Talk:Causes of autism/Archive 3

Ambient noise

 * "rv animal study, abstract does not mention autism"

Practically all human diseases are studied by means of a animal models, and finding an animal model is a crucial step in understanding the mechanisms behind a disease, so the successful development of an animal model places this theory on a much firmer scientific basis than many of the other theories mentioned on this page. The paper's abstract indeed does not mention autism directly, however the motivation of this research is to develop a neurological understanding of the causes of autism. Merzenich himself is one of the world's leading reseachers on autism and brain plasticity. I'd appreciate any suggestions on how I can rewrite this section to provide greater clarity.

Prime Entelechy (talk) 06:45, 16 March 2013 (UTC)
 * Please see WP:MEDRS. Dbrodbeck (talk) 12:22, 16 March 2013 (UTC)
 * The word 'autism' is nowhere in the article cited. Please bring the passage from the book here so we can discuss it.  The article though is out, as I said, it has no mention of the word autism, and, is not about humans.  Dbrodbeck (talk) 15:29, 16 March 2013 (UTC)

The mGluR theory of fragile X mental retardation
This is a pervasive and extremely important study going on to find a genetically caused molecular reason for autism among other mental retardations. The paper is online and should be brought up, as recovery of normal functioning has also been proven possible in mice.

Therazzz (talk) 05:06, 22 April 2013 (UTC)


 * The first article you supplied is nearly ten years old and the second is a six-year-old primary study in mice, so they're not the kinds of sources we are looking for per WP:MEDRS, but the theory does seem to have some support in secondary sources, see for example (although that may not be the best one).  Secondary sources do indicate that the Fragile X theory seems to have become the most important genetic theory for a cause.  The Fragile X theory is discussed at Autism but is not mentioned here.  Discussion of the Fragile X theory should definitely be added here generally, probably mGluR in particular too.    18:22, 22 April 2013 (UTC)

It's very important to understand there are hundreds of genes linked to autism. Fragile X is not an alternative to those hundreds of other genetic causes, it's just more common than most of them. But I agree it is very much worth mentioning. — Preceding unsigned comment added by 75.61.133.172 (talk) 00:49, 13 May 2013 (UTC)

Review paper in JAMA
http://archneur.jamanetwork.com/article.aspx?articleid=1182176 — Preceding unsigned comment added by 75.61.133.172 (talk) 01:42, 2 June 2013 (UTC)

Quote from paper linked above:

Observed in approximately 10% to 12% of mothers of children with autism, this antibody reactivity is thus one of the most prevalent biomarkers for autism discovered to date. — Preceding unsigned comment added by 75.61.133.172 (talk) 01:49, 2 June 2013 (UTC)

Another quote:

Interestingly, a recent report6 indicates a higher than previously reported concordance among dizygotic twins, resulting in a best-fit model determination of AU risk that attributes a 55% contribution of environmental factors and a 37% contribution of genetic factors. Risk for developing the broader diagnosis of ASD was found to have a nearly identical distribution.

Although the authors do not strictly endorse the view of the original researchers they mention it in a context that implies belief. — Preceding unsigned comment added by 75.61.133.172 (talk) 01:55, 2 June 2013 (UTC)

You may find more research papers, and review papers included in the CiteULike "Autism" Group research paper sharing library, which has some 500 or more articles. http://www.citeulike.org/group/12599 dolfrog (talk) 15:20, 7 June 2013 (UTC)

Maternal Antibody Related Autism
An article in Time Magazine mentions Maternal Antibody Related Autism as a possible cause of about 1/4 of cases.

Inclusion in this article is clearly warranted. It passes all the medical article rules. Not the TIME article, but the topic, supported by review papers in peer reviewed journals and such.

Someone removed my edit mentioning it.

At this point, resistance to this is basically anti intellectual, bad faith, and quite contrary to what Wikipedia is supposed to be about — Preceding unsigned comment added by 75.61.133.90 (talk) 17:29, 12 July 2013 (UTC)


 * Note this IP editor was the subject of an ANI discussion found at WP:ANI_AUTISM_IP in which it was found the editor has been engaging in a long history of disruption of Wikipedia autism articles, specifically in promoting the "maternal antibodies" theory. As a result of that discussion, anyone who finds their edits disruptive may revert them without comment.   17:48, 12 July 2013 (UTC)

"Autism is associated with prenatal maternal infection with rubella virus or cytomegalovirus."
The text "Autism is associated with prenatal maternal infection with rubella virus or cytomegalovirus. Clostridia bacteria species are associated with autism (these bacteria are present in greater numbers in the guts of autistic children)." is on the List_of_human_diseases_associated_with_infectious_pathogens currently, and I just want to make sure that the sources being used for that statement are correct, and if so should they be present also here? — Soap — 21:54, 14 July 2013 (UTC)
 * That is a single study, and not a review. It seems to me that we would need a secondary review to meet WP:MEDRS to include it here, and frankly it ought to be deleted there.  Dbrodbeck (talk) 12:15, 15 July 2013 (UTC)

Request that this change not be undone (with explanation)
Laserbrain, you removed this: Research on mechanisms related to parental age has been extended one generation back, in a large study published in 2013. Researchers, to quote the New York Times, used "Swedish government data on parental and grandparental ages of 5,936 children with autism, comparing them with more than 30,000 children without autism. They found that compared with men who had a child when they were 20 to 24, those who became fathers when they were 50 or older were about 73 percent more likely to have a grandchild with autism. The connection held even after controlling for other factors, including the age of the grandchild’s parents. The mechanism is unknown, and there may be various genetic and environmental factors involved. But it appears that a mutation may pass from a man to his child and then get activated, or turned on, not in the child but in the grandchild." (REF:Nicholas Bakalar, "Grandfathers’ Age Linked to Autism," New York Times, March 29, 2013 |URL=http://well.blogs.nytimes.com/2013/03/29/grandfathers-age-linked-to-autism/ )

I previously referenced the original peer-reviewed scientific publication, and because that was the primary source it was undone pending review. But this iteration references a reliable secondary source, the New York Times, thus satisfying previous concerns. I request that it be reinstated, therefore. Please let me know what you think. Thanks.Brozhnik (talk) 20:35, 4 August 2013 (UTC)
 * The New York times does not meet the secondary source standards of WP:MEDRS. If the study, and its conclusions, get mentioned in a secondary review article, then we have something.  Dbrodbeck (talk) 20:39, 4 August 2013 (UTC)
 * OK, thanks, now I think I got it.Brozhnik (talk) 00:47, 5 August 2013 (UTC)

Postnatal causes - are these even needed?
Most of the "causes" listed in this section have been wholly discredited (leaky gut, mercury and vaccines to name a few). This section just seems like a catalog of speculative proposals, rather than actual causes. Is it worth keeping something like fridge mom in an article about the causes of autism even though it isn't a cause of autism? ComfyKem (talk) 15:48, 12 May 2013 (UTC)

I am not sure leaky gut is completely discredited, I attended a recent lecture by Paul Patterson of Caltech who reported findings which seemed to hint at some gut issues in some autism cases. But it's true this article is full of very far out theories with little support.

