Talk:Autism/Archive 12#To-do list

Co-occurring disorders is a redirect to dual diagnosis (i.e., having a substance use disorder plus another mental/neurological condition). I looked through PubMed for a while, and few of the results mentioned autism.

I realize that "Co-occurring disorders" feels to many autistic editors like it's a neutral tone. However, a fraction of this article's readers are likely to see that phrase and think first about alcoholism and substance use disorders, and only later think about the plain English words. Is there a viable alternative? WhatamIdoing (talk) 17:34, 30 April 2025 (UTC)

:I wonder if "co-occuring conditions" or "diagnosis's" would be different enough to make people stop and think about the meaning? IntentionallyDense ^(Contribs) 18:04, 30 April 2025 (UTC)

::I don’t think we should use said wording at all simplify it: most/some people who are diagnosed with autism are also diagnosed with other mental conditions such as (insert data from reliable source) its easy simple to read and straightforward •Cyberwolf•. talk? 19:02, 30 April 2025 (UTC)

:::What do you propose the subheading for this be as "most/some people who are diagnosed with autism are also diagnosed with other mental conditions" is a bit too long for a subheading. IntentionallyDense ^(Contribs) 03:54, 1 May 2025 (UTC)

:These two books use "co-occurring conditions" in their titles and do not refer primarily to substance use disorders.[https://academic.oup.com/edited-volume/28150][https://link.springer.com/book/10.1007/978-981-97-0656-3] LogicalLens (talk) 04:41, 1 May 2025 (UTC)

::The fact that the phrase is sometimes used in other contexts does not disprove the fact that it is mostly used in the context of drug addiction. I assume (because of the euphemism treadmill) that the addiction field considers the occasional use outside their stigma-laden area to be a desirable quality. WhatamIdoing (talk) 18:49, 1 May 2025 (UTC)

:::I think this is looking at it slightly the wrong way around to be honest {{U|WhatamIdoing}}. The drug field, due to intense stigma, are rather among the first to account for linguistic issues that promote stigma, followed by adoption in other fields. CFCF (talk) 02:25, 2 May 2025 (UTC)

:::If you search for "co-occurring conditions" (not "co-occurring disorders") on Google Scholar, you get mostly autism results. LogicalLens (talk) 03:40, 2 May 2025 (UTC)

:I do not think that the phrase suggests drug abuse in any way. Co-occurring just means 'happening at the same time'. It could be used for sneezing and watery eyes in a description of hay fever. Urselius (talk) 07:20, 1 May 2025 (UTC)

:I had no idea that 'co-occurring disorders' had this oddly specific meaning in the USA.

:'Co-occurring conditions' is surely fine. Oolong (talk) 10:05, 1 May 2025 (UTC)

::This is not just "in the USA".[https://carelearning.org.uk/qualifications/level-2-sh-suicide/intro-suicide/2-4-describe-what-is-meant-by-the-term-co-occurring-disorders/][https://www.ukat.co.uk/help-guides/dual-diagnosis/#post-853][https://www.westyorks-ca.gov.uk/media/10869/drug-and-alcohol-research-mental-health-pathway.pdf] WhatamIdoing (talk) 19:01, 1 May 2025 (UTC)

:::I just think it came to that field first. CFCF (talk) 02:25, 2 May 2025 (UTC)

:Comorbidity/comorbid disorders or coexisting disorders. Personally, I prefer the former, which is used more in scientific publications. Димитрий Улянов Иванов (talk) 22:21, 1 May 2025 (UTC)

::I agree; this was my first thought as well when reading the beginning of the discussion. I'm more active in articles related to personality disorders, and there for example the consensus is absolutely to talk about comorbidity, as a point of view in addition to academia. In fact, it makes for a good wikilink to comorbidity. BlockArranger (talk) 01:51, 2 May 2025 (UTC)

:::You can create a wikilink for one article and still use another word: co-occurring conditions. LogicalLens (talk) 03:42, 2 May 2025 (UTC)

::::@LogicalLens Well yes, that's actually not a really strong argument. However, as the topic has been decided to be denoted at comorbidity, judging by the actual main article, I see it as there at least existing some previous consensus for that being a decent, or as I would call it - very good, name. BlockArranger (talk) 14:25, 2 May 2025 (UTC)

:::::The difficulty with comorbidity is that if you say that autism and ____ are "comorbid", you are implicitly saying that autism is a morbidity. Implying that autism is a morbidity annoys people who believe that autism is a perfectly normal, perfectly healthy part of human experience. WhatamIdoing (talk) 16:32, 2 May 2025 (UTC)

::::::We annoy people with article content all the time. Everyone is expected to be civil and respectful in interactions with other editors, but article content isn't a safe space. GMG^talk 19:48, 2 May 2025 (UTC)

:::::::This is not about having some sort of "safe space". If you write something that annoys some editors, they'll try to change it. Persistently. Endlessly. Until, in fact, you follow the policy rule about making "an effort to address editors' legitimate concerns through a process of compromise" within the framework of our policies and guidelines.

