Talk:Down syndrome/Archive 3

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Overview

One of the peer review comments is to expand the lead material, WP:LEAD. The article is currently about 30K long, and the recommendation is 3 or 4 paragraphs. One quick way to do this is to merge the Overview section into the Lead material. Does this seem reasonable? Is there a better solution? Ted 19:14, 1 June 2006 (UTC)

Hearing no comments, I went ahead and did it. Ted 16:17, 3 June 2006 (UTC)

Down syndrome in lead paragraph

After a short discussion with Alterprise ([1]), I decided to do a short survey of names for various genetics disorders/syndromes. I looked for genetic disorders with only one name (ignoring, for example, Prader-Willi syndrome), which may follow different rules. For each of them, I looked to see if they gave alternate "possessiveness" in the lead paragraph. Without exception, they did not. I then looked to see which form they used. Without exception, they used the form for wherever the article was located. All of them, except one, had a redirection from the other form. The one exception was Edwards syndrome. I suspect it is because "Edwards" already has a trailing "s". It did, however, include a redirect from Edward's syndrome, which is incorrect in any case. Following are the articles I surveyed, which have both possessive and nonpossessive forms:

• Turner syndrome
• Crohn's disease
• Patau syndrome
• Edwards syndrome
• Alzheimer's disease
• Huntington's disease (which also give Huntington's chorea)
• Klinefelter's syndrome
• Hirschsprung's disease
• Angelman syndrome

Some of the article names follow the NIH/Chicago Manual of Style guidelines, others do not. While I have been in favor of giving both forms in the lead, I am convinced by Alterprise's argument of simplicity. I have changed the lead paragraph. If we need to change the History section, then we can do that. Ted 20:20, 3 June 2006 (UTC)

history changes

I tried to make this section a little clearer in terms of timing of the eugenics movement and de-institutionalization. It was a force in public policy with medical and scientific backing mainly from about 1910 to about 1945, and not when Dr Down originally wrote about it. I hope no one thinks I have removed useful info. alteripse 19:38, 4 June 2006 (UTC)

In the late 1970s, Josef Warkany (an eminent syndromologist) mentioned in a lecture to Cincinnati pediatric residents that a Harvard doctor had testified in court around 1950 that Down syndrome could be caused by trauma from a car accident early in pregnancy. I have not been able to find a printed version of this story, but if anyone else can provide a source it might be a nice addition to the midcentury paragraph. alteripse 01:56, 5 June 2006 (UTC)

"'mongolian idiocy' had become an odious term". Is "odious" the real term they used? I guess I really need to get a copy of the two Lancet publications (this exchange and the 1974 statement). Ted 14:31, 5 June 2006 (UTC)

Odious means distasteful, offensive, hateful. I have no idea whether they used this specific word but do you doubt that is why they sought to change it? Also, only the larger medical school libraries are likely to have 1960s Lancet. You might save yourself a trip if you call ahead to see if it is easily accessible on their shelves or whether they need to pull it from storage. Lancet letters and editorials are usually very concise, so the whole exchange might only involve copying 2-5 pages (a guess). If you are going to take the trouble to do that, see if they have a copy of Josef Warkany's Congenital Malformations text from the early 1970s (big blue book), and see if he has any unusual history items in it like the above story (he retired around 1978 and saw the whole clinical development of chromosome disorders during his career). David Smith was the second author on a 1966 text specifically on Down's Syndrome (title something like "The Down's Syndrome Child" if I recall correctly). Good luck. [User:Alteripse|alteripse]] 17:08, 5 June 2006 (UTC)

I have the requests in. It will take sometime between a week and forever. It's like the lottery that way. Ted 14:28, 6 June 2006 (UTC)

I have received copies of both letters to The Lancet. The first is essentially what we thought. I've used a couple of direct quotes from it in the article. The second seems to be an announcement of an "international workshop [to be convened] later to examine and finalise the classification." The quote is given as: "The possessive use of an eponym should be discontinued (e.g., Down—not Down's—syndrome)." I am trying to find out if the workshop was ever held. I have a request for another Lancet letter which may shed some light. I don't see the quote that everyone throws around. It is possible it was added by someone else as "justification." We'll see. Ted 18:39, 7 June 2006 (UTC)

Good sleuthing. alteripse 23:42, 7 June 2006 (UTC)

Dead end. It was simply a letter complaining about the proposed nomenclature. In the end, it would be somewhat humorous if there was never a workshop and the letter is all there is.... Ted 00:18, 8 June 2006 (UTC)

