Talk:Ethical challenges to autism treatment

Neutrality of "Historic prognosis for permanently institutionalized autistic children"

I created the "Ethical challenges to autism treatment" article because the autism rights movement article was getting too big. The section on "Historic prognosis ..." I did not write but I do have some concerns about neutrality of that section. I was able to prefix some opinions in that section with things like "it is the opinion of autism rights activists ..." but I don't know enough about the topic to edit it more than that. I'd like for someone else who knows more about that topic to check that section and make sure it is neutral. Q0 03:28, 6 Feb 2005 (UTC)

Weasel terms

The section historic prognosis for permanently institutionalized autistic children was flagged as having weasel terms. Please try to improve as necessary. -Frazzydee|✍ 04:14, 11 Feb 2005 (UTC)

Neuroleptics

Medical professionals I have talked to, as well as an instruction for Swedish healthcare personell which I don't have anymore, stated that neuroleptics should never be administered to people with pervasive developmental disorders (I believe it mentioned ADHD and Asperger explicitly, though I assume the same goes for autism), unless it is the only way to prevent immediate risk of significant harm to the patient or others. The reason for this was, as I recall, that these people are more sensitive to long-term effects than neurotypicals. Anecdotally, I have PDD/NOS with features of ADD and Asperger, and got severe long-term effects from a single 5mg dose of Nozinan, including but not limited to severe cognitive, personality, motor and hormonal changes. Some of these have slowly started to reverse after 3 years, starting after a prolonged course of treatment with dopaminergic drugs. Of course, that can't be in the article, but it bears searching for further information about the topic. Zuiram 06:45, 15 December 2006 (UTC)

Original research

The following section, without an outside citation, is original research and really shouldn't be in here. Furthermore, it doesn't actually say anything about autism aside from OIL being one of the pioneers of autism treatment. Wikipedia can't make arguments, it can only report pre-existing arguments from reliable sources. WLU 14:25, 25 June 2007 (UTC)

Arguments from precedent

Homosexuality was listed as a mental disorder in the DSM until it was removed in 1973 mostly due to political activism and controversy. Some ABA critics have noted there are still efforts to "cure" homosexuality through "reparative therapy", although the scientific consensus is that sexual orientation is unchangeable.[1] Ivar Lovaas, generally considered to be the father of behavioral interventions for autism, is one of the authors of a 1974 article titled Behavioral treatment of deviant sex role behaviors in a male child published in the Journal of Applied Behavioral Analysis [2].

Double Blind for ABA

How can you possibly do a double blind study of a behavior modification technique? I think it would always be pretty obvious to the subject whether they were receiving behavior modification or not. That's like saying there are no double-blind studies proving that incisions in the skin cause bleeding. 71.63.105.172 16:30, 22 August 2007 (UTC)

I had the same reaction as the previous poster. Ive hear criticism like this from a speech therapist, and I thought "gee, don't you have the same problem?". How would any therapist not know what treatment they are giving to a patient if it involves knowing information about the patient. Hornung9 02:25, 26 October 2007 (UTC)

Hence the need to use single-subject designs (either reversal or multiple baseline) -- glad to see that people are seeing through some of the straw-men being put up!Josh.Pritchard.DBA (talk) 04:48, 22 December 2007 (UTC)

Or Alternating Treatment Design... yay single case design! I am highly supportive of your work Josh. - Hornung9 —Preceding unsigned comment added by Hornung9 (talk • contribs) 02:48, 18 March 2009 (UTC)

Alternative autism treatment

Modern medicine sees all mental illness including austism, deriving only from the brain - primarily from neurotransmitter imbalance and nothing else - the truth is that in many cases there is often an underlining physical cause (eg: infection, celiac disease, etc) and this is often never investigated, and so its no wonder today we are faced with the current tragedy that the Mentally ill die 25 years earlier, on average!. We have found many interesting medical studies such as: 'Enterocolitis in children with Autism' 'an autopsy of 82 patients who had been diagnosed with schizophrenia. Gastritis was found in 50%, enteritis in 85% and colitis in 92%.' read more... '99% certain of a genetic association between schizophrenia and coeliac disease' Gut and mental illness

Neutrality Challenged...