:::::::We know this language will result in disputes until it is removed. We know this language is not required by any policy or guideline. So – maybe avoid using it? There are other policy- and guideline-compliant options, after all. WhatamIdoing (talk) 20:02, 2 May 2025 (UTC)

::::::::That sounds a lot like "we're going to argue until everyone else loses interest and then claim consensus." GMG^talk 20:13, 2 May 2025 (UTC)

:::::::::Not really? I mean, if this were a WP:FRINGE area, then I'd agree that the scenario you describe is unfortunately likely. But I find, overall, that the editors interested in this article are not only some of the most consistently patient and polite editors on Wikipedia, but also dedicated to following Wikipedia's rules in both the letter and the spirit. It's just that even if current editors A and B and C agree not to change it, then, next month, there will be new editors D and E asking for the same change. And even if editors A, B, C, D, and E agree not to change it, then we'll soon have editors F and G asking for the same change. WhatamIdoing (talk) 20:36, 2 May 2025 (UTC)

::::::::::I'm not seeing the part where you disagree with my comment. GMG^talk 22:14, 2 May 2025 (UTC)

:::::::::::Because they're not expecting everyone else to lose interest, and they're not going to claim consensus until there actually is one. WhatamIdoing (talk) 22:23, 2 May 2025 (UTC)

::::::::::::Well then, for whatever it's worth, comorbid is the standard terminology. I'm not terribly concerned if it "annoys" some people. Age of Earth also probably annoys some people too. We don't craft articles based on hurt feelings and personal dispositions. Wikipedia is not therapy. GMG^talk 12:58, 4 May 2025 (UTC)

:::::::::::::If your meaning differs from "Given a choice between (a) spending the next decade arguing about this wording and (b) finding a synonym that does not predictably produce endless arguments, I prefer having the arguments", then I have misunderstood you and would ask you to rephrase.

:::::::::::::If that's your meaning, though, I happen to have a different preference. WhatamIdoing (talk) 20:20, 4 May 2025 (UTC)

{{outdent}}

No, I very much see the "endless arguments" as fueled by those who want to essentially merge this article with that on Neurodiversity, because we might, in your words, annoy some people. GMG^talk 14:16, 7 May 2025 (UTC)

:And maybe if we find a word for the first sentence that (a) is still accurate and (b) isn't "disorder", then those people will decide that something else is more important than objecting to the use of the word "disorder" in the first sentence of this article. WhatamIdoing (talk) 17:39, 7 May 2025 (UTC)

::Or maybe people could just drop the stick and we can use the accurate term as we do in any other similar article. GMG^talk 17:42, 7 May 2025 (UTC)

:::I don't think that will happen. Even if every single editor this year – all three-quarter million of them – agreed to do this, next year we would get a newbie who hadn't signed up to that agreement, and it would start all over again. These arguments will only stop if we stop using the objected-to word. WhatamIdoing (talk) 17:50, 7 May 2025 (UTC)

::::The fact that someone is willing to argue indefinitely is not evidence that they are correct. This is a silly argument that would justify half of disruptive editors on controversial subjects. That you think this is a valid rationale is puzzling at best. GMG^talk 17:55, 7 May 2025 (UTC)

:::::It's not "someone". If it was just one person, we could block the account. Instead, the pattern is:

:::::* Alice sees what she believes to be a problem with Autism. She creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. Alice argues for a long time and then goes away.

:::::* A few weeks later, Bob sees what he believes to be a problem with Autism. He creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. Bob argues for a long time and then goes away.

:::::* Soon after that, Chris sees what they believe to be a problem with Autism. They creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. Chris argues for a long time.

:::::* The next month, David sees what he believes to be a problem with Autism. He creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. David argues for a long time. Chris joins in. Eventually David gives up and goes away.

:::::* Eve sees what she believes to be a problem with Autism. She creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. Eve argues for a long time, with Chris backing her up.

:::::* Frank sees what he believes to be a problem with Autism. He creates a new account and tries to remove the word 'disorder'. We explain that we're using it on purpose. Frank argues for a long time and then goes away.