IMO, the article should clearly explain there are thought to be at least around 300 genes involved, maybe more, that any one single gene only seems to account for 2% of cases at most, but that non-genetic causes are also very important in some cases. Epigenetics, SNPs, CNVs, and prenatal effects all should be explained in layman's terms.

Above all, that "autism" is kind of a catchall term that is only defined by fitting a very broad behavioral phenotype. It's like asking the cause for tallness.

A total rewrite is in order to have a good article but ???? — Preceding unsigned comment added by 75.61.133.172 (talk) 01:02, 13 May 2013 (UTC)


 * I saw the request at WT:MED for other opinions. IMO these ideas should be addressed on this page.  It might be appropriate to split some of them into an "Previous ideas" section.  It would be odd for something like Refrigerator mother to not get even a paragraph, even though it is not considered relevant now.
 * Also, speaking or the refrigerator mother idea, I was just reading a few days ago that Kanner(?) didn't originally propose that parental behavior caused autism, only that the parents tended to be cold in their personal interactions. His original idea was essentially that the parents had (mild) autism themselves and that it was therefore hereditary, not that their "bad" behavior caused autism to appear in a child who would have been healthy if raised by warm, expressive people.  So our summary here might be a bit oversimplified.  WhatamIdoing (talk) 15:37, 13 May 2013 (UTC)
 * I do think that they are useful specially since they will be re-added at some point or other if eliminated, however what I think is missing is is sentence in most of them indicating that are minority or even fringe views largely discredited by scientific data, instead the many lines saying "more studies are needed". --Garrondo (talk) 19:59, 13 May 2013 (UTC)
 * There are a few articles included in the CiteULike Autism research paper sharing library that discuss Autism and gastro-intestinal GI issues and use the GI tag dolfrog (talk) 19:58, 12 June 2013 (UTC)
 * I think it's a disservice to the reader to make them skim through all that bogus material, and I'd like to see it eliminated. Maybe the "refrigerator mother" should be kept in a history section because it has such an impressive pedigree, and the vaccine thing should be kept as a warning to the gullible. Leadwind  (talk) 23:25, 12 October 2013 (UTC)
 * I agree with Leadwind on this. Dbrodbeck (talk) 00:14, 13 October 2013 (UTC)

is fetal testosterone link actually controversial?
This sentence says it's controversial, but the referenced article doesn't talk about autism. A well-meaning editor has apparently made original use of the article to criticize a finding that they don't agree with. If no experts raise a controversy over this theory, then we editors should humbly refrain from doing so ourselves.

The theory and findings are controversial and many studies contradict the idea that baby boys and girls respond differently to people and objects.

Yes, I know that this is the touchy topic of sex differences again. Yes, I know that certain editors don't want to let claims about sex differences go unchallenged. But we don't have any business citing an article if it's not about the causes of autism, do we? Leadwind (talk) 23:15, 12 October 2013 (UTC)


 * The paper cited doesn't appear to talk about autism. Agree this looks like original research and should probably be removed.  (Not really necessary to theorize about editors' motivations...)   00:24, 13 October 2013 (UTC)
 * Thanks for agreeing with me, Zad. As for editors' motivations, what I've noticed is that references to sex differences have been repeatedly omitted or minimized on the ASD pages. That's an issue regardless of any hypothetical editors' motivations. Leadwind  (talk) 14:52, 19 October 2013 (UTC)

Incorrect use of hat note
Please read up on summary style and the appropriate use of hatnotes. When this article contains a brief summary of that article, we use the main template. This isn't a correct use of a "main" template. At most, evolutionary medicine might be linked somewhere in this article, if someone can find a complaint secondary source and text that could be used for the link. Sandy Georgia (Talk) 18:42, 27 October 2013 (UTC)

Removed for discussion
I've removed the following because I cannot locate the source in PubMed, but it looks like primary source speculation. Does anyone have a secondary review that discusses this theory? (In fact, I suspect there are quite a few theories in this article that do not include secondary review of those theories, and these should be teased out.) Sandy Georgia (Talk) 11:07, 24 October 2013 (UTC)


 * Keep up the good work. This theory seemed to get a lot of coverage considering how out of date it is. Leadwind  (talk) 15:52, 27 October 2013 (UTC)


 * Actually, I found a secondary source on this theory, namely a study by Paul Shattock: . Jinkinson   talk to me  12:31, 28 October 2013 (UTC)
 * I don't have access to the full text of ; anyone can review the abstract, but could you post (minor) excerpts from the conclusions so we can discuss text to be added? Sandy Georgia  (Talk) 15:25, 28 October 2013 (UTC)

Opiate theory
In 1979, Jaak Panksepp proposed a connection between autism and opiates, noting that injections of minute quantities of opiates in young laboratory animals induce symptoms similar to those observed among autistic children. (Panksepp, J. (1979) A neurochemical theory of autism. Trends in Neurosciences, 2, 174-177) Opiate Theory hypothesizes that autism is caused by a digestive disorder present from birth which causes gluten (present in wheat-derived foods) and casein (present in dairy products) to be converted to the opioid peptides gliadorphin (aka gluteomorphin), and casomorphin.

According to the theory, exposure to these opiate compounds in young children interferes with normal neurological development by dulling sensory input. Lacking sufficient sensory input, the developing brain attempts to artificially generate the auditory, vestibular, visual, and tactile input on its own. This attempt at generating input manifests itself as behaviors common to autism, such as grunting or screaming (auditory), spinning or rocking back and forth (vestibular), preoccupation with spinning objects or waving of the fingers in front of the eyes (visual), and hand flapping or self-injury (tactile).

