Talk:Down syndrome/Archive 12

Opening paragraph is extremely biased
The opening paragraph says " mild to moderate intellectual disability", however the proven scientific reality is that down syndromers have extremely severe mental retardation. There are hundreds of easily accessible references for this.
 * One could also read the read the review that supports the text in question which says " IQ values vary, usually ranging from 35 to 70, indicating mild to moderate mental impairment; severe mental impairment is only occasionally seen in children with DS" Doc James  (talk · contribs · email) 13:21, 31 January 2016 (UTC)

Another misleading phrase in the opening section is "The extra chromosome occurs by random chance. There is no known behavior or environmental factor that changes the risk." The risk indeed does increase with maternal age according to Mayo clinic http://www.mayoclinic.org/diseases-conditions/down-syndrome/basics/risk-factors/con-20020948. The two sentences with the same source is also odd and the first sentence isn't very meaningful since everything occurs by random chance. — Preceding unsigned comment added by Tomhiatt (talk • contribs) 02:03, 22 March 2016 (UTC)

More relevant info needed re Real World People with Down's (I'm English so we say Down's in UK)
This is a good article HOWEVER it's been said to me time and time again how depressing it is. There is fat too much mention of the physical and not enough on social or present day thinking on people with different abilities. AND ... there is NO mention of people with Down's Syndrome's ABILITIES and far too much focus on their disabilities. In case you're wondering what I might know about this subject, I am more of an expert than most as my sister had Down's, my brother in law who is alive at age 66 has too...I am a local advocate. I am going to be editing and adding to this article. I am also a health professional and advise and care for clients with children, some of which have disabilities. I would love this article to add the info about people with Down's in film, TV (why isn't there a link to this article when it's actually on wikipedia???? Janet_Mitchell, advertising, modelling http://www.dailymail.co.uk/femail/article-3415061/Down-syndrome-model-Madeline-Stuart-set-return-New-York-Fashion-Week-runway.html and more M&S modelling http://www.mirror.co.uk/news/real-life-stories/downs-syndrome-hasnt-stopped-beautiful-5371782 and photography http://www.bbc.co.uk/news/magazine-29107894.  why isn't there a link to this page either? do people with Down's Syndrome not deserve links from the page about their 'condition' ?? List_of_people_with_Down_syndrome  I recently counselled a client whose first child has Down's and she came here and spent a few hours crying because there was NOTHING about what people with Down's syndrome have achieved. There is also no mention of the various charities who campaign for Down's in UK and other countries. So, how would we word the inclusion of people with Down's ABILITIES? I've been watching this page for over 10 years and for the people who KEEP asking 'why is there a picture of a kid with Down's using a toy drill?'....the answer is, if you go back in time, WHY NOT?.. his FATHER took the photo, and he was having fun learning how to use a drill !!! OK?? so please stop asking that question! People with Down's get married http://www.dailymail.co.uk/news/article-2991767/Woman-half-UK-s-married-s-Syndrome-couple-dies.html, give birth and have 'normal' children http://www.jaypeejournals.com/eJournals/ShowText.aspx?ID=764&Type=FREE&TYP=TOP&IN=_eJournals/International%20Journal%20of%20Infertility%20and%20Fetal%20Medicine.jpg&IID=70&AID=16&Year=2010&isPDF=YES , have jobs Yes, REAL jobs http://www.theguardian.com/money/2007/aug/18/discrimination.socialexclusion , star in films, http://creativity-online.com/work/coordown-how-do-you-see-me/46014 have friends, go to school/college, run businesses http://www.mirror.co.uk/news/world-news/restaurant-owner-downs-syndrome-announces-7232080 , even work in their local council as councillors http://www.bbc.co.uk/news/magazine-28196677 ... you name it, someone with Down's will have done it... I think the heading should be named 'INCLUSION' what is the consensus? xx <3 Veryscarymary (talk) 16:07, 14 April 2016 (UTC)
 * There is a link to List of people with Down syndrome in the article. It is right after the "society and culture" heading were one often sees these sorts of links.
 * We discuss fertility. It is "estimated to be present in 30–50% of females." and is lower in males. And we even say the chance of having a non Down child "around half of the children of someone with Down syndrome will also have the syndrome"
 * Gah not the mirror and we do not use case reports. Doc James  (talk · contribs · email) 19:39, 14 April 2016 (UTC)

Down Syndrome, Amyloid precursor protein (APP), and Alzheimer's Disease
I read a US Pharmacist article on Alzheimer's Disease dated January 2015, and it stated the chromosome 21 is the source of the amyloid precursor protein that gives rise to too much Beta amyloid in Alzheimer's Disease. It further states that "essentially all individuals with Down Syndrome will develop AD by age 40". I have my doubts about the academic quality of the remark, but below is the citation given to justify it. Chromosome 21. Genetics Home Reference. November 2013. http://ghr.nlm.nih.gov/ chromosome/21. — Preceding unsigned comment added by 172.78.16.114 (talk) 04:43, 15 May 2016 (UTC)

Genocide!?
Others argue that Down syndrome shouldn't be prevented or cured and that eliminating Down syndrome amounts to genocide. What a bizarre statement. Only one of the two sources at the end of this sentence mentions genocide and that is from a mother who says: "There's the perception that [preventing and eliminating the genetic disorder] is almost a type of cultural genocide, that our children represent an international global community." Keywords: "perception", "almost", "cultural genocide". Saying that a portion of people see curing DS as the same as genocide is a huge leap from there. Bataaf van Oranje (Prinsgezinde) (talk) 12:42, 26 June 2016 (UTC)

MR
Can someone please change the word MR to ID. In this day and age there is NO good reason to use that awful term. The person who wrote that, should be ashamed. — Preceding unsigned comment added by Tara221 (talk • contribs) 19:36, 16 December 2013 (UTC)
 * For the curious, what the user above is referring to was the use of the term "Mental retardation" in the Characteristics table, which has now been replaced with "Intellectual disability." David (talk) 00:24, 26 January 2014 (UTC)
 * Sounds good. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 00:42, 26 January 2014 (UTC)
 * Keep that Euphemism Treadmill going. The People Who Decide Such Things told us that "moron", "imbecile", etc. were bad words, and we were to refer to these folks as "mentally retarded".  But once people figured out that the new euphemism meant exactly the same thing as the Old Bad Words meant, the New Good Words became Bad Words too.  Soon enough, "Intellectual disability" will be seen as so horrible that Nice People won't even use the words, and will be forced to use abbreviations. 168.137.100.23 (talk) 20:58, 29 August 2016 (UTC)

That whole chart still seems problematic to me, and unfortunately since the it's a Spanish (i.e. from Spain, not just the language) publication it seems hard to check the source of all those percentages or the terminology they used. Other sources around the 'net that describe the characteristics of DS don't cite percentages, so I'm not sure the chart could be replaced with an English version that uses the currently acceptable terminology in English speaking countries.

Site that talk about the different physical and mental characteristics of DS usually seem to use the terms "cognitive impairment" or "learning disability" which are much more specific descriptions than the broader "intellectual disability" term. In particular, this site: https://www.nichd.nih.gov/health/topics/down/conditioninfo/Pages/symptoms.aspx#f1, mentions that DS is rarely associated with severe cognitive impairment, which seems to be much less alarming or stigmatizing as the MR or ID terms.

For now, I'm going to change it to "cognitive impairment," though it would be nice if we could update this chart or even just eliminate it for nothing better can be found than the Spanish resource. I'll try to dig around the library at Boston's Children Hospital next time I'm in the area, maybe they have something. 3lb33 (talk) 13:44, 28 January 2014 (UTC)
 * The ACP uses mental impairment thus switched to that. Will work on updating the table eventually.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 13:49, 28 January 2014 (UTC)
 * Much of it is supported by this ref  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 13:56, 28 January 2014 (UTC)
 * And the rest appears to be here  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 14:14, 28 January 2014 (UTC)
 * Awesome job Doc. Thanks! 3lb33 (talk) 14:44, 3 February 2014 (UTC)

"Mentally Retarded" literally means "mentally slow" it is a euphemism  for mental deficiency. It was coined as a less harsh way of putting it. Whatever euphemism you substitute for "mentally retarded" will eventually lose it's euphemistic power also. Some people already consider the word "special" to be an insult. John Alan Elson ★  WF6I A.P.O.I. 00:19, 12 September 2015 (UTC)

There is no known behavior or environmental factor that changes the risk
I'm reluctant to change the lead of this article labelled good but I find this statement partial and misleading. You have to read well down to the epidemiology section to find that the risk of Down Syndrome increases from 0.1% to over 3% as the age of the mother increases from 20 to 45. This seems to me an obvious behavioral factor and is so well known that it should be included in the lead. Chris55 (talk) 12:02, 8 October 2016 (UTC)
 * A mothers age is not a behavioral risk factor. But agree we should add the age difference to the lead. Doc James  (talk · contribs · email) 21:01, 11 October 2016 (UTC)

The last sentence of the fourth paragraph should be changed from "The genetic cause of Down syndrome—an extra copy of chromosome 21—was identified by French researchers in 1959." to "The genetic cause of Down syndrome—an extra copy of chromosome 21—was identified by French researcher Jérôme Lejeune in 1959." with a hyperlink to Jérôme Lejeune's wikipedia site: https://en.wikipedia.org/wiki/J%C3%A9r%C3%B4me_Lejeune — Preceding unsigned comment added by 134.153.158.103 (talk) 20:09, 21 October 2016 (UTC)
 * Done Doc James  (talk · contribs · email) 05:06, 16 November 2016 (UTC)

Cognitive Development and Early Intervention Therapies for Children with Down Syndrome
I would like to add a section 6.2 (cognitive development) in regard to how children with Down syndrome's ability to acquire language, literacy, and speech is affected by their level of cognitive development in infancy and childhood. I will also be briefly describing several early intervention therapy techniques which aid in furthering developing an increased level of cognitive development. Smb2007 (talk) 18:37, 17 November 2016 (UTC) If you want to suggest a change, please request this in the form "Please replace XXX with YYY" or "Please add ZZZ between PPP and QQQ". Please also cite reliable sources to back up your request, without which no information should be added to, or changed in, any article. - Arjayay (talk) 18:48, 17 November 2016 (UTC)
 * ❌ This is not the right page to request additional user rights.

Semi-protected edit request on 17 November 2016
I would like to add a section 6.2 (cognitive development) in regard to how children with Down syndrome's ability to acquire language, literacy, and speech is affected by their level of cognitive development in infancy and childhood. I will also be briefly describing several early intervention therapy techniques which aid in furthering developing an increased level of cognitive development. Smb2007 (talk) 18:49, 17 November 2016 (UTC)
 * Red question icon with gradient background.svg Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. 🔯 Sir Joseph 🍸 (talk) 19:39, 17 November 2016 (UTC)

Formatting
For medical articles we standardly have "Down syndrome (DS or DNS),". I have not see "Down syndrome (abbreviated to DS or DNS), " standardly done. Others thoughts? Doc James (talk · contribs · email) 18:17, 15 December 2016 (UTC)
 * The MOS is here  Doc James  (talk · contribs · email) 17:18, 16 December 2016 (UTC)
 * You are right, . Best regards. --BallenaBlanca [[Image:BallenaBlanca.jpg|25px]] [[Image:Mars symbol (bold blue).svg|12px]] (Talk)  17:34, 16 December 2016 (UTC)

Semi-protected edit request on 8 March 2017
{hi mine is yours) — Preceding unsigned comment added by 157.185.64.117 (talk) 14:15, 8 March 2017 (UTC)

Semi-protected edit request on 13 March 2017
I have worked in hospitals before. And have a few things about the face and the way the body grows and develops Bobbins1279 (talk) 19:06, 13 March 2017 (UTC)
 * Red information icon with gradient background.svg Not done: this is not the right page to request additional user rights. You may reopen this request with the specific changes to be made and someone will add them for you, or if you have an account, you can wait until you are autoconfirmed and edit the page yourself.  JTP (talk • contribs) 19:35, 13 March 2017 (UTC)

Why chromosome 21?
Is there any information about what makes chromosome 21 so much more commonly duplicated than other chromosomes? — Preceding unsigned comment added by 184.65.77.230 (talk) 18:10, 29 July 2015 (UTC)
 * Actually, it's not! In most cases, it's not truly a "duplication." Instead, it's a "nondisjunction" (i.e. the chromosomes get "stuck" together when the cell is dividing). The most common "nondisjunction" is actually Trisomy 16, however, it is impossible for the embryo to survive with Trisomy 16 so the pregnancies end in spontaneous abortion. Most trisomies end in spontaneous abortion early in pregnancy and, as a result, Trisomy 21 is the most common in living babies. I hope that answers your question. FMatuszak (talk) 05:16, 17 March 2017 (UTC)
 * The small size of the 21st chromosome is probably a major factor in the relatively mild effects of trisomy-21 as compared to all other trisomies in humans. (Remember, most other trisomies are so rare only because either 1) the zygote cannot even divide properly, 2) the embryo cannot develop properly and spontaneously aborts, or 3) the infant cannot survive after birth) Being smaller, there are fewer active genes on chromosome 21 so that there are fewer disruptions arising from genetic "overdosing".

