::::Plurality ≠ division. It means documentation. See: WP:DUE.

::::

::::The name’s Recursiva—not Reclusiva.

::::Catch me where the footnotes flirt and the paradigms shift.

::::Recursiva (talk) 07:28, 8 May 2025 (UTC)

:::::If you're here for friction, then you're WP:NOTHERE for Wikipedia, and I suggest that you quit. WhatamIdoing (talk) 15:59, 8 May 2025 (UTC)

::::::Says the editor who once told an autistic contributor to go "get social skills". Then cited WP:NOTHERE when I cited policy. Recursiva (talk) 16:12, 8 May 2025 (UTC) 16:06, 8 May 2025 (UTC)

:::::::If you want to accuse editors of being rude, then you should provide a link, so people know that you haven't made it up, misremembered it, or selectively quoted it. [https://en.wikipedia.org/w/index.php?search=%22get+social+skills%22+whatamIdoing&title=Special%3ASearch&profile=advanced&fulltext=1&ns0=1&ns1=1&ns2=1&ns3=1&ns4=1&ns5=1&ns6=1&ns7=1&ns8=1&ns9=1&ns10=1&ns11=1&ns12=1&ns13=1&ns14=1&ns15=1&ns100=1&ns101=1&ns118=1&ns119=1&ns126=1&ns127=1&ns710=1&ns711=1&ns828=1&ns829=1&ns1728=1&ns1729=1 This search] shows that I've never said that.

:::::::Is this not your first account? WhatamIdoing (talk) 16:34, 8 May 2025 (UTC)

{{collapse bottom}}

::::{{tqq|A majority of editors in this thread are autistic}} {{mdash}} citation needed. Mitch Ames (talk) 14:12, 9 May 2025 (UTC)

:::::You can look through their contributions if you want to find the diffs. There are only 11 of us in this discussion, so it shouldn't take you very long, and most of the ones who have publicly self-identified have even done so on this talk page. WhatamIdoing (talk) 16:58, 9 May 2025 (UTC)

::::::I'm gonna unsub from this because person first will never win for this page. Anthony2106 (talk) 12:38, 11 May 2025 (UTC)

:::::::Sure, but neither will identity first - and since it was pointed out that guidelines recommend using both as appropriate, no one has suggested using person first language exclusively. CFCF (talk) 15:51, 11 May 2025 (UTC)

::::::::Well look at the page. What does it use? Anthony2106 (talk) 13:39, 13 May 2025 (UTC)

:::::::::That is a circular nonsense argument, and the willful removal of all person-first language was what prompted this discussion. @Anthony2106: WP:TROUT CFCF (talk) 07:04, 14 May 2025 (UTC)

Despite the gridlock that has made progress so difficult on this entry, I am hopeful that progress can occur with a bit of clarity about what a neurodiversity approach actually means, and where it sits with respect to contemporary autism research, practice and communities.

In the hopes of getting past certain sticking points, I am going to lay out some basic facts which I believe we can establish beyond reasonable doubt, based on reliable sources. I will follow this with my thoughts on where we could go next with this entry. I'm afraid this is pretty long, largely because there are a number of objectively difficult questions at stake.

1. The neurodiversity perspective does not contradict any scientific consensus. I wrote about the relationship between [https://oolong.medium.com/neurodiversity-and-science-41fc303a1782 neurodiversity and science here] following earlier Wikipedia discussions, but in short, there are two main reasons for this:
2. Whether autism (or similar) is best viewed as a disorder or a healthy aspect of human diversity is not primarily a scientific question. It is a question with political, philosophical, scientific and practical dimensions & implications. Nearly all scientists would agree that unprovoked killing is wrong, but that doesn't constitute a scientific consensus, because the ethical status of murder is not a scientific question.
3. There is no consensus among researchers (including among relevant scientists) regarding the key positions associated with the neurodiversity approach. They are hotly debated in the literature, with many prominent autism researchers speaking out in their favour (including, incidentally, a strong majority of autistic autism researchers) and multiple journals explicitly coming down on the neuro-affirming side of the debate.
4. Key positions associated with neurodiversity include:

{{ordered list|Autism is a healthy part of the variability of human experience and the ways people process information.|Curing or preventing autism, if it were ever to become possible, is likely to be undesirable.|Making autistic people as much like non-autistic people as possible is also unhelpful.|It is worth pursuing autistic thriving.|The degree to which autistic people are disabled depends heavily on their social and physical environments.|Autistic people often have considerable insight into autism, and should be listened to about it.

| type = lower-alpha

}}

{{ordered list|Of the above, a (which largely defines neurodiversity) remains controversial; b is largely a moot point, given what we now know about the genetics of autism, but we do have survey-based evidence that most autistic people would not want to be cured, if that ever came up. Certainly, many autistic people would not. c is much more immediately relevant, and backed up by extensive research on the harms of masking (i.e. hiding the things that might make someone be seen as autistic, or just 'not normal'). d might sound uncontroversial, but is in tension with psychiatric orthodoxy, which only grants a label of 'autism' in case of considerable suffering. Notably, there is substantial research on the relationship between autistic wellbeing and positive autistic identity, and the harms of stigmatisation. e is sometimes referred to as the social model of disability, and in this weak form, at least, is quite clearly correct.  f is something that seems obvious to many people, but is in any case backed up by evidence on the value of autistic-led autism training, studies directly looking at autistic insight into autism, and various scientists and others writing about how much they have learned by listening to autistic people about autism.

| 2 = The prominence and acceptance of the neurodiversity approach has increased hugely in recent years. Many autism scientists are now talking about it. [https://doi.org/10.1089/aut.2023.0030 Something like 30% of relevant scientific papers use neurodiversity-affirming language]; this number is certainly growing, but again, these are not primarily scientific questions - just questions of great relevance to scientists.

It is also relevant that most of the [https://www.amazon.co.uk/s?k=autism&i=stripbooks&s=exact-aware-popularity-rank&crid=2P4842RBWIWS0&qid=1744033902&sprefix=autism%2Cstripbooks%2C161&ref=sr_st_exact-aware-popularity-rank&ds=v1%3Ai2xfp24Ks%2FWzlWSQ%2F9PjPUSs%2BiB0ak0YvvRhiZvyDik books people are buying about autism], from respected publishers, take a broadly neurodiversity-affirming approach; that governments and other relevant authorities (in health and education, for example) are increasingly taking these perspectives on board (although many do not); and that among autistic people and stakeholders such as family members and professionals, in the English-speaking world, [https://journals.sagepub.com/doi/full/10.1177/13623613241273029 the basic claims and goals associated with neurodiversity are widely accepted] (though not universal).

| start = 3

}}

To give a flavour of that ongoing shift, just in the week or so since the RfCs on this page ran their course, we have seen the [https://www.un.org/en/observances/autism-day UN run their World Autism Awareness Day event with the Institute of Neurodiversity] (on the theme of neurodiversity and the UN's Sustainable Development Goals), and [https://books.google.co.uk/books?hl=en&lr=&id=jGQgEQAAQBAJ&oi=fnd&pg=PP1&ots=Yj9pVIHzhR&sig=o49ktK0JrapM4WcNS108c32rorM&redir_esc=y#v=onepage&q&f=false The Neurodiversity Affirmative Child Autism Assessment Handbook] has become available to pre-order.

First, if we have one central article on autism, it must give due weight to these perspectives. That probably doesn't mean equal weight, but right now, something like 90% of the Autism entry is written from a medical/biomedical perspective. That is clearly not justified by the balance of relevant, reliable sources; it certainly doesn't reflect the views of leading scholars on the nature of autism, either.

In order to fairly represent mainstream understandings of autism, we can either rebalance this entry, or split it: we could have one entry on autism as a medical concept (i.e. Autism Spectrum Disorder) and a separate article on autistic people - or, to put it another way, on autism as a way that some human beings are different from others.

We do have models of how this kind of thing can work in practice, from other categories of difference where medicalised and non-medicalised approaches are both important. Wikipedia has one entry on being trans, for example, and another on gender dysphoria, which is the medical diagnosis associated with being trans (replacing 'Gender Identity Disorder'). It also has a short entry on deafness, which links to both hearing loss and Deaf culture. I remain unsure whether a split of this sort would be the best approach, but I do see it as the only defensible alternative to substantially refocusing and restructuring this entry.

Some of the objections to changing the focus of this entry were based on the fact that autism is a medical condition - which it is, of course, in the sense that it is included in diagnostic manuals and largely diagnosed by medical professionals; but it is [https://www.autismnetworkinternational.org/dont_mourn.html much more than that]. Autism is something that pervades autistic people's beings, shaping how we experience the world at every level. It is not a disease, and does not fit most definitions of 'disorder'. From what I can gather, most autistic people never see medical professionals about their autism at all, outside of the diagnostic process (80% of 120 respondents to [https://autistics.life/@Ferrous/114290318766609721 this poll] said they had never done so; it may be somewhat more common among those with high support needs, but only about a third of autistic people are now thought to have co-existing learning disabilities). There is, of course, some fuzziness around the boundaries of what counts as a medical professional, and what counts as part of autism.

Acknowledging the limitations of the medical perspective - and the fact that many autistic people, scientists and relevant professionals see it as a healthy aspect of human diversity - does not mean glossing over how difficult life often is for autistic people. However, it does mean thinking carefully about how we use language, and about what sort of thing we include.

Ask yourself: when someone looks up autism, what sort of thing are they likely to want to know about it? What sort of thing might it be helpful for them to know? Is there anything it might be unhelpful for them to read?

For reference, the existing entry spends more than 1000 words on classification, more than 3000 on 'signs and symptoms' or 'common characteristics', 2400 or so words on 'causes' (even though this has its own entry), almost 1000 on 'correlations and comorbidities' (which also has a separate entry), 800 or so words on 'epidemiology' (although this, too, has its own entry) and 2000+ words on 'management'. It adds up to more than 8,000 words before the entry even starts to try to address the question of what might be helpful for autistic people, their families or people working with them, leaving aside a few words in the lead, and maybe a couple of scattered comments along the way. There is also remarkably little on what it means to be autistic

Who is this for? Do we think people are more likely to come here with an academic interest in autism science than they are to come here because they know people who are (or might be) autistic? Surely not?

There are some difficult questions about how to improve this entry, but also some changes which should not be controversial at all, at least in outline.

Clearly we need summaries, but no more than that, on things which have their own entries: causes; co-occurring conditions; epidemiology; and history.

I would argue, as many autistic people do, that [https://oolong.medium.com/autism-symptoms-are-no-such-thing-fa94c0e97b9a 'symptoms' is at best an extremely misleading term, and worst, totally inappropriate], beyond describing the diagnostic criteria (which are also described in both 'classification' and 'diagnosis'). The 'signs and symptoms' section largely describes a mix of coping strategies, difficulties caused by inaccessible environments, and things which are not inherently negative.

It also omits many extremely common autistic experiences, which are important for anyone interested in autism to understand, such as meltdowns and sensory overload. In common with quite a few of the things that are mentioned, these may or may not be considered in the diagnostic process, which makes 'common characteristics' or perhaps 'common experiences' a more accurate heading. WP:MEDORDER has just 'characteristics', but is clear that its headings are just suggestions.

Causes and physiology are highly technical topics, of little relevance to most readers, and the science on these is, in any case, extremely inconclusive. There is no reason that these should appear in the article before a section on supporting autistic people, but if they were appropriately short summaries, their placement would be less important than it is now.

I would suggest fully replacing 'management' with 'support', and moving this immediately after 'common characteristics'. Symptoms might be managed; people need support. This is a huge topic, taking in parenting, education, workplaces, community and healthcare, as well as therapies of various sorts and also disability aids. We will therefore want numerous subsections.

The 'prognosis' section is about the right length, but it's a mess.

The 'society and culture' section should also be reduced to a summary of the points that are of widest interest, given the societal and cultural aspects of autism entry exists; but the place of autistic people in society is something that should inform many other parts of this article, as you would expect in any article about a minority group.

Alternatively, we could have an article that is only about autism as a medical thing, as seen by psychiatrists and similar. My suggestion would be to file this under Autism Spectrum Disorder, and have 'autism' cover the broader view of autistic people's existence - similar to the gender dysphoria/trans split. Alternatively, we could have a short 'autism' article, giving a balanced account of the different perspectives, similar to the 'deafness' entry. We could then have a new entry titled something 'autistic people' (or possibly just 'autistic'? 'being autistic'?) setting out to cover what autism actually means in human terms: common experiences, the place of autistic people in society, education, work, families, and so on. Oolong (talk) 14:18, 7 April 2025 (UTC)

:Oppose - This sledgehammer approach is not likely to lead to anything positive. Pick out relevant issues and build consensus iteratively. CFCF (talk) 17:25, 7 April 2025 (UTC)

::If we can get past reflexive opposition to iterative improvements, based on misconceptions, we can absolutely do that. This was always very much my preferred approach. Oolong (talk) 07:13, 11 April 2025 (UTC)

:Oolong, does anyone actually believe that "pursuing autistic thriving" (2d) is an unworthy goal? NB that I'm looking for a reliable source that says nobody should care about this. I am not looking for a reliable source that sort of implies it by saying society should (for example) put more effort into improving diagnosis or into discovering why "normal human variation" is associated with neurotoxic pollutants, even if we interpret that preference for their "Goal A", in purely practical terms, as resulting in fewer potential resources being available for other goals (including, but not limited to, autistic thriving). WhatamIdoing (talk) 20:00, 7 April 2025 (UTC)

::I ask this because you say there is no consensus about this, and I've literally never seen anyone – not even an ignorant nasty person on the internet – saying that they wished autistic people weren't thriving. WhatamIdoing (talk) 20:22, 7 April 2025 (UTC)

:::{{tps|w}} This is from my personal experience, so it's certainly not universal, but I've had someone say to me that I should have been aborted because I was autistic. I have certainly met horrible people that would love to wipe autistic people (and neurodivergent people in general) off the face of the earth. Bowler the Carmine | talk 16:32, 8 April 2025 (UTC)

::As I say, it might seem obvious, but it's in tension with psychiatric orthodoxy. If an autistic person thrives too much, we cease to meet the diagnostic criteria. Many people, in practice, are denied a diagnosis because a clinician doesn't think they meet the threshold for 'functional impairment'.

::See Robert Chapman and Havi Carel, [https://research-information.bris.ac.uk/en/publications/neurodiversity-epistemic-injustice-and-the-good-human-life Neurodiversity, epistemic injustice, and the good human life].

::"Here we build on the neurodiversity perspective by arguing that autistic thriving has been rendered both invisible and unthinkable by interlocking forms of testimonial and hermeneutical injustice. On the view we propose, rather than autism being at odds with the possibility of living a good life as such, We argue that our mainstream conceptions of the good life have excluded autistic manifestations of happiness and flourishing. This leads to an epistemic catch-22-like paradoxical situation whereby one can be recognised as autistic or as thriving, but not both." Oolong (talk) 07:18, 11 April 2025 (UTC)

:::So the model here would be "If you're not unhappy about your experience of the world, you can't be autistic", to be compared against "If you're not unhappy about your gender, you can't be trans"?

:::I obviously oversimplify, but it seems to me that this is just another way of saying nobody knows what autism is. If you define autism as people who are not thriving, then thriving people can't have it. It's not that "our mainstream conceptions of the good life have excluded autistic manifestations"; it's that our conception of autism requires the existence of problems that need clinical attention. If you instead defined autism as people with a brain structure of ____ or people with a genetic situation of ____, then you could have people with autism and no problems. But you'd have to agree on what autism actually is first. (For myself, I suspect we will eventually agree that autism is a bunch of different things – neurobehavioral complications of autoimmune disease for this person, neurobehavioral complications of a viral disease for that person, result of neurotoxic pollution for the next person, and so forth.) WhatamIdoing (talk) 18:07, 11 April 2025 (UTC)

::::This is at least partially true, but doesn't really address the point at hand.

::::Someone doesn't stop being autistic when they find themselves in a situation where their traits are fully accommodated and they are capable of thriving - the fact that the diagnostic criteria suggest otherwise is something that many people would take issue with, if they ever stop to consider it.

::::Autistic thriving is possible, and worth pursuing. That is something that, for example, autistic people and family members need to hear; it was a radical suggestion 30-odd years ago, when autism was widely viewed as an awful tragedy for everyone. It is much less likely to be seen as radical now, but it is still something that we should be talking about; more particularly, what does it take for autistic people to thrive, and what are the barriers to doing so? Oolong (talk) 16:46, 21 April 2025 (UTC)

• First steps...Stop posting suggestions that are 2,000 words long. Has the 50-100k words already spilt on this not taught anyone anything? Pick a specific issue. Make a specific suggestion. Make your pitch in a format that someone can read in under a cigarette. GMG^talk 20:11, 7 April 2025 (UTC)
• :How about this for a short summary?
• :"The Wikipedia article that is at the title Autism should represent my POV, and if necessary, other POVs should be shunted to a separate article."
• :I have suggested on another page that Autistic identity or Autism as an identity might be the appropriate place for an article dedicated to this POV. WhatamIdoing (talk) 20:25, 7 April 2025 (UTC)
• ::I'm not sure a POV fork is really helpful. But if you think it'll survive AfD, make whatever article you want. Whatever this is from OP, is not helpful. GMG^talk 00:25, 8 April 2025 (UTC)
• ::A separate "autistic identity" article has the same problem that you think @Oolong's suggestion has: The main autism article reflects the views of proponents of the medical model and other viewpoints are shunted to a different article. An article “autistic identity” could be created and filled with information on identity and autistic communities, but I don't think this would resolve the conflict around the main autism article.
• ::The question regarding the POV fork is whether the editors who disagree with the proposed changes would accept that the current autism article is unbalanced towards medical information but are hesitant to shorten the medical sections because they consider the information important. Then this would be an article spinoff (WP:SPINOFF). But if these editors think the balance in the current version of the article is adequate and we just want to avoid our conflict, then it would be a forbidden POV fork, if I understand the guidelines correctly and if @FactOrOpinion is wrong in arguing that we are talking about different things. The category of autism contains articles for different diagnoses such as Asperger’s, “pervasive developmental disorder” and others but none called “autism spectrum disorder”. So it could also be argued that it is the lack of such an article that creates an undue weight problem here in the autism article.
• ::On the other hand, the amount of medical information could be reduced by following @Oolong's suggestion because it is generally recommended to reduce sections to summary length for which separate articles exist. This would solve a significant part of the undue weight problem, along with inserting some of the more recent research. The other major part is the language. But the other editors who said it is better to discuss individual issues rather than an overarching strategy are also right. Therefore, I start with two proposals.
• ::WP:MEDORDER lists as suggestions either “Signs and Symptoms” or “Characteristics”. So, the latter can even be used following the medical model. This guide does not specifically suggest “Common characteristics”, but the heterogeneity of autism could justify this.
• ::We could change “management” to “interventions and supports”. “Interventions” is used by both medical model and neurodiversity proponents and medical model supporters would not deny that autistic people need supports outside the medical realm.
• ::From my understanding, some editors who disagree with the changes are not aware that diseases and disorders are social constructs and take the framing of “clinically significant impairment” and the underlying norm of what humans should be like as a fact without truly understanding that exactly this concept is under debate. LogicalLens (talk) 04:20, 10 April 2025 (UTC)
• :::Two points in response:
• :::* I am not opposed to shifting language towards a less disease-centric model - for instance I shifted comorbid across the entire article to co-occurring. Sure, it might be taken to be slightly more clunky, but the central point here is that it is precise, and the terms are direct synonyms. If you look to replace "signs and symptoms" with characteristics, these are not directly synonymous to "characteristics". The problem is that signs are distinct from symptoms - and to establish a suspicion of autism among children - signs are among the most important part of this. This is precisely why adjustments need to be discussed on a case by case basis.
• :::* The suggestion that there is a lack of awareness that diagnoses are social constructs is most certainly false - and there is nothing to support that assertion among editors who oppose large-scale changes here. This relativism is unlikely to serve anything but to muddy the waters and is not a valid argument. The fact remains that for the vast majority of readers, the medical diagnosis of autism will be what they are looking for in this article. We should adapt to accommodate neurodiversity and interest group perspectives, but not if this risks harming what the majority of first time readers will be looking for or creating confusion.
• :::CFCF (talk) 07:41, 10 April 2025 (UTC)
• ::::"The fact remains that for the vast majority of readers, the medical diagnosis of autism will be what they are looking for in this article."
• ::::Is it? How do you know?
• ::::If I was looking for a specifically medical perspective on something, I'd probably go to a specifically medical site... but again, even such sites, for example [https://www.nhs.uk/conditions/autism/what-is-autism/ the National Health Service] and the [https://my.clevelandclinic.org/health/articles/autism Cleveland Clinic] - often go for far less medicalised framings than we have here on Wikipedia, a general encyclopaedia.
• ::::I think this is probably because they figure people looking up autism mostly just want to understand what autism is? Oolong (talk) 07:29, 11 April 2025 (UTC)
• :::::Oolong - Thank you for this. Cleveland Clinic is my go-to site for basic medical info, but I had not read their [https://my.clevelandclinic.org/health/articles/autism Autism] article. It's worth reading, especially for others like me who lean toward the biomedical approach, to get an idea of how other sources incorporate the neurodiversity perspective. (Since we do need to harmonize our autism article with Wikipedia's neutral point of view policy.) Here is a quote from the article:

  When discussing autism, it’s important to acknowledge that words aren’t perfect. And sometimes, “medspeak” that healthcare providers use — like disorder, symptoms or diagnosis — doesn’t quite match the lived experience of autistic people or their families. Throughout this article, we’ll use such language as needed to describe how healthcare providers can support your family — while recognizing that autism is an identity, not just a diagnosis.