Relating to the context under History my opinion is that the expression "mongolian idiocy" should not be used and be replaced with it or this: By the 20th century, ‘’this’’ had become the most recognizable form of mental retardation”, as both expressions have been used sufficiently in the sentences above, thus avoiding overusing what has become a negatively charged expression and emphasizing the correct one – even if the dispute and change is described further down (no pun intended). --Profero 16:41, 23 June 2006 (UTC)

I'm also concerned that the paragraph has both "mongolian idiocy" and "Down syndrome". The actual diagnosis was mongolian idiocy at the time, but I'm sure that any such diagnosis is now considered Down syndrome. Normally, I'd stay with historical diagnosis, but I'm not sure it is required in this instance. Whichever way it goes, it should be consistent within a paragraph. Ted^Talk/_{Contributions} 05:26, 28 June 2006 (UTC)

I added a line that specified the relevance of the "mongoloid" connection in Down's theory. Without the understanding that Down saw mogolism as retrogression, the reader doesn't know why it's relevant that the syndrome was later found among all racial groups. Jonathan Tweet 00:19, 31 July 2006 (UTC)

Pictures

After someone added the ultrasound, I looked back over and thought it would be nice to have pictures for most of the sections. I blew it and missed the Special Olympics this past weekend here. It would be nice to have some more pictures of individuals. Ted 00:20, 8 June 2006 (UTC)

I have some pictures of my son you could use. I would add one but this article has been blocked from editing.Jackie69 01:16, 27 July 2006 (UTC)

I've only blocked anonymous or newly-registered users (less than four days), to stop the anonymous AOL blanking. You can either wait another three days and then edit the article yourself, or upload the pictures and let us know on the talk page, and someone else can insert them. Thanks for the offer, some more pictures would be great. --ajn (talk) 05:15, 27 July 2006 (UTC)

Suggestion

allowed to use powertools - ouch !. In my hometown there are numerous sheltered workshops with Downs afflicted people working - using power drills, drill presses and other power tools. the picture is appropriate and a better one than my attempts- Peripitus (Talk) 09:49, 21 June 2006 (UTC)

The comment is a good enough reason to keep the picture. It is a picture of the son of one of the early editors and is quite good. Ted^Talk/_{Contributions} 16:07, 27 June 2006 (UTC)

<Personal Attack Deleted by Ted^Talk/_{Contributions} 14:03, 22 July 2006 (UTC)>

I suggest unregistered Jackman69 apologizes to Mayor Westfall and the rest of the Wikipedia community for using such language, and I hope for consensus to remove the comment of Jackman. --Profero 09:10, 22 July 2006 (UTC)

Risk vs Chance

A little while ago, an editor changed "chance" to "risk." As a statistician, I have no problems with either way. However, earlier this year the change was made from "risk" to "chance" by some other editor (I forget who made the changes), feeling that the word "risk" carried unneeded connotations. The change from "chance" to "risk" was made without regard to the construction of sentences, so it will either have to be fixed or changed back to "chance."

What is the feeling now about the preference for either of these two words? Ted^Talk/_{Contributions} 16:04, 27 June 2006 (UTC)

Copyright violation

While working on the lead paragraphs, I discovered that a large part of it is also found here: [2]. This material used to be part of the, now defunct, Overview section. If you look back at that section as it existed in March, it is nearly word-for-word identical. I don't know if this website took the material from Wikipedia without attributing it, or we plagiarized from them. I have deleted most of the lead section and reworded the remaining paragraph (the first paragraph seems to be OK). If there is useful information that should be reinserted, we should do so without using that language. Ted^Talk/_{Contributions} 20:39, 28 June 2006 (UTC)

False alarm. It looks like the site used Wikipedia as a source without attributing it. I'll keep out the source and replace the information -- using this as an opportunity to clean up the presentation. Sorry, again, for the panic. Ted^Talk/_{Contributions} 22:38, 28 June 2006 (UTC)

Abortion

As was asked in the peer review, I found some rates for elective abortions. It is in the section on prenatal testing.