Folate
I would like to propose an addition, namely the addition of a section on folate receptor autoantibodies. This should probably be added under the autoimmune disease section, however I realize SandyGeorgia will probably remove it for being based on a paper published earlier this year, due to WP:RECENTISM, as she has done in the past on this page. I think it may be worth adding, though, given that that paper is a review article. Should it be added or not, in your view? Jinkinson  talk to me  12:45, 28 October 2013 (UTC)
 * The full text of doesn't seem to be freely available, so I can't comment further on the quality of the article, or whether it is strictly a review, or a primary study with some review elements.  I am not aware of having removed text based on secondary reviews that are compliant with WP:MEDRS, here, or anywhere.   Sandy Georgia  (Talk) 15:31, 28 October 2013 (UTC)
 * I am referring to this edit, in which you removed two papers which I had added--however, both were primary sources, so it made sense to remove it based on WP:MEDRS. Hopefully, the message of "secondary sources are the only thing that count" has gotten through to me by now. Jinkinson   talk to me  15:51, 28 October 2013 (UTC)
 * Thanks for clarifying: I was surprised that you seemed to be saying I had removed text and sources compliant with MEDRS with a claim or RECENTISM. In those two instances, we already had secondary reviews sourcing the text, and didn't need to add new, unreviewed primary studies. Sandy Georgia (Talk) 16:00, 28 October 2013 (UTC)

I would like to provide an additional secondary source on this topic:  Jinkinson   talk to me  15:51, 28 October 2013 (UTC)
 * is from the same journal as, I don't know the quality of the journal, and I don't have access to the full text of either. Perhaps others will review and comment.  In the interim, things may go faster if you propose the text you want to add based on those sources.  Regards, Sandy Georgia  (Talk) 16:00, 28 October 2013 (UTC)

Perhaps the following: "Some recent evidence suggests an association between antibodies to folate receptors and autism spectrum disorders, and it has been suggested that these antibodies may have been formed in response to a milk protein. This hypothetical association is supported by the observation that antibodies against placental FR proteins are associated with neural tube defects." Reference:  Jinkinson   talk to me  18:29, 28 October 2013 (UTC)
 * Just for clarity, are you then not using the more recent (2013) or  (also 2013), in favor of the older (please view in edit mode for the citation style used in this article):
 * Questions:
 * The PMID indicates errratum in Am J Clin Nutr. 2010 Oct;92(4):1001.  What was the error correction?
 * The abstract for this review is not convincing: The findings of the review were conflicting. The variance in results can be attributed to heterogeneity between subjects with autism, sampling issues, and the wide range of analytic techniques used. Most genetic studies were inadequately powered to provide more than an indication of likely genetic relations. Conclusions: The review concluded that further research is required with appropriately standardized and adequately powered study designs before any definitive conclusions can be made about the role for a dysfunctional folate-methionine pathway in the etiology of autism. There is also a need to determine whether functional benefits occur when correcting apparent deficits in folate-methionine metabolism in children with autism.
 * What do the two more recent reviews above have to say?
 * Relationship to the text we already have here?
 * In summary, it appears that you may have located adequate sources to say something about folate, but it's not clear (to me, at least) that what you propose to say is what is best supported by at least this one source. If we're going to say something, it should at minimum state the conclusions of the reviews, which is that there are no definitive conclusions, and more study is needed. Sandy Georgia  (Talk) 18:45, 28 October 2013 (UTC)
 * In summary, it appears that you may have located adequate sources to say something about folate, but it's not clear (to me, at least) that what you propose to say is what is best supported by at least this one source. If we're going to say something, it should at minimum state the conclusions of the reviews, which is that there are no definitive conclusions, and more study is needed. Sandy Georgia  (Talk) 18:45, 28 October 2013 (UTC)

evolutionary medicine
It looks as though we have a master's student trying to help us with evolutionary approaches to autism. I'm sure we're all excited to have an expert like that willing to help us out. But she's new to WP and doesn't know the protocol. I humbly suggest that we try to work with her so that we can benefit from her expertise. Here's text that was deleted, and I'm not sure why. I could try to make this material suitable if I knew the problem with it.

'' For males, a high level of empathizing would not be beneficial when it came to the long periods of solitude that accompanied hunting and the elimination of rivals. ''

I'm willing to work with the text once I know why it was reverted in the first place. Thanks everyone. Leadwind (talk) 16:31, 19 October 2013 (UTC)


 * Thank you very much for your willingness to help this student. Sanetti (talk) 21:45, 19 October 2013 (UTC)


 * I've placed my proposed edits on my talk page. Suggestions for improvement are definitely welcome. Sarmocid (talk) —Preceding undated comment added 23:27, 21 October 2013 (UTC)


 * I was just over at your talk page composing a long post to explain why it might be easier to work in sandbox, and when I attempted to set one up for you, found that you already had one at User:Sarmocid/sandbox! Which is a good thing.  After a long weekend away, I am not yet caught up, but the proposed edit has numerous problems, and I hope to get over to User talk:Sarmocid/sandbox before the end of the week to discuss. One thing you might have a look at in the interim is WP:UNDUE, as it explains how an encyclopedic entry should balance text according to the prominence different views hold in the secondary literature.  I will also teach you how to format citations so that you don't have to repeat the same citation x times.  Also, please see WP:MSH (uppercase on section heads).  An additional issue in a well-developed medical article (such as some of our Featured articles, that is, autism and Asperger syndrome, which comply with WP:WIAFA) will be a discussion of the requirement for high-quality sources, and possible problems with a journal whose stated purpose is to promote a hypothesis or proposal by students.  (The language in the source you are using is quite tentative.) We can all best advance the topics your course seeks to add by finding mention of evolutionary views of autism in more general, secondary, recent reviews.  I do not have full journal access, but if you can access some recent secondary reviews on causes of autism, and provide excerpts of discussion about evolutionary aspects, our work will be more productive.  Best regards, Sandy Georgia  (Talk) 15:48, 22 October 2013 (UTC)


 * Thanks for the advice. Once I get the time, I'm going to find some reliable and recent reviews that support the evolutionary hypotheses proposed on my talk page. In addition, I will take the WP:UNDUE issue into account, and make the necessary deletions from my proposed edit. I am unfamiliar of what is "too little" or "too much", so I'll be sure to leave this on my talk page until I am certain it follows WP:UNDUE. Sarmocid (talk) 20:11, 23 October 2013

I'd like to add some information to the "Other psychogenic theories" subheading -- a few summary sentences with a link-out to Imprinted brain theory. My proposed changes are at User:Sarmocid/sandbox. Suggestions for improvement are welcome. Sarmocid (talk) 16:24, 3 December 2013 (UTC)

Proposed addition
Hi,. The first line of your proposed text from sand box is unencyclopedic and redundant. I've reworked your first line, copyedited your text, and corrected your citation format (please view this in edit mode to understand the citation format of this article), and posted your proposed addition below. The article is not listed in PubMed as a review, although it appears to be; I do not have full text and will ping and  to have a look. I am also unsure if your text would go in the "Genetics" section of this article, or in the article heritability of autism, as it relates to a genetic model. Sandy Georgia (Talk) 16:55, 3 December 2013 (UTC)