:::::It's not someone. It's "some-many", probably "some-hundreds". The problem of autistic self-advocates objecting to Wikipedia's use of this term in this article will not go away unless we stop using this term in this article. WhatamIdoing (talk) 18:06, 7 May 2025 (UTC)

::::::Yet we seem to do just fine on other articles where some issue is brought up repeatedly. GMG^talk 18:50, 7 May 2025 (UTC)

:::::::It's easier to deal with that kind of thing when the stream of people bringing up objections is objectively wrong in some way.

:::::::As it should be. Oolong (talk) 09:45, 10 May 2025 (UTC)

::::::::I don't agree that "we seem to do just fine on other articles where some issue is brought up repeatedly". Having to deal with the same problem over and over and over and over causes problems. It wastes time; it creates WP:DRAMA; it causes experienced editors to quit. Even when the objection is objectively wrong, there is a limit to how many times most people are willing to explain things like "Guess what? 80% of women is not the same as 80% of people, so you can't just do a mindless search-and-replace change to make this article about menstruation be gender neutral." After a while, you start thinking that your time would be better spent doing anything else. WhatamIdoing (talk) 17:55, 10 May 2025 (UTC)

:::::::::{{tq|80% of women is not the same as 80% of people...}} What are you even talking about? GMG^talk 11:04, 11 May 2025 (UTC)

::::::::::This is a problem I've encountered more than once in a different article. It says something like "80% of women get ____ menstrual symptoms", and multiple well-meaning editors have changed it to "80% of people get ____ menstrual symptoms". Guess what? 80% of people don't menstruate at all, so 80% of people don't get any menstrual symptoms at all. And I'm heartily sick of correcting this innumerate nonsense.

::::::::::I give this specific example as proof that we don't always "seem to do just fine on other articles where some issue is brought up repeatedly". Sometimes having an issue brought up repeatedly causes problems like irritation and burnout. WhatamIdoing (talk) 16:56, 11 May 2025 (UTC)

:::::::::::Okay. You revert it and move on. We don't allow people to hold an article hostage because unless we do what they want they'll argue until the end of time. GMG^talk 20:54, 11 May 2025 (UTC)

::::::::::::Yes. I revert it, I explain it, I move on. And then a few months later, someone else shows up and makes the same stupid mistake, and I do this all over again. And again. How many times should I be expected to do this?

::::::::::::We almost lost one of our long-time FTN regulars because he has gotten so tired of repeating the same stuff about COVID origins. If we actually "do just fine on other articles where some issue is brought up repeatedly", why did he almost quit over some issue being brought up repeatedly? Others have taken those articles off their watchlists, because they're just so sick of it. I don't think this is "doing just fine". I think this is a sign of a problem. WhatamIdoing (talk) 21:05, 11 May 2025 (UTC)

:::::::::::::We don't let people hold an article hostage. People can come and go as they please. We don't make content decision based on whether some people will get tired and go. We don't practice appeasement, and if you're one of the people dedicated to arguing until the end of time then you're part of the problem. GMG^talk 22:07, 11 May 2025 (UTC)

::::::::::::::I think what we need to practice, in cases such as this one, is developing a Wikipedia:Consensus that is able "to address editors' legitimate concerns through a process of compromise while following Wikipedia's policies and guidelines", to quote that policy.

::::::::::::::We have legitimate concerns here:

::::::::::::::* "Disorder" is not obviously appropriate in every case. People might not look at some famously successful autistic people, such as Pokémon's creator, Satoshi Tajiri, or the artist Henriett Seth F., and think they're actually "disordered".

::::::::::::::* "Difference" is not obviously appropriate in many cases. People do not look at adults with no ability to navigate ordinary daily tasks and think "Wow, it's a little different that a 25 year old can't figure out how to buy food at the grocery store and starts screaming if the line for the playground swings exceeds his tolerance, but he's so obviously just like everyone else."