Down syndrome and uranium / radon / natural radioactivity
My personal research has led me to reveal a clear link between uranium / radon levels in the environment and Down Syndrome Would be interesting to see if there is possibility to integrate it in the article.--FlorentPirot (talk) 09:50, 8 May 2017 (UTC)
 * Do we have a WP:MEDRS compliant source? Doc James  (talk · contribs · email) 17:28, 8 May 2017 (UTC)

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Down's syndrome
In the UK this is always called "Down's syndrome". This needs to be mentioned in the opening sentence. 109.149.189.238 (talk) 03:39, 7 October 2016 (UTC)
 * It is in the infobox and can go in the body. All the small alternative spelling differences do not need to go in the first sentence. Doc James  (talk · contribs · email) 21:03, 11 October 2016 (UTC)
 * It also used to be what it was called in the US, before politically-correct nonsense took hold.136.32.83.232 (talk) 23:24, 15 November 2016 (UTC)
 * Could someone please add Down's Syndrome to the lede or title.Royalcourtier (talk) 01:55, 18 July 2017 (UTC)
 * Already in the infobox. Not needed in the first sentence aswell. Doc James  (talk · contribs · email) 04:51, 18 July 2017 (UTC)

Name
In the 'Name' section, 'Mongolian People's Republic' is misspelled as 'Mongolia People's Republic' ('n' missing). I'd correct it myself, but the article lacks an Edit tab, so I'm commenting here in the hope that someone with the necessary technical expertise can make the change (and add an Edit tab). And when I try to enter this comment I'm told to use a Capcha because the comment 'includes new external links' - which is complete nonsense!213.127.210.95 (talk) 13:51, 26 July 2017 (UTC)


 * thanks and done Doc James  (talk · contribs · email) 15:23, 26 July 2017 (UTC)

"Slanted eyes"
Please replace the ambiguous and historically racially  tinged description of the eye surface  appearance of Downs individuals. Changing "slanted eyes " to the anatomically accurate description that 60% of individuals exhibit a plica palpebronasalis and palpebronasal fold. Or epicanthal fold ( from Wikipedia   https://en.wikipedia.org/wiki/Epicanthic_fold  )    This is accurate, neutral and sensitive.


 * That would be unnecessarily technical, and the average reader would have no idea what that meant, even if wikilinked. In this case, "slanted eyes" is already linked to Epicanthis fold, and that seems good enough.  Chaheel Riens (talk) 20:44, 27 July 2017 (UTC)
 * I would need to look up "plica palpebronasalis and palpebronasal fold". We use common English. Doc James  (talk · contribs · email) 21:37, 27 July 2017 (UTC)

Chromosomal disease
Down syndrome is not a disease, it's a Syndrome. A disease in medical terms implies there could be a cure through treatment, suffering and a disease is undesirable. Down Syndrome is as the name suggests, is a syndrome, a chromosomal event. It is important to note that people with Down Syndrome do not suffer. It is derogatory to say it is a disease as the current advocacy movement states that the only way to cure Down Syndrome is to kill all those with Down Syndrome. Down Syndrome can be akin to a race of people, where they should be treated like the general population. Although intellectually delayed, they have a typically positive sense of well being, content, and easier to parent. Research by Brian Skotko has founded that parents with children with autism, experience much more stress and family discord as a result of their behaviors. People with Down Syndrome are capable of more than what was expected of them a decade ago. They have jobs, live independently, have relationships, get married, can be sexually intimate with a partner, go to College/University, and self-advocate. People do not die of Down Syndrome but, due to illnesses just like the general population. They have a weaker immune system that may cause susceptibility to illnesses but doesn't mean they are hospitalized often. They die of similar illnesses that the general population experience. One with Down Syndrome only dies of Down Syndrome itself in utero or directly after birth. Not every person with Down Syndrome will have all the characteristics of Down Syndrome. That's why there is such variability in capacities and intelligence. Speech delay or impediment is not indicative or reflective of actual intelligence and often are more intelligent. SWHazlett (talk) 22:20, 26 August 2017 (UTC)
 * That is precisely why this article does not describe Down syndrome as a disease. The phrase "chromosomal disease" does not appear anywhere in the article. Did you have any suggestions for improving the article? General Ization  Talk   22:31, 26 August 2017 (UTC)

Semi-protected edit request on 7 January 2016
Please change "Their is no know behavior" to "There is no known behavior". Please also change "Their is no cure for Down syndrome" to "There is no cure for Down syndrome". I am requesting these changes because there is a grammatical error; the wrong form of the word is used.

TillieMae (talk) 00:52, 7 January 2016 (UTC)
 * Yes check.svg Done Thank you for the suggestions that helped improve Wikipedia. -- &#124; Uncle Milty &#124; talk  &#124; 01:37, 7 January 2016 (UTC)

What is the original date of publication? Mandymoo6 (talk) 06:01, 20 September 2017 (UTC)

Graph for "The risk of having a Down syndrome pregnancy in relation to a mother's age" is wrong
The article includes a graph "The risk of having a Down syndrome pregnancy in relation to a mother's age". The graph is said to be taken from "Revised estimates of the maternal age specific live birth prevalence of Down’s syndrome" by Morris et al. However, the graphs in the above paper do not look like the graph in the wikipage. In particular, the wiki graph is declining past age 45 , whereas the graphs in the original paper stay constant or rise past that age. (See figure 2 in the paper). A better figure would be this:

It is true that the data in the paper has a lower rate past age 47, but that is a result of small numbers. In any case, you can not cite a paper for a plot, but then show a plot with different results. — Preceding unsigned comment added by Mltam (talk • contribs) 18:24, 5 February 2018 (UTC)


 * Padlock-silver-open.svg Not done: According to the page's protection level you should be able to edit the page yourself. If you seem to be unable to, please reopen the request with further details. — MRD2014  Talk 00:05, 8 February 2018 (UTC)

Crimson Cheeks
The one with the bell! [] In terms of a determined gaze and focus...

False Positive Rates
I am not an expert in medical statistics, but can anyone confirm that the stats re false-positive are correct? A 5% false-positive rate means that only one in 28 would have a confirmed case - surely that would be a false-positive rate of 95%, not 5%? And it would be one in 20 - where does the 28 come from? I haven't got the understanding to interpret the original document in a medical capacity but based on stats those figures seem to go against mainstream maths. 31.53.77.58 (talk) 19:34, 3 July 2016 (UTC)


 * Totally Agree! This math seems very suspect.  A 5% false-positive rate would mean that of 100 fetuses that were predicted by the test to have down syndrome, 5 of them would _not_ have down.  The other statistic mentioned is the following: "If the screening test has a 2% false-positive rate, this means one of 10 who test positive on screening have a fetus with DS.[72]".  This is completely wrong.  If a screening test has a 2% false positive rate then of 100 positive test results only 2 would _not_ have DS.  The person who wrote these paragraphs needs to review basic math.  The author says 1 in 10 positive tests would have DS and by my count that equates to a 90% false-positive rate, not a 2% false positive rate.96.241.142.238 (talk) 18:59, 4 July 2016 (UTC)

Text is "If Down syndrome occurs in one in 500 pregnancies and the test used has a 5% false-positive rate, this means, of 28 women who test positive on screening, only one will have Down syndrome confirmed." So you test 500 pregs and the test is wrongly positive in 5% (500 * 5%) = 25. Than you add the one true positive to that and you get 26 rather than 28 so corrected. If you use 2% * 500 = 10 false positives for one true positive. Doc James (talk · contribs · email) 14:21, 5 July 2016 (UTC)

Shouldn't the FP rate be the FP/FP+true negatives? So 25FP/25FP+474TN=5.01%?

Also this makes the test sound useless. Perhaps attention should be called to the negative predictive value so people don't recklessly skip the screening?
 * Not sure what you mean? Screening for a rare condition with a test with a 2 to 5% false positive rate means you end up with a lot of false positives. This means that one than needs to do a confirmatory test to verify that the first test is actually correct.
 * But basically what it is saying is, if you are not going to have an abortion if the test is positive no mater what they do not have the test. If you do have the test and it is positive than do not just abort before the confirmatory test but realize that the confirmatory test has some risks. Doc James  (talk · contribs · email) 07:32, 1 December 2017 (UTC)

This section (Before birth) still caused me come initial confusion, though it now makes sense. Wondering if it might help to put in a little more intermediate reasoning to help people who are still confused, maybe using some actual rates from most recent studies. E.g. something like "In the study (give ref) of N subjects using diagnostic test, P tested positive, but only TP were confirmed as having Down's syndrome." Simon Grant (talk) 07:16, 21 May 2018 (UTC)

This little section is indeed very confusing, on the surface I couldn't make much sense of it and thought along the lines of the first posters here. However looking into it, the description is correct, but still not very clear. Using the same reference for the false positive rate, I wonder if something along the lines of

"This further testing is required as while screening will detect 90-95% of cases, 2-5% of all tests will come back with a false positive which need to be excluded before a comprehensive diagnosis can be confirmed. This means that for every 1000 screening tests, 20-50 will return positive, and of these, only 1-2 of these actually have Down syndrome which can be confirmed with additional, more invasive testing."

Might be a little less ambiguous and easier to follow without having to look up a tutorial on how to calculate false positive probabilities.

Choice-as (talk) 21:47, 7 November 2019 (UTC)

Objectifying pictures
Could we consider the role of the pictures in this article, which seem only to have the function of priveleging physical characeristics? A picture of a person with Down Syndrome which is there for the sole purpose of showing 'what a person with Down Syndrome looks like' seems to me to be rather like putting a picture of a woman up, randomly, on a page about women (caption: 'Woman' - or indeed we could think of numerous categories of people for which illustrative pictures would be somewhat arbitrary). Are there pictures that could be sourced that have some specific function beyond the illustration of physical characteristics?

another issue re: There is no known behavior or environmental factor that changes the risk
To the contrary, there is a well-known and documented behavior that absolutely changes the risk. That is, freezing eggs at a younger age. I'm not really sure what the point of this sentence was, at all, but it is clearly false so it should be changed. WikiAlto (talk) 02:06, 10 March 2018 (UTC)

Wrong statistical sentence
This sentence "It occurs in about one per 1,000 babies born each year." is nonsense. It must be: "It occurs in about one per 1,000 babies born." — Preceding unsigned comment added by 46.109.200.147 (talk) 17:08, 18 April 2018 (UTC)


 * Perfectly true, and the nonsensical wording is still in there almost a year later. Could someone fix that please?
 * Just to illustrate the nonsense: You might just as well say "It occurs in about one per 1,000 babies born each week" or "It occurs in about one per 1,000 babies born each decade", and it would be equally true - and equally nonsensical. --87.150.8.132 (talk) 08:46, 8 January 2019 (UTC)

Inappropriate Medicalisation of the subject matter
The article commences with the grim warning: "Down syndrome (DS or DNS), also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21.[2] It is typically associated with physical growth delays, characteristic facial features and mild to moderate intellectual disability.[1] The average IQ of a young adult with Down syndrome is 50, equivalent to the mental ability of an 8- or 9-year-old child, but this can vary widely.[7]

One might as well start a new article on people without DS, starting with some grim medical facts about obesity, average IQ, addiction, average life expectancy, height, and lack of good sense of humour, don't you think? What is normal, and what a disorder? I guess it all depends which side of Trisomy 21 you are looking from, doesnt it?

I tried to change the negative tone of this article many years ago, and gave up, because there was then, and still is, a 'bully element ' of senior wikipedia editors who seem determined that they have the right to decide how to write an article, not people who are personally affected.

I would blow most of this page into smithereens if I could because it is still old fashioned and deeply patronising in tone: but I cannot figure my way through the labyrinthine complaints system and lack the energy or time to take it further. Excalibur (talk) 17:10, 10 May 2018 (UTC)
 * Down syndrome is associated with lots of health problems. It is a genetic syndrome not a simple variant of "normal". I disagree with the issues you raise. Doc James  (talk · contribs · email) 18:21, 10 May 2018 (UTC)

Well, let's agree to disagree then, and that is fine: but I am the father of a child with DS: so what exactly are your own qualifications to support this kind of opinion? We are increasingly embracing diversity in so many ways: gender, disability, age, sexual orientation, whatever: we are all minorities now. It was not that long ago that Homosexuality was classified as a mental illness, and Africans or Jews were considered mentally subnormal by substantial elements of mainstream medical opinion. Is this any different, and is it not a self-fulfilling prophecy? Look, you probably know fine well that no person with DS, and none of the parents or siblings, would agree with the terminology used in this page, so why not admit that this article is a form of bullying? Who owns this topic? Excalibur (talk) 20:13, 10 May 2018 (UTC)


 * That none of them agree that DS is a syndrome or a genetic disorder? Doc James  (talk · contribs · email) 20:28, 10 May 2018 (UTC)


 * For the record, I'm also the father of a child with Down's Syndrome, and have been for nearly 20 years now. I disagree with pretty much all of your comments, and am astonished that somebody with such a close connection to the subject would deny the realism of a genetic condition being a medical matter.  I also asked one of my other sons to read both the article and this talk page, and even though he's only 12 so much of it was beyond him, he found nothing to upset him, or that he found objectionable.  Chaheel Riens (talk) 20:33, 10 May 2018 (UTC)

Relocated from my talk page
==Down_syndrome==

Naturally I expected you or someone else to revert my cheerful edit: it was of course made as a mild protest about the inappropriate 'medicalisation' of people with DS. The fact that you (and I) happen to have the usual set of chromosomes (2) does not enable you or anyone else to 'label' someone with a slightly different combination of chromones as a medical case, if for no other reason than that DS is not a disease or an illness.