 * In the context of evolutionary medicine, the imprinted brain theory hypothesizes that autism is a result of amplified paternal imprinting.  Over-expression of genes promotes selfishness and an increase in the display of basic survival behaviors, commonly associated with autistic individuals, thereby promoting the reproductive success of the father.
 * and, any thoughts on this addition? has confirmed that the source follows WikiMed guidelines. Just needs a content check before I can upload. Sarmocid (talk) 18:00, 7 December 2013 (UTC)
 * Sarmocid, it would be helpful if you first cleared up the two spots in the text that are tagged as unclear.  I don't know what that text is saying.  Sandy Georgia  (Talk) 18:09, 7 December 2013 (UTC)
 * As per Sandy. You need to clarify the wording. Remember we are a general encyclopedia. We need to write in language that can be understood by a grade 12 student at least. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 18:38, 7 December 2013 (UTC)


 * I'm not convinced that the main source (10.1007/s10803-013-1811-1) makes any pronouncements on selective advantage of "selfish" traits, considering the fact that the words "evolution", "selection" and "survival" do not occur in the text. I am very worried that the addition as currently proposed constitutes original research. JFW &#124; T@lk  21:12, 7 December 2013 (UTC)

better lead
This page could use a lead that better summarizes the topic. The lead should summarize the topic so well that it could theoretically stand alone and still be useful to the reader. Summarizing the topic would also give us an opportunity to help the reader differentiate between the prominent theories, the second-string theories, and the discredited theories. Leadwind (talk) 16:23, 27 October 2013 (UTC)
 * I'm not a fan of working on leads for articles that haven't been written; the entire article is a mess. Usually, leads are summaries of articles, and you need the article first.  Sandy Georgia  (Talk) 18:42, 27 October 2013 (UTC)
 * Thanks for your feedback. Leadwind  (talk) 19:14, 8 December 2013 (UTC)

what is the current best understanding of what causes autism?
This page dutifully lists all the proposed causes of autism, but what our readers want is useful information. I'm no autism expert, but I'm sure that someone here can tell us what the leading theories are, or what we know. One paper I read says that the leading theory is that a polygenic tendency meets a developmental insult. Is that right? If so, let's say it. If not, what is the leading theory? Leadwind (talk) 19:18, 8 December 2013 (UTC)
 * See Autism. Sandy Georgia  (Talk) 01:12, 9 December 2013 (UTC)

Primary sources, undue weight, and laypress
Primary sources, original research, and laypress reports are increasingly finding their way into this article as speculation. See for example the Gastrointestinal connection section, where the laypress was used to cite speculative text from primary source rat study (and the editor inserting that text breached WP:BRD to reinsert it again) breaching WP:MEDRS, WP:UNDUE, WP:NOT (news) and WP:RECENTISM. Sandy Georgia (Talk) 19:31, 8 December 2013 (UTC)


 * Three sections with a predominance of or entirely sourced to primary sources, WP:UNDUE, lacking WP:MEDRS-compliant secondary reviews are:
 * Gastrointestinal connection
 * Excessive hygiene
 * Other psychogenic theories
 * It's unfortunate that this article was clean and tag-free for so many years, and is recently being filled with primary sources and undue speculation. I've gone through and identified all the secondary reviews and meta-analyses, but see that the vcite journal template doesn't format that information into the citation as the cite journal template does. Sandy Georgia  (Talk) 01:23, 9 December 2013 (UTC)

Removed from "Other in utero" section
All primary sources and editorials (even!); a 2006 theory should have been discussed in secondary reviews by now, removed for WP:UNDUE and WP:MEDRS. Sandy Georgia (Talk) 01:12, 9 December 2013 (UTC)

A 2006 study found that sustained exposure of mouse embryos to ultrasound waves caused a small but statistically significant number of neurons to fail to acquire their proper position during neuronal migration. It is highly unlikely that this result speaks directly to risks of fetal ultrasound as practiced in competent and responsible medical centers. There is no scientific evidence of an association between prenatal ultrasound exposure and autism, but there are very little data on human fetal exposure during diagnostic ultrasound, and the lack of recent epidemiological research and human data in the field has been called "appalling".
 * Good work. Thanks. Leadwind  (talk) 01:29, 9 December 2013 (UTC)

the prevailing view
"In summary, the prevailing view is that autism is caused by a pathophysiologic process arising from the interaction of an early environmental insult and a genetic predisposition." from Etiology of infantile autism. I'm no expert, but this looks like a strong article with a relatively clear message about the causes of autism, or at least the "prevailing view." If this is indeed the prevailing view, can we describe it as such on this page? Leadwind (talk) 16:06, 27 October 2013 (UTC)
 * That's from 1999, 14 years ago. There's been a ton of new research into autism and new theories proposed.  There's no way it'd be appropriate to use a paper that old and present it as the current "prevailing view".  Can you find something more recent please?   16:15, 27 October 2013 (UTC)
 * So what 'is' the prevailing view? Leadwind  (talk) 01:31, 9 December 2013 (UTC)

causes and proposed causes
We have a sentence about discredited causes in the lead. Since there are more discredited causes than known causes, I'd like to say a little more here to give our readers some perspective. Something like this:

Originally, psychologists blamed so-called "refrigerator mothers" for autism, saying that they had treated their children too coldly. Today, researchers favor genetic explanations over psychogenic ones. Many other causes have been proposed, but few theories have led anywhere. Some researchers argued that childhood immunizations caused autism, but numerous clinical studies have shown no scientific evidence linking it to vaccinations, and the paper linking MMR vaccine to autism was recalled.