My question is, Is it useful to keep? Does it improve the article, or just act as a lightening rod? Ted^Talk/_{Contributions} 18:34, 3 July 2006 (UTC)

I think it is a very relevant and useful piece of information, well-handled in the last paragraph without begging for rebuttal. In fact, the way it is expressed might slide it right past those whose ability to grasp other viewpoints is especially limited (or at least we can hope so...). alteripse 22:29, 3 July 2006 (UTC)

I don't understand why Alteripse feels it's important to question the intelligence of people who feel that "eugenics by abortion" is unethical. She obviously can't grasp the viewpoints of people who disagree with her ideas towards abortion. Not everyone feels that it is wrong simply based on religious beliefs. Many atheists feel it is unethical coming from a strictly scientific viewpoint.—The preceding unsigned comment was added by 205.188.116.136 (talk • contribs) 16:45, 24 July 2006 (UTC)

Wow, what a bundle of offensive and unwarranted assumptions you can create out of thin air! alteripse 23:06, 24 July 2006 (UTC)

Prenatal screening

I've quit trying to rewrite pieces of this article because you kept rewriting what I contributed and overall you are hard at work making this a great article and I have no quibble with your facts. But let me make a constructive suggestion about this section: keep it simple and clear. You don't need to explain that prenatal screening is done for lots of conditions or squirm around about why screening is done. The basic facts are that (1) most parents would prefer not to have a child with DS, (2) it is possible to identify a woman at highest risk of carrying a DS fetus with a simple blood test and give them a choice about confirming the diagnosis with amniocentesis, which then gives them the choice of (3) preparing for the birth of a child with DS or choosing not to have a child with DS by aborting the fetus. The first round test is simple but not entirely reliable (lots of false positives and negatives). The amniocentesis is not "simple" and incurs a small risk of inducing miscarriage but is highly reliable at determining whether the fetus has DS. Reported statistics show the vast majority of parents who learn their fetus has DS choose to abort it. There are a minority of people who feel this is the wrong decision and that having a child with DS is not sufficiently bad to warrant depriving the potential child of life. End of summary. Feel free to reword, but try to keep it clear. alteripse 00:36, 5 July 2006 (UTC)

Many people who do make the decision to terminate base it on outdated information given to them by doctors who make the diagnosis and exaggerate the severity of the condition. There has been a movement in recent years by various groups to provide mothers with pamphlets that give more current information and prevent the diagnosis from being skewed by an ignorant doctor. It has been proven that the way the diagnosis is given has a great effect on the mother's decision on whether to keep the baby or not.205.188.116.136 00:10, 25 July 2006 (UTC)

I'm sorry I've been so busy with the article. I start teaching again tomorrow, so I will not be active much for the next several weeks. I was pushing to get something to let sit for awhile. I need to step back and let it age properly. I only have two projects left: 1) Find out what is really going on with the NIH workshop in 1974. It is strange that it seems to have disappeared. I don't really want to look through every issue of Lancet from 1974 to 1980, but I may eventually have to do that. 2) I may create a drawing for Robertsonian Translocation that shows the possible outcomes for a translocation carrier.

I agree with simplicity. I just don't think I can do that now -- I tend to get more long-winded when I write too much in a short time. I'll leave it up to others. Ted^Talk/_{Contributions} 01:01, 5 July 2006 (UTC)

health

There is some evidence that individuals with Down syndrome have a much lower rate of lung cancer than others, as is expected for all cancers caused by tumor suppressor genes. . This isn´t explained on the page tumor suppressor gene. Are the genes responsible for the cancer (that woulnd´t be logical), or is a failure/ mutation of the genes responsible for the cancer happening. This is not clear for me, and I´d be happy if someone could clarify in the article. regards Sean Heron 21:29, 5 July 2006 (UTC)

I'm not really sure how useful it is to explain it in detail. Tumor suppressor genes follow the "two-hit" model -- they have to have two mutations to cause cancers. With trisomy 21, it becomes a "three-hit" model. Ted^Talk/_{Contributions} 19:38, 15 July 2006 (UTC)

You may wish to reword this paragraph since the incidence of all cancers except leukemia and testicular cancer are reduced in people with Down syndrome, rather than singling out lung cancer.--Lleshin 02:00, 30 July 2006 (UTC)lleshin

mongolism

The April 8, 1961 page 775 Lancet letter to the editor entitled "mongolism" by 19 leading geneticists was in volume 1 of 1961, not volume 277 in the print version of The Lancet. In those days (and through 1989), there were two volumes (numbered 1 and 2) every year. PubMed entries and contemporaneous citations in other journals still use these volume numbers. When The Lancet made its archives available electronically, it renumbered the volumes to start from the year 1823 and harmonize with their current (1990- ) volume numbering today, so 1961's volume 1 = volume 277 via ScienceDirect. Howard-Jones N (1979). On the diagnostic term "Down's disease". Med Hist. Jan; 23(1):102-4. PMID 153994 notes that the Mongolian delegation to the WHO specifically objected to the use of the terms "mongolism" and "the Klinefelter mongol" in a speech by the President of the Assembly (Dr. V.V. Olguin of Argentina) during the May 6, 1965 Fifth Plenary Meeting of the Eighteenth World Health Assembly awarding a prize for research work on mental subnormality to Professor L. S. Penrose (incidentally one of the 19 geneticists who signed the 1961 Lancet letter to the editor).