The article commences with the grim warning: "Down syndrome (DS or DNS), also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21.[2] It is typically associated with physical growth delays, characteristic facial features and mild to moderate intellectual disability.[1] The average IQ of a young adult with Down syndrome is 50, equivalent to the mental ability of an 8- or 9-year-old child, but this can vary widely.[7]

One might as well start a new article on people without DS, starting with some grim medical facts about obesity, addiction, average life expectancy, and lack of a GSOH, don't you think? What is normal, and what a disorder? I guess it all depends which side of Trisomy 21 you are looking from, doesnt it?

I tried to change the negative tone of this article many years ago, and gave up, because there was then, and still is, a 'bully element ' of senior wikipedia editors who seem determined that they have the right to decide how to write an article, not people who are affected.

I'd be obliged if you could escalate this general complaint to the relevant committee, (n.b, not my specific edit, the whole point, because I would blow most of this page into smithereens if I could) I cannot figure my way through the labyrinthine system and lack the energy or time to take it further. Excalibur (talk) 17:04, 10 May 2018 (UTC)

I don't really know where to begin with this edit from my talk page. Excalibur is - by all accounts - an experienced editor, but the above section and the edits that prompted it are so at odds with the principles of Wikipedia it's almost reasonable to suspect his account may have been compromised.

By Excalibur's own admission their edit was pointy and done in protest knowing it was to be reverted, seemingly in order to stimulate discussion over the tone of the article. So I've relocated it to this talk page which is obviously the best place to discuss improvements to the article.

For the record I consider Excalibur's edits to have been bordering on vandalism in that they were done not with the intention of improving the article, but to provoke response, and he obviously has an issue with the medical portrayal and categorization of DS - and seems to be attempting to right a great wrong, considering an accurate, factual and sourced description of the condition to be "a grim warning", and by adding inaccurate and stereotypical information - such as under complications "Friendly personality personality, Funny humour, Empathetic Empathy". I see no major issues or problems with the article, and although (like any other) it can be improved - this is not the way to go about it.

Probably not the response Excalibur was hoping for, but they asked me to take action - and that's what I've done. Chaheel Riens (talk) 20:25, 10 May 2018 (UTC)

NPOV
I have not looked up what edits exactly this was all about, and I am completely uninvolved in the discussion so far, and while I will not comment on those edits, I will say that I can understand Excalibur's point.

A close family member of mine very likely has a certain syndrome (completely unrelated to Down syndrome), and after reading the Wikipedia article which is written in a similar tone as this one, he was so offended that he will never ever have himself diagnosed now.

I am sorry to say this, but there is absolutely NO way a pregnant woman is going to read this article and be informed from a neutral point of view about what she has to expect. I am not a general anti-abortionist, but this whole article simply screams "Go! Have an abortion! Quick!".

That is to say: With all its medical phrasing and political correctness and everything, this article has a huge NPOV issue. --87.150.8.132 (talk) 09:11, 8 January 2019 (UTC)


 * Just as a minor illustration of that patronizing POV tone, let me quote one sentence:
 * "Education and proper care have been shown to improve quality of life."
 * This sentence, first of all, transfers the clear message: People with Down syndrome essentially have a bad quality of life.
 * Then, we learn some incredibly insightful wisdom: "Education and proper care" can improve that. Wow, who would've thought! You know, this is so wise we really should add this information to the article human being. They completely missed this point so far, and there seems to be evidence that education and proper care can actually improve most human beings' quality of life!
 * And THIS is the ONLY half-way positive-sounding sentence within four paragraphs of lede horror!
 * Please do rethink and re-evaluate the POV in this article. --87.150.8.132 (talk) 09:59, 8 January 2019 (UTC)
 * The sentence says that quality of life can be improved. Better can be made even better - this is what "improved" means.  It does not inherently mean that you are starting from a bad, negative or poor position.  There is nothing apart from your own inference and opinion that people with DS have a bad quality of life.
 * I also understand Excalibur's point of view - but that doesn't make it correct for the encyclopedia.
 * This article, in basically similar form was a Featured Article in 2010, peer reviewed in 2012 and a Good Article in 2014. Additionally it has been used as an academic source for Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine.  You may not like the lack of fluffy good-news, everything's fine commentary and an assurance that you can still go to Italy not Holland, but that in itself is decidedly POV.  Chaheel Riens (talk) 11:51, 8 January 2019 (UTC)

"Down" or "Down's"
The article uses a mix of "Down syndrome" and "Down's syndrome" throughout. Is there one term that is more common and/or more preferred? -- Ed (Edgar181) 18:48, 18 June 2018 (UTC)
 * We go with the name of the article "Down syndrome". If someone wishes to switch to the other than a move request is required. "Down's" is not used in the text currently. Doc James  (talk · contribs · email) 20:03, 18 June 2018 (UTC)
 * Thanks for restoring the consistency. I should have noticed that it was just one recent edit that introduced the partial use of "Down's".  -- Ed (Edgar181) 13:54, 19 June 2018 (UTC)
 * No worries User:Edgar181 :-) Doc James  (talk · contribs · email) 15:31, 19 June 2018 (UTC)

This issue was debated at length throughout much of the later part of the twentieth century. A meeting of editors of American medical journals decided that they would no longer use the possessive (or genitive) case to describe congenital syndromes. Since then American journals have stuck to "Down Syndrome," but their fatwa is not well observed elsewhere. NRPanikker (talk) 23:57, 14 June 2019 (UTC)
 * I'm thinking it might be good to add "also known as Down's syndrome" in the lead. At present "Down's syndrome" is relegated to "other names" in the infobox, where it seems like an afterthought. While American usage may now favour "Down syndrome", the version with the apostrophe is still commonly used in the UK (by organisations such as the Down's Syndrome Association and the National Health Service, as well as by the general population) and it strikes me as odd not to mention it alongside "trisomy 21" in the lead. Rabascius (talk) 21:47, 28 January 2020 (UTC)

Semi-protected edit request on 25 June 2018
Please review the the phrase "As of 2006, three instances of males with Down syndrome fathering children and 26 cases of females having children have been reported." under the Fertility heading. The phrasing implies that there are only 29 known cases of individuals with Down syndrome having children, but the referenced article referred to a literature search which revealed 29 pregnancies which had been studied in research articles. I do not feel the phrasing is an accurate representation of the article. 2601:1C0:CD00:E350:D477:F3C1:23F5:9EEF (talk) 05:29, 26 June 2018 (UTC)

The part about prognosis is not representative for Down's syndrome and should be redone
The first paragraph under Prognosis:

Between 5 and 15% of children with Down syndrome in Sweden attend regular school.[106] Some graduate from high school; however, most do not.[16] Of those with intellectual disability in the United States who attended high school about 40% graduated.[107] Many learn to read and write and some are able to do paid work.[16] In adulthood about 20% in the United States do paid work in some capacity.[17][108] In Sweden, however, less than 1% have regular jobs.[106] Many are able to live semi-independently,[11] but they often require help with financial, medical, and legal matters.[8] Those with mosaic Down syndrome usually have better outcomes.[60]

Why are statistics from Sweden used? Sweden does not keep statistics on people with Down Syndrome. The whole basis for the Swedish statistics is one single source (from 2006), and that single citation sources its content from the Swedish Down's Syndrome Association. I tried looking for another source without avail, so I chose to go with the facts presented by the Swedish Down Syndrome Association (SDSA from here on out). First of all, let's get one thing clear: this source is full of inherent bias. The data used has been collected by the association sending out surveys to parents who seem to have some connection to the SDSA, e.g. membership. Translated from the third page of the report: "No conclusions about school in relation to all children with Down's Syndrome can be drawn, because the answers presented are not the result of a randomised survey. 

Here is some background on how the educational system of Sweden looks like in regards to Down's Syndrome Article on the Swedish Special schools [in Swedish ]

- Basically: Sweden has until recently encouraged children with Down's Syndrome to attend special schools. This is why few children with Down's Syndrome attend regular school.

- What is a Swedish special school? The school that I'm referring to has the same content and courses as a regular school would, but it has more resources available and teachers trained in special needs. Special school does not mean that the children are to learn less content.

- Translated quote from the article: "Jan Björklund (previous Swedish Minister of Education) claims that the integration of children with intellectual disabilities is a nice thought that doesn't work – but in other parts of the world it works perfectly, says Judith Timoney."

- This isn't a discussion of whether the Swedish way of doing it is right or not, however. It's clear that the Swedish way of offering education to children with Down's Syndrome is very different from the US way.

- But this has changed in recent years. In the last few years, attempts have been made to integrate these children further. This can be noticed in the statistics on page 6, where you'll see that the regular school attendees has gone up from 15% in 2008-09 to 26% in 2012-13, a number that has probably risen further if current statistics were even available.

" The number of 5-15%"

- Considering that the source used for this number is from 2006, and that it cites SDSA, I'm assuming that this number is 1) based on statistics that are dubious at best and 2) extremely outdated, as evidenced by the updated statistics in my linked report where numbers reach 26%.

"The number of 40%"

- The statistic is for people with intellectual disabilities. Why is it in this paragraph? In what way does it contrast the statistic of Sweden, and why aren't we provided more background or context to get an idea of what the number for people with Down's Syndrome is? I have no idea how big or small the subset of Down's Syndrome people is.

"Some graduate from high school; however, most do not."

- The source here is this book, p. 222 second paragraph. The author seems to cite p. 175 of a book. Problem is, there's no implication nor explication that this is in reference to Sweden. Searching the book for "Sweden", the country does show up three pages later. There seems to be no correlation between that Sweden and the "most do not" from page 222.

- I don't know the exact numbers of graduates from Swedish High School. What I do know is that according to this report, also from SDSA, a whooping 8 people talk about their positive experiences in Swedish special high schools. There is no statistic about how many graduated.

"In adulthood about 20% in the United States do paid work in some capacity.[17][108] In Sweden, however, less than 1% have regular jobs.[106]"

Let's look at the phrasing here. In the US example, you're talking about paid work in some capacity. In the next sentence, we see the word "however", a word often used to contradict or contrast the words that preceded it.

1) those two statements barely relate at all. "work in some capacity" could and likely does include "irregular" jobs, whereas we're comparing with Sweden's regular jobs. I have no idea what constitutes "work in some capacity" and what constitutes "regular jobs", but it's obvious this is not a fair comparison. Furthermore, while I don't know what the figures look like, I know that the disability laws in Sweden provide plenty of assistance to find jobs for people with Down's Syndrome. If they don't find a job, they're legally entitled to either take courses or participate in daily activities. While it may not be regular employment, it is a gross misrepresentation to use the 1% figure as if to claim that 99% of them are sitting at home on the couch. 2) there's no source for the 1% figure.

I don't see the point

Why would you ever think that it would be a good idea to mention Sweden in this context? With the lack of sources, the inconsistency in comparison, and the misleading figures, I don't understand how someone could waste time on typing that up. Sweden and the US differ a lot. With one being a welfare state, and the other probably requiring you to work or you'd end up on the street as a person with Down Syndrome, I don't understand what there is to gain in comparing the two. I definitely don't see the point in comparing them in the prognosis section of Down Syndrome.