If a lead is good, it's a big help to our readers. Leadwind (talk) 03:23, 9 December 2013 (UTC)
 * No. Please review our policy on due weight and our guidelines on how to write leads. Refrigerator mothers is so far gone and dead that it's hardly useful to mention it up front.  The second sentence ("researchers favor genetic explanations over psychogenic ones") is original research and not even (likely) citeable.  "Some researchers" is weasly and unnecessary.  Here, for examples, is an old version of what we had here:"Autism and autism spectrum disorders are complex neurodevelopmental disorders. Many causes of autism have been proposed, but its theory of causation is still incomplete. Heritability contributes about 90% of the risk of a child developing autism, but the genetics of autism are complex and typically it is unclear which genes are responsible. In rare cases, autism is strongly associated with agents that cause birth defects. Many other causes have been proposed, such as exposure of children to vaccines; these proposals are controversial and the vaccine hypotheses lacks compelling scientific evidence." and here is what we say about causes at autism:"It has long been presumed that there is a common cause at the genetic, cognitive, and neural levels for autism's characteristic triad of symptoms. However, there is increasing suspicion that autism is instead a complex disorder whose core aspects have distinct causes that often co-occur. Autism has a strong genetic basis, although the genetics of autism are complex and it is unclear whether ASD is explained more by rare mutations with major effects, or by rare multigene interactions of common genetic variants."  Cited, accurate, not giving undue weight to any wacky theory; mentioning the areas of controversy.  We should avoid weasly writing and original research anywhere in articles, but particularly in the lead. Sandy Georgia  (Talk) 03:34, 9 December 2013 (UTC)
 * UNDUE and LEAD are two of my favorite things. Based on my reading of UNDUE and LEAD, this would be a good change. Anybody else care to weigh in? Should the lead summarize the article and pique the reader's interest? Or Sandy, how about you take a shot at improving the lead? It doesn't have to turn out my way; it just needs to get better. Leadwind  (talk) 03:37, 9 December 2013 (UTC)
 * I am always in favor of writing leads last, so that they are accurate summaries of the article. This article hasn't been accurately updated for three years; what it has been (recently) is trashed, so there is no valid text from which to write a lead.  We don't write leads and then make articles fit them.  We write articles and them summarize them to the lead.  If you'd like to work on this article, finding 2011, 2012, and 2013 high quality secondary reviews for updating etiology would be the starting place.  Removing primary sourced information in the article now would also help.  My review and flagging of secondary reviews indicated that MOST of the article is written to reviews, but that several recent additions are primary sources.  Sandy Georgia  (Talk) 03:43, 9 December 2013 (UTC)

Possible source
Here's a 2009 review article associating autism with intellectual disability and with certain genetic syndromes. Seems relevant. Is the article up to standards? Leadwind (talk) 03:17, 9 December 2013 (UTC)
 * A 2009 review is theoretically reasonable to use as a source here, but it's very hard to imagine there aren't a lot of reviews that are much more recent. Autism is a very active field, and there was a lot of publication due to the DSM5 rewrite: why do we need to use a four-year-old review?  Sandy Georgia  (Talk) 03:36, 9 December 2013 (UTC)
 * Why Sandy, I do believe that that's the nicest thing you've ever said to me, so thank you. Leadwind  (talk) 13:58, 9 December 2013 (UTC)

good science versus bad science
I'm hoping Sandy will agree with me when I say that we should be clear about which of this material is "good science" and which is speculative. On this page, we should cover the speculative material. It's a real service to our readers. But we also have to differentiate between the real stuff and the popular press stuff. It looks as though Sandy is already heading in that direction, so good. Leadwind (talk) 01:56, 9 December 2013 (UTC)
 * No, not only can I not agree with that, doing so (unless MEDRS-compliant secondary sources do so) would be original research. We cover speculative material according to due weight when secondary reviews cover it, and we base our text on their judgment of what is "good" or "bad", not ours.  Per our medical sourcing guidelines and due weight, we don't typically add primary source or laypress speculation to medical articles(although some folks have been doing it here lately, which is damaging the once clean article).  It is a shame that an article that has been tag free and well sourced for years is now being damaged by speculation, original research, laypress and primary sources.   I don't know what you mean about me heading in any direction, since I've always subscribed to MEDRS.  I did recently move down the sections that have been filled with garbage so the article won't look so bad.  Unfortunately, that includes one section that was previously well sourced. Reading Wikipedia Signpost/2008-06-30/Dispatches might help you understand what is a secondary review vs a primary study on Wikipedia, and why we avoid primary studies.  Sandy Georgia  (Talk) 02:07, 9 December 2013 (UTC)
 * What you're talking about is pretty much what I had in mind, so great. Leadwind  (talk) 03:19, 9 December 2013 (UTC)
 * It doesn't appear that we have the same thing in mind, as you endorsed the addition of text wholly uncompliant with MEDRS; a laypress report of a primary source, that was a rat study, as speculation about causes.  Precisely the kind of text that we avoid per MEDRS and that led to the MMR vaccine debacle.  Sandy Georgia  (Talk) 03:40, 9 December 2013 (UTC)
 * It looks as though I have a lot to learn from you as we work together to improve this article. Leadwind  (talk) 14:00, 9 December 2013 (UTC)
 * You seem to be keen to get moving on this article; if you could do the PubMed search to locate 2013, 2012, or 2011 general reviews on autism, I would be glad to help you incorporate them (I believe the last time that was done was by Eubulides in 2009). I can't do the work of researching and writing when I'm simultaneously trying to keep the article clean of primary-source speculation.  Sandy Georgia  (Talk) 14:05, 9 December 2013 (UTC)

New problems
This edit introduces multiple problems. Yes, it's a secondary review, which is good. But it does not verify the text that was in the article. And, it's a review of their own work (they acknowledge results reviewed were from the same group), so it's not an independent review. I'll reinstate some of the older stuff until we can sort out what to do with this. Sandy Georgia (Talk) 00:50, 14 December 2013 (UTC)
 * I reinstated the source that was there, and then summarized what the new review says. But I am not comfortable using a review where the authors are reviewing their own work.  Sandy Georgia  (Talk) 00:56, 14 December 2013 (UTC)

CITEVAR
On another matter, please see WP:CITEVAR; this article uses Vancouver citations generated by the vcite template in the bobhog citation filler format. It's a bit tedious for me to have to do all the citation cleanup. Please plug a PMID into this template filler, then change the cite journal to vcite journal, then use that as the citation. Sandy Georgia (Talk) 00:56, 14 December 2013 (UTC)
 * Another:  Sandy Georgia  (Talk) 01:01, 14 December 2013 (UTC)
 * Sure. I have just been using the cite pmid template because I didn't know there were any alternatives. I will switch to the Vancouver thing now. Jinkinson   talk to me   What did he do now?  11:22, 14 December 2013 (UTC)

Gastrointestinal section and undue weight
I am curious as to who flagged the "gastrointestinal connection" section as lending undue weight to certain ideas. Certainly it doesn't say that autistic kids are more likely to have GI symptoms, since there is insufficient evidence that this is true. It also doesn't say that secretin is an effective treatment for autism, because, of course, this has been completely disproven. So what viewpoint is being lent undue weight in that section? Jinkinson  talk to me   What did he do now?  14:16, 19 December 2013 (UTC)

Replace Theory with hypothesis in the list of proposed explanation for autism?
Hi, there is some confusion in the article by using the word theory. One common meaning is a hunch for cause and effect, an idea some one has had in the shower or the other more precise meaning is a scientific model, which is a group of ideas that has systematically (scientific method) shown to explain data, be predictive and be falsifiable such as climate change or evolution. I think the word theory should be replaced with hypothesis in the list of proposed explanation for autism.

Hypothesis: a supposition or proposed explanation made on the basis of limited evidence as a starting point for further investigation.