I 'nominated' -- not sure if I just added a template, or if a bot will bring this to someone who'll render judgement...but anyway, I'm looking at the article and finding no sources that back up any of this being 'an ethical challenge' -- we have a website for DAN and under the ABA heading -- you have the 'ABA Controversy' Ethical_challenges_to_autism_treatment#ABA_controversy. The first 7 sources are in support of ABA as an ethical treatment -- so it seems that the 'sourced info' contraindicates ABA being in this page...Drug Therapy's 'ethical challenge' also not a challenge to ethics -- just a bit of unsourced information about drug treatment...again, I think this page should be removed as it is not about ethical challenges that are sourced at all.Josh.Pritchard.DBA (talk) 20:24, 29 December 2007 (UTC)

Neutrality is established on talk pages through discussions, by editors, not bots. No bot could determine if something is neutral or not :) You could try to track down some of the dedicated contributors for their comment. WLU (talk) 22:21, 29 December 2007 (UTC)

Sorry -- I wasn't clear, I wasn't sure if the tag would alert a bot that would then insert this page on some sort of review page -- and then editors would come and comment, or whether I should be contacting folks myself -- it seems that you're indicating the latter -- I'll begin that, thanks!Josh.Pritchard.DBA (talk) 22:29, 29 December 2007 (UTC)

I believe if you add the tag, it may add it to Category:NPOV disputes, but I don't think that guarantees any sort of oversight or someone looking into it. If you want to attract attention, try a WP:RFC - basically you'll get experienced editors looking into the page to identify problems. I'd try to get it up to snuff as best you can beforehand, just as a courtesy. But it's not really necessary, they'll probably generate a list of stuff for you to work on. I'm not really sure, the only RFC I've ever participated on that wasn't a content dispute didn't turn out so good... WLU (talk) 22:52, 29 December 2007 (UTC)

I agree that this article is a complete and utter mess of vagueness, but I believe it can be saved. I'm digging for proper references for the autistic rights side of things. There's currently a severe lack of such in this entire set of articles. --elmindreda (talk) 06:42, 30 December 2007 (UTC)

I should also add that in my opinion, parts of this article doesn't even accurately reflect the position of those making the ethical challenges (and leaves out key points), which does nothing to alleviate confusion and POV. --elmindreda (talk) 06:57, 30 December 2007 (UTC)

This article lacks citations to show that it is unbiased. I have heard of no claims of ABA causing PTSDT and no documented cases exist to my knowledge. This seems to be on the verge of legal lible. J.C. —Preceding unsigned comment added by 72.94.212.130 (talk) 19:39, 31 December 2007 (UTC)

• In no way would citations - or references - automatically result in an unbiased article, nor does a shortage of citations automatically make an article biased.
• I don't think you can defame (slander, libel) an idea or method, only people, organizations and products. It's PTSD, not PTSDT, and the article links it with the use of aversives. Fenke (talk) 01:54, 1 January 2008 (UTC) (Edit: corrected spelling Fenke (talk) 15:22, 1 January 2008 (UTC))

I agree that lack of citations don't automatically result in an unbiased article...but this article is contending that there are ethical challenges to treatment...thus, without sources, I'd say that it is contentious, and if it isn't/can't be sourced it should be removed. Like I said earlier, I'm not even sure that this is worthy of its own article -- why isn't it under the same named subheading on the autistic rights movement? Josh.Pritchard.DBA (talk) 02:18, 1 January 2008 (UTC)

I disagree that there would not be any ethical challenges to treatment, but we should indeed find some sources. Let's keep the article for a while, although it's related to the autism rights movement, it's also a separate issue. --Fenke (talk) 12:12, 1 January 2008 (UTC)

<undent>Do you have any sources that are not autism rights related that discuss ethics of ABA? I haven't heard of one...so I don't agree with your statement 'its a separate issue' Josh.Pritchard.DBA (talk) 18:09, 1 January 2008 (UTC)

Ehm, do you have any sources that show that all ethical issues regarding autism treatment are autism rights related. You can disagree, but if you want a merge, you need to show why.

