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Revision as of 17:09, 28 July 2006

Asperger syndrome

Review commentary

This article requires major review. Since it was originally given featured article status, this article has changed significantly. In particular, the sourcing for much of the article is now vague, with many column-inches given over to handwaving and speculation. For example, there is an entire major subsection of the article, "A gift and a curse" wherein nearly every sentence begins with qualifiers like "Some speculate...", "Some claim...", "many critics...claim...", "Many people think..." without a single citation in sight. This section of the article is also rife with what appears to be original research (eg: "Such speculation may simply be an attempt to create role models for autistics to demonstrate that they can be exemplary contributors to society.") More or less the entire latter half of the article currently reads like a personal essay. Nandesuka 13:56, 26 June 2006 (UTC)

• It's been in bad shape for quite a while: so bad, I was afraid to tackle it alone. If there isn't significant editing to clean it up, I'll support FARC quickly. I agree the article is a speculative, poorly-sourced essay, in bad need of cleanup. Sandy 15:53, 26 June 2006 (UTC)
• Support sending to FARC as I was part of the group of editors (me, User:PurplePlatypus and User:ManekiNeko basically, of whom I'd reccommend ringing for those who need help in keeping it a FA) who helped save it from its last FARC at Misplaced Pages:Featured article removal candidates/Asperger's syndrome. Since then it has been the victim of a lot of soapboxing and dubious edits - there is likely some original research, etc.. Mainly the problems are lack of sources/cites - also someone might want to check and see if any useful info got nixed from the (second) featured version (circa ). RN 20:17, 26 June 2006 (UTC)
• FARC it. I can't add much more to the above, but it doesn't read well and does lack citation and solid evidence. S.Skinner 08:50, 3 July 2006 (UTC) I am currently awaiting the outcome of the review. Opinion: Withdrawn S.Skinner 09:16, 7 July 2006 (UTC)
  • Please allow sufficient time for the major review. RN and myself have gotten other editors involved now in improving and referencing the article; a good chunk of the speculation has been identifed, some removed, and much has been referenced; and other editors are now working with us to improve the article. There appears to be resistance from one editor only, but consensus has developed around the need to improve the article to a medical standard. Work is in progress and, with a few more days, we may be in shape to ask for some help with a major copyedit, to smooth out the prose. I'll be the first to vote to FARC if work stalls or resistance to improving the article prevails. Work remaining to be done is outlined on the article talk page. Help is welcome. Sandy 14:50, 3 July 2006 (UTC)
    • The article has come a long ways. There are still problems (some vague unreferenced portions, in need of wikilinks, and others), but massive speculative sections have been removed or sourced, and the article is better organized and referenced. Some help with a major copy edit would be helpful at this point, and would go a long ways towards encouraging the involved editors to continue making the needed improvements. Comments on work still needed would also be helpful. Sandy 02:30, 7 July 2006 (UTC)

• I've had a go at copy-editing the top half. It was a lot of work. Can someone help by going through the rest and changing all references to the syndrome to "AS". I think this is better than the inconsistent terminology that is currently used, including Asperger syndrome and Asperger's syndrome. Tony 16:32, 7 July 2006 (UTC)

I'll do that. Thanks, Tony ! Sandy 17:14, 7 July 2006 (UTC)

Looks like RN beat me to it, changing all references to Asperger syndrome.AS. Sandy 17:16, 7 July 2006 (UTC)

I guess it's OK now, but I'd be happy for further tweaking to be done over the next few months. BTW, I'm a little concerned that one text appears to have been the source for too much of the text (I may be wrong, but I just get that feeling). Tony 00:11, 10 July 2006 (UTC)

The article has come very far, with the combined efforts of many people. I am also concerned about the sourcing, though, and prefer to see mostly PMID sources for medical articles, rather than a couple of books. Although the sourcing could be better, at least the article is now based on reliable sources, without speculation, and more comprehensive. It will need to be watched closely to make sure original research doesn't creep back in again. I've got in on my watchlist, and I think the editors there now understand the standards for referencing any new content. Sandy 00:24, 10 July 2006 (UTC)

The current state of this article is horrible. It should imidiately be sent to FARC. The article currently is reading like a promotional effort for NIH, and basically every opinion that goes contrary to NIH-disorder view has been remooved in the name of "peer-review". It is horrible that the insight of people in the autistic community have been effectively silenced. Not only that, controversial information put in separate articles have also been "dragged back" into the article, but only the views that fits NIH. Every effort to remove this stuff has failed. --Rdos 20:50, 13 July 2006 (UTC)