• :::::I am not suggesting that we mimic Cleveland Clinic's approach. Rather, because the piece exemplifies a well-written review that adopts a predominantly neurodiverse framework, it might help enkindle ideas for improving our article. Mark D Worthen PsyD (talk) [he/him] 14:02, 14 April 2025 (UTC)
• ::::::Thanks @Markworthen! Yeah, I've linked it a few times in this discussion because it's a very neat example of how it's possible to balance these perspectives. Oolong (talk) 16:59, 14 April 2025 (UTC)
• ::::@CFCF, would you agree on "Signs and Characteristics"? We could then leave instances of "signs" but change "symptoms" to "features" or "characteristics". There are some cases in which the word "deficit" is used. I suggest replacing it with "difficulties" except within direct quotes. LogicalLens (talk) 04:07, 12 April 2025 (UTC)
• :::::It's complicated. I do think this article needs to clearly discuss "signs, symptoms and deficits" in the classification and diagnosis sections - but it might be appropriate to use characteristics outside that section. I think it would have to be handled carefully. CFCF (talk) 12:22, 12 April 2025 (UTC)
• ::::::The sections on classification and diagnosis directly quote the DSM and ICD. This is what I meant by instances in which words like "deficit" cannot be replaced, but as you said, "characteristics" can be used outside these two sections. That would be a step forward. LogicalLens (talk) 01:26, 13 April 2025 (UTC)
• :::::::As no one else responded, I now made these changes outside the sections on DSM and ICD. LogicalLens (talk) 02:40, 20 April 2025 (UTC)
• ::::::::This seems okay, not unless everybody starts using support labels the same way as functioning labels. Anthony2106 (talk) 13:02, 20 April 2025 (UTC)
• :::::::::This paper even recommends avoiding support labels and to instead talk about specific needs. But it is sometimes difficult if a section is not about specific support needs as this would then make the section longer.[https://www.liebertpub.com/doi/10.1089/aut.2020.0014] LogicalLens (talk) 01:50, 21 April 2025 (UTC)
• ::::::::Next: The term "risk" is only appropriate for co-occurring conditions that are universally viewed as bad and for things like suicide. When referring to autism, "likelihood" should be used, which is recommended even by the NIH style guide.[https://www.nih.gov/nih-style-guide/autism]
• ::::::::Moreover, I suggest changing the section title "epidemiology" to "prevalence". LogicalLens (talk) 04:01, 21 April 2025 (UTC)
• :::::::::Yes, 'risk' is an obvious one to correct.
• :::::::::I wonder if 'demographics' wouldn't fit better than just 'prevalence'? Oolong (talk) 16:08, 21 April 2025 (UTC)
• ::::::::::Next: we could proceed with expressions like “autism spectrum disorder”, “ASD” and “disorder” in a similar way as with “symptoms”. These terms are appropriate in the sections on classification and for the description of the formal diagnosis in the assessment section. When the reader knows that DSM and ICD classify autism as a disorder and that these manuals are used for diagnosis, there is no need to repeat the term disorder every time. WP:SUFFER says: “Choose appropriate words when describing medical conditions and their effects on people. Words like disease, disorder, or affliction are not always appropriate.” This is another reason to reduce the number of repetitions of these words.
• ::::::::::Regarding the lead: WP:WIKIVOICE says that (even majority) viewpoints must not be presented as facts which is the case with a sentence like “Autism is a neurodevelopmental disorder.” One way to solve this would be “neurodevelopmental disability” which is accepted by neurodiversity proponents as well. LogicalLens (talk) 04:27, 22 April 2025 (UTC)
• :::I agree with LogicalLens that "A separate "autistic identity" article has the same problem" – if it is actually a POVFORK to get identity information out of this article. If it's just an ordinary article about autism as an identity (just like any other article on a sub-topic), then I think it would be fine. WhatamIdoing (talk) 01:14, 12 April 2025 (UTC)
• ::This is exactly the kind of gross misrepresentation that has prevented us from making the sorts of substantial but piecemeal improvement that people keep saying we need.
• ::Can you not? Oolong (talk) 07:19, 11 April 2025 (UTC)
• :{{tps|w}} This is a complex issue that warrants a complex response. Sure, specific suggestions for improvement would be very useful, but we need a lot of them, and having a bigger strategy to them would help us not waste time. Not all issues on Wikipedia can be solved in a single edit. Bowler the Carmine | talk 16:48, 8 April 2025 (UTC)
• ::A valid analogy and heuristic from complexity science, is that sometimes a complex issue does not warrant a complex response. Rather an admission that it is complex means we should refrain from radical change to parts where our thoughts are not fully formed. This is precisely what is being suggested - to pick out individual issues and to work them through. As for the need of an overarching strategy, sure - but we aren't going to agree if we can't even summarize potential faults in less than a few thousand words. I've seen UN strategies that are shorter than this on far more complex issues than what is wrong with a Wikipedia article. CFCF (talk) 20:05, 9 April 2025 (UTC)
• :::Again, the only reason I'm resorting to 2000-word essays is because edits - by many different editors, not just me - have persistently been blocked on grounds that are based on misunderstandings of the edits being made, and/or what reliable sources collectively say about autism. Wikipedia is supposed to proceed by consensus wherever possible.
• :::If people think the neurodiversity approach suggests things that it simply does not, and persistently block constructive edits on that basis, those misconceptions need challenging. How would you prefer to approach this?
• :::I would absolutely prefer to just work through individual issues - which is, of course, what nearly the whole suggested changes section above is about. As @Bowler the Carmine says, though, this is a complex issue, and it does call for at least a somewhat strategic approach. Oolong (talk) 07:41, 11 April 2025 (UTC)
• :It's long because there are complex issues at stake, which people need to have some grasp of if they hope to contribute constructively; and a lot of work to be done.
• :Here's a bullet-point summary for you:
• :* This article is heavily slanted towards a biomedical perspective on autism
• :* That perspective was once overwhelmingly dominant in autism research and discourse, but this is not the case any more
• :* This article is badly out of date, not just because the mainstream has shifted, but also because it just hasn't been updated enough
• :* Articles of this size should be written in summary style, meaning several sections should be reduced to mere summaries; separate articles have already been spun off, but the summarising bit never happened
• :* There are a series of major omissions that need rectifying
• :* There is weirdly little about what kinds of support can be helpful
• :* To attain neutrality in Wikipedia's autism coverage, it would be simplest (but not simple) to balance competing perspectives in this article (see points 1-3)
• :* An alternative would be to split the article, on similar lines to transgender (general) vs gender dysphoria (specifically medical)
• :Hope this helps. Oolong (talk) 16:31, 11 April 2025 (UTC)
• ::There's also a bunch of stuff in there about what the neurodiversity approach actually means, because this is just required background knowledge for contributing to public-facing things about autism in 2025 - and because there has been a pattern here of people resisting changes based on apparent misunderstandings of neurodiversity.
• ::It would be very helpful if we could simply take this stuff as read, but it has come up again and again, so I spent a few paragraphs summing it up once more. Oolong (talk) 16:39, 11 April 2025 (UTC)
• :::Fundamentally, part of what you take issue with is central to Wikipedia's coverage of any topic (see WP:GOODBIAS). Wikipedia is biased towards science, and the fact remains that at its core autism is a medical diagnosis that has been explored chiefly through this scientific lens. The diagnosis arose through scientific development, and it is still today far more a medical diagnosis than a social phenomenon (even if the latter may exist in its own right).
• :::Whether other movement build upon this diagnosis, construct support or advocacy networks etc. does not change the fundament of what autism is. The neurodiversity movement has certainly brought with it a fair share of good, but when it comes to fundamentally redefining what autism is - that just isn't what Wikipedia is going to cover, and it is certainly not something over which there is consensus. Instead I would say there is a general consensus in the published literature against it, with diagnostic manuals not considering it beyond needs to use inclusive and respectful language.
• :::There is also absolutely no divide between a biopsychosocial and psychiatric perspective on autism, and whatever the alternative is. It is quite telling that you say it is slanted towards the biomedical perspective, without expressing what it is slanted from. The simple answer is that it is not biased, because there is no divide.
• :::There may be room to include more information on the neurodiversity movements views on how autism should be considered, but this can under no circumstance redefine what it is.
• :::The analogy to transgender and gender dysphoria is also entirely inadequate, because autism is the medical diagnosis. If anything this argues for the construction of autistic identity as a separate article, but I don't think that is an appropriate response - because it is likely to turn into a WP:POVFORK. CFCF (talk) 12:32, 12 April 2025 (UTC)
• ::::While the neurodiversity viewpoint is not currently the majority perspective in the academic literature, there are many sources supporting it. I posted a list of citations in February.[https://en.wikipedia.org/wiki/Talk:Autism#c-LogicalLens-20250226044700-Survey_(on_RFC_on_focus)] There is clearly a divide between the medical model and the neurodiversity perspective, because neurodiversity is not just a cultural concept within autistic communties but actively challenges the classification of autism as a disorder. The goal is to replace the psychiatric notion that there is a correct brain and to move towards a non-pathologizing disability framework that recognizes support needs without labeling the person as disordered.[https://link.springer.com/chapter/10.1007/978-981-13-8437-0_13] The distinction between disorder and disability is crucial because some people think neurodiversity rejects disability, which is does not and which would be absurd, at least when looking at autistic people with intellectual disability etc.
• ::::Gender dysphoria is also a medical diagnosis within the DSM. LogicalLens (talk) 02:20, 13 April 2025 (UTC)
• :::::So to summarize, because I think you misunderstand. The broader aims of the neurodiversity movement to improve people's lives and to be considerate of self-described understanding of autism is not at odds with the biopsychosocial psychiatric model of autism.
• :::::Redefining the diagnosis is however a minority viewpoint, that at its best could merit a one sentence note that such a movement exists per WP:DUE. At worst, it is fringe, and should not be described in this overview article. This is not bias, and this is not the article being slanted.
• :::::Lastly, yes precisely - gender dysphoria is the diagnosis, gender identity is not. Autism is the diagnosis, autistic identity is not. CFCF (talk) 08:23, 13 April 2025 (UTC)
• ::::::@CFCF I have read quite a lot—books and hundreds of articles—on neurodiversity, and from what I have consistently seen, depathologizing autism and reframing it from a disorder to a difference is a core principle. I would be happy to share more sources that support this if it is helpful. What is the source or perspective behind the idea that it is only about acceptance and lived experience?" LogicalLens (talk) 09:53, 13 April 2025 (UTC)
• :::::::What is at issue is how there is a difference between 1) acknowledging a movement that wishes to depathologize a condition and to act to use language that avoids stigma or overt pathologization, and 2) accepting head-on a redefinition of the diagnosis in accordance with that movement. Those are not the same thing.
• :::::::While neurodiversity perspectives have gained much traction, and are WP:DUE, they are still not dominant. As for rejection of the current diagnostic manuals and a push for redefinition of the diagnosis, this is a very small minority view. If it does reach such momentum that guidelines adapt - then we are in another ballpark - but right now it doesn't, so it needs to be treated appropriately per WP:DUE and WP:CRYSTALBALL. The fact remains that this article is about the diagnosis - not the identity - which when I give it some more thought fits under Neurodiversity rather than Austistic identity.
• :::::::I think perhaps this strikes to the heart of the issue. Neurodiversity is a perspective, but not the total perspective, and frankly hitherto a minority perspective. CFCF (talk) 10:45, 13 April 2025 (UTC)
• ::::::::Nobody here argued that the article or the section on diagnosis should be written from a neurodiversity-only perspective and @Oolong are ready to accept that the medical model is still presented as the majority viewpoint.
• ::::::::The reason why neurodiversity advocates in general do not directly call for a removal of the autism diagnosis in the ICD or DSM is that in many current legal systems, having a diagnosis is necessary for access to support services. A similar debate existed for transgender people where the question was whether depathologizing gender identity would end insurance coverage of transition treatments. The long-term goal of the movement is switching to a disability framework that assesses the needs of individuals without using a disorder diagnosis.
• ::::::::While the neurodiversity perspective is not currently dominant, I guess you still underestimate its prevalence even in guidelines. See the guidelines from Australia that recommend neurodiversity-affirming practice.[https://www.autismcrc.com.au/best-practice/assessment-and-diagnosis/guideline/reading-the-guideline#reading-the-guideline] The Psychological Society of Ireland writes in the preface that the classification as a disorder is being challenged.[https://www.psychologicalsociety.ie/source/PSI%20Autism%20Guidelines%202022%20(Interactive%20Version).pdf] There are also multiple professional books on carrying out diagnosis in a neurodiversity-affirming way without viewing autism as a disorder.[https://www.routledge.com/Is-This-Autism-A-Guide-for-Clinicians-and-Everyone-Else/Henderson-Wayland-White/p/book/9781032150222][https://uk.jkp.com/products/the-neurodiversity-affirmative-child-autism-assessment-handbook][https://uk.jkp.com/products/the-adult-autism-assessment-handbook] LogicalLens (talk) 05:34, 14 April 2025 (UTC)
• :::::::::@CFCF yes, it's a minority view, but a very significant one. Nobody is suggesting that the entire entry should be rewritten to conform with it!
• :::::::::This article is about the phenomenon known as autism, which is both a medical diagnosis, and a neurodevelopmental difference which profoundly shapes people's experiences of sensory and social worlds, among other things. The psychiatric category is an attempt to characterise this difference.
• :::::::::A huge amount of work has also been done on and around autism that doesn't have a medical focus or a medical framing at all. It's still a minority of the literature, but it's a large and growing one - widely acknowledged as a major shift within autism research, while popular literature has come a lot further still. Bear in mind that many professionals working with autistic people are in education, or other non-medical fields.
• :::::::::We could have an entry on the diagnosis, which is actually Autism Spectrum Disorder, and make it all about the psychiatric category - in other words, discussing autism from a specifically medicalised perspective.
• :::::::::That is not what we have now, though. The encyclopaedic approach to covering autism would be to balance the main coexisting perspectives on it. Oolong (talk) 12:46, 14 April 2025 (UTC)

:::::::::::I have to say, {{U|Oolong}} I strongly disagree that this article is not mainly on the medical diagnosis, which as you say is the dominant view. You are right that neurodiversity is a significant view, as is clear by the neurodiversity article at the very least.

:::::::::::I am inclined to agree with {{U|LogicalLens}} here: (even if I disagree that {{tq|Nobody here argued that the article or the section on diagnosis should be written from a neurodiversity-only perspective}}) that if this is present in guidelines especially as phrased as acknowledgement and adoption of "neurodiversity-affirming practices" - I think it appropriate to mention this perspective from guidelines in the article in a WP:DUE fashion. One should note however, adopting neurodiversity-affirming practice does not necessarily entail full adoption of depathologization or a rejection of other perspectives. I do not see that these guidelines reject the disorder as such, even if they mention the existence of debate - and I am less inclined to include mentions from medical text books to support it at the high-level article on autism, because there are so many and it would need to be balanced with a myriad of textbooks and reviews that take other views.

:::::::::::The fact of the matter is that the medically defined condition is the focus of this article, and it should be written as such. Autistic identity is a significant minority view, and it is not dismissive to be clear that this is described in the article on Neurodiversity (I don't think we need a new article for it, because that would just contribute to making things more unmanageable, by adding one more to the overwhelming number of articles that already exist about autism. CFCF (talk) 17:34, 14 April 2025 (UTC)

::::::::::::As many editors not involved in the dispute resolution have entered the discussion, the moderator @Robert McClenon is not active anymore, and several users have made changes anyway, I think it no longer makes sense to follow the rule of not editing the article while the dispute resolution is ongoing. We would still need some discussion beforehand as otherwise, pro- and anti-change editors would consistently revert each other’s edits. While debating abstract strategies is difficult, it will take years if we discuss every paragraph separately like @WhatamIdoing suggested. LogicalLens (talk) 06:45, 15 April 2025 (UTC)

• :::::::@CFCF is correct. Declassifying autism as a disorder is NOT a core principle in the field, in fact it contradicts the international scientific consensus. For comprehensive references in the context of Wikipedia guidelines on this matter, see: Talk:Autism#c-Димитрий Улянов Иванов-20250317212900-Survey (on RFC on focus). Димитрий Улянов Иванов (talk) 22:06, 13 April 2025 (UTC)
• ::::::::I really wish you would stop using the phrase 'scientific consensus,' when you really mean the 'medical model'. There is no scientific consensus concerning the causes and effects of autism, this is why there are and have been so many hypotheses in and out of vogue - childhood schizophrenia - refrigerator mother - vaccination - extreme male brain - monotropism - systematisation-driven etc. etc. Urselius (talk) 06:03, 22 April 2025 (UTC)
• :::::::::@Urselius Daim yeah, along with symptoms.[https://en.wikipedia.org/wiki/Talk:Autism#c-Димитрий_Улянов_Иванов-20250406173000-Anthony2106-20250403015800] Maybe changing words is hard. Anthony2106 (talk) 10:35, 22 April 2025 (UTC)
• :::::::::It is not solely a medical model and equating it with the "refrigerator mother" hypothesis absolutely is not a valid comparison. That idea was the parent bashing engaged by Bettelheim and colleagues back in the 40s and onwards who saw the learning, development, and neurodevelopmental disorders of children as merely the parents' fault. There was not a shred of scientific evidence to support his position and the decades of cruelty suffered by people with ASD and their families was atrocious and inexcusable and is one of the worst historical periods in the history of ASD. You can read the book In a Different Key if you want to read what about what happened to families and children back then; it is unconscionable. How that borderline pre-scientific era and nonscientific idea about autism has anything to do with our current, evidence-based understanding is beyond me. Димитрий Улянов Иванов (talk) 15:08, 22 April 2025 (UTC)
• ::::::@CFCF depathologisation has always been one of the core features of neurodiversity. Oolong (talk) 08:48, 14 April 2025 (UTC)
• :::::::I don't believe I've called that into question. CFCF (talk) 17:15, 14 April 2025 (UTC)

I made some adjustments to the lede to simplify the language - and to give neurodiversity more prominence (and to remove the WP:WEASEL wording "some researchers"). I do not think that any of the actual message is changed, I have focused on making what is there more readable and less repetitive.

However, a broader criticism of the entire scope of articles about autism, and which has been touched upon by others - but that I see being unrecognized - is not so much that this article isn't summarizing all the other articles. But rather, that there are far too many sub-articles to summarize. We need to get rid of quite many of the See also Main article and other links. This article has turned into a monster that can not be maintained. The problem is not that we aren't summarizing the sub-articles, but that there are too many sub-articles. We need to cut and just have the subarticles as wikilinks, not prominently displayed banners stating that there is a main article on the topic. CFCF (talk) 11:42, 13 April 2025 (UTC)

:This is something @Oolong and I have previously said multiple times. We are overwhelmed by this article and cannot maintain it. What we are proposing is not inserting additional summaries but replacing very long sections in the article that have separate articles (causes, for example) by summaries. Removing unnecessary summaries and "See also"/"Main article" are both ways to make the article shorter. LogicalLens (talk) 03:46, 14 April 2025 (UTC)

::I would recommend going for concise and not just short. It's a pretty high level article and so it's going to have some meat on the bones. It's going to have a lot of articles beneath it because we're writing an encyclopedia article and not a book.

::If nothing else, I've yet to meet the article that couldn't be trimmed down ~20% just by getting rid of words that make no difference in meaning. But I would agree that we could probably trim more substantively in a lot of places. And any way, we have to fix the article before we fix the lead. The tail doesn't wag the dog. GMG^talk 23:55, 14 April 2025 (UTC)

:::Do you have concrete suggestions what we can make shorter or more concise? LogicalLens (talk) 06:27, 15 April 2025 (UTC)

::::Well for starters:

::::* I think we have to drop the use of any use of the {{Excerpt|}}, realizing that even this is far to extensive and that the language used is often to technical in nature - and actively makes editing and abiding by MOS/MEDMOS difficult. Just for instance - the Assessment/Diagnosis section links to Diagnosis of autism three times in short succession - and relinks both the WHO and ICD-10, despite these being mentioned before.

::::* The section on History and Culture is cluttered with images of flags and is essentially a WP:GALLERY - which should not be used. The aim is to get the general message across, what this is about, not indiscriminately list the flag of every supportive movement.

::::* What ought perhaps be a single line or half a paragraph on Digital media use is now a long excerpt that is WP:UNDUE at this high-level article.

::::* The "Pre-diagnosis" sections is a bullet list that is not useful. Further, I don't see how the prominent link to the Outline article serves any purpose here. There is also no general narrative overview of what assessment/diagnosis is, just a long list of steps.

::::And that is just spending 3 minutes looking for objective stylistic issues. CFCF (talk) 07:45, 15 April 2025 (UTC)

:If I'm reading Wikipedia:Summary style correctly (and this is not, itself, well-structured - so I'm finding it hard to be sure of the details) we are supposed to have summaries for subtopics. I think we're supposed to treat these summaries like leads, so probably 250 or at most 400 words each?

:We currently have well over 4000 words of duplicated content on subtopics that already have separate entries, as described under heading #The article as it stands. We should lose at least three quarters of that, I think, and likely reduce a couple more subtopics to summaries as well. Oolong (talk) 16:21, 21 April 2025 (UTC)

::I don't think that it's helpful to think of the local summary as a WP:LEAD, because the local summary should contain somewhat different information. Some material that's normal for leads (e.g., pronunciation, other names, related concepts) should be omitted and other material should be expanded. For example, the lead for Applied behavior analysis should contain information about its use in non-autism situations and the history of its development, but if we decided to add a Main-type summary for that article in Autism#Non-pharmacological interventions, then it should not include any information about those two points. (NB: I'm not advocating for including such a summary; this is only example.)

::Back in the day, we recommended that the local summaries be longer than a typical lead. That recommendation was removed years ago. The local summary should be as long, or as short, as makes sense for the local article. In some cases, that will be only a few sentences. In others, it will be a thousand words. WhatamIdoing (talk) 17:19, 21 April 2025 (UTC)

:::Fair enough. I feel like clearer guidance could be helpful here, but I guess we just improvise. Oolong (talk) 15:39, 23 April 2025 (UTC)

Within the field of autism, the generally used term when undergoing evaluation is Assessment, and there has been considerable discussion here to improve use of non-pathologizing language. Because we are writing to a broad audience and the intent is to provide an introduction about autism to a broad public, which to a significant degree will include those we are either thinking about assessment or introduced to the process - it makes sense to structure the article around this, with the process itself being described rather than the formal criteria, which are defined under the first section on classification. WP:MEDORDER, part of WP:MEDMOS clearly describes a list of {{tq|suggested}} headings which may or may not be appropriate for all articles. I wrote this on my phone, so I was unable to provide the full nuance - but I would think this is in line with the consensus to avoid overt pathologizing language - without being imprecise, incorrect, or by avoiding mentioning what we are talking about. There is a real need to clarify what assessment really entails, not just repeating information from the classification. CFCF (talk) 07:37, 18 April 2025 (UTC)

:This section is more intended for official diagnostic criteria, which other sections do not mention and shouldn’t. Since there is a move to slightly de-pathologize the article, I can see how adding broader autism identification criteria in a non-pathological sense is possible, in which “Assesment” would be the appropriate name. However, I am not aware of the existence of such and am worried it may cause more confusion. If this section remains exclusively for diagnostic criteria, then “Assessment” would be a broad term possibly related to symptoms and classification, which is why I lean towards naming it “Diagnosis”. I am open to moving this section above “Causes”, but not “Signs and symptoms” as the characteristics of autism are of greater importance for the reader. Let me know your input into this, thank you. Slothwizard (talk) 08:12, 18 April 2025 (UTC)

::There is an additional reason why it shouldn't be called diagnosis, which is inherent to the condition and definitions described in the classifications section. Since the classification is so central to formal diagnosis, they really make up the diagnosis - and nothing is helped by reiterating them first in a definition, then in diagnosis. I placed the section before signs and symptoms, because I think in this case it is a far more logical flow, and more directly relevant to readers who are learning about autism (also not helped by how the signs and symptoms section is in quite a sorry state).

::Autism is, even more so, than other psychiatric conditions synonymous with the diagnosis. All psychiatric diagnoses are pretty much constructed (I don't want so say socially), and are therefore not objective in the sense that say a cancer diagnosis is. Yet, autism also differs from quite a few other psychiatric diagnoses, where one does not speak of a spectrum or persistant findings since childhood, i.e. bipolar disorder, depression etc. - but instead mainly about severity or on occasion type. In autism the specific difficulties define how to manage it, whereas in many other conditions management is, at the very least, less influenced by specific symptoms. CFCF (talk) 09:37, 18 April 2025 (UTC)

:::I think that a description of the process, regardless of whether it's called ==Diagnosis== or ==Assessment==, would be appropriate. For example, if someone suspects Breast cancer, then most readers expect the process looks like a mammogram and a biopsy, and this is what Breast cancer#Diagnosis starts with.