Maybe change "According to the theory, exposure to these opiate compounds in young children..." to "According to the hypothesis, exposure to these opiate compounds in young children..."

This would stop ambiguity and also give more credibility to the wiki. Should I change it? I'm pretty new to doing this btw.

Quote ratinoalwiki:

Essentially, the following five steps make up the scientific method:

* Observe - Look at the world and find a result that seems curious. As Isaac Asimov put it, "The most exciting phrase to hear in science, the one that heralds new discoveries, is not Eureka! (I found it!) but rather, 'Hmm... that's funny...'" * Hypothesize - Come up with an explanation. * Predict - The most important part of a hypothesis or theory is its ability to make predictions about result that have yet to be observed. These predictions should be falsifiable and specific. * Experiment - Compare the predictions with new[3] empirical evidence (usually experimental evidence, often supported by mathematics). This step is the reason why a hypothesis or theory has to be falsifiable – if you can't prove it wrong, you can't really prove it right. Information from these predictions can lead to a refinement of the hypothesis. * Reproduce - ensure the result is a true reflection of reality by verifying it with others.

http://rationalwiki.org/wiki/Scientific_method

Skinnytony1 (talk) 04:19, 26 April 2014 (UTC)

Mitochondria
The latest bombshell in the theory that autism is a genetic disorder is here. Children with autism experience deficits in a type of immune cell that protects the body from infection. Called granulocytes, the cells exhibit one-third the capacity to fight infection and protect the body from invasion compared with the same cells in children who are developing normally. If true this is a giant step far, far away from all of the other mainstream theories about mercury and lead exposure. But if it's true that children with autism have weakened mitochondria in their white blood cells, what is the cause of that? It obviously can't be passed down 100% through genes. And if true, why are people with autism not far more susceptible to all sorts of diseases? Is this weakness only expressed during the earliest stages of life, or even only within the womb? A further complication is that this great new study is drawing its conclusions from a sample size of ten, therefore more work needs to be done. — Soap — 00:31, 28 September 2014 (UTC)

Separate hypothesis by; untested, inconclusive, tested and not correlation found etc?
Wouldn't it be less confusing if the different hypothesis were separated on sections for the associated results, if any, of studies done on it, if any? --TiagoTiago (talk) 10:09, 27 October 2014 (UTC)

Needs to be renamed "Proposed causes of autism"
This really needs to be moved to Proposed causes of autism. The title is very misleading. People arrive here and automatically assume that these are all causes. Not everyone actually reads the real content. They see the headings and get the wrong impression. The title should alert them. -- Brangifer (talk) 16:40, 10 December 2014 (UTC)
 * That's not a problem with the title; that's a problem with the content. That is, the article is a dumping ground that should be cleaned up, but the title is correct.  Adding "proposed" would just make the problem worse, introducing speculation.  Sandy Georgia  (Talk) 16:42, 10 December 2014 (UTC)
 * Well, much of the current content is speculation using RS, but not always MEDRS. Are you proposing we only include proven causes, which is what the current title implies? Say more. -- Brangifer (talk) 05:19, 11 December 2014 (UTC)
 * I went through this article once and made sure everything in here was a secondary review. I can't speak to the state of the writing, since I was absent from Wikipedia for many months.  The content should reflect the sources, and at one point, the sources all complied with WP:MEDRS-- at a quick glance, I don't see primary sources or non-MEDRS sources.  Sandy Georgia  (Talk) 05:25, 11 December 2014 (UTC)
 * Okay, User:SandyGeorgia, let's lay that aspect aside for the time being and focus on the discrepancy between the title and the content. The title suggests that these are all actual causes of autism, but they are only proposed causes. We need to harmonize this. If you consider the content to be properly sourced, then it's the title, not the content, which needs changing. That's a very simple solution. We have many articles of this type, and they are good encyclopedic content. -- Brangifer (talk) 06:42, 12 December 2014 (UTC)

The title is fine, IMO; I don't see the problem you allege. Introducing "Proposed" will create a magnet for primary sources. Sandy Georgia (Talk) 10:57, 13 December 2014 (UTC)
 * I don't want the article to use primary sources for biomedical claims anymore than you do, which is why I made that one deletion, but apparently the preliminary nature of that reference was no problem for you ("A 2008 preliminary case-control study based on a parent survey" is an awfully weak and totally non-MEDRS source), so I'm choosing to ignore that issue for now.
 * The content is currently about proposed causes, and we do, as required, use the word "proposed" several times in the lead, because we must describe the content accurately. The problem is that the title implies that the content is about actual proven causes of autism, when most are only proposed causes. We could arrange the content into groups of "proposed" and "proven" causes. That would improve things, and then we wouldn't need to change the title.
 * My main concern now is the total and gross discrepancy between the content and the title. We can't allow such a situation, and I don't understand why you defend it, or is your point that you don't see any discrepancy? Please try to explain your position with other words so I can understand why we're not understanding each other. I don't understand your reasoning. -- Brangifer (talk) 17:20, 13 December 2014 (UTC)

Old reviews now misleading or dis-proven
Is it possible to put a warning tag at the top of this article that warns of it's dated, incorrect, or misleading text? Terrible introduction! Just scanned the body, and it's better though.32cllou (talk) 01:18, 1 January 2015 (UTC)
 * I understand that you believe, based on recent publications, that genetics are no longer a factor in autism, but they are. Please stop trying to eliminate genetics from autism articles.  Yes, some of the reviews here are old, but that information is still accurate.  Also, as far as I know, everything in this article is sourced to a secondary review; it would be helpful if you would discuss your edits before making them, as you don't yet seem to have a firm grasp on Wikipedia's policies and guidelines.  Sandy Georgia  (Talk) 05:12, 2 January 2015 (UTC)

Are these sources reliable enough?
http://www.molecularautism.com/content/2/1/15/abstract (facial features)

http://www.ncbi.nlm.nih.gov/pubmed/22926922 (lungs)

They got removed, just want to confirm. Ylevental (talk) 16:05, 30 May 2015 (UTC)
 * They are not secondary sources, that is for sure. Dbrodbeck (talk) 16:26, 30 May 2015 (UTC)
 * Work on facies for early detection of syndromes has been going on for many years. I'm surprised there isn't a better reference. All the best: Rich Farmbrough, 02:45, 21 July 2015 (UTC).