The terms mongolism, mongol, and mongoloid were used much more commonly than the term mongolian idiocy—all were somewhat racist and objectionable. 68.253.210.208 05:04, 20 July 2006 (UTC)

Which is best for the reader to be able to find the article? When I've requested reprints from Lancet through my library, it has been my experience that the ScienceDirect numbering of volumes was much faster -- the other way required my requests to be sent to another office to find the article (probably from ScienceDirect). I don't normally have references to Lancet, so I don't know what format other journals would require. My only goal is to allow others to get the article if they so choose.

My apologies for hastily changing back your edits. Without an "edit summary", the changes appeared to be someone playing around with Wikipedia. You are probably right about "mongolism", although the request from the Mongol delegation appears to have been verbal, without record. I will put back your statement, & probably change it somewhat later on (including the reference you kindly provided). Ted^Talk/_{Contributions} 12:28, 20 July 2006 (UTC)

Mainstreaming

Mainstreaming is actually a pretty outdated form of education when it comes to disabled children. The new trend is towards "inclusion". My son with Down Syndrome goes to a full inclusion school and is in a class with both gifted children, autistic children, and children with behavioural problems since all these groups benefit from special education.

Maybe there should be a section on inclusion schools even though they are fairly uncommon in the public education system. In New York they are common but I don't know about the rest of the country.

Inclusion usually involves a one-on-one aid to assist the more severly disabled children but also allow them to be fully integrated into the classrooms.

An example of a full inclusion school is the Child Development Center of the Hamptons in East Hampton, NY.

My son is also removed from class for his individual therapy sessions when they are scheduled. —The preceding unsigned comment was added by 205.188.116.136 (talk • contribs) .

Go for it. Write up a section. Or, add to the section on mainstreaming. The hardest part is getting citations, although I have access to several. Ted^Talk/_{Contributions} 01:00, 25 July 2006 (UTC)

restored paragraph accused of bias

Someone removed this with the accusation it is biased: Despite this change, the reduced abilities of people with Down syndrome pose a challenge to their parents and families. While living with their parents is preferable to institutionalization for most adults with Down syndrome, they often encounter patronising attitudes and discrimination in the wider community. The paragraph consists of 2 relatively uncontroversial statements of fact, and 1 statement of value preference.

1. Reduced abilities of people w DS pose a challenge for their families.
2. Living with parents is preferable to institutionalization for most adults with DS.
3. People with DS often encounter patronising attitudes and discrimination in the community.

So which statement is biased? Should we assume our anon deleter feels that institutionalization is preferable for the majority? alteripse 23:19, 24 July 2006 (UTC)

You leave out the fact that many people with Down Syndrome marry and live on their own which is neither "institutionalization" or "living with parents".

You make the assumption that people with DS encounter patronising attitudes and discrimination in society. By using the word "often" you imply that this is discrimination is widely practiced without backing it up with any facts.

By harping on their "reduced abilities" you ignore all the advances made for these people through special education and early intervention programs which can render their "reduced abilities" obsolete.

This paragraph greatly underestimates the abilities of these and in previous statements you have made you appeared to hold the opinion that termination of DS fetuses was your preferred choice in dealing with DS.

So by using this paragraph to makes their lives seem more difficult than they are in reality you show bias. —The preceding unsigned comment was added by 205.188.116.136 (talk • contribs) .