:::So what's the equivalent for autism? Adults will fill out a lot of questionnaires. (We should list some popular ones.) Parents will fill out a lot of questionnaires. Very young children will be observed directly. What do you do for a non-speaking child? Do you need an appointment with a pediatrician, a psychiatrist, a psychologist, a therapist, someone else? WhatamIdoing (talk) 22:39, 19 April 2025 (UTC)

:I suspect that there's a US-oriented legal consideration underlying the field's preference. Only certain healthcare providers are allowed to "diagnose" people, but a lot more people are allowed to "assess" them. For example, a school nurse can call a child's parent and say "Your child needs to leave school; they have a cough and a temperature of {{convert|40|C|F}}" but they aren't supposed to say "Your child needs to leave school; they have a cough and a fever of {{convert|40|C|F}}", because attributing the elevated temperature to fever (instead of, e.g., heat illness) is a "diagnosis", and school nurses can't legally make a diagnosis (except for a Nursing diagnosis). WhatamIdoing (talk) 22:30, 19 April 2025 (UTC)

::Interesting point, but I don't think when it comes to autism that it is US-centric. Formal diagnosis is only made by a psychiatrist in most countries, whereas some allow for psychologist diagnosis. Rather, the reason for talking about assessment is that it is a) quite an intricate process requiring the collection of data from several different people; and b) the joint assessment of direct observation and reports from individuals who know the person; c) cases are often not clear-cut, where there is a lot of subjectivity - which deviates from many other diagnoses; d) intentional attempt to avoid pathologizing. As far as I'm aware this, or similar, distinctions are made in most countries. CFCF (talk) 15:22, 20 April 2025 (UTC)

:The section should not be renamed. It is the the term used in authoritative sources including the ones in the article, the term found in Wikipedia’s own style guide, is consistent with similar and sister articles, and the title readers will expect. “Diagnosis” also covers the section’s full scope: referral and screening pathways, gold‑standard instruments, diagnostic criteria, and differential diagnosis. By contrast, “Assessment” would invite material about post‑diagnostic support‑needs evaluations and other data‑gathering exercises that belong elsewhere, blurring the line between identifying autism and managing it. Renaming would therefore sacrifice precision, consistency, and alignment with both sources and policy. Arguments found for other language changes do not apply here. Tacitusmd (talk) 06:04, 20 April 2025 (UTC)

::Where do "post‑diagnostic support‑needs evaluations" belong? WhatamIdoing (talk) 19:14, 20 April 2025 (UTC)

:::Most of these are also performed from the perspective of more in-depth diagnosis, which in turn is what guides support-needs both from a care-giver and insurer perspective. That the term is suggested in WP:MEDMOS implies it is a good start, but with a clear rationale why we should not use it (which I think is given here and in literature) - there is no reason not to choose a more appropriate in-field term. CFCF (talk) 11:13, 21 April 2025 (UTC)

:::Wading into this after skimming this entire discussion - I would place the detailed information about post-diagnostic support and the related assessments in the Management section, if the current article structure is to be kept, with a brief mention in the Diagnosis/Assessment section. Regardless of whether Diagnosis or Assessment is a better header for the section on the process and criteria for diagnosis, I would argue that, while an autism diagnosis can include some amount of support needs assessment, the majority of support needs assessments (eg. those performed by a speech pathologist, occupational therapist, physiotherapist, etc) don't really belong in the same section as the autism diagnosis process itself. Ethmostigmus 🌿 (talk | contribs) 12:46, 22 April 2025 (UTC)

::Many authoritative sources do prefer 'assessment' over 'diagnosis'. The NHS [https://www.nhs.uk/conditions/autism/getting-diagnosed/how-to-get-diagnosed/ 'how to get an autism assessment'] page is one obvious example, although the use of the term 'diagnosis' in the URL and a couple of times on the page suggests that they have only partially transitioned away from the 'diagnosis' framing, so far. See also [https://www.england.nhs.uk/publication/autism-diagnosis-and-operational-guidance/ this national framework]. [https://www.autismcrc.com.au/best-practice/assessment-and-diagnosis These Australian guidelines] use both, as do [https://www.nice.org.uk/guidance/cg142/chapter/Recommendations#identification-and-assessment-2 the NICE guidelines].

::See also [https://uk.jkp.com/products/the-adult-autism-assessment-handbook The Adult Autism Assessment Handbook] and [https://uk.jkp.com/products/the-neurodiversity-affirmative-child-autism-assessment-handbook The Neurodiversity Affirmative Child Autism Assessment Handbook], both handbooks for clinicians.

::I accept that to some degree the two terms refer to separate but overlapping concepts, but I'm not sure that needs assessments can or should be neatly separated from the diagnostic process? In fact, doesn't the DSM-5 explicitly require them? Or am I being confused by terminology here? Oolong (talk) 16:36, 21 April 2025 (UTC)

:::{{tq|I'm not sure that needs assessments can or should be neatly separated from the diagnostic process? In fact, doesn't the DSM-5 explicitly require them? Or am I being confused by terminology here?}} To clarify, when you say that the DSM-5 requires support needs assessments, are you referring to the "severity levels" (ie. level one "requires support", level two "requires substantial support", level three "requires very substantial support")? If so, I would not classify that alone as a support needs assessment.

:::How much detail is given to an autistic individual's support needs during the initial diagnosis process depends on the diagnostic team/their resources and the request of the individual/their guardian, but in my personal experience, it is largely separate. Again, just from my experience (take it with a grain of salt, things may be done very differently elsewhere!), the diagnostic team does not themselves conduct a dedicated support needs assessment but rather refers the autistic person to support services they think may be of use (eg. speech or occupational therapy) for more detailed assessment and support. Certainly, there are support needs assessments that can occur long after a person was initially diagnosed, eg. to access programs like the National Disability Insurance Scheme or Meals on Wheels. It can occur as part of the diagnosis process, but it doesn't always, and mentions of it shouldn't be restricted to within the context of diagnosis. Ethmostigmus 🌿 (talk | contribs) 13:11, 22 April 2025 (UTC)

::::That makes sense - and yes, I was referring to the DSM-5's requirement for an assessment of support needs for what they call "severity level".

::::It still seems like it's going to be tough to delineate what is (or should be) part of the diagnostic process, and what is or should be part of a broader or later assessment. I wonder how much this distinction varies between countries, practices etc - from what I know, the answer is, I think, quite a lot. Oolong (talk) 15:44, 23 April 2025 (UTC)

:::::I think you are coming at this with some confusion over what the diagnostic process is. It is not only the formal process of ascertaining the presence of a condition, but also the type/character/subtype/degree/severity of the condition. One can diagnose a condition, and then more precisely diagnose the type or degree - while still engaging in diagnosis. CFCF (talk) 13:37, 29 April 2025 (UTC)

::::::I'm not sure why you think you're disagreeing with me. My point is that diagnosis routinely includes broader assessment than simply naming a condition.

::::::Given this, I'm unconvinced that 'assessment' is in any sense an incorrect or inappropriate term for the process we're talking about. Oolong (talk) 10:12, 1 May 2025 (UTC)

• Right now the assessment and characteristics sections are a hot mess. They lack any clear focus or sense of narrative. GMG^talk 16:27, 20 April 2025 (UTC)
• :You're absolutely right, but it's not just those sections.
• :Hence the persistent efforts to address the many outstanding problems with the article in at least a semi-systematic way.
• :Would you be up for making a start on redrafting either of these sections? Oolong (talk) 09:49, 10 May 2025 (UTC)
• ::I do not think the article is a mess anymore, at least not to the extent of one month ago. It can be argued that it is a bit confusing and possibly redundant that there is a pre-diagnosis section that distinguishes between social and behavior characteristics, followed by another section that does the same. Maybe, a distinction could be made between signs and characteristics, with the signs being moved into the assessment section. That section is redundant in part because the pre-diagnosis signs section also has a paragraph that starts with "Clinicians often consider assessment..." and the assessment section explains the DSM-V criteria in its second paragraph which belongs into the DSM subsection in the classification section. LogicalLens (talk) 03:08, 11 May 2025 (UTC)
• :::Thanks, @LogicalLens! I've been pretty busy the last month or so (mostly with writing chapters about autism, ha) and have gotten so used to this process being intensely stressful that I only stop in when I am feeling particularly resilient - so I haven't fully kept up with improvements to the article!
• :::I see that the physiology section is gone, which is sensible, but Autism#Causes is still way longer than it should be, and @Slothwizard has restored the inappropriate title of the 'Management' section, without making a positive argument for why it would be better.
• :::It's definitely good to see some progress starting to be made! Oolong (talk) 18:03, 11 May 2025 (UTC)
• ::::Regarding the "Management" section, "therapies" itself implies there is an issue that may need to be resolved. The "supports" are literally medications. They are managing symptoms (which I guess we are not supposed to use that term?) that cause complications, if they occur. Unlike "Treatment", "Management" does not imply that therapies and supports are absolutely required, given that some characteristics of autism are not inherently pathological (e.g., special interests), and instead are just signs. Would it be appropriate for Homosexuality to have a "Therapies and supports" section due to discrimination from society? No, obviously not, because homosexuality is not pathological, a different name would be required. This article is about autism when clinically diagnosed. I do not understand what most of these name changes are supposed to accomplish. Slothwizard (talk) 19:07, 11 May 2025 (UTC)
• :::::I wrote this above under #Next steps:
• :::::"I would suggest fully replacing 'management' with 'support', and moving this immediately after 'common characteristics'. Symptoms might be managed; people need support. This is a huge topic, taking in parenting, education, workplaces, community and healthcare, as well as therapies of various sorts and also disability aids. We will therefore want numerous subsections."
• :::::Leaving out descriptions of support which fall outwith the heading 'management' means omitting a huge amount of highly pertinent information. The intention of the name change was chiefly to ensure we have somewhere it makes sense to include this information.
• :::::Why would 'management' be better? I'm still not seeing a positive argument for this. Oolong (talk) 14:03, 14 May 2025 (UTC)
• ::::::I wonder whether "support" could be split between ==Management== (e.g., he needs to wear a helmet to prevent concussions) and ==Accommodations== (e.g., this dev needs to be able to work from home). WhatamIdoing (talk) 17:36, 14 May 2025 (UTC)

@Zenomonoz, a co-occurring (or comorbid) condition does not require a causal link, although there is a genetic overlap between autism, ADHD, and other things. This means there is no specific reason to have a section that is only about conditions and leaves out everything else for which a correlation has been found. @Ó.Dubhuir.of.Vulcan argued above (Talk:Autism#c-Ó.Dubhuir.of.Vulcan-20250307003100-Tacitusmd-20250302111500) that it is biased towards the biomedical view of autism. LogicalLens (talk) 01:59, 21 April 2025 (UTC)

:{{u|LogicalLens}}, what are you talking about? I modified it because being gay (or transgender) is not a “condition”. Gender dysphoria is a condition, so I put that into the list. The section title refers to ‘conditions’. Zenomonoz (talk) 03:19, 21 April 2025 (UTC)

::Would you agree on changing the section title to "Co-occurring conditions and other correlations"? LogicalLens (talk) 04:04, 21 April 2025 (UTC)

:::I'm not sure this is wise. That title is far too long - and whatever one may make of it, definitions-wise sexual identity is a "condition", even though it certainly isn't a medical condition. If anything having that long title would lump them together more. One could perhaps use "Co-occurring conditions and traits" or even better "Co-occuring phenomena", but I'm not sure it is wise to lump this together in a single section - because it will regardless imply that there is something in common with medical conditions and these non-medical conditions/traits. Correlations also means so much more, and we don't want to get into a semantic debate or need to spell out our definitions in the section. CFCF (talk) 11:10, 21 April 2025 (UTC)

::::Why not just something like "demographics"? Agree that we shouldn't label non-medical associations as being comorbid. I can't imagine a world where we would label being black as "comorbid" with heart disease. GMG^talk 12:34, 21 April 2025 (UTC)

:::::If we went in that direction, I would suggest merging this section with "epidemiology". Oolong (talk) 16:38, 21 April 2025 (UTC)

:::::"Comorbid" has been changed to "co-occurring" which carries no connotation of medical disorders/diseases. LogicalLens (talk) 20:45, 21 April 2025 (UTC)

::::::The problem is with correlation not co-occurring. One could reasonably split with:

::::::==Co-occuring conditions==

::::::===Medical conditions===

::::::===Traits===

::::::The issue with correlation is that everything that is co-occurring is also correlated - so the distinction is false. The majority of readers will also likely not get what we mean with correlations, as it is a technical term. Association is also better from a purely methodological/epidemiological standpoint, but is no less confusing for lay readers. As for merging with epidemiology, I think most general readers would not look under the ==Epidemiology==-section for co-occurring conditions, assuming instead that the section would cover prevalence of autism etc.

::::::What do we make of this? CFCF (talk) 21:44, 21 April 2025 (UTC)

:::::::On second thought, I'm also a bit apprehensive how we should describe the correlation with LGBTQ - it may be difficult, as we have to be very short in this overview article. CFCF (talk) 21:45, 21 April 2025 (UTC)

::::::::The difference between "co-occurring" and "comorbid" is purely semantic. GMG^talk 13:04, 22 April 2025 (UTC)

:::::::::So is the one between trait and condition, barring medical conditions. CFCF (talk) 21:18, 22 April 2025 (UTC)

::::::::::The subheadings could be "non-medical traits" and "medical conditions". The heading of the entire section is now "co-occurring phenomena", so I see no reason why these non-medical characteristics could be mixed up with the medical ones. LogicalLens (talk) 03:47, 25 April 2025 (UTC)

:::::::::::The subsection "non-medical traits" could be called "non-medical phenomena" and then also include the higher likelihood of being the victim of a crime in autistic people. LogicalLens (talk) 03:52, 25 April 2025 (UTC)

:::::::::I'm not sure what you're getting at here? Yes, the chief difference between any two terms is semantic, which is to say they mean different things.

:::::::::In this case, comorbidity is the subset of co-occurrence that describes diseases in particular, or medical conditions more broadly. Oolong (talk) 07:49, 27 April 2025 (UTC)

::::::::::Are you content with this edit?[https://en.wikipedia.org/w/index.php?title=Autism&diff=prev&oldid=1287738469] I moved the content into the demographics section. LogicalLens (talk) 04:19, 28 April 2025 (UTC)

::::::I thought the argument was that autism is (according to this POV) not a type of morbidity itself; ergo, it can't be co-morbid with anything. Autism is only allowed be considered a perfectly healthy, normal, non-morbid thing that correlates with actual diseases.

::::::Compare: There's nothing wrong with having abnormally long and thick eyelashes, even though it correlates with a long list of actual diseases. Or even: There's nothing wrong with having red hair, green eyes, and freckles, even though it causes disease. WhatamIdoing (talk) 21:44, 21 April 2025 (UTC)

:::::::Maybe you're right - those traits could go under epidemiology, and have the co-occurring conditions section only be medical conditions. Hmm... CFCF (talk) 21:47, 21 April 2025 (UTC)

::::::::I think using "Co-occurring phenomena" as a section title with subsections "medical conditions" and "traits" is best. LogicalLens (talk) 22:03, 21 April 2025 (UTC)

:::::::::@LogicalLens, can you name some "Traits" that "co-occur" with autism, but are neither medical conditions nor part of autism? For example, stimming is a "restricted, repetitive behaviors", which means it's a core feature of autism, and therefore it can't be a "co-occurring phenomenon".

:::::::::It might be clearer if I say it this way:

:::::::::* Autism has these traits: A, B, and C. (example: stimming)

:::::::::* People with autism often also have co-occurring medical conditions: D, E, and F. (example: epilepsy)

:::::::::* People with autism might have some co-occurring non-medical traits: G, H, and I.

:::::::::The "co-occurring" model means that anything in the "A, B, and C" group cannot be part of either the "D, E, and F" group or the "G, H, and I" group. Items can only be placed on one line. You cannot say that stimming is part of autism and also that it is not part of autism. ("Co-occurring" means "not part of"). WhatamIdoing (talk) 18:47, 22 April 2025 (UTC)

::::::::::Also isn't stimming clearly a behavior as opposed to a trait? Unless we want to be convoluted about it and say "a propensity to stim" - but that is just intentionally confusing. CFCF (talk) 21:19, 22 April 2025 (UTC)

:::::::::::Yes, stimming would be better described as a behavior, feature, or characteristic than as a trait. This is especially true if you're using trait in the sense of a genotypic or phenotypic trait. WhatamIdoing (talk) 22:55, 22 April 2025 (UTC)

::::::::::@WhatamIdoing the user @Zenomonoz removed the higher rate of LGBT and atheism because these are non-medical traits. Therefore, I suggested splitting it up into "medical conditions" and "other traits" while renaming the section to "co-occurring phenomena". I still prefer this approach but these non-medical traits could also be inserted into the section that is currently called epidemiology and that we could rename to demographics. LogicalLens (talk) 00:19, 23 April 2025 (UTC)

:::::::::::It sounds like a split between ==Associated medical conditions== (e.g., epilepsy) and ==Demographics== (e.g., LGBT prevalence) would be feasible.

:::::::::::How clear is the line between core features and co-occurring psychiatric conditions? Does everyone agree whether anxiety is a feature of autism vs a separate condition? WhatamIdoing (talk) 00:58, 23 April 2025 (UTC)

::::::::::::As far as I know, reliable sources generally describe anxiety as a co-occurring condition. LogicalLens (talk) 04:30, 24 April 2025 (UTC)

::::I agree with CFCF. I also think things like this belong more under the epidemiology section and that co-occurring conditions should focus on actual medical conditions. Just like you wouldn't put something like race or age under "co-occuring conditions" it would go under epidemiology. IntentionallyDense ^(Contribs) 23:19, 21 April 2025 (UTC)

:::::You've convinced me of my own argument now. CFCF (talk) 21:17, 22 April 2025 (UTC)

Please feel free to join in the talk about the standard image for 'autism' on Wikidata:Talk:Q38404#Image. Laurier (xe or they) (talk) 13:12, 22 April 2025 (UTC)

:I would really appreciate you joining in the discussion on which image or photograph would best symbolize autism. Thank you in advance. Laurier (xe or they) (talk) 06:16, 24 April 2025 (UTC)

The article needs a section explaining the difference between the medical model and the neurodiversity perspective in sufficient detail, and it is best, in my view, to place it directly below the lede.

@Oolong made several suggestions for new content in a discussion section a few months ago. These could also be included. LogicalLens (talk) 03:51, 25 April 2025 (UTC)

:I fully endorse your and Oolong's suggestions as they relate to the proposed new content. DoItFastDoItUrgent (talk) 21:57, 26 April 2025 (UTC)

:Thanks, @LogicalLens.

:Here's my original list of glaring omissions. Just things that really obviously need to be included - there are a lot of other things that one could also make a case for! Oolong (talk) 07:52, 27 April 2025 (UTC)

Because I have not received any responses on this in a branched discussion above, I start it as a separate topic.

Regarding the lead: WP:WIKIVOICE says that (even majority) viewpoints must not be presented as facts which is the case with a sentence like “Autism is a neurodevelopmental disorder.” One way to solve this would be “neurodevelopmental disability” which is accepted by neurodiversity proponents as well. Another reason is that WP:SUFFER says: “Choose appropriate words when describing medical conditions and their effects on people. Words like disease, disorder, or affliction are not always appropriate.” LogicalLens (talk) 04:39, 25 April 2025 (UTC)

:Yes, it must be prominent in the lede. This is not up for discussion. To clarify, and to avoid unnecessary repetition of debate - this was just covered up in the Suggestion section, where it was discussed less than a week ago. CFCF (talk) 15:31, 25 April 2025 (UTC)

::I'm not sure this specific question was adequately covered in previous discussion - could you perhaps link to the relevant part of the discussion?

::In case you're not aware, you can get a URL for a specific comment from the datestamp - here's the specific comment @LogicalLens referred to.

::It is good that we seem to be moving towards an agreement on respecting the guidelines in WP:SUFFER and using language that different major bodies of opinion agree on where possible, rather than presenting widely contested statements as facts. I am aware that this remains a controversial approach here, though, and we have had many misunderstandings occurring in these discussions where people have misunderstood each other's intentions... Oolong (talk) 08:09, 27 April 2025 (UTC)

:::I can not summarize the section, and I sincerely suggest you read it again. The discussion took place over 3-4 weeks, and there is consensus that this article should follow the general field - where autism is a medical diagnosis, and specifically a neurodevelopmental disorder. There is consensus that neurodiversity is a significant minority view and should be treated as such. It will be mentioned, but does not dictate the format of this article. Neurodiversity-affirming language, as per some guidelines, is not the same as accepting all tennets of the movement. CFCF (talk) 12:27, 27 April 2025 (UTC)

::::Which discussion do you mean? @Oolong suggested that you provide a link to it. LogicalLens (talk) 00:11, 28 April 2025 (UTC)

:::::I now think you mean the discussion where we talked about whether the neurodiversity movement actively challenges the classification as a disorder. There, @Oolong wrote that depathologization was always a core tenet and you responded that you did not question that. While we cannot remove the word disorder entirely from a prominent position in the lead section, the current phrasing is outdated.

:::::Options for improvement are:

:::::1) "Autism is [predominantly/primarily/largely/mainly] [viewed/conceptualized] as a neurodevelopmental disorder."

:::::2) "Autism is a neurodevelopmental [difference/condition/disability] characterized by differences and difficulties in social communication and interaction, sensory processing differences, and by [focused/intense] interests and repetitive behaviors such as stimming. In most clinical contexts, including diagnostic systems like the DSM-5 and ICD-11, it is currently classified as a neurodevelopmental disorder under the term autism spectrum disorder (ASD)." LogicalLens (talk) 06:56, 29 April 2025 (UTC)

::::::I don't have time to get into the nitty gritty, but I actually quite like #2 with neurodevelopmental condition. The second sentence there is sufficient for mandatory context. However, if we go for this approach it should be marked out that the inclusion of that sentence is a matter of consensus. CFCF (talk) 13:32, 29 April 2025 (UTC)

:::::::As a procedural point, we do not normally require specific sources to choose between words that are generally considered synonyms. In particular, disease, disorder, medical condition, and illness are normally treated as interchangeable synonyms unless some special circumstance applies. If editors want to chose "neurodevelopmental condition" instead of "neurodevelopmental disorder", then that falls in the category of using our own words.

:::::::(That said, it looks like there are [https://pubmed.ncbi.nlm.nih.gov/?term=%22neurodevelopmental+condition%22+autism&size=200&filter=datesearch.y_10 hundreds of articles at PubMed] using that language.) WhatamIdoing (talk) 17:45, 30 April 2025 (UTC)

::::::::Since every disorder or condition is also a difference and the context of the classification is given directly after that, "neurodevelopmental difference" could be appropriate. "Neurodevelopmental condition" could be used for the short description. LogicalLens (talk) 23:41, 30 April 2025 (UTC)

:::::::::It's not obvious to me what we would lose by going with 'neurodevelopmental disability'. Its status as a 'condition' is, as discussed, contested, including by authoritative sources - although many would agree that 'condition' is at least a slight improvement on 'disorder'.

:::::::::I don't think many in psychiatry, autism research or the neurodiversity movement would dispute that it is a disability. Oolong (talk) 09:33, 1 May 2025 (UTC)

::::::::::From a quick search:

::::::::::* "Some autistic people do not see themselves as disabled at all. This is because they can do the things they want to do. They see autism as a set of differences that do not get in the way of them living the life they want to live."[https://autismunderstood.co.uk/what-actually-is-autism/is-autism-a-disability/]

::::::::::* "Presenting personal truths as universal can invalidate the experiences of others. For instance, if someone insists that "autism is not a disability" based on their positive experiences, it can dismiss the struggles and legitimate needs of those who do experience autism as a disability"[https://www.psychologytoday.com/us/blog/positively-different/202405/healing-the-invalidation-the-complex-truth-of-autism]

::::::::::* "Autism is different ability, not a disability"[https://www.tribuneindia.com/news/anniversary/autism-is-different-ability-not-a-disability/]

::::::::::* "Many people in the autism community argue that their autism is not a disability, that their autistic characteristics are simply core parts of who they are."[https://www.thinkglobalhealth.org/article/autism-and-identity-navigating-disability-versus-difference]

::::::::::* "Although the medical community uses the term autism to refer to a disorder or disability, psychologists consider autistic people to be neurodiverse, meaning autism means otherness, not a disability."[https://tnnenglish.com/autism-is-not-a-disability-but-a-different-ability/]

::::::::::I think that defining autism as a disability conflicts with your prior comments about "autistic thriving". A person who is defined as disabled is a person who is defined as not fully thriving. WhatamIdoing (talk) 19:15, 1 May 2025 (UTC)

:::::::::::Strictly speaking, neurodiversity advocates would argue that autistic people are disabled but do not in all cases have a disability. I think @Oolong's concern was that if we write "neurodevelopmental difference", that could be seen as too neurodiversity-affirming. Although I still think that it is appropriate because the context of the classification as a disorder is given directly after that and every disorder is a difference, I could also accept "disability" because it is more neutral than disorder. But I also agree with you in the argument that “condition” is nearly synonymous with “disorder” and an explanation of the classification as a disorder is confusing and seems redundant in this case. LogicalLens (talk) 04:14, 5 May 2025 (UTC)

::::::::::::Thank you, @LogicalLens and @CFCF, for the thoughtful engagement.

::::::::::::I’d like to offer a clarification that may help preserve both encyclopedic neutrality and conceptual accuracy.

::::::::::::Strictly speaking, the classification of autism as a neurodevelopmental disorder reflects the dominant medical model, which is appropriately acknowledged early in the article. However, this classification does not exhaust the range of academic or experiential perspectives informing the discourse—particularly in the fields of disability studies, neurodiversity research, and cognitive science.