I'm not going to request to delete the paragraph yet because I'd prefer a discussion, and my motivation for putting this much time into it is that it is after all an ex-featured and currently good article. Especially considering this information has been here for 4 years. — Preceding unsigned comment added by Ommar365 (talk • contribs) 17:01, 26 July 2018 (UTC)

Change title of "Neurological" subsection to "Cognitive"
The subheading "neurological", in the "signs and symptoms" section, should be changed to "cognitive", because it doesn't mention anything neurological (i.e., brain structure). It talks entirely about cognitive issues. 2A00:23C4:C100:BF00:FCAD:AA8:4984:9DF (talk) 19:04, 10 September 2018 (UTC)

Human specificity
The article should mention at the beginning it's a human disease. Some may argue its human specificity follows from the fact that it's related to a chromosome, but this might not be evident for laypersons. Also, analogues in other species (such as chimpanzee 22 trisomy) could be mentioned in a section. 189.203.28.238 (talk) 22:48, 14 September 2018 (UTC)

Semi-protected edit request on 14 December 2018
Change picture, "A boy with Down syndrome assembling a bookcase." The boy is holding drill incorrectly--right hand is holding the spinning chuck. 122.53.154.132 (talk) 09:04, 14 December 2018 (UTC)
 * ❌. The text is fine. It is clear that he is in the process of assembling the bookcase. He is presumably guiding the drill into place before removing his guide hand and then pulling the trigger. You can see that his finger is not on the trigger. – Jonesey95 (talk) 11:29, 14 December 2018 (UTC)

Grammar Check
There is a an obvious error in the following sentence. Due to his perception that children with Down syndrome shared facial similarities with those of Blumenbach's Mongolian race, John Langdon Down used the term "mongoloid".[62][129]

'his' needs correction SethisintheHouse (talk) 13:28, 13 April 2019 (UTC)
 * I do not see any error. Ruslik_ Zero 20:50, 13 April 2019 (UTC)


 * It's wrong because it's unnecessarily structured as a dependent sentence using "his" in the dependent clause to refer to John Down before we even know what the sentence is about. Blumenbach is not really necessary as a reference. Also we need not be vague about what it was in the face that John Down saw that led to the term. — Preceding unsigned comment added by Saffloped (talk • contribs) 15:54, 15 August 2019 (UTC)

Addition of Granno et al (2019) and Sullivan et al (2016)
Please note that this addition is NOT self-promotion. Down Syndrome is my prime field of expertise in research and I feel these two recent studies (peer-reviewed and published in reputable journals) are worthy of mention and very relevant to Down syndrome. Please assess them on the basis of their quality before removing. I have spend over half a decade studying this condition so I would appreciate not being written off as simply self-promoting myself. After all these studies are very relevant and I believe their mention to be appropriate, or at least worthy of honest debate. Thank you

Semi-protected edit request on 12 June 2019
Change "Down syndrome (DS or DNS), also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21"

For "Down syndrome (DS or DNS), also known as trisomy 21, is a human genetic disorder caused by the presence of all or part of a third copy of chromosome 21" 187.189.84.110 (talk) 02:13, 12 June 2019 (UTC)
 * Yes check.svg Done NiciVampire<b style="color:black">Heart</b> 21:07, 12 June 2019 (UTC)


 * It can also occur in other animals per the article so reverting. Doc James  (talk · contribs · email) 02:30, 14 June 2019 (UTC)
 * Huh, I completely missed the Other animals section the first time around. Thanks for catching that! <b style="color:black">Nici</b><b style="color:purple">Vampire</b><b style="color:black">Heart</b> 12:26, 14 June 2019 (UTC)

Semi-protected edit request on 4 September 2019
Fefedefeq (talk) 08:23, 4 September 2019 (UTC) To avoid ambiguity, the last title says "Other animals", then the text says "Down syndrome may also occur in animals". I suggest the title to be "In other animals", and the next text to say "Down syndrome may also occur in other animals"
 * Yes check.svg Done I tweaked your wording a bit, but humans are animals too. &#8209;&#8209; El Hef  ( Meep? ) 19:45, 4 September 2019 (UTC)
 * "Other animals" is the heading we use in hundreds of articles and is suggested per Manual_of_Style/Medicine-related_articles Doc James  (talk · contribs · email) 10:45, 5 September 2019 (UTC)

Testing
"If Down syndrome occurs in one in 500 pregnancies and the test used has a 5% false-positive rate, this means, of 26 women who test positive on screening, only one will have Down syndrome confirmed. If the screening test has a 2% false-positive rate, this means one of eleven who test positive on screening have a fetus with DS. "

So basically you test 500 pregnancies. In reality 499 have no DS and one has DS.

Of the 500 tests 5% are falsely positive which is 25 women. One is truly positive.

The rate in a population is critical when looking at false positive tests.

Please see Doc James  (talk · contribs · email) 10:57, 5 January 2020 (UTC)

Changing image in infobox
I'm proposing that the image in the infobox should be changed. The current image of the boy assembling the bookcase doesn't show much about the characteristics of the condition. The image from the CDC displaying the facial features of Down syndrome seems to gives more incite into the condition, therefore should be put in the infobox. - Iamreallygoodatcheckers (talk) 02:00, 25 January 2020 (UTC)
 * Yah not unreasonable. Doc James  (talk · contribs · email) 01:38, 20 February 2020 (UTC)

's
There are hundreds of diseases that can be written with and without the "'s". This minor variation can go in the infobox and be discussed in the body of the text. Does not need to go in the first sentence. Doc James (talk · contribs · email) 01:39, 20 February 2020 (UTC)
 * The UK name for "Down syndrome" is "Down's syndrome". It is quite different and should be mentioned in the first sentence. Alternate names used commonly always go in the first sentence. It is quite apparent that you, a North American, are trying to bury the UK name. Jenny Jankel (talk) 11:49, 20 February 2020 (UTC)
 * No this is not a UK, US thing. It is simple a possessive versus none possessive thing. Both countries use both.
 * The document from the UK also uses "Down syndrome" here  Doc James  (talk · contribs · email) 19:43, 20 February 2020 (UTC)
 * This is very much a US/UK thing. The difference between "Down's" and "Down" is not a "minor variation", but a completely different way of expressing the condition.  It may be a minor spelling difference, but not in expression.  It is the name of a condition, the name does not have to conform to grammatical rules because it's a noun which can take any necessary form given to it.  I doubt anybody has taken issue with the username "Doc James" demanding that you change it to "Doctor James" because they don't like the contraction.  This is essentially the same thing.  A name can be anything you want, and although it is correct to be non-possessive that doesn't automatically make it incorrect to include the possessive.  I like to think that the UK is inclusive and accepts that "Down" is used by other countries, but I fear it's not an inclusion shared by many other countries - by which I mean predominantly the US, many of whom are rabid about "Down's" being incorrect, usually backed up by a link to the relevant section of the (American) NDSS.  The issue is predominantly that John Langdon Down was a British physician, and the work was carried out in England at Normansfield, and "Down's Syndrome" is how it was first described.
 * Incidentally, that booklet is not an NHS exclusive form, but one produced by a 3rd party - Eurofins - in partnership with the NHS. Eurofins is a European company, based in Luxembourg, so cannot be considered a particularly good example.  I'm sure you could find others - don't view such a statement as a challenge to be risen to - I'm just pointing out that it's not as simple as you make it out to be.  Chaheel Riens (talk) 20:47, 20 February 2020 (UTC)
 * Thank you. You worded it better than I could, and you are 100% correct. Jenny Jankel (talk) 01:17, 22 February 2020 (UTC)
 * You have sources that discuss this, with this being the significance of spelling differences between the US and the UK for this condition?
 * Currently what we have is "In 1975, the United States National Institutes of Health (NIH) convened a conference to standardize the naming and recommended replacing the possessive form, "Down's syndrome" with "Down syndrome".[135] However, both the possessive and nonpossessive forms remain in use by the general population.[136]" This is a minor spelling variation. Not all minor variations belong in the first sentence. They can also be discussed in the body.
 * We have dozens of conditions like this for example Parkinson's disease and we do not include the non possessive in first sentence of the lead. Doc James  (talk · contribs · email) 00:11, 26 February 2020 (UTC)
 * agree w/ Doc James on this point--Ozzie10aaaa (talk) 00:25, 26 February 2020 (UTC)
 * That doesn't mean much, since you and Doc James have a history. Jenny Jankel (talk) 13:52, 26 February 2020 (UTC)
 * Yes User:Jenny Jankel we have a history of being the two most prolific medical editors on English Wikipedia. Doc James  (talk · contribs · email) 17:39, 29 February 2020 (UTC)
 * It's a bad thing for Wikipedia when its most prolific editors suffer from blatant national bias. Jenny Jankel (talk) 20:12, 29 February 2020 (UTC)
 * I think it's noteworthy that many authoritative sources have dropped the possessive form and deem it incorrect in contrast to the "it's a name" arguments made above (e.g., we don't say Nobel's prize, we say the Nobel prize). The AMA Style manual doesn't use it (used by the very high impact journal JAMA). Neither do Dorland's Dictionary, the National Down Syndrome Society, OMIM, the Council of Scientific Editors (granted, these are mainly United States based organizations), and the World Health Organization (international). Personally, I don't think it's particularly relevant where the person used for the eponym is from when determining how to properly use eponyms. That could lead to a lot of confusion since eponyms for diseases come from all over the world and they may all have differing opinions on the matter. I would definitely advocate for consistency. TylerDurden8823 (talk) 00:35, 26 February 2020 (UTC)
 * Parkinson's disease is known primarily as such throughout the Anglosphere. Down syndrome is not. It may well be "Down syndrome" in several countries, but the primary title used in the UK is "Down's syndrome", as evidenced by the NHS website, the Down's Syndrome Association, Mencap, BBC, and just about any other British reliable source. The evidence is clear that the UK primarily uses the term "Down's syndrome", and as such, this alternative title needs to be offered in the first sentence. Jenny Jankel (talk) 13:50, 26 February 2020 (UTC)

"(granted, these are mainly United States based organizations)" - that's precisely the point. You are using US sources to explain why the usage of a country that is not the US should not be included in the lede. I don't doubt that the US calls it something else - as do many other countries, but the UK categorically calls it "Down's Syndrome". The argument used against inclusion was that it is a "minor variation", which is patronisingly dismissive.

It is being asked that "Down's Syndrome" be included in the lede as a valid and commonly used alternative to "Down Syndrome" - the argument for this is that an entire country primarily uses the term "Down's" rather than "Down" and that the claim of it being a "minor variation" is inaccurate.

The argument seems to rest on the repetition of the term "minor variation" - it is minor only in the loss of two characters, but the representation and context of those two characters is not minor. If this is a valid argument, why do we include both "DS" and "DNS" in the lede - surely you can't get much more minor variations than those two? Why can't one variation suffice?

There is no request that the term "Down's" replaces, or takes precedence over any other term, just that it is included as an "DS, DNS or Down's Syndrome". There is no loss to the article, only inclusion. The above arguments even support the usage of the term even while calling it incorrect, or deprecated. That may be so - but it is still a commonly used term.


 * Down's Syndrome UK website
 * BBC news reports on Down's Syndrome
 * NHS page on Down's Syndrome

I wonder if this is how the Hells Angels feel when people ask them about their apostrophe. Chaheel Riens (talk) 21:16, 26 February 2020 (UTC)
 * Additional - I've just realised we've been going about this all wrong. This is a national variation exclusive to a country, and therefore comes under WP:ENGVAR, and also MOS:LEADALT for an alternate name.  Whilst Engvar doesn't specifically cover the issue, Leadalt does say "significant alternative names for the topic should be mentioned in the article, usually in the first sentence or paragraph"  There are many articles where this is done (as per MOS,) so I see no argument as to why the same cannot be done here:


 * Model (person)
 * Harry Potter and the Philosopher's Stone
 * Sega Genesis
 * Trousers


 * All are examples where a national variation - sometimes only used by a single country - is included in the lead as an alternative spelling for the article subject. Chaheel Riens (talk) 07:32, 27 February 2020 (UTC)
 * There are lots of minor variations on the name "Down syndrome". The goal is not to put all possible variations in the first sentence.
 * Yes it says "significant alternative names for the topic should be mentioned in the article, usually in the first sentence or paragraph" This is a minor spelling variation. It is in the infobox and discussed in the body of the article.
 * Three oppose its addition to the first sentence well two support. Doc James  (talk · contribs · email) 17:40, 29 February 2020 (UTC)
 * That's why I used the qualified mainly, note that the WHO dropped the 's. That's very noteworthy and an international organization. It feels like that part of my post was conveniently discounted. I also note Down Syndrome International (based in the UK, I might add) . TylerDurden8823 (talk) 17:47, 29 February 2020 (UTC)
 * No, there are not lots of minor variations of Down's Syndrome. Apart from "DNS" and "DS" which are minor variations of themselves, but you seem to have no issue with both being in the lead.  I'll also add that "Down's Syndrome" after a cursory search seems to be far more commonplace than "Trisomy 21".  And as has been stressed, this is not a minor variation anyway, this is a national variation.  The fact that it is a minor spelling change is not the issue, the issue - that is also conveniently discounted - is that this is the spelling for an entire nation.  It may appear minor, but the context is major.  "Aluminum" and "Aluminium" only have a single character difference - due to a national difference, but both variations are included in the lede.  Also color and colour, "neighbourhood" and "neighborhood", etc,  I think this should be taken to DR.  Just as one side is being accused of "conveniently discounting" sections, I feel that the same behaviour is being levelled by those very same accusers as well.
 * There has never been any dispute over who (no pun intended) has or hasn't dropped the 's, only that those who include the 's are not a minor spelling category, but as was realised later on, a national variation, and there is enough significant usage and relevance to include it in the lead, more so than both "DNS" & "DS", and possibly more relevance than "Trisomy 21". Chaheel Riens (talk) 19:10, 29 February 2020 (UTC)
 * It's pretty obvious that Doc James is trying to bury what isn't North American. His argument is almost laughable. There is no precedent to back up his argument and we will keep going in circles if the debate remains here. Jenny Jankel (talk) 20:07, 29 February 2020 (UTC)
 * no one is trying to 'bury' anything, the argument is based on logic--Ozzie10aaaa (talk) 21:58, 29 February 2020 (UTC)
 * Chaheel Riens has very clearly pointed out how there is no logic to Doc James' argument. And you have added nothing to the argument as yet. Jenny Jankel (talk) 22:59, 29 February 2020 (UTC)

Just for the record, there is logic to Doc James' argument, it's just misplaced. His argument is based solely on the fact that there is a minimal spelling difference between "Down Syndrome" and "Down's Syndrome", and that is all that matters. I have agreed that the spelling difference is minor, but that the context is not. The context of the spelling difference falls into the category of a national variation, and that is not a minor matter. (In my above post I have shown many examples of where a minor spelling difference is included in the lede due to national variations. This is not an unknown logical reasoning for inclusion.)  I have pointed out that there are significant national resources to show that "Down's" has major usage, and also that "Down's Syndrome" has a greater common name presence than "Trisomy 21" does, also that we include "DNS" and "DS" in the lede already, one of which logically falls into the minor variation category.