The issue of ethics is a bit wider then ABA and the Autism rights movement, consider for instance facilitated communication. Fenke (talk) 19:09, 1 January 2008 (UTC)

Proof of the exception, rather than inclusion is required...thus, I don't say, well, you say that birds have wings...and you must prove to me that ALL birds have wings...rather, we look for exceptions as disproof(a bird without wings). At this point, all I've seen is autism rights making 'ethical' challenges -- not only to ABA but meds, etc...you bring up FC...but it isn't on the page. I don't see how this article is either notable as its own, as it seems to have little to no content and is unsourced -- which means it should not be included. Again -- if you say it is not autism rights movement(ARM)...source something that is an ethical challenge to autism treatment that is not from ARM and I'll reconsider my stance. Until then -- I firmly stand by my position that it should be merged back into its 'parent' article. Josh.Pritchard.DBA (talk) 20:15, 1 January 2008 (UTC)

Facilitated Communication

Fenke, FC is not only used w/autism, but also DD, CP, and brain injuries...and it has been debunked not as a treatment for autism, but treatment for anything -- I view this differently than the medications for autism -- they're only ethically indicated for treatment of autism -- the argument isn't that antidepressants aren't good for treatment; it is that they aren't good for the treatment of autism. Josh.Pritchard.DBA (talk) 23:07, 1 January 2008 (UTC)

It doesn't matter if it's 'debunked' or not, ethical issues concerning it and other treatments can still be raised and even if such treatments never see application again, the issues could be mentioned for historical reasons. Fenke (talk) 12:23, 2 January 2008 (UTC)

No citations

There have been no efforts to cite much of this -- I'll begin to remove non-related copy as well as non-cited copy until we have a well-cited article. Josh.Pritchard.DBA (talk) 02:31, 1 January 2008 (UTC)

Merge Proposal

I've proposed a merge back into the Autism Rights Movement - there is some discussion above why this may be a good or bad idea. All points should have some sort of source, rather than your OR. I will being, I see no verifiable information in this article that would not fit under the same heading under the Autism_rights_movement. In fact, the majority of verifiable information on this page is opposing the inclusion of those topics as ethical challenges. Please discuss. Josh.Pritchard.DBA (talk) 03:20, 2 January 2008 (UTC)

I still don't see any reliable sources that say that the articles should be merged, do you? But there never could be, the discussion about merging is about the wikipedia structure, for which there are no reliable external sources. Any discussion or decision regarding wikipedia article structure will always be OR. Fenke (talk) 08:53, 2 January 2008 (UTC)

Right now the page is virtually unsourced - there's some articles for ABA being verified, but nothing for any of the counter-claims. There's two articles for higher rates of seizures in people with autism, and a strange sentence following the citations that's about treatment, not about ethics at all. There's a reference to APANA, apparently just to prove it exists, then a citation that neuroleptics appear to be worse for people with autism than non-autistics. Aside from these points, nothing is cited, and can therefore be removed. Any remaining information could either be moved to the ABA page (and it's already there), either autism treatments page or seizures page for the seizure and drug info, the ARM page for APANA. The rest is unsourced, packed with weasel words, OR, repeatedly unproven assertions of vaccine and heavy metal causes of autism, and ultimately very, very little about the ethics of treatment. The drug therapy section is more about the efficacy of treatment than the ethics of it. The page is almost three years old, but there appears to be very little justifying keeping the page. Fenke, if you wanted to paste the text to a sub page and work on a sourced draft, that would allow you to keep the info while looking for citations, but right now I don't see a reason to not merge the page. It's the lack of reliable sources that makes the page gutable and mergable. From WP:PROVEIT, the burden is on the editor who adds or replaces material to provide citations, not on the editor who removes it. There is so little material on the page that is justified by sources, it's essentially empty. I acknowledge that the treatment of autism is a controversial subject among the ARM and the neurodiverse, but this page isn't doing the controversy justice. I think there is some merit in relaxing the requirements for reliable sourcing somewhat to allow statements from lobby groups, mostly because I think that's the only place you'll get any info from, barring newspapers and counter-points in academic journals. Michelle Dawson and Temple Grandin's blogs or personal publications might also work, but would have to be used very carefully. WLU (talk) 17:22, 2 January 2008 (UTC)