::::::::::::The term “neurodevelopmental difference” is not inherently partisan. It reflects a broader conceptual model in which autism is both medically classified and understood by some as a variant neurocognitive architecture. This view is substantiated in peer-reviewed literature and by recognized scholars:

::::::::::::Milton, Damian (2012). “On the ontological status of autism: the ‘double empathy problem’.” Disability & Society, 27(6), 883–887. doi:10.1080/09687599.2012.710008

::::::::::::Silberman, Steve (2015). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity. Avery Publishing.

::::::::::::Walker, Nick (2021). Neuroqueer Heresies: Notes on the Neurodiversity Paradigm, Autistic Empowerment, and Postnormal Possibilities. Autonomous Press.

::::::::::::Kapp, Steven K. et al. (2013). “Deficit, difference, or both? Autism and neurodiversity.” Developmental Psychology, 49(1), 59–71. doi:10.1037/a0028353

::::::::::::Autistic Self Advocacy Network (2020). “What is the Neurodiversity Paradigm?” https://autisticadvocacy.org

::::::::::::That said, I agree with the point that “disability” may offer a useful middle ground: it captures the functional reality of many autistic people’s experiences while not precluding the framing of autism as difference rather than intrinsic defect.

::::::::::::Suggested compromise framing:

::::::::::::“Autism is a neurodevelopmental disability classified within the medical field as a disorder. Some academic and advocacy perspectives additionally frame it as a form of neurocognitive difference that becomes disabling in specific contexts.”

::::::::::::This acknowledges the clinical classification while neutrally referencing documented minority views, in line with WP:NPOV and WP:RS. Recursiva (talk) 23:50, 5 May 2025 (UTC)

:With a quick search, "neurodevelopmental difference" is unusual (just eight papers during the last 10 years at PubMed). When it is used in the context of autism, it tends to have a pro-neurodiversity POV ([https://pubmed.ncbi.nlm.nih.gov/36090460/], which rejects "the orthodox scientific approach to autism") and not necessarily the sole description ("Autism is a lifelong neurodevelopmental difference and disability").

:For comparison, "neurodevelopmental disorder" is 900x as common, "neurodevelopmental condition" is 100x as common, and "neurodevelopmental disability" is 60x as common. WhatamIdoing (talk) 01:47, 6 May 2025 (UTC)

::Thanks for the PubMed breakdown; it’s a useful metric for gauging dominant terminology. I agree entirely that neurodevelopmental disorder should remain central in the article, as it reflects the current clinical classification and the prevailing medical model.

::That said, I’d gently suggest that citation frequency doesn’t necessarily indicate conceptual superiority. Medical history is full of terms that were once widely used, institutionally reinforced, and later reconsidered—hysteria, moral defect, and the former classification of homosexuality as a disorder, for example. Their prominence in the literature didn’t make them accurate, only entrenched.

::Neurodevelopmental difference is certainly less common, but it does appear in verifiable academic and advocacy sources (e.g. Kapp et al., Milton, ASAN), often to reflect an alternative framing grounded in disability studies, cognitive science, and lived experience. It’s not a rejection of science but an expansion of how autism is understood.

::Including this view—clearly attributed and proportionately weighted—would be consistent with WP:NPOV and WP:DUE. It wouldn’t displace the dominant clinical model, but it would help ensure the article reflects the wider academic and experiential discourse around autism. Recursiva (talk) 02:20, 6 May 2025 (UTC)

:::"Neurodevelopmental difference" is almost three orders of magnitude less common than "neurodevelopmental disorder". What you write about difference being used as an "alternative framing grounded in disability studies, cognitive science, and lived experience" means "according to proponents of the NDM POV". Difference is not neutral; difference belongs to the NDM POV. WhatamIdoing (talk) 04:36, 6 May 2025 (UTC)

::::@WhatamIdoing Thanks again for the continued engagement. I’d like to offer a final clarification—not to restate the full thread, but to situate the core principle as clearly as possible.

::::Yes, “neurodevelopmental disorder” is the dominant clinical term and should remain the central classification in the article. That’s not in dispute. But dominance of usage is not the same as exclusivity of framing.

::::The argument from volume—the claim that citation frequency equals epistemic authority—is one of the weakest available in conceptual discourse. As history repeatedly shows, it’s also one of the least reliable indicators of accuracy, particularly when dominant views have justified continuing harm. From the widespread medical endorsement of lobotomy to the pathologisation of homosexuality, dominant classifications have often persisted well beyond their ethical or empirical defensibility.

::::Reliable sources in disability studies, cognitive science, and advocacy literature—including Kapp et al., Milton, and ASAN—use “difference” intentionally to reflect an alternative conceptual model. Including this framing, when done clearly and proportionally, does not undermine neutrality. It reflects it.

::::This is exactly why Wikipedia follows due weight, not majority rule. The inclusion of reliably sourced alternative framings—such as “neurodevelopmental difference” in peer-reviewed literature—isn’t fringe or promotional. It’s proportional. It reflects the fact that paradigms evolve, and that encyclopedic neutrality isn’t about suppressing minority views, but representing them clearly, with attribution and context.

::::Which seems especially relevant, given that we’re discussing a condition explicitly described as a spectrum.

::::One final note of clarification: there seems to be a recurring conflation between two very different things—point of view and presentation of point of view. Neutrality on Wikipedia doesn’t mean that every concept must originate from a “neutral” worldview. It means that Wikipedia itself must present differing perspectives fairly, proportionally, and with clear attribution.

::::Otherwise, we’d have to delete major swathes of political, religious, and philosophical content. What matters is whether the perspective is verifiable, reliably sourced, and presented with due balance.

::::Neutrality isn’t the erasure of perspective. It’s the accurate representation of it.

::::Recursiva (talk) 08:31, 6 May 2025 (UTC)

:::::I am in full agreement with WhatamIdoing, and must state for the record, that any argument from epistemic authority is purely WP:CRYSTALBALL. As was expressed very early on in this discussion, there is consensus: to consider neurodiversity; and to, when appropriate, use neurodiversity-affirming language. There is not consensus to let neurodiversity override all other views (there is frankly consensus against that). No matter how we look at it, neurodiversity is a minority view, but not insignificant. That means that we should give it WP:DUE weight in relation to the majority view. For the question of terminology of disorder vs. difference specifically, due weight is at most a single sentence in a subsection on neurodiversity.

:::::Neurodevelopmental condition is a reasonably neutral middle-ground that is depathologizing, and I agree we can use it despite it being less common. However, neurodevelopmental difference is not neutral and speaks to a view that is not carried by the mainstream. I think ultimately there is a confusion here that we can reason our way to "the right answer", as expressed by using terms like epistemic authority. What I mean when I say that the argument is speculative, is not only that is presupposes that there will in the future be a result that is in line with the arguments that "I" put forward, but that such an argument can reasonably lead to a logical conclusion based on some set of maxims. The terminology isn't logical, it is consensus-based and builds on trade-offs - and for now it is what we must consider. CFCF (talk) 10:17, 6 May 2025 (UTC)

:"Neurodevelopmental disorder" should stay as is. I do not see how the alternatives are of any improvement, as "disability" or "condition" are all under the same umbrella as "disorder". Neurodevelopmental disorders listed in the ICD or DSM are usually referred to as such on the first sentence in any other article (such as attention deficit hyperactivity disorder). This is not to say that it is a rule, it absolutely isn’t, but given the significant probability of mild or severe functional impairment, it is appropriate to keep it as it is now. Slothwizard (talk) 05:49, 8 May 2025 (UTC)

::As a general rule, there are two ways to address neutrality concerns about individual words/phrases. One is to be more ambiguous, and the other is to be more concrete. Both let people bring their current beliefs, biases, and background knowledge to the article without feeling like we're contradicting them. For example, if there is a disagreement about whether to call some snake oil "a treatment" (which some people interpret as saying that it is effective for treating a disease), then editors might choose vaguer words like "a product" or even "a product intended to treat a disease". Alternatively, they might get more specific: It's "a chemical solution composed of table salt and food dye". No matter what your belief about that snake oil is, neither approach tells you that you're wrong.

::In this case, "condition" is an attempt to go a little bit vaguer. Some people will read it as "Oh, condition. They mean medical condition, and that's just another word for disease or disorder. It's great they're not pretending autism is a harmless or normal thing." Other people will read it as "Ah, condition: like situation or the human condition. How nice that they're not pathologizing autism."

::And – the key point from my POV – neither of them, despite holding opposite POVs, will complain about it. WhatamIdoing (talk) 16:26, 8 May 2025 (UTC)

:::There would be no clear direction for the article if this is done. For example, what should the short description be? Condition? Difference in human experience? This is not DUE. There is a substantial amount of research done on autism. The neurodiversity perspective should have good coverage, but there is an overall scientific consensus as to what autism is. The first sentence should not be vague in this case. Slothwizard (talk) 04:14, 10 May 2025 (UTC)

::::Short descriptions often use the language from the first sentence, so if we settled on "Autism is a neurodevelopmental condition", it'd probably say "neurodevelopmental condition", and if we settled on "neurodevelopmental disorder", it'd probably say "neurodevelopmental disorder", etc. WhatamIdoing (talk) 05:11, 10 May 2025 (UTC)

:::::This is correct, though neurodevelopmental condition is explicitly a medical condition. Only "condition" alone would be vague. Slothwizard (talk) 05:15, 10 May 2025 (UTC)

::If you think disability, condition, and disorder mean a similar thing, would you then object to disability? LogicalLens (talk) 02:58, 9 May 2025 (UTC)

:::I would object to this. Disability is slightly more specific than disorder, since autism causes disability, while autism itself is the disorder. It is an inflexible descriptor of autism. I do not support changing it to "neurodevelopmental condition" or "condition" either since that would create a redirect to neurodevelopmental disorder, which is the name of the article. "Condition" itself—without a wikilink—implies that there is a lack of research and understanding of autism. While we do not understand the pathophysiology of any mental disorder well, autism is substantially researched and we have a better understanding of it. It was fine as "neurodevelopmental disorder" because it establishes the consensus of what it is and reflects common understanding of autism. Slothwizard (talk) 04:03, 10 May 2025 (UTC)

::::IMO so long as "we do not understand the pathophysiology", then we don't actually know what autism "is". We just know what appearance it produces. That, in turn, suggests that if you wanted to rely on dictionary definitions instead of the particular word choices by reliable sources, then autism "is" a syndrome, in the sense that it's a collection of associated features whose pathophysiology we don't understand. I doubt that this would be more acceptable than disorder to people holding the anti-pathologizing POV. WhatamIdoing (talk) 05:14, 10 May 2025 (UTC)

:::::I was going more for a dictionary definition. We have a poor understanding of pathophysiology for most mental disorders, even more so for autism, so I agree that we do not know what it *is* in a deeper sense. Because most research point towards a pathology, and also the lack of an article representing those on the severe end of the spectrum, having an ambiguous lead would not be appropriate. Disability and condition do not de-pathologize autism anyway; they both suggest a pathology. Slothwizard (talk) 05:29, 10 May 2025 (UTC)

::::::As I explained above, I think that condition can be interpreted as non-pathologizing language. After all, being a genius is also "a neurodevelopmental condition", and nobody thinks that's a problem. WhatamIdoing (talk) 06:09, 10 May 2025 (UTC)

:::::::Being a genius is not a pathology. Savant syndrome, if that’s what you’re referring to, is described as a phenomenon in its article, which is ambiguous. In that case, it is absolutely correct. It was observed that some people had a superability that co-occurs with a neurodevelopmental, genetic, or neurological disorder. It is not itself a disorder. People refer to this as a disorder or condition colloquially due to the fact that it co-occurs with one, though no diagnostic manual would designate it as such. It would be like calling imposter syndrome a clinical disorder. Slothwizard (talk) 06:31, 10 May 2025 (UTC)

::::::::Being a genius is not a pathology. Being a genius can be fairly described as "a neurodevelopmental condition". After all, being a genius is the condition that the person is in, and it's about that person's neurodevelopmental situation.

::::::::Some people are upset when we say that autism is pathological. However, they might not be upset if we say that autism is a "condition" that some people have/are in. After all, being autistic is the condition or state that the person is in, and it's about that person's neurodevelopmental situation.

::::::::Other people are upset when we say that autism isn't pathological. However, they might not be upset if we say that autism is a "condition" that some people have/are in. After all, "condition" can also mean medical condition, and it's about that person's neurodevelopmental situation.

::::::::This is ambiguous – people can read it to align with their own biases – but I suggest that it's not actually wrong. WhatamIdoing (talk) 18:03, 10 May 2025 (UTC)

:::::::::When someone refers to "genius" or a certain superability as a neurodevelopmental condition, they are implying that it is a disorder. This does not mean that people believe that it is a medical condition, but it is often referred to as such due to common semantic use. "A person with an ability" or "a genius" would be the more common non-pathological language used. Similarly, if a person was blind, you could say "they are blind" or "he/she has a condition of blindness". The latter, if you interpret it literally, does not have to be seen as pathological. However, it will still imply pathology due to how people interpret words. It is not likely that calling autism a "neurodevelopmental condition" or "condition" would create a more neutral view of autism, especially that it will likely be wikilinked. Outside of this, the amount of evidence validating the neurodiversity framework is not sufficient enough to change the first sentence. De-pathologizing the first sentence, which likely means that disorder and the other suggested terms would have to be done away with, would cause a full alteration of the article. Using the term condition, even alone, would not accomplish this anyways; it provides only semantic ambiguity while still implying pathology, which is something Wikipedia should avoid. Slothwizard (talk) 20:22, 10 May 2025 (UTC)

::::::::::Which part are you objecting to? The part where "semantic ambiguity" reduces the endless parade of autistic people from saying that we're pathologizing their lives by using words like disorder in the first sentence, or the part where we'd be "implying pathology" because condition could be (but isn't necessarily or automatically) a medical condition (which, in turn, isnt' necessarily or automatically a pathological situation; see also Pregnancy, which is a non-pathological medical condition)? WhatamIdoing (talk) 22:46, 10 May 2025 (UTC)

:::::::::::I object changing "neurodevelopmental disorder". I was making the point that if we do end up changing it, condition wouldn’t work. But I ultimately oppose changing it in the first place. Sorry, I probably got too wordy, that is my bad. Slothwizard (talk) 22:58, 10 May 2025 (UTC)

::::::::::::WP:WIKIVOICE says that opinions must not be presented as facts (which a sentence like "Autism is ..." does), and this even applies to majority views like considering autism as a disorder. “Condition” is less pathologizing than “disorder”, albeit not neurodiversity-affirming. As “neurodevelopmental condition” (which would also be the short description) is clear enough, the possible confusion about the term "condition" is not a problem here. Another option would be, as I wrote above, to avoid the definition in the first sentence (“Autism is characterized by…”). LogicalLens (talk) 07:18, 11 May 2025 (UTC)

{{outdent}}

:The World Health Organization describes autism as a neurodevelopmental disorder. Any view that "neurodevelopmental condition" would be a superior term is just POV; this is not what autism is commonly referred to as nor what most sources and diagnostic manuals describe it. Is there are neurodevelopmental disorders that need a similar discussion (i.e., ADHD, Tourette syndrome)? The scientific community has already established autism as a neurodevelopmental disorder.

:The dispute to this is not nearly sufficient enough to warrant integrating this into the article beyond various mentions, which the lead currently does a perfect job of this. Slothwizard (talk) 18:47, 11 May 2025 (UTC)

::"Condition" is still on the medical model side. See this survey that finds that the more people support neurodiversity, the less they are willing to accept "condition".[https://www.liebertpub.com/doi/abs/10.1089/aut.2024.0297] The sources supporting neurodiversity would currently not be sufficient to remove the pathologization entirely but they are sufficient to choose a less pathologizing term among medical model terms. I also agree with @WhatamIdoing that "condition" is a useful solution to the dispute here. It is not my personal preference, but we have to find a solution. LogicalLens (talk) 01:33, 12 May 2025 (UTC)

:::A survey of people concluding that people may not like the term disorder doesn’t make autism not a disorder. We are not here to appease people's feelings. Also, like I said before, this article is largely referring to autism in the clinical sense. Slothwizard (talk) 02:33, 12 May 2025 (UTC)

::::The fact that "this article is largely referring to autism in the clinical sense" is one of the things that is being objected to. Some editors think this article should also think about autism in the non-clinical sense. Imagine a world in which the other person is not entirely wrong. Is there something we could write that would be not only fair and true, but also include more than just the clinical POV? WhatamIdoing (talk) 02:40, 12 May 2025 (UTC)

:::::That would probably require the article to be split. There are people with very severe presentations of autism causing people to be non-speaking, have no theory of mind, etc. I understand it causes confusion regarding people with less severe or mild presentations, but bundling non-clinical autism (a phenotype) would not be compatible. Merging content regarding people with non-complicated characteristics of autism (different personality, perceptions without impairment) with people who are completely unable to speak does not make any sense. Slothwizard (talk) 02:47, 12 May 2025 (UTC)

::::You misunderstood what I was talking about. I am not arguing that this survey is a reason why “disorder” should be removed. “Disorder” should be replaced by “condition” because the latter is less pathologizing (which is appropriate, given the growing support of neurodiversity in the literature), while still being a term of the majority medical model. It is also wrong that neurodiversity only applies to the world outside the clinical realm as neurodiversity advocates for a change in clinical practice. It also does not deny that autism is in many cases a disability, like the ones you mentioned where people are non-speaking. It just argues that a disability is not intrinsically a bad thing, see for example the disability theories by Elizabeth Barnes. LogicalLens (talk) 06:00, 12 May 2025 (UTC)

:::::I agree in this, as it is a reasonable trade-off to use neurodiversity-affirming language in this article—while also being strict about how this article is about the majority view—of autism as a medical condition.

:::::Whether we want to use the overarching label of disorder, disability, or condition as the main term (e.g. relegating mention of specific classification as a disorder/disability to when it is discussed in context of sections on ICD or DSM) seems to me a minor semantic point, where we have little to lose, including a very limited loss of precision, but much to gain by being more affirming and depathologizing in language use throughout.

:::::I did like the suggestion that one can split out Broader autism phenotype. If I had more time, I would have given that article a start, as I don't think it would be all too difficult to create a viable stub.

:::::It seems that this would cut to the core of any dispute, in that we acknowledge that neurodiversity is a significant minority view that merits in-depth coverage, just not here - and that there is little dispute on the use of neurodiversity affirming language also in covering the medical aspects (without fully endorsing the neurodiversity view as the majority or only view). CFCF (talk) 08:02, 12 May 2025 (UTC)

::::::If we now have a majority here to use "neurodevelopmental condition", we could make the change.

::::::I am not sure why some believe that creating an article on the broader autism phenotype would resolve any part of the current dispute. This discussion centers on autistic people—those who meet the diagnostic criteria for autism. The core principle of the neurodiversity movement is not that autistic traits are acceptable only if someone can function according to neurotypical norms. Rather, it emphasizes that being autistic—even when it involves challenges in a world built around neurotypical expectations (what proponents of the medical model might call "clinically significant impairment")—is not inherently negative or pathological. This is not yet the majority view in the clinical world but this broader autism phenotype article would in no way alleviate the concerns of editors here who argue for greater coverage of the neurodiversity view. LogicalLens (talk) 07:23, 13 May 2025 (UTC)

:::::::Well because there is no content dispute - because this article is about the majority conceptualization. That vocal editors here do not ascribe to this view is irrelevant. CFCF (talk) 08:03, 13 May 2025 (UTC)

::::::::Creating a broader autism phenotype article is in no way meant to "alleviate the concerns of editors here who argue for greater coverage of the neurodiversity view". It is meant to provide information about a concept used in research and recognized in practice by affected families. WhatamIdoing (talk) 17:05, 13 May 2025 (UTC)

:::::::::Then I misunderstood you. LogicalLens (talk) 01:18, 14 May 2025 (UTC)

::::::::::@Slothwizard, multiple users here agree on "neurodevelopmental condition" as, while the significant proportion of sources supporting the neurodiversity view does not justify removing the pathologization completely, it is sufficient to choose a less pathologizing term among medical model terms. LogicalLens (talk) 03:50, 17 May 2025 (UTC)

:::::::::::I agree in part, but condition is not a more neutral term, it just creates a redirect to neurodevelopmental disorder. More than several sources refer to it as a neurodevelopmental disorder as well, many of which were on the lead. Slothwizard (talk) 04:30, 17 May 2025 (UTC)

::::::::::::Condition doesn't have to "be" a more neutral term for this purpose. At some level, it only needs to "seem like" a more neutral term to some people. WhatamIdoing (talk) 04:38, 17 May 2025 (UTC)

:::::::::::::No it does not. We are not here to appease people; this is an informal way to go about this. Slothwizard (talk) 04:50, 17 May 2025 (UTC)

::::::::::::::I agree: Condition does not have to "be" a more neutral word to be a helpful word choice for this article.

::::::::::::::Or were you saying with "No it does not" that you think it's not sufficient for a word to merely "seem like" it is more neutral, and that we should find one that the medical establishment does not see as a near-synonym for disorder? WhatamIdoing (talk) 04:59, 17 May 2025 (UTC)

::::::::::::::While it is true that the phrase "neurodevelopmental condition" links to the article Neurodevelopmental disorder, that alone does not invalidate its use. Wikipedia often uses different phrasings or synonyms that redirect to the most comprehensive article. Additionally, Wikipedia style guidelines do not mandate rigid adherence to the title of a linked article. It is acceptable and common for Wikipedia to use phrasing that redirects to or links to a more general or technically titled page. LogicalLens (talk) 04:57, 18 May 2025 (UTC)

:::::::::::::::I am not arguing this. I am saying that there isn’t a compelling reason to be changing it. I have no idea what changing disorder to condition accomplishes. This is very arbitrary. Slothwizard (talk) 05:10, 18 May 2025 (UTC)

::::::::::::::::Changing disorder to condition accomplishes the highly desirable, policy-based goal of making the article appear, in the opinions of a significant number of editors, to use a more appropriate Wikipedia:Neutral point of view#Impartial tone. WhatamIdoing (talk) 05:14, 18 May 2025 (UTC)

Thanks for your continued input.

Consensus isn’t the omission of perspectives just because they’re inconvenient.

Unfortunately, the most recent position mooted:

• Misapplies WP:CRYSTALBALL to dismiss live, sourced epistemic shifts
• Frames proportional inclusion as domination
• Claims consensus where none exists
• Positions “disorder” as neutral and “difference” as political—while denying that “disorder” is itself value-laden
• Undermines policy-grounded reasoning with rhetorical appeals to vague trade-offs

As outlined in WP:CONSENSUS, it’s not a comfort mechanism. It’s a policy framework for surfacing plural, sourced perspectives—especially when they challenge legacy defaults.

This argument has already been substantially dismantled—both in terms of sourcing and policy alignment—but instead of engaging the core points, responses have shifted sideways.

WP:CRYSTALBALL is misapplied—and inverted.

“Neurodevelopmental difference” isn’t a prediction. It already appears across academic literature, APA Style, advocacy discourse. Including it in the lead—attributed, proportionate—is documentation, not speculation.

CRYSTALBALL warns against rejecting sourced content because of projected future shifts. That’s what’s happening here.

This isn’t about what might happen. The shift is already underway.

Volume is not policy—and it’s not epistemic rigor.

Frequency in outdated corpora ≠ weight. WP:DUE asks for proportionality now, not word count across diagnostic manuals from the 90s.

Volume tracks inertia—not validity. If you want epistemic currency, look at rate of adoption, disciplinary spread, diversity of sources—not just raw mentions.

“Difference” is no more ideological than “disorder.”

Both carry worldview. Neither is “neutral.” The question is: which are verifiable, in use, and appropriate to context? The answer is both.

WP:NPOV doesn’t mean suppressing one framing. It means reflecting them all—accurately and in proportion.

Consensus isn’t a veto.

There’s no consensus to exclude neurodiversity framing from the lead. In fact, it’s already present in the article. This isn’t an overhaul—it’s a structural alignment.