Jenny Jankel also brings up an interesting point - can Doc James (or any other dissenting editor) back up the claim, apart from continual "minor spelling" argument - can you cite policy that says a national variation should be excluded on the grounds of the spelling being too similar to the article subject title? I've given arguments, backed up by policy and precedent, as to why inclusion is not proscribed. Chaheel Riens (talk) 09:17, 1 March 2020 (UTC)
 * We have the FA Parkinson's disease which one can write without the 's. We also have Alzheimer's disease, Crohn's disease, and Huntington's disease which can also be written without 's. The spelling without in each case is in the infobox.
 * If this article was named "Down's syndrome" I would be against adding "Down syndrome" to the first sentence aswell.
 * We should not be trying to put all possible names in the first sentence. Have converted it to a "note" which IMO is still excessive as it is in the infobox. Doc James  (talk · contribs · email) 22:47, 3 March 2020 (UTC)
 * Sorry but the note doesn't suffice, and you have ignored everything that Chaheel Riens and I have said/asked, which sums up this whole conversation. Time to take this higher. Jenny Jankel (talk) 00:28, 4 March 2020 (UTC)
 * I have reverted the change. As stated in the edit summary - just as we don't get to add in "Down's Syndrome" while we're discussing it, you don't get to add in your own preferred version of the article, especially not when there is considerable discussion surrounding it.  If you have a suggestion, that's exactly what you do - you suggest it, rather than implement and assume that all would be happy with it.  I'm surprised that an experienced editor would make such an arrogant and obviously contentious edit.  I appreciate that Jenny has seemingly done the same thing, but she only has 110 edits to her name, and there had been no response since 29th February even though you've made multiple edits since then, so it's not as though you've been away.  I would have personally waited a few more days, before assuming you'd dropped out, but hey ho.
 * Your examples are not good ones - searching for any of them brings back no individual results, and you are as usual ignoring the primary reason for change - that this is a national usage, and one that garners considerable use - more usage than one of the existing entries, and although it's hard to quantify, probably more than "DNS" and "DS" as well.
 * Your examples are not good ones - searching for any of them brings back no individual results, and you are as usual ignoring the primary reason for change - that this is a national usage, and one that garners considerable use - more usage than one of the existing entries, and although it's hard to quantify, probably more than "DNS" and "DS" as well.
 * You'll see that I've duplicated the above section. This is because - as Jenny notes - you're ignoring it, and have refused to address it.  Once again, for the record, please can you cite policy that says a national variation should be excluded on the grounds of the spelling being too similar to the article subject title?  I've given arguments, backed up by policy and precedent, as to why inclusion is not proscribed.
 * Oh look - that's three times I've asked the same thing - if you're unable to respond to these particular arguments it would seem reasonable to assume that there is no valid criteria for exclusion. Don't bother to simply state "it's a minor variation and I'm against adding in all names" because I've already explained - backed up by policy - why this is not applicable.
 * This is not a minor spelling variation - or at least if it is, then it is one that has enough use to elevate it out of the minor spelling context. Chaheel Riens (talk) 03:38, 4 March 2020 (UTC)
 * I have no issue with you undoing it. I actually do not think it is really needed.
 * We have "When this title is a name, significant alternative names for the topic should be mentioned in the article, usually in the first sentence or paragraph. If there are three or more alternative names – including alternative spellings, longer or shorter forms, historic names, and significant names in other languages – or there is something notable about the names themselves, a separate name section is recommended."
 * So we mention "trisomy 21" and the abbreviation "DS" in the first sentence. We than have a section on the other names in the body of the article. There is no mandate that all names must occur in the first sentence.
 * Here it goes on to say "The editor needs to balance the desire to maximize the information available to the reader with the need to maintain readability." Doc James  (talk · contribs · email) 03:53, 4 March 2020 (UTC)

Well, given the similarity, yet contextual difference between the names, I think readability is better maintained by including "Down's Syndrome" in the lede.

Proposal
I propose that the lede is changed from the current to read:

Down syndrome, also known as D(N)S or Down's Syndrome, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21....

The reasoning for this is all above, but to summarise:
 * Down's Syndrome is a national variation, not just a simple spelling variation. Given the similarity between the two, and the national usage by an entire country, it is important to clarify the alternative usage in the lede as soon as possible.  Multiple examples have been provided to show that national variations are clarified in the lede.
 * There is no need to specify both "DS" and "DNS" in the first sentence - one is quite obviously a minor spelling variation of the other. I would be amenable to either "DS" or "DNS"
 * "Down's Syndrome" has a greater common usage and Google return than "Trisomy 21", and is a more relevant entry in the lede.
 * Removing the lesser-used "Trisomy 21" and one of the "D(N)S" entries will meet your criteria of not naming all forms in the lede.

As you point out, all other names are included elsewhere, so there is no reason not to remove "Trisomy 21" and replace it with "Down's Syndrome" - this would meet everybody's criteria. We get "Down's Syndrome", and you get only a couple of examples - less than current in fact - in the lede sentence. Chaheel Riens (talk) 07:56, 4 March 2020 (UTC)
 * I support this proposal, while suggesting that is equally effective. Jenny Jankel (talk) 10:44, 4 March 2020 (UTC)
 * I support this proposal. Rabascius (talk) 23:00, 10 March 2020 (UTC)
 * No dissenting opinion or argument after a week - and three supports (myself included), so I'm making the change. Chaheel Riens (talk) 10:37, 11 March 2020 (UTC)


 * Oppose It is fine as "Down syndrome (DS or DNS), also known as trisomy 21," trisomy 21 is actually significantly different than Down syndrome. Also would be useful to ping the other people involved User:Ozzie10aaaa Doc James  (talk · contribs · email) 02:05, 12 March 2020 (UTC)
 * You had a full week to make comments here, and managed to make your views known without being pinged before. You may now discuss why it should be changed from the current article to your preferred version.  Chaheel Riens (talk) 10:52, 12 March 2020 (UTC)
 * No one calls it "D(N)S" or writes that ever. Trisomy 21 is actually significantly different not just a minor spelling difference. Doc James  (talk · contribs · email) 15:03, 12 March 2020 (UTC)
 * The proposal was that it could be listed as "DS" or "DNS" - hence "D(N)S" as a description only. You'll note that "D(N)S" was not one of the listing in the actual article.  This should be clear from the proposal, the examples, and the actual implementation.  Trsiomy may be a different cause, but the end result is still the same, and it still has less usage than "Down's syndrome".  It is a less common usage of the term.  Chaheel Riens (talk) 15:33, 12 March 2020 (UTC)
 * No idea what you mean by "Trsiomy may be a different cause" Doc James  (talk · contribs · email) 16:30, 12 March 2020 (UTC)
 * Just to add, James, that your modus operandi of editing the article and ignoring the talk page until the main article is reverted, is not going to help anyone. You clearly think that method will make your opposition disappear or forget. It won't. Jenny Jankel (talk) 16:48, 12 March 2020 (UTC)
 * No I could care less about the typo. I make plenty myself. I have no idea what you mean by "Trsiomy may be a different cause" even if you were to spell it correctly. Doc James  (talk · contribs · email) 17:26, 14 March 2020 (UTC)


 * oppose per Doc James rationale--Ozzie10aaaa (talk) 16:10, 12 March 2020 (UTC)
 * Yes, we've already established that you and Doc James are best buds. If you could ever actually produce your own rationale, maybe that would help. Jenny Jankel (talk) 16:51, 12 March 2020 (UTC)
 * you may want to look at Assume_good_faith--Ozzie10aaaa (talk) 16:57, 12 March 2020 (UTC)
 * Doc James, if you are genuinely trying to mock a typo where I miss-spell "Trisomy" as "Trsiomy" then that reflects very poorly on you indeed - if the best you can do to defend your position is to belittle a typo, then you are obviously grasping at straws to support your stance, and on very shaky ground. The alternative is that you haven't read the article, which is also not a great way to argue your point.  Which is it?
 * You also seemed to be unable to grasp the meaning of "D(N)S", despite both meaning and implementation being clear in the article. There was no need to ponder the usage and say that nobody uses that form when it wasn't even used in the article.  I have to assume that once again you are just using it as an argument against implementation, or as a tool for distraction, despite nobody actually suggesting that usage.
 * The point - that you have consistently ignored - is that Down's syndrome is not a minor variation, but a regional difference. It is also in greater usage than Trisomy 21.  Both "DS" and "DNS" are listed in the lede.  All these issues you have not addressed.
 * After I made the proposal which you would have been alerted to on your talk page, two other editors also commented - both of which would also have been highlighted on your watchlist. You managed to comment enough on the previous discussion without ping, so don't lay the blame for your inaction at our feet there.  A week is a long time for discussion - long enough for you to make literally hundreds of edits on Wikipedia elsewhere, so you have not exactly been idle or away from the project.
 * Rather than simply reiterating the comment "minor variation", or feigning ignorance over blatantly obvious typos and semantics - please address the other arguments brought up. Chaheel Riens (talk) 17:58, 12 March 2020 (UTC)


 * Oppose per Doc James. Flyer22 Frozen (talk) 04:02, 13 March 2020 (UTC)
 * It's all well and good people saying "oppose as per Doc James", but none of this addresses the fact that Doc James, and by proxy all others are not discussing the argument that "Down's syndrome" is not a minor variation, but a national variation - and it is accepted practice to include national variations in the lede - "Aluminium", color, and neighbourhood for example.
 * Also Doc James has consistently ignored any arguments put forward, simply responding with "better before", feigning ignorance or mockery. None of these are rational arguments or address the poitns raised.
 * None of the proposals put forward by myself have actually been addressed.
 * You'll note that I'm repeating myself somewhat - that's because the points I raise have not been answered. Chaheel Riens (talk) 07:33, 13 March 2020 (UTC)
 * It is a minor spelling difference. It is not a completely different name. It is in the infobox and the 's is discussed in the body of the article. Not everything needs to be pushed into the first sentence of the article. The argument over how to spell the disease is minor and trying to put it in the first sentence is WP:UNDUE. Doc James  (talk · contribs · email) 17:24, 14 March 2020 (UTC)
 * It's not WP:UNDUE, in the sense of "giving undue weight to a viewpoint", to include one of the two commonly used names for DS in the first sentence. And it's hardly true that "the 's is discussed in the body of the article". The only time "Down's" is mentioned in the article is in reference to the NIH's 1975 recommendation to use "Down", which is kind of begging the question. There is no mention of the fact that DS was previously universally known as "Down's syndrome". It's almost as though the article is trying to suppress it. And while the very next sentence of the article refers to "forms" of the name, the relevant citation (136) treats them not as different forms but as different terms. More importantly, it mentions that "both remain in use by the general population", with "Down's syndrome" being "more commonly used in the UK". The latter form is also current in several other countries, as evidenced by the names of their national DS associations and societies; while even in the US the NDSS admits, in its preferred language guide, that both spellings are "popular". Which is surely the strongest reason for including both names in the lead: it's not our job to decide what name should be used, or which of two names is more "correct", our job is to reflect common usage, and common usage is split, depending on where you are and who you talk to. Lastly, consider this: multiple editors have suggested adding "also known as Down's syndrome" to the first sentence because they feel, for whatever reason, that it ought to be there. In other words a plurality of editors consider that this addition would be an improvement. Unless someone can offer a convincing argument as to why the proposed addition would have the opposite effect (and by convincing I mean something more than simply saying "we can't include all names/variants/spellings", which no one is suggesting and in any case we all know that there are in fact only two names, which is what this is about), then surely action ought to trump inertia. How can it be better to do nothing than to do something? Or do we imagine the article to be perfect as it is? Surely not. Rabascius (talk) 02:46, 15 March 2020 (UTC)