::::::::::::::Both of these concerns can be found in reliable sources, so they're legitimate. The question is therefore: Can we address editors' legitimate concerns by finding a word that falls somewhere in between the two extremes – in between "there was definitely something medically wrong with Einstein" and "it's all fine"? WhatamIdoing (talk) 23:16, 11 May 2025 (UTC)

:::::::::::::::@WhatamIdoing Given how most of these discussions have been going, I am apprehensive to believe that a consensus can be reached. If others agree this is the direction we should go, then that is fine. However, the disputes mostly revolve around whether we should change terminology against what diagnostic manuals go by. In gender dysphoria, a consensus was reached not to classify it as a mental disorder, however, the diagnostic manuals also stressed how using terms like disorder should be avoided, so we again did not deviate from them. As for your point of where people {{tq|think they are actually "disordered"}}, this is not a fair statement. That is not correct usage of disorder and is just your POV of how people interpret that term. I believe we should start moving on to discussing the actual content of the article, instead of arguing whether we should remove medical terminology to avoid possibly offending people. Slothwizard (talk) 23:33, 11 May 2025 (UTC)

::::::::::::::::How do we "start moving on to discussing the actual content", if we can't form even a basic, general agreement on what kinds of words to use? What is there to discuss, that doesn't involve words? WhatamIdoing (talk) 23:41, 11 May 2025 (UTC)

::::::::::::::::@WhatamIdoing Maybe I just don’t understand the argument. Why should we use different terminology than comorbidity? This is technically the neutral term and I do not see much of a compelling argument as to why we should use a euphemism. The arguments made so far could be applied to any medical condition. Slothwizard (talk) 23:59, 11 May 2025 (UTC)

:::::::::::::::::Do you really believe that a term that declares autism to be morbid has a neutral tone? WhatamIdoing (talk) 01:06, 12 May 2025 (UTC)

::::::::::::::::::Comorbidity and morbidity are not at all the same thing. You are debating the word itself, so should we remove the use of comorbidity in ADHD? What about every other article about a condition that isn’t fatal? Also, this issue is more philosophical than practical. Slothwizard (talk) 01:18, 12 May 2025 (UTC)

:::::::::::::::::::Morbid means sick, regardless of whether it's terminal. An ordinary common cold is a morbidity, even though almost nobody dies from it.

:::::::::::::::::::I think this issue is more human than "philosophical". People think "comorbidity" means "two or more diseases happening at the same time". Autistic self-advocates don't want autism to be called a "disease". If we write, e.g., "Autism is frequently comorbid with anxiety", we actually are writing "Autism and anxiety are both diseases, and people frequently have both".

:::::::::::::::::::The consensus-oriented goal here is to find a way to say that autism and anxiety frequently happen together, without using language that says "and autism itself is a disease!" For example: "Autistic people frequently also have anxiety disorder." Or "Autism and anxiety are statistically correlated." Or "Autistic adults are n times as likely to have anxiety disorder as non-autistic adults." We should be able to find lots of ways to convey the facts without using the specific word comorbidity. Some of those ways might even use simpler words or clearer explanations, and thus result in more people correctly understanding the facts. WhatamIdoing (talk) 02:15, 12 May 2025 (UTC)

::::::::::::::::::::This is a very rigid way of interpreting comorbidity. You are looking at its etymology and basing the definition off that. In medicine, it is for any medical condition, not just the more subjective label of disease. We can’t be changing words because people may think it means something else, even when it literally doesn’t. Also, your argument affects its usage in almost all psychiatric disorders, not just autism. Slothwizard (talk) 02:41, 12 May 2025 (UTC)

:::::::::::::::::::::I don't think that's really true. For example, the phrase "comorbid with pregnancy" is very unusual (e.g., Google Books finds zero instances). Pregnancy is a medical condition, but not a disease, and we tend not to use the word comorbidity to describe pregnancy. WhatamIdoing (talk) 02:46, 12 May 2025 (UTC)

::::::::::::::::::::::Pregnancy is definitely not a medical condition, it is a physiological response to conception. For example: anxiety is not a medical condition—it is an emotion (don’t confuse that with anxiety disorders). Fever is not a medical condition, it is a symptom. The fight-or-flight response is a physiological response, etc. No doctor or researcher would ever refer to pregnancy as a medical condition. Slothwizard (talk) 02:53, 12 May 2025 (UTC)

:::::::::::::::::::::::Recently, https://jme.bmj.com/content/51/1/37.long argued that pregnancy is a disease. WhatamIdoing (talk) 03:28, 12 May 2025 (UTC)

::::::::::::::::::::::::This is not productive. The source you provided does not suggest pregnancy is a disease, but that it should be regarded as a disease for research purposes. It creates a metaphor referring to a gamete as a pathogen. You can’t selectively pick out studies to find what you want, that’s not how this works. You also can’t randomly define words based off the textbook definition or its etymology under similar contexts just to get what you want. You say that comorbid doesn’t sound good, but there needs to be a compelling reason as to why this term should be avoided, and not sounding good isn’t one of them. I have the same issue with the dispute about disorder and condition. A neurodevelopmental condition, according to you, can be interpreted as a human condition or medical condition, even though it will probably be wikilinked, and most people will probably view this as a medical condition since people have an intuition and autism is most regarded as a mental disorder. The scientific community has already established what autism is in the frame of what we are discussing. We cannot be changing terms because some people worry other people will interpret it wrong. Slothwizard (talk) 03:48, 12 May 2025 (UTC)