Calling “consensus” midway through a live, policy-based proposal isn’t a policy argument. It’s a rhetorical move.

Evasion is not a rebuttal.

There’s been repeated engagement with weaker arguments while the central policy-based ones go unaddressed. That’s not good faith editing. That’s selective avoidance.

Let’s name the discomfort under this resistance:

Including language like “difference” challenges a worldview where autism and ADHD are framed only as dysfunction. It opens the possibility that these may be forms of cognition that exceed normative capacity—and that the system isn’t designed for them.

This isn’t about abolishing clinical terms.

It’s about whether Wikipedia reflects sourced, evolving plurality—or keeps reinforcing a single frame despite evidence of shift.

If the article already underrepresents the neurodiversity paradigm, excluding it from the lead doubles the distortion.

A single, proportionate sentence doesn’t overreach.

It begins to correct the imbalance.

1. WP:CRYSTALBALL is misapplied—and inverted.
2. :“Neurodevelopmental difference” is not a speculative term. It is already present in peer-reviewed literature, APA Style guidance, and multiple advocacy and academic contexts. Its inclusion in the lead—clearly contextualized, proportionate, and attributed—is documentation, not prediction. CRYSTALBALL prohibits suppressing sourced content because of projected consensus shifts. That’s precisely what this argument has attempted to do.
3. :More to the point, the framing of autism and ADHD is already evolving. We are not arguing for a future hypothetical—we are pointing out that the dominant framing being defended here is being revised in real time across multiple disciplines.
4. :The future that feels uncomfortable to you has already arrived.
5. Volume isn’t policy—and it’s the wrong epistemic tool.
6. :Appealing to historical frequency as a measure of weight is not just weak—it’s conceptually incorrect. WP:DUE asks for proportionality within current contexts, not total word counts across outdated corpora. Volume tracks inertia, not epistemic accuracy.
7. :If you’re committed to tracking actual language evolution, you’d be examining rate of adoption, contextual presence, and source diversity—not which term appeared most in diagnostic manuals from decades ago.
8. :Continuing to cite volume as policy is not due diligence. Delay does not equal authority.
9. “Difference” isn’t more ideological than “disorder.”
10. :The claim that “difference” is politically loaded while “disorder” is neutral doesn’t hold up. Both terms encode worldview. The question is not which is neutral—neither is—but which are verifiable, current, and contextually relevant.
11. :The answer is both. And WP:NPOV and WP:DUE require us to reflect both—with balance, not erasure.
12. Consensus is not a veto.
13. :There is no consensus to suppress the neurodiversity framing from the lead. The existing consensus supports proportional inclusion of the neurodiversity paradigm. This proposal reflects that balance and simply extends it to the lead. Declaring consensus against a live, policy-aligned proposal mid-discussion is not a policy move. It’s a rhetorical one.
14. :So is consistently responding to lesser arguments while ignoring the stronger ones.
15. Avoiding the argument weakens the position.
16. :You’ve repeatedly replied to adjacent or easier comments while leaving the policy-grounded points here unaddressed. That’s not collaborative editing—it’s selective engagement. And it undermines your position more than it defends it.

Let’s also acknowledge the discomfort beneath this resistance:

The inclusion of language like “difference” threatens certain worldviews because it implies that autism and ADHD may not be dysfunctions—but forms of cognition that could exceed normative capacity in ways the current system isn’t designed to accommodate.

This isn’t about rejecting clinical language.

It’s about whether Wikipedia reflects sourced, policy-aligned plurality—i.e., the increasing usage in academia, policy, and public discourse of alternative framings—or whether it continues to limit the lead to a single model, despite clear consensus for proportional representation.

If the body already underrepresents the neurodiversity paradigm, then excluding it from the lead compounds the distortion. A single, proportionate sentence does not overreach—it begins to correct the imbalance.Recursiva (talk) 12:00, 7 May 2025 (UTC)

• It is a disorder. It is a diagnosis. If it doesn't cause "clinically significant impairment" then it isn't autism; it's within the range of normal human variation. It's not a philosophical debate. It's definitional. GMG^talk 12:32, 7 May 2025 (UTC)
• : GMG^talk Ecactly! Lova Falk (talk) 14:06, 7 May 2025 (UTC)
• ::This reminds me that I've wanted to see whether Broader autism phenotype could be a viable article. (That's apparently the term for people who have autistic traits without clinically significant impairment.) WhatamIdoing (talk) 17:42, 7 May 2025 (UTC)
• :::I think that is a good idea! Lova Falk (talk) 04:47, 8 May 2025 (UTC)
• :::I support this! Significant amounts of research has been made regarding this. Slothwizard (talk) 05:36, 8 May 2025 (UTC)
• :::While the definition may be oversimplified here, I support this. Developing dedicated subarticles—like one on the Broader Autism Phenotype (BAP)—would enhance the structural integrity of the Autism article. As the central node, the main article can link to subarticles that explore diagnostic, trait-based, and conceptual frameworks. This structure aligns with WP:DUE by giving proportionate space to each perspective, including the clinical, without overburdening the lead.
• :::
  
• :::Moreover, this architectural strategy reinforces the rationale for a lead that reflects autism’s evolving conceptualization. @LogicalLens’s proposed wording, which integrates both clinical classification and identity-based framing, exemplifies this balance. And it does so in a way that remains squarely within MOS:FIRSTSENTENCE and WP:NPOV.
• :::Recursiva (talk) 06:13, 8 May 2025 (UTC)
• :@GMG – Your response repeats a definition but doesn’t address the policy‑based concerns actually raised.
• :* Non‑engagement: The earlier post set out five policy points (WP:CRYSTALBALL, WP:DUE, WP:NPOV, WP:CONSENSUS, selective engagement). None of those are answered here.
• :* Definitions evolve: Even the DSM‑5 says impairment is measured “in context.” ICD‑11 calls autism a “neurodevelopmental condition,” not merely a disorder. Peer‑reviewed literature (e.g., Bury 2020; Kapp 2021) and APA Style guidance routinely use “neurodevelopmental difference.” So the claim that there is a single, settled definition is not supported by current sources.
• :* WP:NPOV / WP:DUE: Wikipedia summarizes all significant, sourced viewpoints in proportion. That includes the clinical model and the neurodiversity framing. Declaring one perspective “not a philosophical debate” doesn’t negate the policy requirement to represent the other.
• :In short, re‑asserting a traditional definition without engaging the sourcing and policy issues already on the table doesn’t resolve the dispute—it restates it. Please address the policy concerns directly if you wish to move the discussion forward. Recursiva (talk) 15:07, 7 May 2025 (UTC)
• ::WP:CRYSTALBALL has nothing nothing to do with this article whatsoever. The ICD calls autism a disorder about a million times. DUE doesn't mean rewriting things agreed upon by the majority of relevant experts to avoid hurt feelings. Diverging views regarding neurodiversity can go on the main article for the topic and not on the topic covering the diagnosis. GMG^talk 15:31, 7 May 2025 (UTC)
• :::I am going to adress you policy-based concerns in full {{U|Recursiva}}, with a brief comment:
• :::* Each point you bring up is touched upon in my prior comment. That you disagree, is mostly you being wrong, and partially us disagreeing - which is fine. Your assertion that a shift has happened already, when it hasn't, is textbook WP:CRYSTALBALL. Reiterating the same argument 10 times over, in extremely voluminous posts, then demanding repetition of answers, does not make your points more valid.
• :::CFCF (talk) 17:00, 7 May 2025 (UTC)
• ::::One option would be to use "neurodevelopmental disability" as a compromise, the other would be to avoid the definition in the first sentence altogether: "Autism is characterized by differences and difficulties in social communication and interaction, sensory processing differences, focused interests and repeated behaviors such as stimming. In most clinical contexts, including diagnostic systems like the DSM-5 and ICD-11, it is currently classified as a neurodevelopmental disorder under the term autism spectrum disorder (ASD)." LogicalLens (talk) 23:06, 7 May 2025 (UTC)
• :::::I don't think your suggested first sentence aligns with MOS:FIRSTSENTENCE, and the "currently" in your suggested second sentence implies a change that nobody believes is forthcoming. WhatamIdoing (talk) 00:20, 8 May 2025 (UTC)
• ::::::I would like to hear other editors' opinions on whether my suggestion is compatible with MOS:FIRSTSENTENCE.
• ::::::The "currently" does not mean that a change is automatically going to happen but that a change in the future is possible (and a growing number of sources advocate for it). Second, these definitions have always been changing. The DSM-IV classified autism as a “pervasive developmental disorder” and distinguished between Asperger syndrome and childhood autism, in the future there might be a "profound autism" category (whether anyone likes it or not), and it is possible that multiple subtypes of autism are identified. The classification as a neurodevelopmental disorder is likely to be temporary. LogicalLens (talk) 05:21, 8 May 2025 (UTC)
• :::::::@LogicalLens I agree—highlighting how classifications have shifted over time (e.g., DSM-IV vs DSM-5, the emerging category of “profound autism”) helps position currently not as speculative, but as grounded context. That choice strengthens the encyclopedic tone.
• :::::::It also reinforces a key point: autism’s framing isn’t epistemically static. The lead should reflect both the prevailing classification and the range of perspectives in reliable sources—clinical, academic, and advocacy-based.
• :::::::Your proposed structure, with clear attribution and proportionality, aligns well with both MOS:FIRSTSENTENCE and WP:NPOV.
• :::::::Recursiva (talk) 05:37, 8 May 2025 (UTC)
• ::::Stating “you’re just wrong” is your personal opinion. It is not a rebuttal but rhetorical deflection.
• ::::WP:CRYSTALBALL prohibits rejecting sourced present-day shifts because they challenge legacy norms. That’s exactly what’s happening here. The sources cited (Milton, Kapp, Bury, ASAN, APA) are real-time documentation, not prediction.
• ::::Volume ≠ validity. Repetition only exists because the argument hasn’t been addressed directly.
• ::::If there's a policy-grounded rebuttal to the proposal’s sourcing and framing, I’m open to it. To date, none has been offered.
• ::::Recursiva (talk) 02:58, 8 May 2025 (UTC)
• ::While I understand and share many (not all) of your positions, your walls of text with lots of repetitions are a problem. I was criticized for a similar thing a few months ago and would recommend you to read this essay[https://en.wikipedia.org/wiki/Wikipedia:Don%27t_bludgeon_the_process] and also WP:REHASH. It weakens your position and makes solutions to the conflict less likely. LogicalLens (talk) 23:11, 7 May 2025 (UTC)
• :::I appreciate your continued engagement. “Neurodevelopmental disability” seems like a workable middle ground, especially when paired with attribution that aligns with WP:NPOV.
• :::Your earlier phrasing, which acknowledged both the clinical classification and the identity-based framing, stood out for its clarity and balance. It’s one of the few responses in this thread that feels grounded in both policy and lived experience.
• :::If you’re open to naming specific points of agreement or disagreement, or pointing me to anything I’ve missed, I’d genuinely welcome the exchange.
• :::Recursiva (talk) 05:15, 8 May 2025 (UTC)
• :Arguments that autism must exclusively be framed through the medical model—or that this framing is the only objective or valid one—overlook the legitimacy of alternative perspectives. These views are not attempts to deny reality as the existence of disability is acknowledged by neurodiversity proponents. This is viewed mostly through a social model of disability lens and in cases of inherently disabling features, through a model similar to that proposed by Elizabeth Barnes that views disability as neutral.
• :In practical terms, it is also worth noting that several incremental edits to the article have already been made, and what is under discussion now is not a wholesale reworking of its focus. When some editors refer to “shifting the focus,” this is not about removing information on diagnostic criteria or overwhelming them with cultural content. Rather, it is about presenting autism in ways that reduce stigma while maintaining accuracy—an approach that many contributors support, even if they do not fully align with all aspects of the neurodiversity paradigm. LogicalLens (talk) 06:49, 8 May 2025 (UTC)

At this point, the core policy-aligned argument—that autism should not be defined solely through the clinical lens of ASD—has been mooted, sourced, and remains unrefuted.

Objections have either misapplied policy (e.g., WP:CRYSTALBALL), deflected to tone, or selectively responded to easier points while avoiding the sourcing and DUE/NPOV alignment at the center.

Unless a clear policy-grounded counterargument is presented, WP:CONSENSUS can reasonably be inferred from the unresolved clarity of the proposal.

Proportionate mention of the neurodiversity framing in the lead reflects Wikipedia policy (not ideology). Recursiva (talk) 02:48, 8 May 2025 (UTC)

:Consensus means "agreement". When there is an open dispute, with multiple editors on different sides, then we don't have consensus. Your conviction that your view is the correct one is not evidence that others have agreed with you. WhatamIdoing (talk) 03:43, 8 May 2025 (UTC)

::Precisely. A considerable number of editors have been working quite collaboratively, eking out consensus over many months and quite consistently avoiding conflict over the past two months. I hope we can keep that up.

::However, I must maintain that, yes WP:CRYSTALBALL is exactly the correct policy to apply in relation to your propositions {{U|Recursiva}}. Wikipedia does not determine what to include, or what language to use by logic or epistemic validity, but by what is present in reliable sources. I would implore you to read WP:WEIGHT, which mentions that text should be in {{tq|proportion to the prominence of each viewpoint in those sources}} - not in proportion to what editors think is logically consistent (over which we also seem to fundamentally disagree). CFCF (talk) 08:20, 8 May 2025 (UTC)

Just a note on a late debate that I noticed - on whether to use severity in the lede. I am cautiously pro omitting severity from the lede, but insist it must remain in some part of the article, if nothing else in the classification section. However, it does not make sense to replace severity with presentation or something that misses the range, degree, or spectrum of difficulties. That says something entirely different, and that is not neurodiversity-affirming, that is being euphemistic. CFCF (talk) 15:33, 25 April 2025 (UTC)

:I think the thing about "severity" is fundamentally about a POV. I realize I've been harping on this point for a year now, but the problem is that we don't have a shared understanding of what autism is.

:If autism is an atypical wiring pattern in the brain, then of course you could have "mild autism" or "severe autism" or whatever; that would just be a description of how close to the middle it is, and no different from saying that today's weather is ordinary, but last week's was severe.

:But if autism is a normal human variation, then how could it be "severe"? We don't usually say that a person is "severely normal".

:Of course, all of this assumes that the person is literally interpreting the words. We know that medical language shouldn't be interpreted literally (cf. Chronic Fatigue Syndrome, which isn't being tired all the time; Polycystic ovary syndrome, which doesn't require polycystic ovaries). However, we also know that autistic people are more likely than neurotypical people to interpret words literally, and I think we can safely assume that autistic people make up both a high proportion of editors of this article and a somewhat higher proportion of readers of this article. In this case, "severe autism" doesn't mean "a lot of autism"; it means that the person is severely impaired (non-verbal, abnormally low IQ, unable to care for self) due to autism. It is not literal wording. WhatamIdoing (talk) 18:01, 25 April 2025 (UTC)

::Is it not as simple as being clear that the deficits/difficulties are severe, just as you say? CFCF (talk) 18:08, 25 April 2025 (UTC)

:::I think that "severe" and "severity" are words that some Wikipedia editors would like to excise from any sentence about autism, regardless of context. Some autistic people seem to react to it as if it is automatically a slur. WhatamIdoing (talk) 20:14, 25 April 2025 (UTC)

:I think the lede should certainly include coverage of severity, including a broadening of the definition of autism. For example, diagnoses of 'severe' autism have apparently not been increasing, while more autism cases under a broader definition have increased. This is an important detail in refuting the claim that autism is 'on the rise' (made by the likes of RFK Jr). Zenomonoz (talk) 23:58, 25 April 2025 (UTC)

:"Varying support needs" is a non-euphemistic alternative to "varying levels of severity". LogicalLens (talk) 00:06, 26 April 2025 (UTC)

::I don't think these are the same.

::"Varying support needs" could mean the type of support ("Alice uses ear defenders in noisy environments, and Bob needs clothes that don't itch") or the amount of support ("Alice lives by herself in a one-bedroom apartment and drives herself to work each morning, but Bob needs round-the-clock supervision").

::"Varying levels of severity" is more obviously about the amount of support. WhatamIdoing (talk) 02:09, 26 April 2025 (UTC)

:::Terms, such as "profound autism" and "severe autism," are not standardized or widely accepted medical terms. They're chiefly pushed by organizations that go out of their way to be as pathologizing as possible, such as the Autism Science Foundation and the National Council on Severe Autism. It's not appropriate to treat those labels as if they are standardized or widely accepted here on Wikipedia. They should only be mentioned in direct quotes with explanatory context. I agree with LogicalLens' suggested verbiage for the lede. DoItFastDoItUrgent (talk) 02:29, 26 April 2025 (UTC)

::::I disagree. Words do not have to be "standardized" to be useful. The color blue, for example, is not standardized, and yet people manage to use them.

::::I agree that you have removed references to severe autism on Wikipedia, but I do not think that your removals or your addition of scare quotes around it ([https://en.wikipedia.org/w/index.php?title=National_Council_on_Severe_Autism&diff=prev&oldid=1283246772 example]) are always appropriate. WhatamIdoing (talk) 06:06, 26 April 2025 (UTC)

:::::They're not scare quotes. They're quotes designed to make it clear that the terms are unofficial, and you can't make a legitimate argument that editors on Wikipedia should use terms, like "severe autism" or "profound autism" (or use derivative phrases, like "severely autistic" or "profoundly autistic"), without quotes or explanatory context. If, in a few years time, ableist hate groups and savior organizations win the language war and those terms become medically standardized or put into wide usage, then you might have a point. We are not at that point yet (and hopefully never will be). And, if you want to discuss one another's edit histories, maybe you'd like to explain what motivated you to create the article for the National Council on Severe Autism. Did you really think the organization was noteworthy and that it made Wikipedia a more comprehensive repository of information, or did you do it solely to promote the organization and its ideology? DoItFastDoItUrgent (talk) 21:28, 26 April 2025 (UTC)

::::::They're scare quotes. They're quotes designed to make it clear that you disapprove of these terms, and I can make a legitimate argument that editors on Wikipedia should use terms without quotes or explanatory context. Specifically, that argument is: Almost everything we write, including your comment above, is neither "quotes" nor "explanatory context".

::::::If you think that an organization of parents caring for severely disabled people is best described as "ableist hate groups and savior organizations", and you think there is a "language war" underway, then I suggest you not edit articles about those subjects.

::::::What motivated me to create the article National Council on Severe Autism is that I (a) read about them in a newspaper, (b) realized that they met the WP:NORG requirements to have an article, and (c) had time to work on it at that moment. I see that you haven't ever created an article, so perhaps you think it's a difficult task that requires external motivation, but I've created well over a hundred, and it's easy for me. WhatamIdoing (talk) 21:43, 26 April 2025 (UTC)

:::::::I am done engaging with you in any way and will ignore any further replies or pings that originate from your user name. During our interactions over the past several months, you have made it abundantly clear that you are outright hostile toward members of the Autistic community (particularly those who subscribe to the neurodiversity paradigm) and have explicitly expressed your opinion that using forcible electric shocks to punish autistic residents at the Judge Rotenberg Center is not necessarily torture (despite overwhelming evidence and expert consensus that it is) and that you view the autistic neurotype as akin to a "genetic disease." It is unfortunate that, seemingly because of your long history here on Wikipedia, that such outright bigotry is largely ignored and tolerated (which seems to be a systemic problem on this site, rather than just a problem involving you). Good luck in your future endeavors here on Wikipedia. DoItFastDoItUrgent (talk) 22:08, 26 April 2025 (UTC)

:::::::::{{U|DoItFastDoItUrgent}}—this latest comment is deeply WP:TENDITIOUS and outright describes a WP:BADFAITH argument. You are entitled to not engage on Wikipedia, and are entitled not to engage with specific editors—but you are not entitled to say that very neutral comments from an editor in high standing (that is trying to be compassionate, while still abiding by Wikipedia's principles and a scientific view)—are "outright hostile" or "bigotry". This is far across the line, and not true. I hope you can refrain from saying such things again. CFCF (talk) 12:31, 27 April 2025 (UTC)

::::::::You are rather asserting baseless accusations, which unfortunately has happened several times on this page. I have kept up with the conversations here extensively and do not recall any instance of them saying such things. The global scientific consensus, as has been referenced elsewhere above, concludes that autism is a neurodevelopmental disorder with varying severity levels. That is what we are trying to reflect on the article, not that it’s a “disease”. It meets the definition of a disorder based on (1) the presence of neurological variation in a trait universal to humans and (2) accruing impairment in major life domains, as well as increased risks for morbidity, injury, and even early mortality. The diagnostic contingency on impairment facilitates the varying severity levels and the use of other terms. Димитрий Улянов Иванов (talk) 00:16, 27 April 2025 (UTC)

:::::::::No 'scientific consensus' exists (global or not) in regard to autism. Please refrain from using this phrase when describing the medical or pathological model of autism. As many academic scientists adhere, wholly or in part, to the neurodiversity paradigm of autism (this can be substantiated by a cursory look at scientific papers and books written in the last decade) describing the medical model as a scientific consensus is provably wrong. Urselius (talk) 07:27, 1 May 2025 (UTC)

:::The phrase "support needs vary widely in both type and amount" would be better and also more informative than "severity" LogicalLens (talk) 02:39, 26 April 2025 (UTC)

::::Assuming that's the point of the sentence/paragraph in question, then I agree that the more specific description is helpful. (Of course, if the point were to communicate that Levels 1-2-3 are actually called things like "severity levels" (as in [https://www.google.com/books/edition/Introducing_Autism/HZ4LEQAAQBAJ?hl=en&gbpv=1&dq=%22autism%22+%22levels%22+%22severity%22&pg=PT45&printsec=frontcover this book]) or "levels of severity" (as [https://www.google.com/books/edition/Handbook_of_Quality_of_Life_for_Individu/ndJyEAAAQBAJ?hl=en&gbpv=1&dq=%22autism%22+%22level+of+severity%22&pg=PA436&printsec=frontcover in this book]), we'd actually have use the word severity.) WhatamIdoing (talk) 06:12, 26 April 2025 (UTC)

:::::@WhatamIdoing, I agree with @CFCF to use "severity" only in the DSM/ICD section. LogicalLens (talk) 06:18, 26 April 2025 (UTC)

:Yes, the situation is that DSM-5 uses the term 'severity' but then makes it clear that what they are actually talking about is varying levels of support needs (in two categories). As such, the term 'severity' is highly misleading in contexts where it might be assumed to carry its everyday meaning.

:The ICD doesn't talk in terms of severity at all. As [https://www.nature.com/articles/s41380-023-02354-y one paper in Nature put it]:

:"ICD-11 retains a multi-categorical system to differentiate individuals with varying levels of developmental history (i.e., regression) and intellectual and language abilities by offering eight subcategories of ASD diagnoses. In contrast to DSM-5, ICD-11 has no specifier for severity that could provide additional information about the degree of support needed in identified areas of deficits. Maybe the reason for this was that the severity metric has shown questionable validity https://pmc.ncbi.nlm.nih.gov/articles/PMC10071646/ 22 or that in the conceptualization of ASD in ICD-11 severity in sense of impairments in functionality do not need to be present as implied in the previous statement that some individuals with Autism Spectrum Disorder are able to function adequately in many contexts through exceptional effort, such that their deficits may not be apparent to others." Oolong (talk) 08:17, 27 April 2025 (UTC)

::The ICD-11 does talk in terms of severity for autism. For example, it states:

::"Persistent deficits in initiating and sustaining social communication and reciprocal social interactions that are outside the expected range of typical functioning given the individual’s age and level of intellectual development. Specific manifestations of these deficits vary according to chronological age, verbal and intellectual ability, and disorder severity."

::As do many other guidelines, expert consensus statements, and reputable sources that we've been citing. So it is not merely the DSM. Димитрий Улянов Иванов (talk) 12:07, 27 April 2025 (UTC)

:::I am still on the fence on what level we need to express severity, but {{U|Oolong}}, what {{U|Димитрий Улянов Иванов}} writes is correct. Severity is very well defined, and very well accepted—and there is really no constructive debate to be had if the premise is that severity is misleading or not validated.