 * Once again, you're still ignoring that fact that this minor spelling difference is - like Aluminum, Colour or Encyclopaedia - a national difference, and as such has a place in the lede. The argument is not how to spell the condition, but that "Down's syndrome" has such widespread use - to the extent that it is more common than Trisomy 21 - that inclusion in the lede is justified.
 * Rabascius also brings up a good point - in what way does including "Down's syndrome" and removing "DNS" and "Trisomy 21" make the article worse? You used the edit summary of "was better before" suggesting you think this to be the case, but why?  Chaheel Riens (talk) 08:06, 15 March 2020 (UTC)\
 * It is in the lead. It is in the infobox. Doc James  (talk · contribs · email) 01:04, 20 March 2020 (UTC)

Not what is meant, and you know it. However, I'll play your game: If you consider the infobox to be the lede then what's the difference between changing its position in the lede from infobox to first sentence? If you consider both to be the lede then you should have no problem with that. But you are once again distracting from the point which is you have not answered the questions raised in the original proposal: Why does the proposed change make the article worse, and why should a national variation not be listed in the very first sentence as it is on other articles? Chaheel Riens (talk) 06:54, 20 March 2020 (UTC)
 * , could you tone it down a few notches please? This is an editorial discussion about where best to present information in an encyclopedia article, it's not something to get angry about. I see Doc James being quite measured in his responses, and you increasingly turning this into a WP:BATTLEGROUND. Accusing him of playing games assumes bad faith - that isn't a road you want to go down. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  07:36, 20 March 2020 (UTC)
 * I see nothing to tone down. If you read through the discussion you'll see it to be an accurate representation of the discussion so far.  I'm not angry, merely trying to get a response to my questions and proposals from Doc James.  In all of the above I have asked the same question many times, and Doc has refused to answer it, using distraction and digression as a common technique to do so.  Do you not agree that so far my questions of "why do the proposed changes make the article worse, and why should a national variation not be listed in the very first sentence as it is on other articles?" have not been answered?  Chaheel Riens (talk) 08:07, 20 March 2020 (UTC)
 * , Doc James isn't under any obligation to answer your questions, which could be described as a rhetorical device of your own. You've expressed your view, he's expressed his - you can leave it at that. Seriously though, saying that he is playing games is a personal attack, and the number and length of your posts risks opening you up to an accusation of bludgeoning this discussion. As an uninvolved administrator, I'm advising you to cool it. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  08:30, 20 March 2020 (UTC)
 * Hang on, you're saying that there is no obligation to answer a proposal for inclusion into the article? Please explain what you mean by "rhetorical device"?  If the question and answer is so obvious as to be rhetorical, does that not then support the change?
 * Bludgeon states: "Bludgeoning the process is where someone attempts to force their point of view by the sheer volume of comments, such as contradicting every viewpoint that is different from their own. Typically, this means making the same argument over and over, to different people".  I have made one comment to the same editor and only because a response has not been forthcoming.  You're correct that an answer is not obligated, but this but a request for a response to a very specific and explicit reason behind the proposal, it seems reasonable that a response opposing it should be expected.
 * I shall take my proposal to DR then, which I suppose should have been done a while ago. Chaheel Riens (talk) 10:18, 20 March 2020 (UTC)
 * , this is a request for comment. The idea is that lots of editors will come along, read the discussion so far, and give their opinion. So far, you have replied to every person who has expressed an opinion counter to yours - and you've responded to Doc James multiple times, that's what I'm talking about with the bludgeoning. He's not obliged to answer any question if yours, but whoever closes this RFC will weigh the strengths of your arguments against those of his when determining the consensus. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  14:08, 20 March 2020 (UTC)
 * Doc James may not be required to answer questions, but his failure to do so, when those questions are fundamental to the outcome here, does dismantle his argument. Jenny Jankel (talk) 22:52, 20 March 2020 (UTC)

First of all, happy World Down Syndrome Day everyone! I think it might be useful to take a look back at the history of this article and remind ourselves what it is that we're discussing here. Just to be clear, the debate is NOT about what the article should be called. There was some discussion way back in 2002 over whether it should be at "Down's syndrome" or "Down syndrome" but this was inconclusive and it remained at "Down syndrome". Since then, the lead has always included the words "or Down's syndrome" (or a similar formulation such as "also known as Down's syndrome" – more on this later), except during a brief period that lasted from 1 September 2005 until 24 November 2005. The article continued to improve and grow over the years but the lead remained stable, at least as far as the inclusion of both names is concerned. Until 4 March 2016, that is, when Doc James  removed the words "or Down's syndrome" with this revision. We don't know what prompted the revision because he omitted to include an edit summary. Since the removal of "or Down's syndrome", a number of editors have attempted to restore it (perhaps in order to bring Wikipedia back into line with such publications as the Encyclopaedia Britannica, the American Heritage Dictionary of the English Language, Oxford Dictionaries, Merriam-Webster, and so on, all of which include "or Down's syndrome" or "or Down syndrome" as the case may be). What happened next?
 * On 13 May 2016 Royalcourtier restores "or Down's syndrome" and is promptly reverted by Doc James  on the grounds that the term is In the infobox (of course it is: it was put there by Doc James on 4 March 2016 moments after removing the restored "or Down's syndrome").
 * On 29 September 2016 GhostOfNoMeme restores "or Down's syndrome" and is reverted the next day by Doc James  on the grounds in the infobox already.
 * On 1 December 2016 Picapica restores "or Down's syndrome" and is immediately reverted by Doc James  because it's In the infobox.
 * On 14 December 2016 NotThatAnonymous gives it a whirl and is reverted mere hours later by Doc James  on the grounds In the infobox which is enough.
 * On 12 February 2017 NotThatAnonymous suggests that The synonyms should be mentioned first, even though they are in the infobox but is reverted a day later by Doc James  using the (disingenuous?) edit summary moved minor spelling differences to the infobox.
 * On 20 July 2018 Hippo43 restores "or Down's syndrome", with the edit summary alternative name in lead and is reverted the next day by Doc James  with a terse in the infobox.
 * On 16 November 2018 Necrothesp points out that Down's syndrome is still the common name in the UK for starters and is reverted the next day by Doc James  with a reluctant-to-engage minor spelling variation moved to infobox.
 * On 2 March 2019 FatherStack "fixes the grammar" by changing "Down" to "Down's" throughout and is understandably reverted by Doc James, who suggests quite rightly that such a change Needs consensus.
 * On 20 February 2020 Jenny Jankel adds "or Down's syndrome (UK)" after "also known as" and is reverted five hours later by Doc James  with the somewhat dismissive minor spelling variations can go in the infobox. Jenny Jankel follows up with that's not a minor spelling difference. it's a significant difference between the US and UK names and is told by  Doc James  that It is a simple "'s", not important enough to be placed in the first sentence, in the infobox and body (that bit about "in the body" is not strictly true, as we will see).

At this point the discussion switches to the talk page, where it has pretty much stalled because what seems to be happening is that those in favour of having the wording of the lead reflect actual usage in English, which is what Wikipedia is supposed to do, by which I mean, in case it isn't clear, having it include both of the two commonly used names for DS, just as the article has done for most of its life and just as reliable sources throughout the Anglosphere continue to do, are being stonewalled by the same user who made the unilateral change, without obtaining (or even seeking) consensus, in the first place! Let's have a look at the arguments against having the lead reflect actual, current usage in English: And the arguments for including "or Down's syndrome" in the lead sentence? There's only one:
 * Fait accompli: "it's in the infobox". Ignoring the fact that it's only in the infobox because Doc James put it there, at the same time as he was deleting it from the lead, MOS:INFOBOXPURPOSE states that the purpose of an infobox is "to summarize (and not supplant) key facts that appear in the article (an article should remain complete with its summary infobox ignored)." This requirement is not satisfied if "Down's syndrome" does not appear in the article (and it doesn't, except in the section on how some people decided to stop using it! There is no mention at all of the fact that before the NIH recommended "Down syndrome" everyone was calling it "Down's syndrome" (I mean, you can't recommend changing a name to something without changing it from something, can you?), or of the fact that in a bunch of countries around the world people are still calling it Down's syndrome (except when they're calling it "Down syndrome" because people are like that: inconsistent. Real world usage, remember), and even using it in scholarly papers (such as here, here , or here ).
 * Minor variation/spelling variation. Leaving aside the fact that if either of the two commonly used names for DS is a variation, it is surely the more recent name that is a variation of the older name, not the other way round (but let's not split hairs), there is nothing in Wikipedia policy that says that variations should not appear in the lead. Quite the opposite, WP:ENGVAR and MOS:LEADALT specifically provide for this.
 * The 's is discussed in the body of the article. No, it really isn't! And even if it were, what could such a discussion consist of except to say that some people recommend using "Down syndrome" and some other people continue to use "Down's syndrome" regardless? And how would that justify eliminating one of the two commonly used names for DS from the body of the article?
 * We should not be trying to put all possible names in the first sentence. Sure, but nobody is. There are two commonly used names, "Down syndrome" and "Down's syndrome", plus a commonly used abbreviation, "DS". All these things should appear in the first sentence. Apparently "trisomy 21" is used as a synonym, despite the fact that it should probably really be in a section called "Types of Down syndrome", but since the article is supposed to reflect actual usage on the basis of reliable sources rather than prescribe "correct" usage on the basis of personal preference/bias (because that's how Wikipedia works), perhaps "trisomy 21" needs to stay too. Personally, I'm less sure about the need to include "DNS" in the lead, but maybe that's just me. Even so, we end up with a lead sentence that begins "Down syndrome or Down's syndrome (DS), also known as trisomy 21, is a genetic disorder caused by..." Surely this is clear and readable and accurate? MOS:LEADSENTENCE warns us to "be wary of cluttering the first sentence with a long parenthesis", but this doesn't look very cluttered to me, and that parenthesis is downright short.
 * Three oppose its addition to the first sentence. Isn't this overlooking the fact that restoring "or Down's syndrome" isn't adding anything new, it's restoring something that was already uncontroversially there? And the fact that every time anyone has tried to restore it they've been reverted on fairly spurious grounds?
 * Trying to put it in the first sentence is WP:UNDUE. I mentioned this in a comment further up but was ignored. It's not WP:UNDUE, in the sense of "giving undue weight to a viewpoint", to include both of the two commonly used names for DS in the first sentence. It isn't a "viewpoint" that "Down's syndrome" is a commonly used name, it's fact. Just as "Down syndrome" is a commonly used name. Both deserve equal weight in the lead sentence. Both could serve equally well as the title of the article, as Doc James  concedes when he says: "If this article was named 'Down's syndrome' I would be against adding 'Down syndrome' to the first sentence as well."
 * It's one of the two commonly used names for the subject of the article, as used by two out of three of the world's most read online newspapers; it appears alongside "Down syndrome" in reputable dictionaries and encyclopaedias; it is used alongside "Down syndrome" by the international academic and medical communities; it is used by a variety of national DS societies and associations (and is acknowledged to be "popular" even by those national DS societies that opt to use "Down syndrome"). It isn't a variation or an alternative name, it is one of two names that are widely used around the world, today, right now, by lots of people. DS stands for "Down syndrome or Down's syndrome". The Wikipedia article should reflect that, not relegate one of two equally valid names to the infobox because of personal or professional bias or preference.