::::::::::::::::::::::::I really do not see the problem with “co-occurring conditions”. It is an expression frequently used in reliable sources. They do not seem to worry that it gets interpreted as substance use disorder. LogicalLens (talk) 05:14, 12 May 2025 (UTC)

:::::::::::::::::::::::::I don’t recant my position, but "co-occurring conditions" is my second choice. I don’t think people would confuse this with SUD, nor do I think it’s a major formatting issue on that front. Slothwizard (talk) 01:19, 17 May 2025 (UTC)

:::::::::::::::It is a disorder. Being depressed is part of the normal range of human variation. Having depression is not. Feeling anxiety is part of the normal range of human variation. When it reaches the point of causing clinically significant impairment or distress then it is a disorder. I'm sorry if some people with depression or anxiety feel depressed or anxious because we describe it on WP as a disorder, but WP isn't therapy and it's not here to be affirming and make people feel better about themselves. GMG^talk 00:22, 12 May 2025 (UTC)

::::::::::::::::Exactly! We should not be merging non-clinical terminology with an article on a medical condition, especially since there are many who have severe presentations of autism. If someone wanted information about autism as a diagnosis, where would they go? This article is becoming less suitable for that. Slothwizard (talk) 01:15, 17 May 2025 (UTC)

:::::::::::::::::Our changes do not remove important information on the diagnosis. And, as has been said multiple times on this talk page, the article is called "autism". This means all published sources regarding autism have to be taken into account. It is arbitrary to exclude sources that do not fit one's own viewpoint. LogicalLens (talk) 02:56, 17 May 2025 (UTC)

::::::::::::::::::* If we're going to Wikipedia:Make technical articles understandable, then we need to use "non-clinical terminology". WP:MEDMOS even recommends this. Plain English, rather than medicalese, is always the goal.

::::::::::::::::::* If someone wanted information about autism as an experience that some people have, where would they go?

::::::::::::::::::WhatamIdoing (talk) 04:14, 17 May 2025 (UTC)

:::::::::::::::::::This is a compelling argument. For the discussion about “co-occurring conditions”, it could probably stay like this; it’s not a major formality issue and I probably won’t comment about it much further. For autism as an experience, I feel as though it is a similar situation with anxiety and generalized anxiety disorder, or depression and major depressive disorder. The normal range and clinical range typically have separate articles. This is not to say a new article is required or that information needs to be excluded (which it absolutely shouldn’t). There has been growing research regarding autism as an experience, though replacing words with euphemisms while retaining its original meanings did not appear to me to be a good way to go about this. I don’t see “co-occurring conditions” as one of those euphemisms though, this is a separate thing. Given the direction we’re going, it would be okay to keep this. Slothwizard (talk) 04:46, 17 May 2025 (UTC)

:::::::::::::@GreenMeansGo @WhatamIdoing I don't know of any useful solutions but there is indeed a major issue. For example, I don't think some arguments here are worth pursuing any further as it will just take valuable time away from other projects and the facts are unlikely to be convincing. We’re covering the same ground repeatedly, which usually this means no further progress can be made. And there is little point in correcting misinformation where critics having their own conflicts make it impossible. It is often claimed in policy that Wikipedia is based on consensus, not voting. This apparent difference must be an artefact, some kind of an illusion. I think these issues have much to do with the bureaucracy of Wikipedia as well as competing interests. Димитрий Улянов Иванов (talk) 22:32, 11 May 2025 (UTC)

::::::Well, I see you point. What if we would just suggest a few alternative wordings and see what opposition it gets, if we can't get this straight by the methods which I believe to be more optimal? For example, we could discuss "(psychiatric) disorders occurring alongside autism", and similar ideas. I believe it is absolutely possible to denote this concept in a factually accurate manner without alluding to backstories and grievances. BlockArranger (talk) 23:35, 2 May 2025 (UTC)

:::::::I don't think it's limited to psychiatric conditions. For example, the gut dysfunction some autistic people have is probably neurological rather than psychiatric. WhatamIdoing (talk) 01:14, 3 May 2025 (UTC)