:::An argument can be made that prominent mention of severity is not neurodiversity-affirming, and that is the one I am leaning on in my hesitancy. However, if this argument is found insufficient even by those who want to keep mention of severity out of the lede/article—I will be easily convinced that it should be prominently displayed per WP:DUE. CFCF (talk) 12:40, 27 April 2025 (UTC)

::::Perhaps a concrete example would help. Oolong, consider a statement like this:

::::"There are different severity levels of autism. For example, two autistic brothers might have very different behaviors and very different support needs. One might benefit from a quiet place to take a break and be slower at certain tasks, and be classified as having 'Level 1' support needs. The other might be unable to communicate problems like feeling pain or hunger and need lifelong 24x7 supervision, and be classified as having 'Level 3' support needs."

::::How might people misunderstand or be misled by the use of the word "severity" in that passage? WhatamIdoing (talk) 21:18, 27 April 2025 (UTC)

::::Being less pathologizing is the main reason for the removal, while the questioned validity is an additional argument. LogicalLens (talk) 04:18, 28 April 2025 (UTC)

:::::The questioned validity is a false argument. CFCF (talk) 13:30, 29 April 2025 (UTC)

::::::Yes, I understand that Wikipedia reproduces what reliable sources say and that therefore, our discussion about the validity of severity scales is not a sufficient reason not to include it. But my position on removing it from the lead section does not stand or fall with this argument, it is based on the intention of being less pathologizing. LogicalLens (talk) 04:50, 30 April 2025 (UTC)

:::::::If you were to read a random selection of reliable sources, what approximate percentage of them would you expect to find are meeting the goal of "being less pathologizing"? WhatamIdoing (talk) 17:20, 30 April 2025 (UTC)

::::::::Scientists are experts within their perspective on autism, but they are not experts on ableism and the effects words have on people. Also, this article is not written for scientists but for the general public. For this, the style guides by the US' NIH and by the UK's NHS have been cited multiple times in these debates. WP:SUFFER instructs us to use appropriate language and if we find words that say essentially the same while being less stigmatizing, we should use them. This also solves large parts of our dispute that is ongoing here for months. LogicalLens (talk) 03:31, 1 May 2025 (UTC)

::::::::::This is very false. CFCF (talk) 02:31, 2 May 2025 (UTC)

:::::::::::Why? LogicalLens (talk) 03:15, 2 May 2025 (UTC)

:::::::::I said "a random selection of reliable sources", not "a random selection of sources written by and for scientists". WhatamIdoing (talk) 03:49, 1 May 2025 (UTC)

::::::::::As not all sources use neurodiversity-affirming language, we also should not replace all medical model words by neurodiversity words, for example, we still use "difficulties" and not only "differences" for social interaction and do not currently mention any positive aspects of being autistic in the opening paragraph. The word "severity" is used in the classification section multiple times and I think this is sufficient. LogicalLens (talk) 06:06, 2 May 2025 (UTC)

:::::::::Both the NHS and NIMH contradict themselves in other guidelines of theirs regarding this. We have to be careful to not rely on selective citing. This context has been pointed out repeatedly but keeps being omitted. Димитрий Улянов Иванов (talk) 06:26, 1 May 2025 (UTC)

::::::::::This an argument to use not only neurodiversity-affirming language (as I wrote above), but not one to block all attempts to insert less pathologizing language. LogicalLens (talk) 06:41, 2 May 2025 (UTC)

:::::::::If I am allowed to play armchair psychologist here to prove a point, I believe this post in particular unintentionally and subtly confirms a very noticeable trend with a lot of pro-neurodiversity users here, that being the subjective feelings of being seen as "inferior", or "lesser" in terms of being seen as "disabled" and that because of it, make such edits seeks to promote a greater distrust against or outright hostility towards the consensus of current medical authorities as a whole as ableist for considering the condition they identify with as "disability" or attributes the condition with aspects considered undesirable or even harmful even if it's perfectly objective and factual, and that I worry that treating these subjective and vague feelings of discontent as an objective argument to radically shift the article will risk setting an incredibly bad precedent for dealing with many mental conditions on wikipedia down the line, to where it's far more significantly difficult for average users to distinguish between mental disabilities and perfectly acceptable and normal behaviors because many "problematic" traits associated with various mental disorders could be seen as socially constructed or otherwise relativized, when (with a few exceptions) current diagnosis standards and current understandings of the condition by the research community at large have not changed and ignores many of these traits often are inherently disabling and are not automatically a by-product of the treatment by wider society. 172.97.217.147 (talk) 06:09, 4 May 2025 (UTC)

::::::::::Because you are new to this discussion, I do not know how much of the context you are aware of. Therefore, I summarize a few things:

::::::::::1) The sources that I cited recommend neurodiversity-affirming language and in response, another user cited other sources that do not. So I argued that some parts of neurodiversity-affirming language should be used while others should not, for example, writing "difficulties" in social interaction instead of only differences, and we currently do not mention positive aspects of being autistic.

::::::::::2) Neurodiversity proponents argue that autism is not a disorder but not that it is not in a significant fraction of cases a disability. There are certainly aspects for which it would be absurd to claim that they are not disabling, for example a complete lack of any communication ability.

::::::::::3) I complied a list of sources supporting neurodiversity 2-3 months ago.[https://en.wikipedia.org/wiki/Talk:Autism#c-LogicalLens-20250226044700-Survey_(on_RFC_on_focus)] LogicalLens (talk) 04:17, 5 May 2025 (UTC)

:::::::We don't change article content based on larger societal implications. GMG^talk 12:17, 1 May 2025 (UTC)

::::::::@GreenMeansGo See WP:SUFFER. Also, severity is mentioned in the classification section which is appropriate. LogicalLens (talk) 12:29, 1 May 2025 (UTC)

::::Ah, apologies, I should have re-read the ICD-11 entry itself before posting. Yes, it mentions severity, it just doesn't classify autism by severity.

::::You suggest that severity "is very well defined, and very well accepted". The definition provided by, for example, Wiktionary, is as follows:

::::# The state of being severe (i.e. Very bad or intense; Strict or harsh; Sober, plain in appearance, austere)

::::# The degree of something undesirable; badness or seriousness.

::::I would suggest that this is quite different from the sense used in the DSM, which specifically refers to level of support required, and emphasises that "severity may vary by context and fluctuate over time" and "social communication difficulties and restricted, repetitive behaviors should be separately rated."

::::I don't believe that the average lay reader would get any of that from seeing the term 'severity' used without clarification. It doesn't sound like a contextual, varying or multidimensional thing at all.

::::The term 'severe autism' comes with many common misconceptions (as does the near-synonymous term 'profound autism' which is sometimes suggested; see e.g. [https://pmc.ncbi.nlm.nih.gov/articles/PMC10576471/ Rachel Kripke-Ludwig 2023]) - failing to recognise that support needs vary hugely with context and over time, for example, and that 'symptom severity' in one domain tells you little about another. Oolong (talk) 10:01, 1 May 2025 (UTC)

:::::The article currently contradicts itself in the spectrum model section: "DSM-5 uses a "level" system, which specifies the level of support needed by the person. In this system, level 1 is the mildest form and level 3 the most severe." and later: "The spectrum model should not be understood as a continuum running from mild to severe, but instead means that autism can present very differently in each person, with support needs depending on context and changing over time." LogicalLens (talk) 10:20, 1 May 2025 (UTC)

::::::I don't think that's a contradiction. They're talking about different things. WhatamIdoing (talk) 17:48, 1 May 2025 (UTC)

:::::::The problem seems to be that the DSM workgroup was obliged to use a severity scale by the APA when what they really meant was support needs: [https://link.springer.com/chapter/10.1007/978-981-13-8437-0_13] LogicalLens (talk) 06:42, 2 May 2025 (UTC)

::::::::Don't most things in the DSM-V have a severity scale? The ICD-11 also uses severity scales (sometimes called "specifiers") widely. Autism is not being singled out in this regard. WhatamIdoing (talk) 19:25, 2 May 2025 (UTC)

:::::::::This is what I meant. The American Psychiatric Association required the workgroup for autism to use a severity scale, although they opposed it, for example because a lower "severity" estimate because an autistic person looks thriving (due to supports) could then lead to the very supports that were necessary for this to be reduced. LogicalLens (talk) 02:11, 3 May 2025 (UTC)

:::::Oolong, I think that "support needs vary hugely with context and over time" is only true in a limited way. It seems most applicable for the less-impaired majority. For example, an autistic person might be happy with no particular support needed when they can work from home and largely interact with people by typing text on a computer screen. That same person might need support to attend a large in-person meeting (access to a quiet room, sitting where no one is likely to touch them accidentally, noise-cancelling headphones, being able to skip social events).

:::::At the other end of the spectrum, the support needs are always huge. There isn't a "context" or a "time" in which a minimally verbal autistic person becomes a fluent communicator. I read about one autistic adult whose support needs included boarding up the windows in their house, because if he could see the windows, he would break the glass. This did not change "over time", and there was no "context" in which he understood that windows should not be broken, or even what the natural consequences of broken windows would be (e.g., if it rained or snowed).

:::::The letter to the editor from the high school student makes the point that being non-speaking is not the same as having no receptive or other expressive language skills, and that accurate IQ testing of someone with limited or no communication skills is difficult. It also makes extraordinary unsupported assertions ("autistics with intellectual disabilities would have pointed out the problems with the study before it was conducted" – if you can point out difficulties with a study design, you're not intellectually disabled. For context, the middle third of people with ID can read and understand children's picture books – Dr. Seuss, not scientific study designs). Overall, it leaves me wondering if this is another case of Augmentative and alternative communication (the student uses a letterboard) that turns out to be her mother 'writing' for her. (Her mother has the professional qualifications you would expect from someone who evaluates study designs.) But it doesn't actually say that people with "profound" problems have huge variations in the amount of support they need. It tends to confirm that the support needs are constantly high. WhatamIdoing (talk) 18:37, 1 May 2025 (UTC)

::::::This is true. While the ability to speak can fluctuate by stress level or other circumstances, autistic people who do not speak at all or who are intellectually disabled will always need much support. I do not think that any relevant academic says that all autistic people can be at all support need levels. The reality is very complicated, both an oversimplifying interpretation and denying the fixed nature of some support needs is false.

::::::Regarding the second part: what you mean is facilitated communication. Augmentative and alternative communication is valid. While it is important to keep in mind the risks, I am very skeptical about attempts to discredit what autistic people with high support needs communicate without clear evidence. If I were such an autistic person, wrongly not being listened to on the grounds of such arguments would be one of the most painful things I could imagine. LogicalLens (talk) 03:36, 2 May 2025 (UTC)

:::::::I agree that there are valid forms of AAC. The problem is that "uses a letterboard" could mean either FC or AAC. WhatamIdoing (talk) 05:41, 2 May 2025 (UTC)

::::::::As you provided no link to a letter to the editor but only to the Wikipedia article for "letter to the editor", I cannot form my own opinion on this particular case, but as I said, I hesitate to silence these people without a proof. Of course, it seems like there are autistic people who will never communicate with words neither in spoken nor in written or typed form and are intellectually disabled regardless of which test is used. LogicalLens (talk) 06:35, 2 May 2025 (UTC)

:::::::::It is the only external link in the comment I was replying to. He labeled it "[https://pmc.ncbi.nlm.nih.gov/articles/PMC10576471/ Rachel Kripke-Ludwig 2023]", as if it were a research paper. It's just a letter to the editor, expressing someone's opinion, some parts of which (such as what I quoted) are obviously unreasonable.

:::::::::On the broader question of ID, about 15 years ago, activists made a push to emphasize adaptive skills (e.g., if you can buy food at a grocery store, including paying the correct amount of money) in the ID diagnosis. If you have a low IQ according to any test, but you also have cognitive flexibility that allows you to function in ordinary daily life, then you don't have ID. It is not enough to "fail" an IQ test; you have to also fail daily living skills. The unintended consequence of this definition is that autistic people who score 65 on an IQ test have a higher chance of being diagnosed with ID than people with Down syndrome who got the same score. This is because cognitive inflexibility is a core feature of autism, but not of Down syndrome, and cognitive flexibility is now half the ID diagnosis. WhatamIdoing (talk) 19:46, 2 May 2025 (UTC)

::::::::::This paper is a journal article, it would not have been published if it contained obviously wrong or unreasonable information. The important question is to how many autistic people this applies. For example, Jordyn Zimmerman is a prominent example of an autistic person who is non-speaking but communicates via AAC. LogicalLens (talk) 03:35, 3 May 2025 (UTC)

:::::::::::This "paper" is [https://pubmed.ncbi.nlm.nih.gov/37732335/#publication-types a letter to the editor]. It is neither peer-reviewed nor fact-checked. Letters to the editor get published if the editor thinks that they have something interesting or controversial to say, including if part of the letter contains known-wrong or fringe-y information. WhatamIdoing (talk) 06:08, 3 May 2025 (UTC)

::::::::::::You are right. The journal says its letters-to-the-editor are not peer-reviewed but the authors of the original paper the letter referred to can respond. This is the response[https://journals.sagepub.com/doi/full/10.1177/00333549231201820], it does not refute the claim that being non-speaking does not automatically mean having no receptive language skills. Different studies show that a significant fraction of non-speaking autistic people understands language at least to some degree.[https://journals.sagepub.com/doi/10.1177/13623613241230709][https://onlinelibrary.wiley.com/doi/abs/10.1002/aur.3079][https://www.nature.com/articles/s44184-024-00062-1] LogicalLens (talk) 02:40, 4 May 2025 (UTC)

:::::::::::::Of course nonspeaking doesn't automatically mean having no receptive language skills. Nonspeaking doesn't even mean having no expressive language skills. The problem isn't that many nonspeaking people can communicate.

:::::::::::::The problem is that the high school student thinks that people with intellectual disability can realistically evaluate a scientific study's design. Adults with moderate intellectual disability, even if they have no speaking problems, have the intellectual ability you would expect from an average child around age 7 to 9. That's the age when kids are reading Dog Man and Magic Tree House books. They're learning basic fractions and multiplication facts. Does that sound like a description of the intellectual talent you'd want to seek for evaluating a scientific study design?

:::::::::::::The high school student also falsely claims that no autistic people were involved. The authors' response directly corrects that mistake. WhatamIdoing (talk) 03:06, 4 May 2025 (UTC)

::::::::::::::This sentence where the author says people with intellectual disability would have pointed out problems in the study design is indeed awkward. Nevertheless, the critique that autistic people have not been involved in an appropriate way is valid, because including some autistic people without giving them equal power is not meaningful participation, see Arnstein ladder of participation. LogicalLens (talk) 03:50, 4 May 2025 (UTC)

:::::::::::::::How do you know that they did not have equal power? Is there a document somewhere that says "By the way, autistic people on this committee only get half a vote"? WhatamIdoing (talk) 04:03, 4 May 2025 (UTC)

::::::::::::::::I was referring to the paper the proposed term "profound autism" emerged from,[https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01541-5/abstract] which included only some autistic people and was heavily criticized.[https://www.liebertpub.com/doi/10.1089/aut.2022.0017]. The letter-to-the-editor discussed here is indeed not a perfect source.

::::::::::::::::To go back to what this discussion was originally about: You criticized @Oolong's statement that support needs fluctuate and that the term "severity" is therefore invalid. As some support needs in autistic people do not fluctuate, this argument is weakened to some extent, which I admit. Still, this term creates an impression that the support needs are more fixed and linear than they actually are. It is a common problem that people look at an autistic person and try to determine how “severely” autistic they are and try to generalize from this observation to support needs in other contexts. Autistic people can require support in very different areas of life and someone who appears independent in one domain can need surprisingly much support in other areas. Autistic people deemed to be at the same level of “severity” can also have very different support needs. This is all obfuscated and oversimplified by the term “severity”. LogicalLens (talk) 04:24, 5 May 2025 (UTC)

:::::::::::::::::My impression is that the point of the "profound" category is to identify the small subset of people whose support needs do not include moments in which the autistic person "appears independent in one domain". That is, it is meant to include autistic people whose support needs are always very high – 24x365, in all settings, under all circumstances, and to exclude people whose support needs are sometimes or always less than that. WhatamIdoing (talk) 06:35, 5 May 2025 (UTC)

::::::::::::::::::Having worked with such patients, I also don't think we should overinterpret "appearing independent in one domain" either. Someone with profound autism who has support needs that mean 24/7 monitoring is needed in order to ensure their personal safety, might reasonably spend an hour doing a puzzle or playing with a toy - during which it could be argued that they probably would seem alright and not in need of monitoring or help. However, the problem is not that they can not do things at all independently, but that in stringing together multiple parts of their day, or even shifting from doing a puzzle to eating lunch is entirely impossible on their own. CFCF (talk) 10:26, 6 May 2025 (UTC)

:::::::::::::::::First you say that autistic people weren't given equal power on that committee. Now you say the problem is that it included "only some" autistic people. Is the complaint that autistic activists did not hold a majority position on the committee? Choosing sources because professional activists with the Right™ POV wrote them or rejecting them because professional activists disagreed with them sounds like POV pushing to me. WhatamIdoing (talk) 06:43, 5 May 2025 (UTC)

::::::::::::::::::I agree fully with WhatamIdoing here - and will also state that criticism of something does not necessarily weaken it at all. If the criticism isn't headed with the appropriate authority of WP:MEDRS it isn't even WP:DUE to consider it on Wikipedia. Further, it seems to me a very dark view to state that because support needs are not ever present, that this would invalidate the presence of a support need. If an autistic person were to need some form of support 1/10 times to go to the supermarket in order to get food, that is a very real and present need, even if 9/10 times they are doing entirely all-right. To suggest that they don't have that support need is basically invalidating their needs, just because "they most often get it right", and is a view brought forth by some penny-pinching lawmakers to remove support from autistic people. To me this speaks less of neurodiversity, and more of being intentionally obtuse in order to invalidate the needs of others.

::::::::::::::::::Further, it is quite common to change the severity classification of a patient over time, and this is certainly not something that invalidates the construct - just a fact of life. CFCF (talk) 10:32, 6 May 2025 (UTC)

:::::::::::::::::::The activist fear about levels, as described in something linked on this page, was that the levels would be used to exclude people from getting support.

:::::::::::::::::::AIUI the DSM committee originally suggested four levels:

:::::::::::::::::::* Level 0 (no support needs)

:::::::::::::::::::* Level 1 (what we have now)

:::::::::::::::::::* Level 2 (what we have now)

:::::::::::::::::::* Level 3 (what we have now)

:::::::::::::::::::But the activists killed the Level 0, so at least one government briefly thought that Level 1 must be the "no support needs" category. The activists should have supported Level 0 and then made sure that nobody was rated that way. WhatamIdoing (talk) 14:44, 6 May 2025 (UTC)

::::::It is of course true, to a point, 'that "support needs vary hugely with context and over time" is only true in a limited way.' I never suggested that every autistic person could run the entire gamut of support needs depending on context!

::::::However, what I wrote remains literally true, and it is true throughout the autistic spectrum. Autistic people generally cope much, much better in some environments than others, and in some cases, have high support needs because of unaddressed health issues, or sensory problems.

::::::See for example [https://www.tandfonline.com/doi/full/10.1080/13575279.2022.2126437#abstract this paper]: "the sensory environments of NHS England-funded in-patient facilities were found to present sometimes extreme challenges for autistic young people that at best hinder wellbeing and at worst exacerbate existing mental health problems: instigating a cycle of progressing upwards through increasingly restrictive settings for some."

::::::As Luke Beardon famously puts it - and he is not just talking about those with relatively low support needs - [https://www.bps.org.uk/psychologist/putting-autistic-children-centre autism + enviornment = outcome]. Oolong (talk) 17:48, 11 May 2025 (UTC)

:::::::While traits + environment = outcome is generally true in biological senses, I'm not sure that it's really showing "support needs vary hugely with context".

:::::::If you have a person who needs:

:::::::* a quiet place, or

:::::::* help coping with a noisy place

:::::::then you don't have "needs vary hugely"; you have a person whose needs are constant (i.e., to not be overwhelmed by noise) and the only thing that differs is how those needs are met. WhatamIdoing (talk) 20:36, 11 May 2025 (UTC)

::::::::But unmet sensory or other needs, distress etc. can lead to autistic people needing more support in other areas, for example, they might lose certain daily living skills. It is a problem if people look at an autistic person, see that this person can do X and then assume the person can always do X and deny them their needed supports. LogicalLens (talk) 01:19, 12 May 2025 (UTC)

:::::::::It's still a person whose needs are the fairly constant.

:::::::::With something like an autoimmune disease, you can have a person who actually has no (disease-related) needs at some points but has differing amounts of symptoms later. For example, lupus is pretty common in women in their 30s. But if a woman with lupus gets pregnant, it usually goes into temporary remission. After giving birth, it typically comes at least as bad. This means that her lupus-related needs could be "3 out of 10" before she gets pregnant, "0" while she is pregnant, and "6" in the months after the baby is born. For example: Before getting pregnant, she could spend time outside in the sun if she wore sunscreen and a hat; while pregnant, she could spend time outside in the sun like anyone else; after giving birth, she gets a painful rash if she's outside for 15 minutes. Or before she was pregnant, she could walk for an hour; while she was pregnant, she could run pain-free; after giving birth, her joints hurt too much to walk for more than a few minutes. The actual needs vary in this case.

:::::::::With autism, it seems that the needs are like "5" all the time. If the needs are met, then everything's okay. If the needs are not met, then that failure becomes visible. But the needs themselves don't change.

:::::::::With lupus, the person is actually able to do different things at different times because the illness itself waxes and wanes. The popular metaphor for lupus is that if you do too much, you're "run out of spoons". That is, you wake up in the morning with a certain amount of energy and other internal resources that you can use. When you use up all your energy, you can't do anything else. However, you might wake up one day with "5 spoons" of energy. Another day, you might have "15 spoons" of energy. It is unpredictable.

:::::::::With autism, the person's problems aren't waxing and waning. Every day, that person wakes up with "10 spoons" of energy, and every day, the cost of the speaking is the same amount of energy for that individual. If they can't do something, it's because they've already experienced so many stressors that day that they've run out of energy and other internal resources. Speaking (or not) isn't because their autism "got better" or "got worse" today; the autism is constant.

:::::::::For example, someone who finds speaking to be a complex and exhausting task is always someone who finds speaking complex and exhausting. If that person still has plenty of "spoons", then they'll be able to speak. If they had to use up their energy on something else, they won't. But they begin each day in basically the same place, and the cost of speaking will always be basically the same. WhatamIdoing (talk) 01:59, 12 May 2025 (UTC)

::::::::::There is an interesting aspect in this however, that the psychological conceptualization of energy as finite, or that specific activities "cost" a pre-specified amount of "spoons"—if one ascribes to it—is more likely to increase the risk of energy "running out". So it might be a good analogy by which to view other people, but not for oneself—likely applying both to autism and lupus (despite etiological differences).

::::::::::The keeping track of "spoons" in turn is not beneficial for all, where it can simplify things such as "How many spoons one wakes up with", beyond what is reasonable or helpful. For instance, so many other things may play in, to how many spoons ones has at onset, like: sleep, being sick, having had a bad week, etc.

::::::::::I think most professionals discourage this specific use of spoon theory, beyond promoting a general awareness that energy is finite, because you can get into issues of "Why am I feeling this bad, I should have at least 5 spoons left?", or "Why am I feeling this energetic? I've already run out of spoons—something must be wrong.".

::::::::::From the perspective of autism support needs, I think the better conceptualization is—"What is the risk of needing support in a specific task?" If one has a 1% risk of needing support to accomplish something, that can be sufficient to receive significant support, if that is a day-to-day essential task that needs to be completed. If for instance paying taxes, grocery shopping, or getting to school/work has a 10% risk of failing, that is quite a significant support need despite outwardly looking as if the person has got everything covered most of the time. What matters is also the consequences of failing at a specific task. If it means not saying "Hi" to the bus-driver when you are low in energy, then it might be very insignificant. (Crude examples, can be replaced but I needed something to illustrate conceptually). CFCF (talk) 07:06, 12 May 2025 (UTC)

:::::::::::I wonder if we should be thinking about "needing support" as specifically "needing external support". For example, if bright lights bother you, bu you are living alone and you turn off the lights yourself, you don't "need support" for that. You are meeting your own needs yourself for that.