I didn't write the paragraph. I have to say you are certainly here with a chip on your shoulder and a fistful of unpleasant and uncharitable fantasies and projections. Please go right ahead and condescend to teach us the politically proper attitudes and values as you have certainly recognized that none of us who have contributed to this article have any respect or affection for these folks. I am sure nearly every paragraph displays some sort of objectionable bias just waiting to be fixed by your superior understanding. alteripse 00:24, 25 July 2006 (UTC)

I was not being condescending. The paragraph didn't belong in an article that was passing itself off as academic. It was loaded with too much personal opinion and not enough verifiable facts. There was nothing political about my argument. It's not about respect or affection it's about fact vs. opinion. Doesn't the fact that somebody is labeled disabled or genetically defective imply that they will have a more difficult life? If you were doing an article about black people would it be just as important to state that they prefer freedom over slavery or that parents who give birth to black babies will face challenges due to the racist attitudes of society? I didn't write anything that was a fantasy. Does pointing out your backwards ideas in regards to Down Syndrome make me condescending? Should I just sit back and let you continue to be ignorant?205.188.116.136 00:56, 25 July 2006 (UTC)

Read my words again: I did not write the paragraph. I also did not write the section on prenatal screening. You have done nothing but make unwarranted personal attacks since you arrived. What is wrong with you? alteripse 01:42, 25 July 2006 (UTC)

POV for prenatal screening

I'm trying to figure out the POV issue for prenatal screening. I presume it has to do with the last paragraph, unless there an issue with even presenting prenatal screening. Rather than guess about the issue, it would help to address it here. I look forward to your presenting your concerns. Ted^Talk/_{Contributions} 01:16, 25 July 2006 (UTC)

I feel it's biased because it doesn't bring up the fact that many people make the decision based on poor information given to them by doctors who have outdated ideas on Down Syndrome. I refer you to the following article: http://www.lifenews.com/nat2292.html

I'm not saying you need to show both sides of the argument but either delete this section entirely or show both sides and present it fairly.

Pre-natal screening deals with an attitude that society has towards Down Syndrome and disability in general. It has nothing to do with the topic of Down Syndrome itself.

Having this section definitely pushes a political agenda that not everyone agrees with.205.188.116.136 01:33, 25 July 2006 (UTC)

I don't see how it is pushing any position. Prenatal diagnosis is a part of Down syndrome. All but the last paragraph is typical fare for articles in medical genetics. So, what is your problem with the last paragraph? The first paragraph mentions the fact of abortion rates. The rest of the paragraph gives resources concerning the ethical ramifications. If you have more or better citations, then add them. I'll check out the lifenews page you suggested. Ted^Talk/_{Contributions} 02:04, 25 July 2006 (UTC)

I'd like to find a good citation for physician pressure that doesn't come from an advocacy group. If you have one, that would be great. In the United States, much prenatal screening is done through genetic counselors, where nondirective genetic counseling is the rule. Ted^Talk/_{Contributions} 02:42, 25 July 2006 (UTC)

I did find this: David W. Britt, Samantha T. Risinger, Virginia Miller, Mary K. Mans, Eric L. Krivchenia, Mark I. Evans (1999). "Determinants of parental decisions after the prenatal diagnosis of Down syndrome: Bringing in context". American Journal of Medical Genetics. 93 (5): 410–416.{{cite journal}}: CS1 maint: multiple names: authors list (link) I haven't read it yet. I'll see what it has. Ted^Talk/_{Contributions} 03:58, 25 July 2006 (UTC)

False alarm. I'm searched out. None of my usual search engines gave up anything. Ted^Talk/_{Contributions} 04:41, 25 July 2006 (UTC) I found an article that might be relevant. I'm checking it out now. Ted^Talk/_{Contributions} 12:23, 25 July 2006 (UTC)

---

Here is what I found. The article (Skotko, BG (2005). "Prenatally diagnosed Down syndrome: mothers who continued their pregnancies evaluate their health care providers". American Journal of Obstetrics and Gynecology. 192: 670–677.) was a survey of mothers who elected to have their babies after a DS diagnosis. They were found through DS support groups in 5 states (US) (from membership rolls). The survey used a 7-point Likert scale (1=strongly disagree, 7=strongly agree). The two questions of interest (and their mean Likert) are: After receiving results of the test, I felt encouraged by my physician to terminate my pregnancy (3.1); and After receiving results of the test, I felt encouraged by my physician to continue my pregnancy (3.5). On the 7-point Likert, 4 is the middle neither agree nor disagree. While I am sure there are physicians who pressure women to have an abortion after a DS diagnosis, these data do not suggest it is wide-spread. Ted^Talk/_{Contributions} 13:17, 25 July 2006 (UTC)

I think that the article does a fantastic job of addressing the medical reality while remaining NPOV as to any value judgment. Like it or not, many people choose not to have children with trisomy 21. InvictaHOG 13:20, 25 July 2006 (UTC)

---

Unless we know what the objections are, I see no reason to keep up the NPOV check. "...either delete this section entirely or show both sides and present it fairly." Deleting the section entirely is not an option. What side is not being presented fairly? We are interested in improving the article. What can be added to present the side fairly? Ted^Talk/_{Contributions} 20:16, 26 July 2006 (UTC)

POV for plastic surgery

Please add your concerns about WP:NPOV for the plastic surgery section here. Thanks. Ted^Talk/_{Contributions} 01:25, 25 July 2006 (UTC)

It's not an important aspect of the Down Syndrome topic. It once again deals with an attitude towards Down Syndrome that not everyone shares.