:I vote for using coexisting conditions -- Mark D Worthen PsyD (talk) [he/him] 02:00, 3 May 2025 (UTC)

::Although "co-occurring conditions" is used more often, I would also accept "coexisting conditions". LogicalLens (talk) 03:43, 3 May 2025 (UTC)

:::I don't like coexisting, because it somehow seems to imply that the they must exist, rather than may occur. Maybe that is just my personal take. CFCF (talk) 22:14, 3 May 2025 (UTC)

::::What about "Conditions occurring alongside autism"? That is very specific to autism, and includes both mental and physical conditions. Conditions include disorders and illnesses, but also states which some claim not to be pathological. BlockArranger (talk) 17:31, 11 May 2025 (UTC)

:::::I think that "alongside" suggests that these conditions are separate from autism. At a neurological level, they probably aren't. WhatamIdoing (talk) 20:40, 11 May 2025 (UTC)

::::::That depends on how you look at it and define it; this distinction is not necessarily objective. In terms of diagnosis, the comorbidities (I use the word here for ease of use) are not diagnosed as extensions of autism, nor is autism an extension of them. If we simplify in order to avoid severity, diagnoses could be seen as toggling presence to true. An analogy would be to check boxes on a paper, where there are options for "electric illumination receiving power" and "house is internally illuminated at point of observation". These most likely have an obvious casual relationship, but the way it is laid out on paper makes these two separate states which are either present or not present.

::::::We thus have to choose which way to frame it here. In medicine, diagnosis serves a purpose not only of being a descriptor, but also as something which ca be correlated with treatment modalities. For example, it would likely be wise to assume that intervention could look a bit different depending on presence of ADHD between members of a set of "autistic people with autism" (finally found something uncontroversial!). This model fails to take etiology into account; however, we are not yet very sure regarding etiology.

::::::I am much more familiar with a similar discussion regarding personality disorders. In editions previous to the DSM-5, and also in its Section II standard model, personality disorders are conceptualized as separate entities, which may or may not be comorbid in different ways. However, a compelling argument is that a person has a single personality after all, and if it is pathological, it would stand to reason that it would not necessarily fit neatly into one of the ten category buckets provided in the standard model. In fact, as PDs are diagnosed based on a subset of criteria, it makes the disorders polythetic, with the possibility in BPD for two people to share only a sigle criterion, which makes me question the validity of the model.

::::::However, the Alternative DSM-5 Model for Personality Disorders has later on adopted a hybrid dimensional framework, and even includes the diagnosis of PD - Trait specified, which is specific with regard to which traits a specific subject has, and may also contain specification on level of functioning. In this manner, psychiatry has managed to create a more holistic view of personality disorders.

::::::The problem here with regard to autism is that many other syndromes, somatic ones in particular, are very difficult to integrate with autism as they may also occur separately, in so called NT people. In this case, a similar framework to the AMPD could be adopted, with autism being a trait domain containing several typical autistic traits. A person could also possess other trait domains related to other types of syndromes or symptoms. Considering that this is mostly a thought experiment so far, I would say it sounds pretty good. However, isn't this what we already have in terms of all the diagnoses in the ICD being available to pick from to describe all noted pathology in a patient? I see the shortcoming here being that the medical diagnostic description only concerns pathology, instead of a whole set of clinical differences including strengths. But even the AMPD has not developed such features so far...

::::::Thus, in conclusion, I believe that we should in fact still divide up the comorbidities, and have them be "alongside" autism, as they are not part of what we know and understand to be autism. Hypothetically, we could imagine a broader underlying phenomenon giving rise to "it all", with autism a syndrome of aspects of this underlying unknown thing. I believe that it could be unwise to just expand autism to be something we infer to exist beyond the understood scope of autism, when autism itself is not definitively explained. I am glad that we are moving away from categorical PDs, but on the other hand, it was an expression of what was believed to once upon a time be the latest science, and thus how the topic was presented in Wikipedia. We don't even (as far as I know) have a new "Alternative Model for ASD", and thus wording is all we really can decide upon, within reasonable limits.