:::::::::::(Thanks for long comment; I thought it was interesting.) WhatamIdoing (talk) 15:37, 12 May 2025 (UTC)

::::::::::::Yes. Needing lights turned down at home is not needing support.

::::::::::::Being too low on spoons to prepare food is.

::::::::::::People in environments where they are constantly pushed towards their sensory, social and emotional limits are likely to require external support, potentially for extended periods even once they are free of that environment.

::::::::::::People in burnout find their support needs increase, often dramatically - and actually, that's still true even in the very broad interpretation of 'support' that includes things like removal of sensory stressors. Oolong (talk) 15:28, 13 May 2025 (UTC)

:::::::::::::To communicate this concept more clearly, and to differentiate it from other meanings of support (like "the neurodiversity movement supports this idea" or "scientific evidence supports this"), perhaps we can find places in the article to say "needs support from other people" or "needs practical support" or "the level of external support". Or even changing some of them from support to assistance or help. WhatamIdoing (talk) 15:57, 13 May 2025 (UTC)

::::::::::::::We can make these edits. Is this the reason why people here hesitate using "support needs" or is it just a marginal point? LogicalLens (talk) 01:22, 14 May 2025 (UTC)

:::::::::::::::I don't know. WhatamIdoing (talk) 05:12, 14 May 2025 (UTC)

As the severity topic has no reply buttons anymore, I start a new thread here.

First, we should distinguish between severity labels and the debate about the proposed category "profound autism". If the latter concept becomes widely adopted in the future and is recognized as scientifically valid (which it is not currently), then we must address it in the article. We can then of course also include the criticism from reliable sources in a proportionate manner but it would not be a reason to remove the concept. What this discussion was initially about is the word choice between severity and other, similar terms like support needs or presentation. @CFCF, I did not argue that the fact that support needs fluctuate invalidate support needs. Not at all. I think you conflated "severity" with "support needs". It is only about the word choice. LogicalLens (talk) 04:44, 7 May 2025 (UTC)

:It's not conflating, severity is measured by the same metrics as support needs and is synonymous. In most jurisdictions support is given based on severity of diagnosis.

:Also, if the reply button doesn't work, you can edit in source, making a new section is confusing. CFCF (talk) 16:50, 7 May 2025 (UTC)

::That the two expressions are synonymous is why I want to write "support needs" instead of "severity". LogicalLens (talk) 23:14, 7 May 2025 (UTC)

::Again, they may well be synonymous in this technical context, but they are not synonymous in ordinary speech, and should not be treated as such on Wikipedia. This is specifically addressed in WP:MEDLANG. Oolong (talk) 09:40, 10 May 2025 (UTC)

:::I must be honest and admit that I do not see what is being discussed here. Only that we should not use profound? Or are we simply agreeing with eachother in an antagonistic way - that yes we can use support needs throughout, but must also define precisely that severity is synonymous in the classification section?

:::Also, @LogicalLens, I never suggested that anyone here was saying that fluctuating support needs invalidates support needs, merely that such arguments are a strategy that is used elsewhere, and that we must be mindful not to open the door too wide as even if we don't think so - it can be interpreted as such by readers. CFCF (talk) 00:41, 11 May 2025 (UTC)

::::The discussion is about replacing "severity"/"severe"/"mild" by "support needs". The classification section already makes it clear that the DSM-5 views these terms as synonymous: "DSM-5 uses a "level" system, which specifies the level of support the person needs. In this system, level 1 is the mildest form and level 3 the most severe." LogicalLens (talk) 03:27, 11 May 2025 (UTC)

Why is a bulleted list not appropriate? Official government websites also use them.[https://www.canada.ca/en/public-health/services/diseases/autism-spectrum-disorder-asd/signs-characteristics.html] LogicalLens (talk) 05:23, 28 April 2025 (UTC)

:Probably because it is "less readable" as per MOS:LISTBULLET. However, I do agree that the list looks fine for it. 24.155.147.107 (talk) 16:09, 28 April 2025 (UTC)

::A bulleted list is not appropriate for a high level encyclopedic entry without any narrative explanatory text (or that extends far longer than the narration). The problem is not that bulleted list are never appropriate, but it is not appropriate here. CFCF (talk) 13:30, 29 April 2025 (UTC)

Co-occurring disorders is a redirect to dual diagnosis (i.e., having a substance use disorder plus another mental/neurological condition). I looked through PubMed for a while, and few of the results mentioned autism.

I realize that "Co-occurring disorders" feels to many autistic editors like it's a neutral tone. However, a fraction of this article's readers are likely to see that phrase and think first about alcoholism and substance use disorders, and only later think about the plain English words. Is there a viable alternative? WhatamIdoing (talk) 17:34, 30 April 2025 (UTC)

:I wonder if "co-occuring conditions" or "diagnosis's" would be different enough to make people stop and think about the meaning? IntentionallyDense ^(Contribs) 18:04, 30 April 2025 (UTC)

::I don’t think we should use said wording at all simplify it: most/some people who are diagnosed with autism are also diagnosed with other mental conditions such as (insert data from reliable source) its easy simple to read and straightforward •Cyberwolf•. talk? 19:02, 30 April 2025 (UTC)

:::What do you propose the subheading for this be as "most/some people who are diagnosed with autism are also diagnosed with other mental conditions" is a bit too long for a subheading. IntentionallyDense ^(Contribs) 03:54, 1 May 2025 (UTC)

:These two books use "co-occurring conditions" in their titles and do not refer primarily to substance use disorders.[https://academic.oup.com/edited-volume/28150][https://link.springer.com/book/10.1007/978-981-97-0656-3] LogicalLens (talk) 04:41, 1 May 2025 (UTC)

::The fact that the phrase is sometimes used in other contexts does not disprove the fact that it is mostly used in the context of drug addiction. I assume (because of the euphemism treadmill) that the addiction field considers the occasional use outside their stigma-laden area to be a desirable quality. WhatamIdoing (talk) 18:49, 1 May 2025 (UTC)

:::I think this is looking at it slightly the wrong way around to be honest {{U|WhatamIdoing}}. The drug field, due to intense stigma, are rather among the first to account for linguistic issues that promote stigma, followed by adoption in other fields. CFCF (talk) 02:25, 2 May 2025 (UTC)

:::If you search for "co-occurring conditions" (not "co-occurring disorders") on Google Scholar, you get mostly autism results. LogicalLens (talk) 03:40, 2 May 2025 (UTC)

:I do not think that the phrase suggests drug abuse in any way. Co-occurring just means 'happening at the same time'. It could be used for sneezing and watery eyes in a description of hay fever. Urselius (talk) 07:20, 1 May 2025 (UTC)

:I had no idea that 'co-occurring disorders' had this oddly specific meaning in the USA.

:'Co-occurring conditions' is surely fine. Oolong (talk) 10:05, 1 May 2025 (UTC)

::This is not just "in the USA".[https://carelearning.org.uk/qualifications/level-2-sh-suicide/intro-suicide/2-4-describe-what-is-meant-by-the-term-co-occurring-disorders/][https://www.ukat.co.uk/help-guides/dual-diagnosis/#post-853][https://www.westyorks-ca.gov.uk/media/10869/drug-and-alcohol-research-mental-health-pathway.pdf] WhatamIdoing (talk) 19:01, 1 May 2025 (UTC)

:::I just think it came to that field first. CFCF (talk) 02:25, 2 May 2025 (UTC)

:Comorbidity/comorbid disorders or coexisting disorders. Personally, I prefer the former, which is used more in scientific publications. Димитрий Улянов Иванов (talk) 22:21, 1 May 2025 (UTC)

::I agree; this was my first thought as well when reading the beginning of the discussion. I'm more active in articles related to personality disorders, and there for example the consensus is absolutely to talk about comorbidity, as a point of view in addition to academia. In fact, it makes for a good wikilink to comorbidity. BlockArranger (talk) 01:51, 2 May 2025 (UTC)

:::You can create a wikilink for one article and still use another word: co-occurring conditions. LogicalLens (talk) 03:42, 2 May 2025 (UTC)

::::@LogicalLens Well yes, that's actually not a really strong argument. However, as the topic has been decided to be denoted at comorbidity, judging by the actual main article, I see it as there at least existing some previous consensus for that being a decent, or as I would call it - very good, name. BlockArranger (talk) 14:25, 2 May 2025 (UTC)

:::::The difficulty with comorbidity is that if you say that autism and ____ are "comorbid", you are implicitly saying that autism is a morbidity. Implying that autism is a morbidity annoys people who believe that autism is a perfectly normal, perfectly healthy part of human experience. WhatamIdoing (talk) 16:32, 2 May 2025 (UTC)

::::::We annoy people with article content all the time. Everyone is expected to be civil and respectful in interactions with other editors, but article content isn't a safe space. GMG^talk 19:48, 2 May 2025 (UTC)

:::::::This is not about having some sort of "safe space". If you write something that annoys some editors, they'll try to change it. Persistently. Endlessly. Until, in fact, you follow the policy rule about making "an effort to address editors' legitimate concerns through a process of compromise" within the framework of our policies and guidelines.

:::::::We know this language will result in disputes until it is removed. We know this language is not required by any policy or guideline. So – maybe avoid using it? There are other policy- and guideline-compliant options, after all. WhatamIdoing (talk) 20:02, 2 May 2025 (UTC)

::::::::That sounds a lot like "we're going to argue until everyone else loses interest and then claim consensus." GMG^talk 20:13, 2 May 2025 (UTC)

:::::::::Not really? I mean, if this were a WP:FRINGE area, then I'd agree that the scenario you describe is unfortunately likely. But I find, overall, that the editors interested in this article are not only some of the most consistently patient and polite editors on Wikipedia, but also dedicated to following Wikipedia's rules in both the letter and the spirit. It's just that even if current editors A and B and C agree not to change it, then, next month, there will be new editors D and E asking for the same change. And even if editors A, B, C, D, and E agree not to change it, then we'll soon have editors F and G asking for the same change. WhatamIdoing (talk) 20:36, 2 May 2025 (UTC)

::::::::::I'm not seeing the part where you disagree with my comment. GMG^talk 22:14, 2 May 2025 (UTC)

:::::::::::Because they're not expecting everyone else to lose interest, and they're not going to claim consensus until there actually is one. WhatamIdoing (talk) 22:23, 2 May 2025 (UTC)

::::::::::::Well then, for whatever it's worth, comorbid is the standard terminology. I'm not terribly concerned if it "annoys" some people. Age of Earth also probably annoys some people too. We don't craft articles based on hurt feelings and personal dispositions. Wikipedia is not therapy. GMG^talk 12:58, 4 May 2025 (UTC)

:::::::::::::If your meaning differs from "Given a choice between (a) spending the next decade arguing about this wording and (b) finding a synonym that does not predictably produce endless arguments, I prefer having the arguments", then I have misunderstood you and would ask you to rephrase.

:::::::::::::If that's your meaning, though, I happen to have a different preference. WhatamIdoing (talk) 20:20, 4 May 2025 (UTC)

{{outdent}}

No, I very much see the "endless arguments" as fueled by those who want to essentially merge this article with that on Neurodiversity, because we might, in your words, annoy some people. GMG^talk 14:16, 7 May 2025 (UTC)

:And maybe if we find a word for the first sentence that (a) is still accurate and (b) isn't "disorder", then those people will decide that something else is more important than objecting to the use of the word "disorder" in the first sentence of this article. WhatamIdoing (talk) 17:39, 7 May 2025 (UTC)

::Or maybe people could just drop the stick and we can use the accurate term as we do in any other similar article. GMG^talk 17:42, 7 May 2025 (UTC)

:::I don't think that will happen. Even if every single editor this year – all three-quarter million of them – agreed to do this, next year we would get a newbie who hadn't signed up to that agreement, and it would start all over again. These arguments will only stop if we stop using the objected-to word. WhatamIdoing (talk) 17:50, 7 May 2025 (UTC)

::::The fact that someone is willing to argue indefinitely is not evidence that they are correct. This is a silly argument that would justify half of disruptive editors on controversial subjects. That you think this is a valid rationale is puzzling at best. GMG^talk 17:55, 7 May 2025 (UTC)

:::::It's not "someone". If it was just one person, we could block the account. Instead, the pattern is:

:::::* Alice sees what she believes to be a problem with Autism. She creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. Alice argues for a long time and then goes away.

:::::* A few weeks later, Bob sees what he believes to be a problem with Autism. He creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. Bob argues for a long time and then goes away.

:::::* Soon after that, Chris sees what they believe to be a problem with Autism. They creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. Chris argues for a long time.

:::::* The next month, David sees what he believes to be a problem with Autism. He creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. David argues for a long time. Chris joins in. Eventually David gives up and goes away.

:::::* Eve sees what she believes to be a problem with Autism. She creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. Eve argues for a long time, with Chris backing her up.

:::::* Frank sees what he believes to be a problem with Autism. He creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. Frank argues for a long time and then goes away.

:::::It's not someone. It's "some-many", probably "some-hundreds". The problem of autistic self-advocates objecting to Wikipedia's use of this term in this article will not go away unless we stop using this term in this article. WhatamIdoing (talk) 18:06, 7 May 2025 (UTC)

::::::Yet we seem to do just fine on other articles where some issue is brought up repeatedly. GMG^talk 18:50, 7 May 2025 (UTC)

:::::::It's easier to deal with that kind of thing when the stream of people bringing up objections is objectively wrong in some way.

:::::::As it should be. Oolong (talk) 09:45, 10 May 2025 (UTC)

::::::::I don't agree that "we seem to do just fine on other articles where some issue is brought up repeatedly". Having to deal with the same problem over and over and over and over causes problems. It wastes time; it creates WP:DRAMA; it causes experienced editors to quit. Even when the objection is objectively wrong, there is a limit to how many times most people are willing to explain things like "Guess what? 80% of women is not the same as 80% of people, so you can't just do a mindless search-and-replace change to make this article about menstruation be gender neutral." After a while, you start thinking that your time would be better spent doing anything else. WhatamIdoing (talk) 17:55, 10 May 2025 (UTC)

:::::::::{{tq|80% of women is not the same as 80% of people...}} What are you even talking about? GMG^talk 11:04, 11 May 2025 (UTC)

::::::::::This is a problem I've encountered more than once in a different article. It says something like "80% of women get ____ menstrual symptoms", and multiple well-meaning editors have changed it to "80% of people get ____ menstrual symptoms". Guess what? 80% of people don't menstruate at all, so 80% of people don't get any menstrual symptoms at all. And I'm heartily sick of correcting this innumerate nonsense.

::::::::::I give this specific example as proof that we don't always "seem to do just fine on other articles where some issue is brought up repeatedly". Sometimes having an issue brought up repeatedly causes problems like irritation and burnout. WhatamIdoing (talk) 16:56, 11 May 2025 (UTC)

:::::::::::Okay. You revert it and move on. We don't allow people to hold an article hostage because unless we do what they want they'll argue until the end of time. GMG^talk 20:54, 11 May 2025 (UTC)

::::::::::::Yes. I revert it, I explain it, I move on. And then a few months later, someone else shows up and makes the same stupid mistake, and I do this all over again. And again. How many times should I be expected to do this?

::::::::::::We almost lost one of our long-time FTN regulars because he has gotten so tired of repeating the same stuff about COVID origins. If we actually "do just fine on other articles where some issue is brought up repeatedly", why did he almost quit over some issue being brought up repeatedly? Others have taken those articles off their watchlists, because they're just so sick of it. I don't think this is "doing just fine". I think this is a sign of a problem. WhatamIdoing (talk) 21:05, 11 May 2025 (UTC)

:::::::::::::We don't let people hold an article hostage. People can come and go as they please. We don't make content decision based on whether some people will get tired and go. We don't practice appeasement, and if you're one of the people dedicated to arguing until the end of time then you're part of the problem. GMG^talk 22:07, 11 May 2025 (UTC)

::::::::::::::I think what we need to practice, in cases such as this one, is developing a Wikipedia:Consensus that is able "to address editors' legitimate concerns through a process of compromise while following Wikipedia's policies and guidelines", to quote that policy.

::::::::::::::We have legitimate concerns here:

::::::::::::::* "Disorder" is not obviously appropriate in every case. People might not look at some famously successful autistic people, such as Pokémon's creator, Satoshi Tajiri, or the artist Henriett Seth F., and think they're actually "disordered".

::::::::::::::* "Difference" is not obviously appropriate in many cases. People do not look at adults with no ability to navigate ordinary daily tasks and think "Wow, it's a little different that a 25 year old can't figure out how to buy food at the grocery store and starts screaming if the line for the playground swings exceeds his tolerance, but he's so obviously just like everyone else."

::::::::::::::Both of these concerns can be found in reliable sources, so they're legitimate. The question is therefore: Can we address editors' legitimate concerns by finding a word that falls somewhere in between the two extremes – in between "there was definitely something medically wrong with Einstein" and "it's all fine"? WhatamIdoing (talk) 23:16, 11 May 2025 (UTC)

:::::::::::::::@WhatamIdoing Given how most of these discussions have been going, I am apprehensive to believe that a consensus can be reached. If others agree this is the direction we should go, then that is fine. However, the disputes mostly revolve around whether we should change terminology against what diagnostic manuals go by. In gender dysphoria, a consensus was reached not to classify it as a mental disorder, however, the diagnostic manuals also stressed how using terms like disorder should be avoided, so we again did not deviate from them. As for your point of where people {{tq|think they are actually "disordered"}}, this is not a fair statement. That is not correct usage of disorder and is just your POV of how people interpret that term. I believe we should start moving on to discussing the actual content of the article, instead of arguing whether we should remove medical terminology to avoid possibly offending people. Slothwizard (talk) 23:33, 11 May 2025 (UTC)

::::::::::::::::How do we "start moving on to discussing the actual content", if we can't form even a basic, general agreement on what kinds of words to use? What is there to discuss, that doesn't involve words? WhatamIdoing (talk) 23:41, 11 May 2025 (UTC)

::::::::::::::::@WhatamIdoing Maybe I just don’t understand the argument. Why should we use different terminology than comorbidity? This is technically the neutral term and I do not see much of a compelling argument as to why we should use a euphemism. The arguments made so far could be applied to any medical condition. Slothwizard (talk) 23:59, 11 May 2025 (UTC)

:::::::::::::::::Do you really believe that a term that declares autism to be morbid has a neutral tone? WhatamIdoing (talk) 01:06, 12 May 2025 (UTC)

::::::::::::::::::Comorbidity and morbidity are not at all the same thing. You are debating the word itself, so should we remove the use of comorbidity in ADHD? What about every other article about a condition that isn’t fatal? Also, this issue is more philosophical than practical. Slothwizard (talk) 01:18, 12 May 2025 (UTC)

:::::::::::::::::::Morbid means sick, regardless of whether it's terminal. An ordinary common cold is a morbidity, even though almost nobody dies from it.

:::::::::::::::::::I think this issue is more human than "philosophical". People think "comorbidity" means "two or more diseases happening at the same time". Autistic self-advocates don't want autism to be called a "disease". If we write, e.g., "Autism is frequently comorbid with anxiety", we actually are writing "Autism and anxiety are both diseases, and people frequently have both".

:::::::::::::::::::The consensus-oriented goal here is to find a way to say that autism and anxiety frequently happen together, without using language that says "and autism itself is a disease!" For example: "Autistic people frequently also have anxiety disorder." Or "Autism and anxiety are statistically correlated." Or "Autistic adults are n times as likely to have anxiety disorder as non-autistic adults." We should be able to find lots of ways to convey the facts without using the specific word comorbidity. Some of those ways might even use simpler words or clearer explanations, and thus result in more people correctly understanding the facts. WhatamIdoing (talk) 02:15, 12 May 2025 (UTC)

::::::::::::::::::::This is a very rigid way of interpreting comorbidity. You are looking at its etymology and basing the definition off that. In medicine, it is for any medical condition, not just the more subjective label of disease. We can’t be changing words because people may think it means something else, even when it literally doesn’t. Also, your argument affects its usage in almost all psychiatric disorders, not just autism. Slothwizard (talk) 02:41, 12 May 2025 (UTC)

:::::::::::::::::::::I don't think that's really true. For example, the phrase "comorbid with pregnancy" is very unusual (e.g., Google Books finds zero instances). Pregnancy is a medical condition, but not a disease, and we tend not to use the word comorbidity to describe pregnancy. WhatamIdoing (talk) 02:46, 12 May 2025 (UTC)

::::::::::::::::::::::Pregnancy is definitely not a medical condition, it is a physiological response to conception. For example: anxiety is not a medical condition—it is an emotion (don’t confuse that with anxiety disorders). Fever is not a medical condition, it is a symptom. The fight-or-flight response is a physiological response, etc. No doctor or researcher would ever refer to pregnancy as a medical condition. Slothwizard (talk) 02:53, 12 May 2025 (UTC)

:::::::::::::::::::::::Recently, https://jme.bmj.com/content/51/1/37.long argued that pregnancy is a disease. WhatamIdoing (talk) 03:28, 12 May 2025 (UTC)

::::::::::::::::::::::::This is not productive. The source you provided does not suggest pregnancy is a disease, but that it should be regarded as a disease for research purposes. It creates a metaphor referring to a gamete as a pathogen. You can’t selectively pick out studies to find what you want, that’s not how this works. You also can’t randomly define words based off the textbook definition or its etymology under similar contexts just to get what you want. You say that comorbid doesn’t sound good, but there needs to be a compelling reason as to why this term should be avoided, and not sounding good isn’t one of them. I have the same issue with the dispute about disorder and condition. A neurodevelopmental condition, according to you, can be interpreted as a human condition or medical condition, even though it will probably be wikilinked, and most people will probably view this as a medical condition since people have an intuition and autism is most regarded as a mental disorder. The scientific community has already established what autism is in the frame of what we are discussing. We cannot be changing terms because some people worry other people will interpret it wrong. Slothwizard (talk) 03:48, 12 May 2025 (UTC)

::::::::::::::::::::::::I really do not see the problem with “co-occurring conditions”. It is an expression frequently used in reliable sources. They do not seem to worry that it gets interpreted as substance use disorder. LogicalLens (talk) 05:14, 12 May 2025 (UTC)

:::::::::::::::::::::::::I don’t recant my position, but "co-occurring conditions" is my second choice. I don’t think people would confuse this with SUD, nor do I think it’s a major formatting issue on that front. Slothwizard (talk) 01:19, 17 May 2025 (UTC)

:::::::::::::::It is a disorder. Being depressed is part of the normal range of human variation. Having depression is not. Feeling anxiety is part of the normal range of human variation. When it reaches the point of causing clinically significant impairment or distress then it is a disorder. I'm sorry if some people with depression or anxiety feel depressed or anxious because we describe it on WP as a disorder, but WP isn't therapy and it's not here to be affirming and make people feel better about themselves. GMG^talk 00:22, 12 May 2025 (UTC)

::::::::::::::::Exactly! We should not be merging non-clinical terminology with an article on a medical condition, especially since there are many who have severe presentations of autism. If someone wanted information about autism as a diagnosis, where would they go? This article is becoming less suitable for that. Slothwizard (talk) 01:15, 17 May 2025 (UTC)

:::::::::::::::::Our changes do not remove important information on the diagnosis. And, as has been said multiple times on this talk page, the article is called "autism". This means all published sources regarding autism have to be taken into account. It is arbitrary to exclude sources that do not fit one's own viewpoint. LogicalLens (talk) 02:56, 17 May 2025 (UTC)

::::::::::::::::::* If we're going to Wikipedia:Make technical articles understandable, then we need to use "non-clinical terminology". WP:MEDMOS even recommends this. Plain English, rather than medicalese, is always the goal.

::::::::::::::::::* If someone wanted information about autism as an experience that some people have, where would they go?