Many scientific studies show a link between vaccines and autism
The statements in this wikipedia article "Causes of Autism" are basically false that deny there are scientific studies showing a link between vaccines and autism. Many scientific studies show a link between vaccines and autism and these are published in credible referred scientific journals, many are linked here:

30 Scientific Studies Showing the Link between Vaccines and Autism, published in Health Impact News. Many of the studies are recent and prominent and they are all published in scientific journals. They should be discussed in this article. Bioextra (talk) 18:14, 7 July 2015 (UTC)
 * Some silly advoacy site - you must be joking! Please see WP:MEDRS for information on what are considered reliable health sources here. Alexbrn (talk) 18:18, 7 July 2015 (UTC)
 * The introduction to the list says "I have ONLY included autism related information, not research on other vaccine injuries of which there are many." yet Aluminum adjuvant linked to gulf war illness induces motor neuron death in mice is clearly not autism related. The research on   Many of the other studies mention vaccination, or autism, but not both (sometimes neither).  For example 23 is about ADHD, 24 is about incidence of Autism in California.  (27 says that heavy metals are bad for you and the best test is a urine test.) The selection of the list also implies coproporphyrin level, mercury level, mercury exposure, thimersol and vaccination are all equivalent.  This sort of sloppiness does not bode well for taking anything form the site seriously without significant further checking.
 * Further checking reveals that this is just a cut-and-paste of this Facebook page, which is in turn a cut-and-past from a blogger's notes.
 * The only source that stood out as possibly being both relevant and meeting WP:MEDRS was tough this is a low impact factor journal. All the best: Rich Farmbrough, 15:08, 21 July 2015 (UTC).

Klinefelter syndrome and fragile X syndrome
According to German Wikipeda (with refs), Klinefelter syndrome is listed by some geneticists among the possible genetic causes of autism. This article does not mention Klinefelter's. --Florian Blaschke (talk) 20:42, 26 November 2015 (UTC)

Fragile X syndrome is not mentioned, either, even though its own article mentions a strong correlation with autism and autism even identifies it as "the most common identified genetic cause of autism". What gives? --Florian Blaschke (talk) 21:25, 26 November 2015 (UTC)

External links modified
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Mercury: any reason not to include the following two review articles?
The review articles in question are:

'The relationship between mercury and autism: A comprehensive review and discussion'

′The association between mercury levels and autism spectrum disorders: A systematic review and meta-analysis′

Although all authorities—such as NIMH (see here) and WHO (see here)—seem to agree (in their statements for the general public) that environmental factors may be important, they seem, at present, reluctant to single out any one environmental factor in particular.

This is why I would prefer to get some feedback before changing the substance of the text.

I think that, at a minimum, the following should be appended to the existing text in the section on mercury:

"However, a 2016 comprehensive review found that 'the preponderance of the evidence indicates that mercury exposure is causal and/or contributory in ASD', and a 2017 systematic review found that 'mercury is an important causal factor in the etiology of ASD'."

Note that, in the present form, the most recent source cited in that section is from 2008.

Reuqr (talk) 23:42, 28 November 2017 (UTC)
 * The first source says "The authors have been involved in vaccine/biologic litigation." A little research shows that the declared affiliation of several authors to "CoMed Inc" is this organisation, "Coalition for Mercury-free Drugs" - is an advocacy group with a "value statement"


 * CONEM also seems to be an advocacy group.
 * The Institute of Chronic Illnesses, Inc shares a street address with Comed.
 * The remaining author lists Kentucky University as his affiliation, but according to his Wikipedia article Boyd Haley is a retired professor of chemistry, and an anti-vaxer. His article makes it clear why we should be wary of considering him a reliable source on this topic.
 * The second abstract I cannot comment on, except to note it is published in the same journal, which throws doubt on the quality of the refereeing.
 * All the best: Rich Farmbrough, 10:34, 6 December 2017 (UTC).
 * All the best: Rich Farmbrough, 10:34, 6 December 2017 (UTC).


 * The second paper is a meta-analysis, and on page 296 notes the following limitation: "The major problem with case-control studies is the temporal relationship between exposure and outcome. It is possible, for example, that older children with ASD may exhibit more mouthing behavior than healthy controls, leading to increased levels of mercury (and other pollutants) in their biological tissues." In spite of this, on the same page the Conclusions are led by this sentence: "Results of the current meta-analysis revealed that mercury is a causal factor in the etiology of ASD." The limitation noted is spot-on, and fully undermines the primary conclusion. I have posted this concern in PubMed Commons for public feedback that the authors can see. I have also written directly to the journal's editor to re-assess the validity of this conclusion. &mdash; soupvector (talk) 12:43, 6 December 2017 (UTC)
 * The second paper is a meta-analysis, and on page 296 notes the following limitation: "The major problem with case-control studies is the temporal relationship between exposure and outcome. It is possible, for example, that older children with ASD may exhibit more mouthing behavior than healthy controls, leading to increased levels of mercury (and other pollutants) in their biological tissues." In spite of this, on the same page the Conclusions are led by this sentence: "Results of the current meta-analysis revealed that mercury is a causal factor in the etiology of ASD." The limitation noted is spot-on, and fully undermines the primary conclusion. I have posted this concern in PubMed Commons for public feedback that the authors can see. I have also written directly to the journal's editor to re-assess the validity of this conclusion. &mdash; soupvector (talk) 12:43, 6 December 2017 (UTC)

Proposal: Add mitochondrial dysfunction sub-section to vaccine section
What is the prevailing opinion regarding adding a section for the mitochondrial-dysfunction hypothesis to the vaccines subsection?

Here are the details: In its 5-year scientific agenda, released February 2011, the Centers for Disease Control's Immunization Safety Office discussed the need to research the relationship between vacciness, mitochondrial dysfunction, and what it termed "neurological deterioration," listing the need to research this hypothetical relationship as a "high priority" (page 31 Item A-V). The CDC listed 9 bullet points to support its opinion that this research was highly necessary. It explained: what mitochondrial disorders are, two studies that show that some children with mitochondrial disorders may have autistic features and that some children with "autistic" spectrum disorder may also have mitochondrial disease, and numerous studies that suggest that children with metabolic disorders including mitochondrial disease are vulnerable to experiencing neurological deterioration at times of physiologic stress (such as taking vaccines). The CDC stated that a number of studies were in progress or completed, and it stated that the outcome would be to develop guidelines for investigations of adverse events following the vaccination of children with underlying mitochondrial disorders.

Other reputable researchers have echoed the need for this research. In this 2008 study published in PLOSOne and co-authored by scientists from institutions such as the Cleveland Clinic, Johns Hopkins University, and Massachusetts General Hospital, the authors wrote, "Large, population-based studies will be needed to identify a possible relationship of vaccination with autistic regression in persons with mitochondrial cytopathies." 

Mitochondrial dysfunction has been mentioned twice in the archives here, but never in relationship to the research that the CDC pushed. 