I really think there should be an article on this topic, but this mess isn't it. Agreed on WLU's statements and tentative yes to merging. --elmindreda (talk) 22:12, 2 January 2008 (UTC)

I'm not sure why you think there should be an article on this...is there an article on any other 'ethical challenge' to treatment?...we should see some ethical challenges to treatment of cancer, of treatment to cerebral palsy, of mental retardation, etc. etc...however, we don't see that - those types of things are generally in the body of the article for that disability. I think the only difference between autism and these other disabilities is that the Autism Rights Movement has made such a big deal about it -- which leads me to my push for a merge BACK into the correct article. To Fenke, you keep using statements that are either circular or illogical...of course there isn't a source as to why a merge should occur -- just like there isn't a source stating that Mars should not have a sub-article called 'Why Mars is red'...the burden is in the other direction. I was also talking not about sourcing why the article should be merged or not, but sourcing content in the article. I've not removed all unsourced content, but when I do, there will be only 159 words left...and that's leaving most of the lead (even though it is unsourced). It seems like consent is that the article should be merged. Fenke and elmindreda, do you want to place the text into a subpage somewhere so you can work on it to get it notable and sourced? Josh.Pritchard.DBA (talk) 00:48, 3 January 2008 (UTC)

It's not a question of merging it back into the article on the autism rights movement, as it was never split off from it.

You apply for a merge so you need to show a merge is appropriate and how and why this article should be a section in the Autism Rights Movement. You attempt to do so by determining the terms by which this discussion is to be held and the sources that can be used. --Fenke (talk) 02:19, 3 January 2008 (UTC)

I don't really see it that way - as soon as anyone removes the unsourced info from the page, there's nothing left. And as is, there's not much 'ethical' on the page now anyway. That's how I see it. You could ask at WP:RFC or some admins or something, but I'm pretty sure you'll get the same response. The other option is to add sources to the page - it can be done, if they can be found, but it's not our area of expertise. In addition, it's already a section in the autism rights movement. And there are no real sources, it's a mess of speculation, weasel words and opinions. But again, if you can provide the sources the page needs to make it into a page worth keeping, then by all means it should be kept! But as is, it really isn't a matter of being worth keeping, it's a matter of there being nothing here that's not already covered elsewhere, or totally irrelevant. That's how I see it. WLU (talk) 03:24, 3 January 2008 (UTC)

I don't see why anyone would want to challenge treatments of cancer on the basis being discussed here. Cancer is a group of diseases, some of them deadly, while autism is a difference of neurology underlying personality and ultimately sense of self and does not shorten one's lifespan. I'm also not aware that either cerebral palsy or mental retardation are considered treatable. The reason for making "such a big deal about it" is precisely because of this push towards the medicalised view of autism. The basis for challenging the ethics of certain treatments (and in all honesty the term itself) is well explained by concepts like neurodiversity and the social model of disability, i.e. the right to be accepted and accomodated as one is. I'm digging for sources anyway and I'll gladly help out whether it becomes a subpage or a subsection. It seems that choice is up to Fenke at this point. --elmindreda (talk) 17:59, 3 January 2008 (UTC)