::::::Oh dear, I seem to have accidentally created an essay! BlockArranger (talk) 17:07, 12 May 2025 (UTC)

:::::::I found your accidental essay to be interesting. Thanks for posting it. This idea of a "broader underlying phenomenon giving rise to "it all"" is what I had in mind. WhatamIdoing (talk) 18:08, 12 May 2025 (UTC)

::::::::I am glad that you liked it! Just also continue the discussion, what do you think, do you agree that we should avoid speculating about a construct behind autism and its comorbidities until it has been accepted as mainstream science, including as a model for conceptualizing comorbidity of autism? BlockArranger (talk) 20:07, 12 May 2025 (UTC)

::::::As something independent of my spontaneously created essay (but I suggest reading it too), I would like to suggest an update: "Conditions occurring in the presence of autism"

::::::This expression avoids disorders and illnesses as categories; thus making it neutral. Indeed, I believe that these conditions occur, rather than exist. I also manage to avoid definitively separating the conditions from autism in my wording, at least the way I see it; yet it also does not contradict the current medical framework (see my essay above), as comorbidities de facto occur in the presence of whichever condition they are comorbidities of. And, well, autism... Refer to other discussions on the topic of ASD/Autism. BlockArranger (talk) 20:16, 12 May 2025 (UTC)

:::::::I do not think "co-occurring conditions" implies either the existence or non-existence of a causal relationship. LogicalLens (talk) 03:53, 13 May 2025 (UTC)

::::::::I agree, whereas "conditions occurring in the presence of autism" is too imprecise, because that would just be all conditions - the presence of a correlation is at the very least necessary to merit mention here, and is covered by co-occurring. CFCF (talk) 08:05, 13 May 2025 (UTC)

:::::::::I think "co-occurring" implies non-causal relationship. WhatamIdoing (talk) 17:07, 13 May 2025 (UTC)

::::::::::Following this dictionary entry,[https://www.merriam-webster.com/dictionary/co-occur] I do not think so. It even gives an example where "co-occurring" is used for autism. LogicalLens (talk) 01:31, 14 May 2025 (UTC)

:::::::::::That dictionary doesn't say anything about causality, so it's not evidence that it doesn't imply a non-causal relationship (or that it does).

:::::::::::The sentence mentioning autism is in a section labeled "Recent Examples on the Web" with a disclaimer that "Examples are automatically compiled from online sources to show current usage", which is not an endorsement of the use (though it's IMO some evidence that this is a common use). WhatamIdoing (talk) 05:29, 14 May 2025 (UTC)

::::::::::::My interpretation is that co-occurring makes no statement as to either causality or non-causality of the relationship. CFCF (talk) 07:03, 14 May 2025 (UTC)

:::::::::::::Strongly support this interpretation. There being nothing about causes in the definition strongly implies a lack of implication one way or the other.

:::::::::::::I've spent a few minutes looking for a definition that runs contrary to this, and found nothing. Oolong (talk) 13:48, 14 May 2025 (UTC)

::::::::::::::[https://pmc.ncbi.nlm.nih.gov/articles/PMC7053108/ "Diseases are said to be co-occurring if the same person has more than one disease. Comorbidity is the greater than chance association between the two conditions in the same individual."]

::::::::::::::In this model, autism + acne = co-occurring but autism + epilepsy = co-morbid. WhatamIdoing (talk) 17:47, 14 May 2025 (UTC)

:::::::::::::::The reference used to support that statement in the headache paper you linked is [https://pubmed.ncbi.nlm.nih.gov/26309916/ a 1970 theoretical paper], which makes no mention of co-occurring at all. Or for what I can make of it - even the idea that co-morbidity implies some form of causal relationship or correlation or a "greater than chance association between the two conditions" (I will admit it is a very dense theoretical paper from 1970, and I merely skimmed it).

:::::::::::::::The 1970 theory paper even states in the first sentence of the summary: {{tq|In a patient with a particular index disease, the term co-morbidity refers to any additional co-existing ailment.}}

:::::::::::::::I can't find that the interpretation of comorbidity to imply causality is generally accepted or supported beyond it being taken by the authors of a particular headache paper, with an improper reference to historical theoretical work. To me, and from what I get the definitions - comorbidity is just co-occurrence of disease - which we are trying to avoid labeling autism as. I may be wrong, but I'm not convinced of it yet. CFCF (talk) 22:33, 14 May 2025 (UTC)

:::::::::::::::Co-occurring is a broader term that can encompass both things with a causal relationship and things without. The list also contains physical diseases for which it is very unclear whether they are directly related to autism. It is probably the case for epilepsy, but even for depression, at least a large part is due to discrimination instead of a biological link. The fact that this authoritative handbook uses the term shows that it cannot be that wrong.[https://academic.oup.com/edited-volume/28150] Therefore, honestly, I consider this entire discussion a waste of time. LogicalLens (talk) 02:37, 15 May 2025 (UTC)

::::::::::::::::I'm with you. 'Co-occurring conditions' is widely used and not meaningfully ambiguous at all. I'm puzzled that we've spilt so many words on this. Oolong (talk) 10:32, 15 May 2025 (UTC)

::Would you object to 'co-occurring conditions'? As @LogicalLens says, it's definitely used more often, and it's not clear that it would cause any confusion at all.