RDos, original research has no place on Misplaced Pages. You have been encouraged several times to present your views by referencing them to primary and peer-reviewed sources. Your own surveys are not a primary source. Please refrain from blanking entire sections which are based on peer-reviewed sources. Sandy 21:23, 13 July 2006 (UTC)

Sandy, ownership also has no place at Misplaced Pages, and POV is one of the cornerstones. Both these seems to apply to this article. --Rdos 14:40, 14 July 2006 (UTC)

So what's the status then? Still at work? Marskell 16:14, 14 July 2006 (UTC)

It's hard to say. The large majority of editors working on the article are collaborating on introducing, upgrading and refining text with appropriate references and a consensual process, and their effort was a good one. It is difficult to know what will happen once the article moves out from under the examination of FAR. It would be sad for their work to be in vain because of insertions of original research, but they are going to have to police it, I guess. My inkling is that, at this point, it is what it is and has been for a long time, and perhaps it should be submitted for a broader vote under FARC. But I defer to RN, who has been involved longer with the article, and who has seen it go through FARC before, only to end up back here with the same problems. I will ping RN. Sandy 17:13, 14 July 2006 (UTC)

Like Sandy, I think it is hard to say as well. If it stays, it is very likely to end up again on FARC in several months from now - if it does go to the "round table" of FARC the stability issue needs to be considered. The article itself has vastly improved in referencing though, and seems to meet at least some of the FA points at the moment. RN 00:39, 15 July 2006 (UTC)

Ryan, as it has improved on one account, it has degraded on another. I don't see this as any general improvement. AFAIK, NPOV is not less important than citing reliable sources. --Rdos 07:53, 15 July 2006 (UTC)

I will leave this up two more days to give it three weeks in the review period before going to FARC. It has had in the range of 700 edits since the nom; at least it's getting attention. No, POV is not less important than citations, but a lack of citations is the most difficult fault to correct in an FA. Given that that isn't an issue here, I see no reason this can't be retained if you can work out the other issues. Marskell 12:06, 15 July 2006 (UTC)

FARC commentary

Main FA criteria concerns are supporting assertions with appropriate citations (2c) and POV (2d). Marskell 15:23, 17 July 2006 (UTC)

Additional concerns emerging during the Major review: 2b) Comprehensive, 2c) Suitability of references, 2e) Stability, and 3a) Lead. Sandy 17:09, 17 July 2006 (UTC)

Talk messages left at Misplaced Pages:WikiProject Medicine/Collaboration of the Week. Sandy 17:09, 17 July 2006 (UTC)

Article history:

• First promoted FA on April 10, 2004:
• Kept FA in September 2005 FARC:
• Prior to June 26, 2006 Major Review:
• After major copyedit by User:Tony1 July 9:
• Compare between Tony copyedit and current: :Struck compare, outdated, significant changes/improvements since article moved to FARC. Sandy 23:41, 18 July 2006 (UTC)

Sandy 18:22, 17 July 2006 (UTC)

Additional concerns:

• 1) Our best work:
  • Please see Cystic fibrosis, the most recently promoted FA for a genetic condition. (Almost every source used is a PMID, medical journal article.)
• 2a) Prose:
  • In good shape since Tony's copyedit, with some minor deterioration since his copy edit (easily corrected). For example, a change after Tony's copyedit resulted in: The cause of AS is unknown, but since it was properly defined several possible causes of AS have been investigated by researchers. Another example is: "AS is defined in section 299.80 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) by six main criteria. These criteria define AS as a condition in which there is: ... " There are other examples, which could be fixed.
    • Strike comment above, as text has changed significantly from copyedit. Sandy 18:24, 20 July 2006 (UTC)
• 2b) Comprehensive "covers the topic in its entirety, and does not neglect any major facts or details": this is a larger problem to overcome, but not insurmountable. This information is readily available, but is deleted when added. Omissions occur in three main areas:
  • Audience: Because AS is a relatively new DSM condition, it is increasingly diagnosed in pediatric populations. It is defined by significant impairment in several realms of functioning. Yet, many editors working on the article have the POV of successful adults with AS, leaving out easily available and much needed information about children with AS who may be coping with difficulties or distress in academic, behavioral or social realms. Specific examples are the lack of information about treatment options, management therapies, diagnostic information, screening tools, school accommodations, and differential diagnosis (for example, what other conditions, such as Stereotypic movement disorder and other Autism spectrum disorders, can be confused with AS, and information helpful in distinguishing between them).
  • Causes: the article completely glosses over Causes, in spite of a growing body of information easily available. It doesn't mention twin studies and other genetic studies which demonstrate a genetic factor, it doesn't discuss the interplay between genetic and environmental factors, and it gives equal weight to all causes, even though a genetic underpinning enjoys wider medical consensus. It would not take more than a couple of paragraphs to summarize what is known and not known about causes. The current version has two sentences.
  • Treatment/Diagnosis/Screening: there are numerous screening tools available, which are not mentioned. Information about a differential diagnosis -- what other conditions to consider -- is not well covered. Treatment is almost entirely glossed over, although there are numerous options that should be discussed. Again, this is a result of an article focus on adult advocacy (acceptance of AS), neglecting significant issues confronting pediatric populations. The diagnosis section (in fact, much of the article) ignores the main diagnostic criteria in use in the USA (DSM), and goes into more detail on other sets of diagnostic criteria (Gillberg, Szatmari, etc.). By overlooking the DSM - the main diagnostic tool used in the USA - undue weight is given to other sets of criteria. It would not be difficult to give equal weight to all.
• 2c) Factually accurate (references): the article is now thoroughly referenced from primary sources, but there are some problems with the sources used. Several of the sources are not independent, medically reliable, or peer-reviewed sources, even though references could be easily found in PubMed (NIH database of journal-published medical literature, identified by a PMID number).
  • A large part of the article is referenced to Attwood's book. While Tony Attwood is held in very high regard by families with AS, he is not widely published in medical journals (relative to his peers), and it is not clear if his book enjoys peer review. Attwood also has his own set of diagnostic criteria, so undue balance is given to that view, overlooking the DSM.
  • Myles has a PhD in special education and learning disabilities. Her CV indicates she is not a physician, and her books are self-published: Autism Asperger Publishing Co was founded by her husband.
  • Kirby (of Romanowski and Kirby) is held in very high regard by families with AS, and is popular because of the OASIS website . Nonetheless, according to book jacket information, Romanowski is an educator, and Kirby is the mother of a child with AS. It is not clear that their book enjoys medical peer review, although its foreward is written by recognized AS experts.
  • There are other examples. On the other hand, the references show a paucity of information from the leading AS experts in the USA, from such places as Yale Child Study Center, Kennedy Krieger, and several of the California UCs, and well-regarded medical texts are never mentioned as resources (example )
• 2d) Neutral:
  • Discussed above. Some editors feel the article is too medically-oriented: I conclude it 1) has an adult with AS POV, overlooking parents of children with AS, and 2) ignores basic medical facts. Presenting accurate medical facts is not incompatible with presenting the view that AS need not be considered a "disorder": it is possible to cover both medical facts and advocacy for acceptance in one article. In spite of repeated requests, alternate text has not been added, even though it should not be hard to find and reference.
• 2e) Stable:
  • The article has been submitted to FARC before, but similar problems have re-surfaced.
  • One editor has appealed outside of the Wiki community to have content removed. (Although this message board professes 5000+ members, only 4 endorsed Rdos concerns, but the potential for disruption and future reverts exists.) Other original research (Wiki spam blocked, see rdos.net) has been deleted from Wiki , but original research is an ongoing problem with the AS and other autism articles.
• 3a) Lead:
  • Following Tony's copyedit, it was 3 paragraphs. It is now 2, and does not summarize the article or basic information about AS. Struck. Sandy 02:46, 21 July 2006 (UTC)
• 4) Images:
  • None of the images have clear Fair Use tags.
• 5) Summary Style:
  • Several sections (for example, Causes) rely on daughter articles which are in dismal shape, with tags, and not referenced.