I'm not aware of the outcomes of the CDC's research efforts, but I do think the fact that the hypothesis has had the serious attention of the CDC is worth mentioning. What do others think? Kekki1978 (talk) 14:09, 17 September 2018 (UTC)


 * Per MOS:MED we generally avoid the truism that Further research is needed. Or is there a suitable source with some actual knowledge on this topic which may be used? Alexbrn (talk) 07:25, 18 September 2018 (UTC)


 * Anecdotally speaking--and I realize this is not research, but Dr. Richard I. Kelley of Johns Hopkins University and the Kennedy Krieger Institute wrote (2009): "Our clinical experience at Kennedy Krieger Institute over the last 15F years has shown that a deficiency of mitochondrial complex I is a common cause of regressive autism...Regression often can be dated to a specific event, most often a simple childhood illness...or viral syndrome, or, rarely, an immunization, most often the MMR vaccine or the former DPT...Regression occurs either acutely during the illness or within 14 days of immunization with the MMR attenuated virus vaccine...The nature of the regression and its timing suggest that mitochondrial failure is caused by immune-mediated destabilization of mitochondria as part of a TNF-alpha/caspase-mediated apoptosis cascade." (He gave the caveat, "This summary reflects the clinical experience with a single institution’s autism population and diagnostic laboratories.") . I believe he has written an updated document [2018], and when I find it I'll post.


 * Regarding the research that has gone on, per the CDC scientific agenda (pdf above): "CISA [the CDC's Clinical Immunization Safety Assessment Project] is currently [2011] conducting retrospective vaccine safety studies of children with mitochondrial disorders at all six CISA sites. Evaluation of immunization rates and AEFIs [Adverse Events Following Immunization] among children with mitochondrial disorders at Northern California Kaiser (NCK) and other sites are conducting similar studies." Also, the "MINI" study (Metabolism, Infection, and Immunity in Inborn Errors of Metabolism) at the U.S.' National Institutes of Health has been looking at this issue.


 * Does anyone know of the findings of these research studies?


 * (Regardless, the article already mentions numerous causes as hypotheses, with the need for further research implied. Vitamin D deficiency and oxidative stress are 2 examples.) Kekki1978 (talk) 12:51, 25 September 2018 (UTC)

The CDC stated that its goal in fostering research in this area is for CISA to "develop guidelines for clinical investigations of individual adverse events following immunizations that might occur in children with underlying mitochondrial disorders" (source above). Is anyone aware of relevant updates to its guidelines? Kekki1978 (talk) 22:43, 26 September 2018 (UTC)


 * The CDC's website currently says that so far vaccines have not been shown to cause mitochondrial disease but more research is needed, it also says that some infectious diseases can trigger a regression to mitochondrial disease. This makes me wonder if the immune response to a vaccine could cause mitochondrial disease, but it looks like there is not enough info to add anything about vaccines and mitochondrial disease to wikipedia at this time. Tornado chaser (talk) 23:15, 26 September 2018 (UTC)

Proposal: Add mitochondrial dysfunction to the "Related disorders" section
And what is the opinion of adding mitochondrial dysfunction to the "Related disorders" section of the article--not in the vaccine section? At least describe it as an "association", and indicate that causality is not yet established? The research regarding an association is clear, and has been cited by the CDC [source above] as well as in this research below, and other studies. [I will try to follow up and make proper cites here. For now, I'm putting links to abstracts or articles.]


 * "Frequency and association of mitochondrial genetic variants with neurological disorders" (2018).
 * "Clinical and Molecular Characteristics of Mitochondrial Dysfunction in Autism Spectrum Disorder" (2018).
 * "Metabolism-Associated Markers and Childhood Autism Rating Scales (CARS) as a Measure of Autism Severity" (2018).
 * "Mitochondrial dysfunction and autism: comprehensive genetic analyses of children with autismand mtDNA deletion" (2018). Excerpt of abstract: "Mitochondrial dysfunction is not rare in ASD." Kekki1978 (talk) 13:35, 25 September 2018 (UTC)
 * Well you've listed a bunch of unreliable (i.e. non-WP:MEDRS) sources. So the question remains: is there accepted knowledge on this topic that can be found in a reliable source? If not, we can't add anything. Alexbrn (talk) 13:58, 25 September 2018 (UTC)
 * Is the characterization of these sources as being unreliable based solely on the perception that they are primary and not secondary? Kekki1978 (talk) 16:48, 26 September 2018 (UTC)
 * That is a problem, yes. Alexbrn (talk) 17:06, 26 September 2018 (UTC)
 * Is that the only reason for the characterization as unreliable? Kekki1978 (talk) 21:47, 26 September 2018 (UTC)
 * Dunno. The purpose of this page is to discuss ways of improving the article with proposals in line with the WP:PAGs, not to enter into quasi-legalistic Q&A sessions. Have you got anything constructive to propose? Alexbrn (talk) 06:43, 27 September 2018 (UTC)
 * I'm merely trying to be efficient in spending time sourcing. I've read the policy, but not your mind. If you believe the examples given fail WP:MEDRS in more ways than one, it would be constructive to communicate the reasons for your opinion. Thanks. Kekki1978 (talk) 10:25, 27 September 2018 (UTC)
 * The use of the word "yet" in "causality is not yet established" tells me someone seems to have a pre-formed opinion here. HiLo48 (talk) 22:46, 25 September 2018 (UTC)
 * Disagreed. Clearly communicating the difference between association (comorbidity) and causality is of the utmost importance. The topic of the Wikipedia article is causality; the topic of the section is related disorders. There's a risk of confusing the reader unless the difference is clearly communicated. Kekki1978 (talk) 16:46, 26 September 2018 (UTC)
 * "Yet" is a problematic, loaded work beloved of POV-pushers. Alexbrn (talk) 17:06, 26 September 2018 (UTC)
 * There's a difference between expressing that something isn't written robustly enough to communicate an encyclopedic tone and assuming something negative about a stranger's motivation. WP:GF The CDC itself discussed comorbidity. There's no personal POV here. Kekki1978 (talk) 21:47, 26 September 2018 (UTC)
 * There was no need to use the word "yet". HiLo48 (talk) 03:24, 27 September 2018 (UTC)
 * The article is already structured to imply "yet" in numerous locations, and I was writing my comment to fit the structure. For example, as of 27 September 2018, "hypothesis" (an implied "yet") is used 8 times. The "Related disorders" section itself is an example, emphasis added: "Environmental factors that have been claimed to contribute to autism or exacerbate its symptoms, or that may be important to consider in future research, include...[list of elements]." No need to assume anything about anyone's motivation. I will keep the "yet" concern in mind when editing. Thanks.Kekki1978 (talk) 10:25, 27 September 2018 (UTC)