Talk:Autism#c-LogicalLens-20250226044700-Survey (on RFC on focus)

{{User:ClueBot III/DoNotArchiveUntil|1743519675}}

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 disability 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:

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)

@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}}

}}

{{Notelist-talk}}

{{hat|1=68 references collapsed in here}}

{{reflist-talk}}

{{hab}}

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)

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)

:@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)

::@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)

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)

• 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)

{{ping|Johnbod}} The [https://en.wikipedia.org/w/index.php?title=Autism&diff=prev&oldid=1284421935 image] is a 300 year old etching of an anonymous woman with a book. Feel free to peruse :c:Category:People with books. There's a few hundred images that are of equal relevance to the subject of the article.

The image is just a place holder for a caption. Neither the artist or the subject have any connection with autism. The content of the caption doesn't seem to be directly reflecting content in the body. The citations aren't used elsewhere in the body. GMG^talk 14:31, 7 April 2025 (UTC)

:A 250 yo engraving I think. Her approach to the book, which she is "reading", not in the normal way, but with a variety of instruments for geometry, seems unusual, and broadly appropriate to the accompanying text. No, "The citations aren't used elsewhere in the body" - why is this an argument for just removing them, as you did? They seem very relevant to the section. Johnbod (talk) 17:46, 7 April 2025 (UTC)

::The dude made maps. It's not that unusual. GMG^talk 18:11, 7 April 2025 (UTC)

:::Huh? I see no maps. Johnbod (talk) 02:52, 8 April 2025 (UTC)

:::::c:Category:Anthonie de Winter GMG^talk 16:37, 11 April 2025 (UTC)

:::::I'm in agreement with GMG on the matter of the image, it really is a poor relation to the text accompanying it. -- Cdjp1 (talk) 17:41, 13 April 2025 (UTC)

{{edit semi-protected|Autism|answered=yes}}

I am an autistic individual and psychology major and I am making this request in order to add some relevant information with reliable sources cited. Alyadar (talk) 15:10, 15 April 2025 (UTC)

:File:X mark.svg Not done: this is not the right page to request additional user rights. You may reopen this request with the specific changes to be made and someone may add them for you, or if you have an account, you can wait until you are autoconfirmed and edit the page yourself. Tenshi! (Talk page) 15:14, 15 April 2025 (UTC)

{{edit semi-protected|Autism|answered=yes}}

The condition was first characterized by Leo Kanner in 1943 as "early infantile autism." 8.25.28.162 (talk) 14:08, 19 April 2025 (UTC)

:File:Red question icon with gradient background.svg Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. twisted. (user | talk | contribs) 16:49, 19 April 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)

::::::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)

::::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)