Forgot to add, 1) our best work: not well wiki-linked. For example, one encounters Attwood's name many times before finding his Wiki entry. Sandy 20:11, 17 July 2006 (UTC) Mostly wiki-linked. Sandy 02:46, 21 July 2006 (UTC)

Neutral. Many editors have brought this article very far in two weeks. In spite of this lengthy list, I believe the necessary work to retain FA status can be completed within the review period, if the editors commit to the work, avoiding original research and using referenced information. I also believe all POVs can be incorporated. I will re-evaluate my vote at the end of the FARC period. Sandy 20:01, 17 July 2006 (UTC) Remaining neutral. Sandy 17:09, 28 July 2006 (UTC)

• Update: Referencing is greatly improved, and NPOV and stability concerns seem to have subsided. But, 2a) prose needs attention, 2b) comprehensive isn't quite there yet, and the lead needs to be massaged into a compelling summary of the article. Work is ongoing, and editors are aware of and working on these areas. Some prose examples:
  • Aspergers in children and adults assistance can consists of contraversial therapies that address the core symptoms of the disorder:
  • Some research is to seek information about symptoms to aid in the diagnostic process. Other research is to identify a cause, although much of this research is still done on isolated symptoms. A lot of research have exposed base differences in things such as brain structure. To what end is currently unknown; however, research is on-going.
  • The direct cause(s) of AS is unknown. Even though no consensus exists for the cause(s) of AS, it is widely accepted that AS has a hereditary factor. It is suspected that multiple genes play a part in causing AS, since the number and severity of symptoms vary widely among individuals. Studies regarding the mirror neurons in the inferior parietal cortex have revealed differences which may underlie certain cognitive anomolies such as some of those which AS exhibits. ther possible causes being investigated include: a serotonin dysfunction and cerebellar dysfunction. Simon Baron-Cohen proposes a model for autism based on his empathising-systemising (E-S) theory
  • A few studies are more useful for determining efficiency of treatment with control group and pre-test and post-test designs and statistic evaluation of efficiency of treatment. These interventions typically are packaged to treat the entire syndrome (UCLA and TEACCH for instance). Side effects are unintended effects. This topic has largely been ignored in the intervention literature on children. Behaviorally based programs rarely include measures of the core symptoms of autism such as the ADI-R or CARS. Sandy 18:24, 20 July 2006 (UTC)

Keep Despite the negetive critisms from Sandy. I feel like the article has done very well in the past 2 weeks, it has less original research and more referenced sources. It is has more then 700 edits which means that people really do care about the article. It is in many parts well written with the minor exceptions of the Causes section and the beginning. I will not re-evaluate my vote at the end of the FARC period.Natche24 23:51, 17 July 2006 (UTC)

Keep Remove unless NPOV is restored. In the last month or so Sandy, RN and several other pro-medical, pro-disorder advocates have completely distroyed the once neutral article. In its current state it reads as a promotional essay for NIH, and should be unlisted from featured status and the entire article should be tagged as biased and POV. Sandy claims we can reinsert the opposing views, but history shows this not to be the case. Attempts to replace biased terms and neutralize unproved claims have systematically been reverted. The best option is probably to revert the entire article to the last FA status review, and then insert the new citations. Sandy above compares AS with Cystic Fibrosis (CF). This is really symptomatic of the problem here. While CF is a disease with known genetic factors, AS is not a disease, neither is the genetic background known. There is a large online autistic community today, and they oppose calling autism an disease, they oppose the disorder-view of NIH and they usually think that many of the problems are due to intolerance. Sandy claims we need to use NIH as a reference for any claim made in the article, but since NIH is clearly a part in this ongoing debate about autism, this is what causes the bias and POV. --Rdos 08:58, 18 July 2006 (UTC)

Just a note: that is not my claim. Please check the talk page. Thanks, Sandy 13:17, 18 July 2006 (UTC)

• Comment The article is improving, but there still exists two sections that are both highly controversial and where NPOV seems very hard to introduce (research into causes and treatments). The rearrangement of the article into a clinical and non-clinical part seems appropriate, but the claims that there is no need to provide NPOV in causes because it is in the clinical part are worrying. I think eventually it would be possible to write a better (and neutral) summary of causes, especially since several neutral reviews have been posted to the talk page. --Rdos 11:01, 19 July 2006 (UTC)

Neutral Very concerned that this article has become, effectively, the province of a single editor and their attitudes/opinions, frequently stated as established fact or policy, editing by bulldozer rather than concensus. As long as the article is subject to this degree of personal autocracy and bias I really do not see how it is worthy of representing the best efforts of the community of Misplaced Pages which, in my opinion, are always achieved by a genuine concensus of equals.