Final consideration: if several editors over a considerable period have independently arrived at the conclusion that the lead sentence would benefit from the addition/restoration of "or Down's syndrome" and have duly proceeded to edit the article in that sense, only to see their edit swiftly reverted by a single editor who apparently considers their edit unnecessary (and says so), might it not be appropriate to refamiliarise ourselves with WP:DONTREVERT, in that whatever any particular editor's individual preference happens to be, no one can seriously argue that adding/restoring "or Down's syndrome" actually makes the article worse? Thoughts, Doc James, Chaheel Riens, Jenny Jankel? Rabascius (talk) 02:46, 21 March 2020 (UTC)
 * A bunch of people here disagree that it is needed. It is in the infobox and the body of the text. Doc James  (talk · contribs · email) 04:42, 21 March 2020 (UTC)
 * Doc James: by "a bunch of people here disagree" do you not perhaps mean "Doc James disagrees"? First of all, "Down syndrome" versus "Down's syndrome" is not just a "spelling difference"; there is also, and more importantly, a pronunciation difference too. Above all, it is the fact that -- regardless of anyone's views as to the merits of the United States National Institutes of Health recommendation concerning nomenclature -- "Down's syndrome" is the name by which this condition is not only very commonly but indeed in many parts of the world primarily known, that makes it appropriate to mention the alternative name in the first sentence. What harm is it doing there? I don't think there is any Wikipedia editorial guidance that says that nothing included in the infobox (which is, by and large, a secondary summary) can appear in an article's opening sentence. If there were, then the start of many thousands of articles would require re-writing! -- Picapica (talk) 11:33, 21 March 2020 (UTC)
 * , in this RfC there are currently three 'oppose' !votes opposed to the proposed change, alongside two in favour of it. Feel free to !vote yourself, but there's no need to pour scorn on Doc James for noting that it's not just him who thinks this. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  12:38, 21 March 2020 (UTC)
 * 1) My reading of the contents of this page was that it has consisted very largely of Doc James repeatedly reverting other editors' amendments without ever really addressing why they were making them. That is what made me a little irritated: I do, nevertheless, apologize for the snide tone of my question. 2) I didn't (and still can't) see any mention of any already existing "RfC" concerning this matter. I should also mention (doubtless revealing my ignorance again) that I don't know what a "!vote" is -- which is why I've never cast one. -- Picapica (talk) 16:48, 21 March 2020 (UTC)
 * , yeah, that was my mistake - I saw the !votes above (where people are saying Support or Oppose) and just assumed that this was an RfC - had I read the whole thing from the beginning, I'd have realised that it's just a talk page proposal. Below, I've suggested that the OP starts an RfC, which might be a better way to establish a firm consensus as it would attract more editors, instead of just a few people going back and forth and not making much progress. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  16:55, 21 March 2020 (UTC)
 * Excuse my ignorance, but I can't see this article listed at WP:RFC/A. What am I missing? Jenny Jankel (talk) 12:48, 21 March 2020 (UTC)

Thanks for your efforts. It's pretty clear from the thorough work by Rabascius that there is a problem editor keeping tabs on this page and consistently ignoring consensus or reason. "or Down's syndrome" needs to be restored to the lead. Jenny Jankel (talk) 12:48, 21 March 2020 (UTC)
 * Apologies - it's not a formal RfC, it's just a talk page proposal. The point remains though that there are other editors who have expressed opinions in-line with Doc James's view. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  13:43, 21 March 2020 (UTC)
 * Double apologies - I mistyped your username and that ping will have failed.  Girth Summit <sub style="font-family:script;color:blue;"> (blether)  13:44, 21 March 2020 (UTC)
 * Incorrect tally on the proposal as well - three !votes support and three against not two support and three against. Jenny Jankel hasn't officially !voted, but it's obvious she's a support, which made it four supporting, and it would seem Picapica is supporting the change as well, but also hasn't !voted.  Chaheel Riens (talk) 15:13, 21 March 2020 (UTC)
 * , you are correct that it is three supports if we include yourself as the nominator. I agree with you that Picapica appears to be in support of the proposal as well, and I invited them to say as much. None of which speaks against the actual point I was making, which was that it is incorrect, and also rather rude, to say that Doc James is alone in his stance here - there are indeed a bunch of people who have voiced their agreement. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  15:21, 21 March 2020 (UTC)

Fair point and acknowledged, although I suspect Picapica's point in response is that only Doc James is actively involved in this discussion, and as evidenced by Rabascius's detailed work above, he was also the editor responsible for removing "Down's syndrome" from the article in the first place - and has been active in keeping it out ever since, despite multiple different editors restoring it over a period of some time. Chaheel Riens (talk) 15:31, 21 March 2020 (UTC)
 * , here's a suggestion - why not start a proper RFC? Write two or three alternative opening sentences - the current one, the proposal above, and anything else that seems relevant - and advertise in the standard places. That might establish a strong consensus, and would hopefully put an end to the back and forth here. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  16:00, 21 March 2020 (UTC)
 * Counting votes is meaningless anyway, especially if certain editors show clear bias or have no rationale for their vote. Jenny Jankel (talk) 17:49, 21 March 2020 (UTC)


 * Of course Down's syndrome needs equal weight in the lede with Down syndrome. I don't even know why we're debating this. It's almost like there's a campaign to cut out the usage in many countries around the world because some editors don't like it. -- Necrothesp (talk) 10:10, 23 March 2020 (UTC)
 * Exactly this. It's everything that Wikipedia shouldn't be. Jenny Jankel (talk) 11:00, 23 March 2020 (UTC)
 * No there is an effect not to try to put all details in the first sentence of articles. Down's syndrome is discussed in this article. Doc James  (talk · contribs · email) 20:25, 23 March 2020 (UTC)
 * It is not a detail, Doc James. If this article were named Down's syndrome instead of Down syndrome, you would insist that Down syndrome be mentioned in the lead. Jenny Jankel (talk) 11:56, 11 April 2020 (UTC)

RfC on the first part of the first sentence
<div class="boilerplate archived" style="background-color: #EDEAFF; padding: 0px 10px 0px 10px; border: 1px solid #8779DD;">
 * The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

How should we start the first sentence of this article? Doc James (talk · contribs · email) 20:30, 23 March 2020 (UTC)

Option 1
"Down syndrome (DS or DNS), also known as trisomy 21,"
 * Support The "'s" version is a minor spelling variation. It is in the infobox. It is discussed in the body of the text. We should try to keep the first sentence shorter. We do something similar at Alzheimer's disease and Huntington's disease but with the "'s" version present. Doc James  (talk · contribs · email) 20:30, 23 March 2020 (UTC)
 * support this is obvious --Ozzie10aaaa (talk) 21:39, 23 March 2020 (UTC)


 * Support Whether an article uses British or American English is basically down to chance — and it is totally inappropriate to have both at the same time, whether that be alternating between them, or even worse: listing them in succession. It is bizarre to, as some do below: state that there is no precedent, when clearly precedent has been stated in the cases of Huntington's and Alzheimer's. And no matter how widespread the variation is, it is certainly minor. We WP:Don't vote here, and many of the arguments against option 1 are invalid. Carl Fredrik  talk 18:53, 25 March 2020 (UTC)
 * Just to point out that no one is suggesting mixing British and American English or alternating between them. That isn't what this is about. The issue is the removal of one of two equally valid, commonly used names for the subject of the article from the first sentence (its natural position as per Wikipedia policy, the manual of style and the precedent of countless other articles across the project) and its relegation to the infobox on the questionable grounds that it is a "variation" (when in fact it is the older, better established name). Huntington's and Alzheimer's have nothing to do with it: no one calls it "Huntington disease" (the name doesn't even appear in the article) and no one is trying to replace "Alzheimer's disease" with "Alzheimer disease". As you say yourself, whether an article uses British or American English is basically down to chance, and if we're treating "Down's syndrome" as the British English version (although that's only part of the story – see the discussion above), you will admit that the article could have just as easily ended up (or started out) at "Down's syndrome", and we would now be arguing for the inclusion of "or Down syndrome" in the lead sentence because, and this is the point, both commonly used names are equally valid and should therefore be given equal weight in the lead. The rest of the article would then use the name that appears in the title of the article, as is the case here, or rather was until someone decided, unilaterally and without seeking consensus, to change it. Rabascius (talk) 21:21, 25 March 2020 (UTC)
 * Additional - precedent has also been set that we do include national variations in the lede, it seems standard behavior behaviour. I included some examples in my own reasoning, but here are a few more:  Pants, Braces, Freeway, Motorway and Expressway, Motorbike, Automobile - in fact the list just goes on and on. It would be more of a challenge I suspect to find a national variation that is not included in the lede of the alternative title.  Chaheel Riens (talk) 07:44, 26 March 2020 (UTC)
 * Exactly. Can you find any national variations from the Anglosphere not included in the lead, Carl Fredrik ? Jenny Jankel (talk) 19:57, 26 March 2020 (UTC)


 * Support. It makes sense to me to remain consistent on this type of style across Wikipedia medical articles. I don't see that an exception is needed in this case. No need to ping me if you reply to me. That stated, we do include the American and English spellings in the lead of some Wikipedia articles, which is allowed per WP:ALTERNATIVETITLE, and I haven't seen it be an issue in those cases. Well, not generally. In a case like the Trousers article, that isn't an alternative spelling issue; it's an issue of a very common alternative name, and there is consistent debate about whether to title that article "Pants." We do include alternative names in the lead of our Wikipedia medical articles when warranted. Heart attack is an example. But, again, this particular case is about a spelling difference. Flyer22 Frozen (talk) 00:38, 28 March 2020 (UTC)
 * This is a very common alternative name and national variation that also happens to be a minor spelling difference: Armor, Colour, Aluminum, Aeroplane, Neighbour, Behavior.  Myocardial infarction is not necessarily a good example because it doesn't include a geographical alternative name, which is the context of this discussion, unlike Controlled-access highway which has no less than three different geographic alternatives.
 * Interesting comment about consistency over medical articles. Medicine is not my forte, and I know of very few conditions with different names in the UK and the US:  Infectious mononucleosis which lists both Mono (American) and Glandular Fever (UK and elsewhere).  Diarrhea and Postpartum depression include both US & UK spellings. Although Rubella also lists alternative names, I don't know if they're geographic.  Chaheel Riens (talk) 08:24, 28 March 2020 (UTC)


 * Support Due to points raised by Doc James  Idealigic (talk) 18:41, 10 April 2020 (UTC)
 * Please note the counter-reasons given by Rabascius, Jenny Jankel and even myself above - this is not a minor spelling difference but a national variation which is included in other articles. Moreover it's wrong - we don't differentiate Huntington's without the 's in the article specified. Chaheel Riens (talk) 06:54, 11 April 2020 (UTC)
 * , you shouldn't be responding to every new person who supports this option. None of the people supporting Option 1 are responding to people supporting the other options - that's because there is a 'discussion' section at the bottom of this RfC, which is where discussion is supposed to happen. The 'survey' sections are simply here for people to voice their opinions. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  11:26, 11 April 2020 (UTC)
 * There's nothing in the RFC guidelines that say responses cannot be made just because there is a discussion section as well. In fact, in Separate votes from discussion it specifically states "You can ask people not to add threaded replies to the survey section, although that doesn't always result in good outcomes."  That stipulation hasn't been made.  Chaheel Riens (talk) 12:24, 11 April 2020 (UTC)
 * , indeed - I'm just pointing out that you have literally responded to every person who has expressed an opinion that isn't in agreement with yours, aside from Doc James and Ozzie10aaaa, who you have already discussed this with at length above. Please take a look at WP:BLUDGEON, and consider whether you really need to do this. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  13:00, 11 April 2020 (UTC)
 * The reason no one has responded to the option 2 support is there's no legitimate way to refute the statements. Jenny Jankel (talk) 18:03, 11 April 2020 (UTC)
 * , I don't believe that your statement is correct - I believe the reason that they haven't responded is they are happy to allow other people to express views that don't align with their own without badgering them. To disagree with someone is one thing; to say that there is no legitimate view but your own is something else. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  19:21, 11 April 2020 (UTC)

Option 2
"Down syndrome or Down's syndrome (DS or DNS), also known as trisomy 21,"
 * Support - "Down's syndrome" is not a minor variation, but a national variation, and the original usage still used by a considerbale percentage of the population. "Down's syndrome" has a greater and more common usage than "Trisomy 21", and in order to keep the lead shorter we don't need to list both "DS" and "DNS", or "Trisomy 21".  National variations are listed in the first lede sentence as per Armor, Colour, Aluminum, Sega Megadrive and others.  Chaheel Riens (talk) 04:08, 24 March 2020 (UTC)
 * Support. "Down's syndrome" is the official and most commonly used name in the UK. It is a joke to suggest that because it is similar in spelling to the North American "Down syndrome" it should be relegated to the infobox. There is absolutely no precedent for that, as detailed in the arguments above and below. Jenny Jankel (talk) 00:36, 24 March 2020 (UTC)
 * Support. Down's syndrome is the official and common form in the UK, is also used in other countries and was formerly used pretty much everywhere. It is not a "minor variation". This simply appears to be a case of WP:IDONTLIKEIT from a handful of editors. It is usual to put all common variations bolded in the lede in articles. I really don't know why this even needs a discussion as it is patently obvious. -- Necrothesp (talk) 11:22, 24 March 2020 (UTC)
 * Support ~ Magna19 (talk) 17:48, 24 March 2020 (UTC)
 * Support. The two versions of the name continue to be equally valid, as demonstrated by reliable sources (scientific papers, encyclopaedias, newspaper articles, etc.), which is more important than the preference of individual editors, and in fact the article could just as easily be at Down's syndrome (not being proposed here, but the issue is periodically raised on the article's talk page – see the archives). This in itself should be enough to justify giving equal weight to the two names in the lead sentence, rather than relegating one of them to the infobox. Also, "Down's syndrome" is not "discussed in the body of the article". As has already been pointed out, the only mention of it in the article is in the Name section (towards the end) in connection with the recommendation by the NIH not to use it. This is not balanced by any mention of the fact that various national authorities and associations around the world continue to prefer the genitive (not possessive) form, and is therefore misleading. Omitting "Down's syndrome" from the lead further compounds this misleading impression. Rabascius (talk) 11:48, 25 March 2020 (UTC)
 * Support. This is quite an important difference of use. Somebody in the UK looking up Down's syndrome will invariably go to Wikipedia - to see it listed just as Down syndrome. So since Wikipedia is not supposed to be geographically biased this is clearly a case of avoidable confusion.--Iztwoz (talk) 09:48, 28 March 2020 (UTC)
 * Support Iamreallygoodatcheckers (talk) 09:55, 28 March 2020 (UTC)
 * Support. Patently obvious. --hippo43 (talk) 21:37, 29 March 2020 (UTC)
 * Support to avoid giving the impression that "Down syndrome" is correct but "Down's syndrome" is not correct, which is a reasonable inference for a reader if they see only one term listed in the first sentence. We generally list regional variations for a word regardless of which variation is used throughout the rest of the article, per the lists by Chaheel Riens in replies to Option 1 above. — Bilorv ( talk ) 23:03, 21 April 2020 (UTC)
 * Support current version is neither too long nor difficult to parse. We should make it clear straight away to a reader who's looking up "Down's syndrome" that they're in the right place.  Consistent with MOS:LEADSENTENCE.  Adrian J. Hunter(talk•contribs) 06:57, 22 April 2020 (UTC)