::::::::::::::::::WhatamIdoing (talk) 04:14, 17 May 2025 (UTC)

:::::::::::::::::::This is a compelling argument. For the discussion about “co-occurring conditions”, it could probably stay like this; it’s not a major formality issue and I probably won’t comment about it much further. For autism as an experience, I feel as though it is a similar situation with anxiety and generalized anxiety disorder, or depression and major depressive disorder. The normal range and clinical range typically have separate articles. This is not to say a new article is required or that information needs to be excluded (which it absolutely shouldn’t). There has been growing research regarding autism as an experience, though replacing words with euphemisms while retaining its original meanings did not appear to me to be a good way to go about this. I don’t see “co-occurring conditions” as one of those euphemisms though, this is a separate thing. Given the direction we’re going, it would be okay to keep this. Slothwizard (talk) 04:46, 17 May 2025 (UTC)

:::::::::::::@GreenMeansGo @WhatamIdoing I don't know of any useful solutions but there is indeed a major issue. For example, I don't think some arguments here are worth pursuing any further as it will just take valuable time away from other projects and the facts are unlikely to be convincing. We’re covering the same ground repeatedly, which usually this means no further progress can be made. And there is little point in correcting misinformation where critics having their own conflicts make it impossible. It is often claimed in policy that Wikipedia is based on consensus, not voting. This apparent difference must be an artefact, some kind of an illusion. I think these issues have much to do with the bureaucracy of Wikipedia as well as competing interests. Димитрий Улянов Иванов (talk) 22:32, 11 May 2025 (UTC)

::::::Well, I see you point. What if we would just suggest a few alternative wordings and see what opposition it gets, if we can't get this straight by the methods which I believe to be more optimal? For example, we could discuss "(psychiatric) disorders occurring alongside autism", and similar ideas. I believe it is absolutely possible to denote this concept in a factually accurate manner without alluding to backstories and grievances. BlockArranger (talk) 23:35, 2 May 2025 (UTC)

:::::::I don't think it's limited to psychiatric conditions. For example, the gut dysfunction some autistic people have is probably neurological rather than psychiatric. WhatamIdoing (talk) 01:14, 3 May 2025 (UTC)

:I vote for using coexisting conditions -- Mark D Worthen PsyD (talk) [he/him] 02:00, 3 May 2025 (UTC)

::Although "co-occurring conditions" is used more often, I would also accept "coexisting conditions". LogicalLens (talk) 03:43, 3 May 2025 (UTC)

:::I don't like coexisting, because it somehow seems to imply that the they must exist, rather than may occur. Maybe that is just my personal take. CFCF (talk) 22:14, 3 May 2025 (UTC)

::::What about "Conditions occurring alongside autism"? That is very specific to autism, and includes both mental and physical conditions. Conditions include disorders and illnesses, but also states which some claim not to be pathological. BlockArranger (talk) 17:31, 11 May 2025 (UTC)

:::::I think that "alongside" suggests that these conditions are separate from autism. At a neurological level, they probably aren't. WhatamIdoing (talk) 20:40, 11 May 2025 (UTC)

::::::That depends on how you look at it and define it; this distinction is not necessarily objective. In terms of diagnosis, the comorbidities (I use the word here for ease of use) are not diagnosed as extensions of autism, nor is autism an extension of them. If we simplify in order to avoid severity, diagnoses could be seen as toggling presence to true. An analogy would be to check boxes on a paper, where there are options for "electric illumination receiving power" and "house is internally illuminated at point of observation". These most likely have an obvious casual relationship, but the way it is laid out on paper makes these two separate states which are either present or not present.

::::::We thus have to choose which way to frame it here. In medicine, diagnosis serves a purpose not only of being a descriptor, but also as something which ca be correlated with treatment modalities. For example, it would likely be wise to assume that intervention could look a bit different depending on presence of ADHD between members of a set of "autistic people with autism" (finally found something uncontroversial!). This model fails to take etiology into account; however, we are not yet very sure regarding etiology.

::::::I am much more familiar with a similar discussion regarding personality disorders. In editions previous to the DSM-5, and also in its Section II standard model, personality disorders are conceptualized as separate entities, which may or may not be comorbid in different ways. However, a compelling argument is that a person has a single personality after all, and if it is pathological, it would stand to reason that it would not necessarily fit neatly into one of the ten category buckets provided in the standard model. In fact, as PDs are diagnosed based on a subset of criteria, it makes the disorders polythetic, with the possibility in BPD for two people to share only a sigle criterion, which makes me question the validity of the model.

::::::However, the Alternative DSM-5 Model for Personality Disorders has later on adopted a hybrid dimensional framework, and even includes the diagnosis of PD - Trait specified, which is specific with regard to which traits a specific subject has, and may also contain specification on level of functioning. In this manner, psychiatry has managed to create a more holistic view of personality disorders.

::::::The problem here with regard to autism is that many other syndromes, somatic ones in particular, are very difficult to integrate with autism as they may also occur separately, in so called NT people. In this case, a similar framework to the AMPD could be adopted, with autism being a trait domain containing several typical autistic traits. A person could also possess other trait domains related to other types of syndromes or symptoms. Considering that this is mostly a thought experiment so far, I would say it sounds pretty good. However, isn't this what we already have in terms of all the diagnoses in the ICD being available to pick from to describe all noted pathology in a patient? I see the shortcoming here being that the medical diagnostic description only concerns pathology, instead of a whole set of clinical differences including strengths. But even the AMPD has not developed such features so far...

::::::Thus, in conclusion, I believe that we should in fact still divide up the comorbidities, and have them be "alongside" autism, as they are not part of what we know and understand to be autism. Hypothetically, we could imagine a broader underlying phenomenon giving rise to "it all", with autism a syndrome of aspects of this underlying unknown thing. I believe that it could be unwise to just expand autism to be something we infer to exist beyond the understood scope of autism, when autism itself is not definitively explained. I am glad that we are moving away from categorical PDs, but on the other hand, it was an expression of what was believed to once upon a time be the latest science, and thus how the topic was presented in Wikipedia. We don't even (as far as I know) have a new "Alternative Model for ASD", and thus wording is all we really can decide upon, within reasonable limits.

::::::Oh dear, I seem to have accidentally created an essay! BlockArranger (talk) 17:07, 12 May 2025 (UTC)

:::::::I found your accidental essay to be interesting. Thanks for posting it. This idea of a "broader underlying phenomenon giving rise to "it all"" is what I had in mind. WhatamIdoing (talk) 18:08, 12 May 2025 (UTC)

::::::::I am glad that you liked it! Just also continue the discussion, what do you think, do you agree that we should avoid speculating about a construct behind autism and its comorbidities until it has been accepted as mainstream science, including as a model for conceptualizing comorbidity of autism? BlockArranger (talk) 20:07, 12 May 2025 (UTC)

::::::As something independent of my spontaneously created essay (but I suggest reading it too), I would like to suggest an update: "Conditions occurring in the presence of autism"

::::::This expression avoids disorders and illnesses as categories; thus making it neutral. Indeed, I believe that these conditions occur, rather than exist. I also manage to avoid definitively separating the conditions from autism in my wording, at least the way I see it; yet it also does not contradict the current medical framework (see my essay above), as comorbidities de facto occur in the presence of whichever condition they are comorbidities of. And, well, autism... Refer to other discussions on the topic of ASD/Autism. BlockArranger (talk) 20:16, 12 May 2025 (UTC)

:::::::I do not think "co-occurring conditions" implies either the existence or non-existence of a causal relationship. LogicalLens (talk) 03:53, 13 May 2025 (UTC)

::::::::I agree, whereas "conditions occurring in the presence of autism" is too imprecise, because that would just be all conditions - the presence of a correlation is at the very least necessary to merit mention here, and is covered by co-occurring. CFCF (talk) 08:05, 13 May 2025 (UTC)

:::::::::I think "co-occurring" implies non-causal relationship. WhatamIdoing (talk) 17:07, 13 May 2025 (UTC)

::::::::::Following this dictionary entry,[https://www.merriam-webster.com/dictionary/co-occur] I do not think so. It even gives an example where "co-occurring" is used for autism. LogicalLens (talk) 01:31, 14 May 2025 (UTC)

:::::::::::That dictionary doesn't say anything about causality, so it's not evidence that it doesn't imply a non-causal relationship (or that it does).

:::::::::::The sentence mentioning autism is in a section labeled "Recent Examples on the Web" with a disclaimer that "Examples are automatically compiled from online sources to show current usage", which is not an endorsement of the use (though it's IMO some evidence that this is a common use). WhatamIdoing (talk) 05:29, 14 May 2025 (UTC)

::::::::::::My interpretation is that co-occurring makes no statement as to either causality or non-causality of the relationship. CFCF (talk) 07:03, 14 May 2025 (UTC)

:::::::::::::Strongly support this interpretation. There being nothing about causes in the definition strongly implies a lack of implication one way or the other.

:::::::::::::I've spent a few minutes looking for a definition that runs contrary to this, and found nothing. Oolong (talk) 13:48, 14 May 2025 (UTC)

::::::::::::::[https://pmc.ncbi.nlm.nih.gov/articles/PMC7053108/ "Diseases are said to be co-occurring if the same person has more than one disease. Comorbidity is the greater than chance association between the two conditions in the same individual."]

::::::::::::::In this model, autism + acne = co-occurring but autism + epilepsy = co-morbid. WhatamIdoing (talk) 17:47, 14 May 2025 (UTC)

:::::::::::::::The reference used to support that statement in the headache paper you linked is [https://pubmed.ncbi.nlm.nih.gov/26309916/ a 1970 theoretical paper], which makes no mention of co-occurring at all. Or for what I can make of it - even the idea that co-morbidity implies some form of causal relationship or correlation or a "greater than chance association between the two conditions" (I will admit it is a very dense theoretical paper from 1970, and I merely skimmed it).

:::::::::::::::The 1970 theory paper even states in the first sentence of the summary: {{tq|In a patient with a particular index disease, the term co-morbidity refers to any additional co-existing ailment.}}

:::::::::::::::I can't find that the interpretation of comorbidity to imply causality is generally accepted or supported beyond it being taken by the authors of a particular headache paper, with an improper reference to historical theoretical work. To me, and from what I get the definitions - comorbidity is just co-occurrence of disease - which we are trying to avoid labeling autism as. I may be wrong, but I'm not convinced of it yet. CFCF (talk) 22:33, 14 May 2025 (UTC)

:::::::::::::::Co-occurring is a broader term that can encompass both things with a causal relationship and things without. The list also contains physical diseases for which it is very unclear whether they are directly related to autism. It is probably the case for epilepsy, but even for depression, at least a large part is due to discrimination instead of a biological link. The fact that this authoritative handbook uses the term shows that it cannot be that wrong.[https://academic.oup.com/edited-volume/28150] Therefore, honestly, I consider this entire discussion a waste of time. LogicalLens (talk) 02:37, 15 May 2025 (UTC)

::::::::::::::::I'm with you. 'Co-occurring conditions' is widely used and not meaningfully ambiguous at all. I'm puzzled that we've spilt so many words on this. Oolong (talk) 10:32, 15 May 2025 (UTC)

::Would you object to 'co-occurring conditions'? As @LogicalLens says, it's definitely used more often, and it's not clear that it would cause any confusion at all.

::I don't really see @CFCF's objection to 'coexisting', but I do think it's worse aesthetically. Oolong (talk) 17:52, 11 May 2025 (UTC)

:::Related conditions? Associated conditions? WhatamIdoing (talk) 20:41, 11 May 2025 (UTC)

::::How are those improvements?

::::'Co-occurring' is, I think, suitably agnostic, as well as being commonly used.

::::Presumably, yes, there's some kind of relationship between them, but we don't necessarily know what: it could be a shared causative factor, indirect causation or something more direct. In general, we should avoid suggesting that we know, when we don't.

::::Would we say depression is a related condition to autism? What about to homosexuality? I would suggest that it is somewhat misleading in both cases, even if technically accurate. Oolong (talk) 13:55, 14 May 2025 (UTC)

:::::It is in my opinion clear that we are talking about pathologies here, and I guess even Autism / Neurodiversity warriors would agree that this is the case. We need to remember to define the scope as such also somewhat implicitly in our description. I know that "slippery slope" is a bad argument, but think for a moment, would it make sense call it "correlated phenomena"? According to what I see in this discussion, it seems to me that some people want to convey the definition implicitly, by what we include and what we don't; if we include intellectual disability and gastrointestinal issues, for example, but not belonging to the "Queer spectrum", the implicit reason for these inclusions and disinclusions should just be understood by readers to be related to what we think is pathological.

:::::The problem at hand is clearly that there is a lot of support for not viewing autism as a pathology, and thus it can be difficult to find the verbal glue which binds a supposedly neutral phenomenon with what is supposedly pathological. Thus, the apparently intense need to put value judgements into everything, is the real pathology here. Admittedly, we need to take it into consideration, as it has infected the population like a pandemic.

:::::As I see it, it is necessary to find a way to state in a concise manner the following: "Clinically recognized pathologies which are known to frequently be part of a clinical picture which also includes the non-judgementally approached autisim". I also get why comorbidity is not optimal though, just to make that clear. However, I bleieve we should first try to define what exactly we are trying to convey, and then find the most efficient way to distill it. BlockArranger (talk) 19:35, 14 May 2025 (UTC)

::::::This bit sounds right: {{xt|it can be difficult to find the verbal glue which binds a supposedly neutral phenomenon with what is supposedly pathological}}.

::::::Then you add on the fact that for some people, autism is not a neutral phenomenon at all, and it becomes very difficult indeed. WhatamIdoing (talk) 01:40, 15 May 2025 (UTC)

::::I think you are at least trying to move us in the right direction, but I see @Oolong's point. What about:

::::"Conditions commonly present with autism" ?

::::We could even add "pathological" or the like. BlockArranger (talk) 19:42, 14 May 2025 (UTC)

The page currently contains a template that the article repeatedly makes medical claims with not sufficiently reliable sources. In my view, this pertains particularly to "Social and communication skills" and its subsections in "Signs and characteristics", while other sections use better sources. LogicalLens (talk) 04:12, 3 May 2025 (UTC)

:Do you think it would help to flag these sources with Template:Medical citation needed? WhatamIdoing (talk) 00:25, 4 May 2025 (UTC)

::Yes, and I did that. LogicalLens (talk) 02:07, 4 May 2025 (UTC)

{{closed|text=Hi all—starting a new thread to raise a concern about structural framing.

At present, the article titled Autism immediately redirects to Autism Spectrum Disorder in the lead sentence. This conflates two distinct concepts:

• “Autism” is widely used across advocacy, education, and lived-experience communities to describe a neurodevelopmental identity.
• “Autism Spectrum Disorder (ASD)” is the clinical diagnosis as defined by DSM-5 and ICD-11.

Conflating the two introduces a factual inaccuracy and creates a policy inconsistency:

1. Per WP:TITLE, article titles should reflect common usage—not just clinical definitions. “Autism” is used broadly beyond the scope of ASD.

2. Per WP:NPOV and WP:DUE, we are required to represent all significant perspectives in proportion. That includes both the clinical and neurodiversity framings—especially when the article’s title uses the broader term.

Redirecting the reader from “autism” directly to “disorder” erases this plurality and introduces bias at the structural level.

Proposal: Reframe the lead so that Autism is introduced as a broader concept, with ASD as a diagnostic classification within that spectrum—not the sole or default definition.

Would welcome views on how best to align structure with policy and source plurality.

Recursiva (talk) 16:24, 7 May 2025 (UTC)

:Autism and ASD are widely used synonymously. GMG^talk 16:33, 7 May 2025 (UTC)

::This has been discussed ad nauseum, there is consensus, and there are even open threads that discuss this consensus. This thread is not conducive to improvement. Closing - please engage, if you must, in the appropriate threads above. CFCF (talk) 19:02, 7 May 2025 (UTC)}}

@Slothwizard, regarding your revert: I made many changes to this infobox and would like to know what exactly you perceive as depathologizing autism too much so that we can discuss the changes in detail. Also, if you think it makes less room for autistic people with high support needs, do you have ideas how these people could be included better?

For other editors: this is the page with the current infobox[https://en.wikipedia.org/w/index.php?title=Autism&oldid=1289675425] and this is the one that I wanted to insert.[https://en.wikipedia.org/w/index.php?title=Autism&oldid=1289512817] LogicalLens (talk) 07:24, 11 May 2025 (UTC)

:The proposed infobox should be strictly medical and not mix with other info that could be explained elsewhere. "Societal barriers" is an unnecessary addition that could be easily explained in the article. "Co-occurring conditions and challenges" is very wordy; it is merely a euphemism for "Complications". About its inclusion of meltdowns; these are very real, but they are not well-defined—I’m not too concerned about this, it’s more of a formality issue. "Supports" is just a euphemism for "Management". Its inclusion of Autism-friendly workplaces could be simplified as "changes in the environment", which is similar to Visual impairment. This way, it could be applied more broadly. It can still be wikilinked.

:I do agree with setting "Usual onset" to always, so I will do that.

:About my edit summary – I could not fit all my problems with it there. The use of euphemisms were my issue in how it was "de-pathologizing". It also included non-medical information, which is atypical. Moving from an established Infobox template to a generic one is just excessive and unnecessary. This page is largely about the clinical presentation of autism, so it wouldn’t make sense to do this. Slothwizard (talk) 19:35, 11 May 2025 (UTC)

::"Autism" is a broad article intended to cover all aspects of the topic, not just those framed within the medical model. It would be arbitrary and limiting to include only medicalized content in the infobox. Autism is different from other things that are classified as medical conditions because a significant proportion of the literature does not view it as pathological.

::The term "complications" suggests that outcomes like bullying or unemployment are direct biological consequences of autism, which even proponents of the medical model must acknowledge is not always the case. Many of these outcomes arise from external factors, such as lack of accommodations, social exclusion, or systemic barriers. That is why I included "societal barriers" and adjusted the description accordingly. That said, I agree the revised wording was a bit long — perhaps "common challenges" would be a more concise and neutral alternative.

::Regarding "autism-friendly workplaces," I agree that a broader term like "autism-friendly environments" would be better. LogicalLens (talk) 07:32, 12 May 2025 (UTC)

:::My main concern is that most of the information in the infobox currently is pathological. The "common challenges" listed are anxiety, depression, etc. These are all complications. The only one I can understand is bullying, since that isn’t really a complication as that’s external. The "specialty" section is psychiatry, clinical psychology, and pediatrics. The "societal barriers" section is extra information that I would not put on an infobox in general, causes clutter. Also, sensory overload is definitely not just a societal barrier, it can occur without other people being involved. This whole template has a clinical theme to it, yet it terminologically presents itself as a neutral information section that happens to list mostly clinical issues. It does not really make much sense.

:::—

:::I apologize for getting back late. I am doing finals right now and editing is usually something I do for leisure, though this has become stressful for me since this is personal (for most of us here too) and I am still busy. Thanks Slothwizard (talk) 01:11, 17 May 2025 (UTC)

::::1) The things in the "common challenges" section exist because a person with the autistic features listed in the "characteristics" section lives in a world with the barriers listed in the "societal barriers" section. This is therefore a logical presentation. Maybe for parts of the increased rate of anxiety, inherent autistic features have a direct link, but not most of the other things listed there. It is definitely arbitrary to remove information on societal barriers.

::::2) I wrote "sensory overwhelm", not "sensory overload". Of course, there can be situations where an autistic person gets an overload from sensory inputs of nature, but in most cases, these are caused by noises etc. by humans.

::::3) I also do not see why “common challenges” is a euphemism. The things listed there are negative (neurodiversity proponents do not deny this) and “challenges” is a negative term but avoids the implication of “complications” that the things are a direct result of autism. LogicalLens (talk) 05:14, 17 May 2025 (UTC)

:::::@Anthony2106 is also in favor of the new infobox, as he thanked me for my edit.

:::::These words are not euphemisms as many people actually mean these neutral words to describe neutral things. A word is only a euphemism if the user of the word still considers the described thing to be negative. LogicalLens (talk) 04:51, 18 May 2025 (UTC)

::::::My revert was thanked by @Димитрий Улянов Иванов. I am not saying to exclude information regarding neurodiversity, but this article is for autism as a diagnosis. Slothwizard (talk) 04:58, 18 May 2025 (UTC)

:::::::This article is about autism in general. LogicalLens (talk) 04:59, 18 May 2025 (UTC)

::::::::That is only partly true. The common name for autism spectrum disorder is autism. This is the main article regarding autism, yes, but this article is formatted as a medicine-related article because that is the scientific consensus as of now and it is a major diagnostic category. Disorders listed in major diagnostic manuals have their own specific article. Slothwizard (talk) 05:07, 18 May 2025 (UTC)

:::::::::Several years ago, the medical model view was nearly the only one. Back then, it was correct to format it strictly as a medical article. But now, a significant minority of the literature does not view autism through a medical model lens. The article thus falls into a category of things that are predominantly viewed as a disorder but not universally. Insisting that it is simply a medical article is circular reasoning. LogicalLens (talk) 05:13, 18 May 2025 (UTC)

::::::@LogicalLens I think I thanked you because you removed the word "symptoms" like I'm sorry my autism deszise is gonna get you! "Oh no the autism pandemic! ITS GONNA KILL US!!1" "IT RUIEND MY DREAM JOURNAL!!!!!!!1" Anthony2106 (talk) 05:00, 18 May 2025 (UTC)

:::::::I think this is a very naive view of symptoms, and disagree that we should avoid mentioning symptoms because of link to contagion. CFCF (talk) 15:29, 18 May 2025 (UTC)

::::::::@CFCF no everyone knows "symptoms" are for bad things like COVID for example. Anthony2106 (talk) 22:03, 18 May 2025 (UTC)

:::::::::Stop it, you’re not being funny. CFCF (talk) 22:44, 18 May 2025 (UTC)

::::::::::@CFCF I'm being more serious now. Anthony2106 (talk) 22:53, 18 May 2025 (UTC)

:::::::::::The lead section already says that for a formal diagnosis, significant challenges must be present and the DSM/ICD sections use the word "symptoms". The style guidelines mentioned in the classification section recommend using "characteristics" instead. LogicalLens (talk) 23:03, 18 May 2025 (UTC)

::::::::::::I have no qualms with sticking to whatever is recommended, but when someone ignorantly equates the word symptom with a stigmatizing view of disease as contagion I will call it out. Autism is not the only condition to face stigma, and promoting stigma towards other conditions, and being on this page does not give a free pass from promoting stigma towards others. CFCF (talk) 05:32, 19 May 2025 (UTC)

:::::::::::::@CFCF sorry I wasn't trying to stigmatize disease. I trying make a Hyperbole. But I still think the word symptoms is inappropriate for autism, and I think this has been spoken about on the on going (probably never ending) dispute resolution for autism. Anthony2106 (talk) 06:32, 19 May 2025 (UTC)

This book chapter:

• {{cite book |last=Van Bourgondien |first=Mary E. |title=Adolescents and Adults with Autism Spectrum Disorders |last2=Dawkins |first2=Tamara |last3=Feldman |first3=Melanie |last4=Marcus |first4=Lee |date=2024 |publisher=Springer International Publishing |isbn=978-3-031-46462-1 |editor-last=Volkmar |editor-first=Fred R. |place=Cham |pages=19–54 |language=en |chapter=Families of Autistic Adults |doi=10.1007/978-3-031-46463-8_2 |editor2-last=Reichow |editor2-first=Brian |editor3-last=McPartland |editor3-first=James C.}} (WP:TWL link: [https://link-springer-com.wikipedialibrary.idm.oclc.org/chapter/10.1007/978-3-031-46463-8_2])

looks like it could be useful for describing family relationships in this or a related article. It mentions factors affecting how close adults siblings are, the expectations on neurotypical adults to care for their autistic siblings, estate planning in the US (ABLE accounts), coping strategies (problem solving is better than avoidance), and even something about spouses (an under-researched area).

Based on what I've seen in the popular press, I think this is an area of interest to readers. WhatamIdoing (talk) 21:40, 12 May 2025 (UTC)