Oh, and to answer your initial inquiry, I think the issues are in fact sufficiently numerous and complex to warrant their own article, but as far as I can tell, they at present are not sufficiently documented by reliable sources to support such an article. For that reason I support this merge, and my hopes are for the future. --elmindreda (talk) 18:09, 3 January 2008 (UTC)

<undent> I agree with WLU -- Fenke, here's how I show the merge is appropriate:

• there is already a section under the ARM page with the exact same title
• this page will be reduced to less than 200 words -- most of the remaining words are either in support of the treatments which are being proposed as ethical challenges (thus supporting that the page is mis-titled, or not useful).
• The sources that I'm 'determining' have happily been deterimned before me: Sources.

Furthermore, I'm simply saying, either source the material, or I'm deleting it; if it is not sourced quickly, there'll be no material left -- and instead of a merge, we'll have an empty page that will be marked for speedy deletion for lack of content. I'm trying to facilitate you(or whomever else thinks this info is important) keeping whatever you can salvage from this mess of an article and merge it into the ARM article. I continue to stand by my statement that it is not notable on its own -- you have yet to refute any of the statements I have made indicating why it should be merged. Therefore -- do you have a reason to oppose the merge, or shall we begin the merging? Josh.Pritchard.DBA (talk) 03:46, 3 January 2008 (UTC)

I did look at the history, and there was Ethical Challenges to ABA in the ARM article LONG before the beginning of this article...and surprisingly, 4 minutes after the creation of this article, the ARM article changed its name to the same title -- it appears to me that this article was then an extension of the ARM article -- supporting my statement that it needs to go BACK to the ARM article. Josh.Pritchard.DBA (talk) 04:15, 3 January 2008 (UTC)

Cool, thanks for the history digging. Do you still have those history URLs about? --elmindreda (talk) 18:01, 3 January 2008 (UTC)

This edit. Fenke (talk) 19:18, 3 January 2008 (UTC)

1. Many articles have sections that summarize another existing article. Obviously that in itself does not provide a reason to merge. Merging an article into another makes linking to it (as a "See also" or "Main article") from articles harder and the article less readable.
2. The article, it's content, needs work, rewriting and sourcing - that much is clear. It will still need that when it's merged into another article.
3. It's good to read that you'll follow regular rules and guidelines about sources.

Merging doesn't help to improve the article, it will only destroy the history and any sources that might be in it. Fenke (talk) 19:18, 3 January 2008 (UTC)

A move might erase the history of the page, but a merge certainly won't - it just takes a bit of fancy clicking to get to the old history. I can show you how to recover the old versions if you'd like. I just redirected; after removing all the unsourced information, and information that wasn't about ethics, this was all that was left - a lead, some see alsos and a navbox. Now it redirects to the autism rights movement. Of the sections I removed, this section was about ABA not being effective. No mention of efficacy. This section was about people with autism suffering from extra side effects. Again, not ethics. If there are ethical issues here, they are not demonstrated in the article. The ABA section didn't discuss how ABA can be used to reduce stimming and force imitation of neurotypical behavior (possibly an ethical issue as I've seen it argued that this destroys the 'self' of some autistic individuals). The drugs section didn't discuss how autistic individuals don't have the ability to refuse medication or object to the severity of side effects - also a possibly ethical issue. Both sections were about if the treatment's worked or not. That's efficacy, not ethics. And the section in the ARM article still doesn't discuss how ABA and other treatments harms autistic individuals. Plus, it is only two sentences, with no citations at all. The Opposition to eliminating autism section on that page touches on this, but it's unclear that it's an ethical issue. I believe there is an issue here, but it's just not visible on the page. Try re-drafting it on a sub-page to emphasize ethics rather than efficacy, I've no opposition to a proper, referenced page replacing the redirect, I am opposed to the unclear version that existed before. WLU (talk) 19:41, 3 January 2008 (UTC)

There's now a section on the ARM talk page discussing this. WLU (talk) 19:51, 3 January 2008 (UTC)