===Option 3=== "Down syndrome, also known as D(N)S or Down's Syndrome, is a genetic disorder..."
 * Support "Down's syndrome" is not a minor variation, but a national variation, and the original usage still used by a considerbale percentage of the population. "Down's syndrome" has a greater and more common usage than "Trisomy 21", and in order to keep the lead shorter we don't need to list both "DS" and "DNS", or "Trisomy 21".  National variations are listed in the first lede sentence as per Armor, Colour, Aluminum, Sega Megadrive and others.  Chaheel Riens (talk) 22:32, 23 March 2020 (UTC)
 * Support but prefer option 2. Jenny Jankel (talk) 00:36, 24 March 2020 (UTC)

Discussion
I have no idea if the national variant claim holds water or not, and I don't feel like wading through the extensive previous discussion to see, but I wanted to point out that there are multiple possible combinations that aren't being considered with the options given. The RfC should probably focus on each question separately:
 * 1) Should "Down's" be given as an alternate name?
 * 2) Should "trisomy 21" be given as an alternate name?
 * 3) Should the DS/DNS abbreviations be given?

For what it's worth, trying to combine the abbreviations as D(N)S is nuts and shouldn't even be considered. DS should be given in the lead because it's being used in the article. However, it probably shouldn't be used in the article – it's a simple two-word phrase that doesn't need to be abbreviated. –Deacon Vorbis (carbon &bull; videos) 03:33, 24 March 2020 (UTC)


 * This is a fair point, and on consideration, my introduction of Option 3 probably dilutes the argument somewhat. I shall strike that option, and leave it at the two original choices.  This, I feel, will give an indication as to whether "Down's syndrome" has the support for inclusion, and while doing so we can establish the actual wording of inclusion here in the discussion section, or talk page in general.
 * Also, there is no intent to combine "DS" and "DNS" as "D(N)S", the intent there - which seemed obvious to me, but apparently was a mistake on my part - was to say that I would be happy with either "DS" or "DNS" in the lede but not both, hence the bracket to show that the "N" was optional depending on the choice made. Chaheel Riens (talk) 04:08, 24 March 2020 (UTC)

I object to restricted option(s) and poll RFCs. That's not the way to work towards consensus. It just leads to "I support so-and-so" votes and people taking adversarial positions. Firstly I think the lead sentence should be easy to read and pronounce. It gets a lot of use not only by our readers on the web, but also by smart devices. So the "D(N)S" thing is very much a non-starter. I've not come across "DNS" in this context before and if I google it, I just get Wikipedia text back at me, so at present I'm not convinced that's a variant we need concern ourselves with. An initialism like "DS" can be mentioned in the lead, particularly if the article uses it. The Trisomy21 term is the overwhelming cause and the question is whether people use it, rightly or wrongly, as a synonym. I suggest consulting high quality literature (NHS, major charities, etc) who haven't lifted the definition from wikipedia, to see whether they consider this important.

As for apostrophes. Well it really is quite simple, and is how all English words transform over time. The "'s" tends to get removed in syndromes because casual pronunciation loses it. The "'s" tends to get kept in diseases because it flows together easily. When we abbreviate the condition by missing out the "syndrome" or "disease", the "'s" magically reappears. So we will say Down's or Alzheimer's and nobody ever says "Jane was born with Down" or "Archibald developed Alzheimer". The "'s" is clearly used by a significant number of careful writers and belongs as a variant in the lead sentence. The reason Alzheimer's doesn't include Alzheimer as a variant is that it is rare, and not because someone won some Wiki argument about variants in the lead. -- Colin°Talk 08:46, 15 April 2020 (UTC)

In terms of main questions rather than free-form options

 * Yes/Yes/No. I'm going with the assumption that "Down's" is relatively common and a national variant. In this case (and I can be swayed still), both versions should be given.  "Trisomy 21" should also be mentioned as a more technical name. The abbreviations are not helpful in the lead, let alone anywhere else.  The usage of "DS" in the article body should be removed for style considerations and to avoid the need to mention in the lead.  –Deacon Vorbis (carbon &bull; videos) 03:40, 24 March 2020 (UTC)
 * User:Deacon Vorbis yah I think it is reasonable to drop the abbreviation either way. There are efforts to 1) move away from possessive forms of disease names 2) naming diseases after people. I imagine the UK will move away from the 's eventually. Doc James  (talk · contribs · email) 21:49, 29 March 2020 (UTC)
 * Why do you imagine that, Doc James? And "efforts" (by whoever) should not affect Wikipedia. Wikipedians should state the facts, not try to create them. Your agenda worries me. Jenny Jankel (talk) 22:17, 29 March 2020 (UTC)
 * I agree about the replacement of "DS" in the article with "Down syndrome", but with regard to the possessive - as per Jenny Jankel and WP:CRYSTALBALL - we'll cover that when it happens, not before. Chaheel Riens (talk) 08:26, 30 March 2020 (UTC)
 * With regard to the national variation - "Down's syndrome" is the preferred term in the UK:
 * https://www.downs-syndrome.org.uk/
 * https://www.nhs.uk/conditions/downs-syndrome/


 * Chaheel Riens (talk) 07:38, 24 March 2020 (UTC)

- I just looked in at this page to see whether the discussion had moved on, to find that you had unexpectedly closed the discussion. Have you looked at Requests_for_comment? It's true that there was a numerical majority in favour of your position, but 10 days is not a long time for an RfC to run, and as someone who !voted in the discussion, and one of the main parties to the content dispute that led to it, I can't see how were in a postion to close it. I think that your closure should be overturned, and the discussion relisted - would you be willing to do that? Girth Summit <sub style="font-family:script;color:blue;"> (blether) 15:49, 9 April 2020 (UTC)
 * No, I see no reason for that. It wasn't just a numerical advantage, but discussion was also in favour of inclusion. The RfC was closed on 2nd April, and nobody else - including another mop-holder, and even those who were involved and against - have considered the closure to be in error or commented since then.  If you think my behaviour was inappropriate then take me to task, but not the decision which is reasonable, and anybody else would have drawn the same conclusion.  Chaheel Riens (talk) 18:47, 9 April 2020 (UTC)
 * , discussions should be closed by an uninvolved editor - which you are not. I am not saying that I disagree with the outcome, but this is out of process. I'm not looking to take you to task, and I don't accuse you of having done this in bad faith - I only want to see that things are done in the proper way. As it stands, this closure is basically meaningless - anyone could easily argue that it was improperly closed, and that the consensus isn't binding. Again - will you revert yourself and relist? If not, I'll raise a thread at WP:AN for further comment. Best Girth Summit <sub style="font-family:script;color:blue;"> (blether)  19:24, 9 April 2020 (UTC)
 * I fail to see why it matters when nobody else has raised an issue with the outcome. If nobody thinks there is a problem with the result - including you - and you accept that it was done in good faith, then why not take this as an application of WP:IGNORE, and let it be?  This just seems like an unnecessary excuse to drag the discussion out for longer and longer.  Nobody else (again - including those opposed) is arguing that it was improperly closed.  I admit I was unaware of the correct process, but that is something that can be borne in mind for the future, there is no reason to re-raise what seems to be a reasonable conclusion.  Why do you think that this is a meaningless close, when there was clear bias to include after several days of non-interaction from anybody - especially if (again) you have no problem with the conclusion, only the way it came about?  Chaheel Riens (talk) 19:58, 9 April 2020 (UTC)
 * , it's entirely possible that nobody else realises you've closed this. 10 days is very short for an RfC. There's no fixed time span, but 30 days is common. I literally just took a look to see what was happening, and was surprised to see it closed so soon - when I saw it was you who had closed it, alarm bells started ringing. As to why it should be done - this consensus now has zero weight. Anyone who wants to ignore it can now do so, and say that the RFC was improperly closed. Then we're back to square one. Again - please revert, relist, and wait for an uninvolved editor to close. If you refuse to do so, I will escalate this - I genuinely don't want to do that, but this is not how things are done. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  20:17, 9 April 2020 (UTC)
 * I guess you might as well do it,, although the outcome is crystal clear, and the conversation was dead. : "Legobot assumes an RfC has been forgotten and automatically ends it (removes the rfc template) 30 days after it begins, to avoid a buildup of stale discussions cluttering the lists and wasting commenters' time. But editors should not wait for that: if one of the reasons listed above applies, someone should end it manually, as soon as it is clear the discussion has run its course." Jenny Jankel (talk) 21:38, 9 April 2020 (UTC)
 * , I don't know what point you're trying to make here. There's a big difference between 10 days and 30 days. I have literally never seen a more improper close than this - I can't see how anyone could be expected to respect the outcome. It's in everyone's interest that this be properly closed.  Girth Summit <sub style="font-family:script;color:blue;"> (blether)  22:19, 9 April 2020 (UTC)

I suspect Jenny's point is that "There is no required minimum or maximum duration" and, as stated "someone should end it manually, as soon as it is clear the discussion has run its course." If nobody else has noticed that the RfC has been closed 7 days after it happened and 11 after the last !vote, then it's patently clear that nobody else is going to get involved and the discussion has run its course. Chaheel Riens (talk) 08:28, 10 April 2020 (UTC)
 * , I'd make two observations. 1: a large proportion of our active medical editing community is very busy at the moment, for reasons which are probably obvious. A discussion like this should perhaps be allowed to run for longer than usual, not cut short because a couple of days have elapsed since the last comment. 2: An RfC isn't a vote, the closer is required to weigh consensus based on the strengths of the arguments in relation to policy. An involved editor can't do that objectively. Thanks though for undoing your close. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  08:49, 10 April 2020 (UTC)

The RFC is posed as an either-or, which is fraught. I agree with neither option listed. I have followed and engaged this article since its 2010 Featured article review, and am aware of the long-standing conflict regarding the apostrophe. Removing it makes no sense, and listing it is not a breach of MOS:FIRST, which is intended to avoid lengthy constructs. I support what is in the article now, Down syndrome or Down's syndrome, also known as trisomy 21. There is no need for the DS abbreviation; it was used only three times in the article, and I replaced those. DNS is never used in the article. Here is the first sentence of this article at each stage of its past content review processes (see the article milestones template at the top of the page): Considering that history (every instance includes Down's), it is astonishing that there is an attempt to remove the apostrophe. Since this was once a Featured article, it is built upon a solid foundation; considering there are now many involved and interested editors, I hope they will be encouraged to work towards bringing it back to featured status. Please ping me in the future if you would like help on that venture (meaning if and after all citations are in a consistent format, using only the most recent secondary sources, and there has been a serious copyedit). Sandy Georgia (Talk)  13:19, 16 April 2020 (UTC)
 * 2014 Good article
 * 2012 Peer review
 * 2010 Featured article review
 * 2006 Featured article candidate
 * 2006 Peer review


 * The discussion above is closed. <b style="color: #FF0000;">Please do not modify it.</b> Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

There is currently an identical debate going on at Talk:Tourette syndrome, if any of you would care to lend a few words,, , , , , , , , ? Cheers. Jenny Jankel (talk) 23:56, 22 June 2020 (UTC)
 * might you have a look at this canvassing please? Sandy Georgia  (Talk)  00:43, 23 June 2020 (UTC)
 * Sandy is correct - this message is inappropriate canvassing. Specifically, by selectively pinging only those users who agreed with your preferred option here, you are vote stacking. Yesterday I gave you a formal warning about making personal attacks against other editors; today I find myself giving you a formal warning about canvassing. I don't believe you've been warned about this particular type of disruptive editing before, so I am not blocking your account immediately, but please tread very carefully. Girth Summit <sub style="font-family:script;color:blue;"> (blether)  07:01, 23 June 2020 (UTC)