::I don't really see @CFCF's objection to 'coexisting', but I do think it's worse aesthetically. Oolong (talk) 17:52, 11 May 2025 (UTC)

:::Related conditions? Associated conditions? WhatamIdoing (talk) 20:41, 11 May 2025 (UTC)

::::How are those improvements?

::::'Co-occurring' is, I think, suitably agnostic, as well as being commonly used.

::::Presumably, yes, there's some kind of relationship between them, but we don't necessarily know what: it could be a shared causative factor, indirect causation or something more direct. In general, we should avoid suggesting that we know, when we don't.

::::Would we say depression is a related condition to autism? What about to homosexuality? I would suggest that it is somewhat misleading in both cases, even if technically accurate. Oolong (talk) 13:55, 14 May 2025 (UTC)

:::::It is in my opinion clear that we are talking about pathologies here, and I guess even Autism / Neurodiversity warriors would agree that this is the case. We need to remember to define the scope as such also somewhat implicitly in our description. I know that "slippery slope" is a bad argument, but think for a moment, would it make sense call it "correlated phenomena"? According to what I see in this discussion, it seems to me that some people want to convey the definition implicitly, by what we include and what we don't; if we include intellectual disability and gastrointestinal issues, for example, but not belonging to the "Queer spectrum", the implicit reason for these inclusions and disinclusions should just be understood by readers to be related to what we think is pathological.

:::::The problem at hand is clearly that there is a lot of support for not viewing autism as a pathology, and thus it can be difficult to find the verbal glue which binds a supposedly neutral phenomenon with what is supposedly pathological. Thus, the apparently intense need to put value judgements into everything, is the real pathology here. Admittedly, we need to take it into consideration, as it has infected the population like a pandemic.

:::::As I see it, it is necessary to find a way to state in a concise manner the following: "Clinically recognized pathologies which are known to frequently be part of a clinical picture which also includes the non-judgementally approached autisim". I also get why comorbidity is not optimal though, just to make that clear. However, I bleieve we should first try to define what exactly we are trying to convey, and then find the most efficient way to distill it. BlockArranger (talk) 19:35, 14 May 2025 (UTC)

::::::This bit sounds right: {{xt|it can be difficult to find the verbal glue which binds a supposedly neutral phenomenon with what is supposedly pathological}}.

::::::Then you add on the fact that for some people, autism is not a neutral phenomenon at all, and it becomes very difficult indeed. WhatamIdoing (talk) 01:40, 15 May 2025 (UTC)

::::I think you are at least trying to move us in the right direction, but I see @Oolong's point. What about:

::::"Conditions commonly present with autism" ?

::::We could even add "pathological" or the like. BlockArranger (talk) 19:42, 14 May 2025 (UTC)

@Oolong created a "Next steps" topic a while ago, which was very long and parts of which have already been done. I think the following things are on the to-do list:

1) @Oolong mentioned including "parenting, education, workplaces, community and healthcare, as well as therapies of various sorts and also disability aids" in the management section that would then more appropriately be called "supports". Education and workplaces are now included.

2) @Oolong suggested shortening the causes section, which has its own article, to summary length.

3) The section on society and culture needs to be rewritten.

4) Checking in which sections lived experience is currently underrepresented and adding more information on that.

5) Replacing non-WP:MEDRS sources. LogicalLens (talk) 02:54, 21 May 2025 (UTC)

:For several of these there are a few questions that would need to be clarified. I do not really see there being consensus for Oolong's suggestions:

:3) In what way?

:4) One should not indiscriminately "add more information", but add appropriate information - and we also need to have consensus on whether any information is appropriate. It won't be everywhere.

:5) Or removing the sections/passages that can't be appropriately or DULY supported by adequate sources.

:CFCF (talk) 10:39, 21 May 2025 (UTC)

::I believe that we should first collectively identify what content is apparently not well-supported. Then we could proceed with finding better sources or, alternatively, delete the content. However, what should and should not be kept might be a question better suited for a separate discussion, as unnecessary content which also happens to have a low-quality source can be removed anyway, as long as we agree that it is irrelevent. BlockArranger (talk) 22:16, 21 May 2025 (UTC)