Does it really deserve an entire section to itself? It's the equivalent of including a "Skin Bleaching" section on the African American topic or "Eye Widening Surgery" on a Korean section. Both of those practices are much more common than plastic surgery for Down Syndrome babies yet you don't feel the need to highlight those as aspects of African-American or Korean culture.—The preceding unsigned comment was added by 205.188.116.136 (talk • contribs) .

I didn't add this section, although I did reduce its prominance to a subsection of health. If anything, it is biased against plastic surgery. Wikipedia is designed to present a balance of viewpoints. It is not required that "everyone shares" the same viewpoints, only that commonly held viewpoints are presented. Ted^Talk/_{Contributions} 02:16, 25 July 2006 (UTC)

I don't think that it's appropriately to entirely delete the plastic surgery section, as was done twice today. I think that a discussion about which aspects should/should not be deleted are more important. Despite the controversy, plastic surgery is a reality and should be covered in an encyclopedia article. This is not an article about Down syndrome culture, it is an article about Down syndrome. InvictaHOG 19:50, 26 July 2006 (UTC)

The plastic surgery is more of a cultural thing than a genetic aspect of the syndrome. It makes a value judgement on the looks of Down Syndrome people automatically implying that they are negative. It's just as wrong as advocating liposuction for fat babies. I think at least this should be posted as a seperate article since it adds absolutely nothing to the understanding of what Down Syndrome is.205.188.116.136 20:33, 26 July 2006 (UTC)

Reporting and documenting the decision by parents/patients to undergo plastic surgery is not making a value judgment. Reporting is not advocating (liposuction is not done, but see circumcision for a discussion about a controversial newborn practice!) InvictaHOG 20:38, 26 July 2006 (UTC)

There have also been plastic surgery procedures to reduce the tongue size of children with Down's, in the hope that this will improve their speech - I've no references, but I remember watching a TV programme on the subject a few years ago (it didn't work). I think that sort of thing is awful, but it needs to be in the article. TedE and InvictaHOG are quite right - this isn't a DS advocacy site, it's supposed to be a factual article which doesn't make judgements. Thanks mainly to TedE, it's also one of the better-referenced articles in Wikipedia. --ajn (talk) 20:47, 26 July 2006 (UTC)

I stumbled upon this page in the course of patrolling recent changes, and while I disagree with the anon user's method of summarily deleting content, I see the person's point. Would it be acceptable to everyone to say something like, "Controversially, plastic surgery has been advocated...", or would that require additional verification?

I agree that the practice should be included in the article. Simply deleting the text won't make the actual surgery go away.

For what it's worth, I had never heard of plastic surgery being used in this context, and thanks to the article, I now know about this troubling (to me) procedure being done. --Tachikoma 21:23, 26 July 2006 (UTC)

---

There isn't a tremendous amount a research in this area. I've found about a dozen references for facial reconstruction and partial glossectomy (tongue reduction) that seem relevant. I haven't found anything about facial reconstruction since 1990. The results are definitely mixed. For facial reconstruction, "although most parents reported improvement in their child's speech and appearance, independent raters could not readily discern improvement..." For partial glossectomy, surgeons and parents have noted improvement in speech. Independent raters have demonstrated a mixed bag — when shown videos or in face-to-face encounters, they indicate improvement, but not when hearing a tape of speech. The most recent study (2005) stated, "The partial glossectomy had obviously a positive impact on both place of articulation and manner of articulation. The analyses revealed a tendency towards vowel speech before surgery along with glottal realizations. After surgery the vowel speech and the compensatory articulation patterns had disappeared." Ted^Talk/_{Contributions} 13:47, 27 July 2006 (UTC)

Location of History section

For some time, the History section has been at or near the beginning of the article. It is probably historical, but it also allowed for a discussion of Down syndrome vs Down's syndrome. We have been several months without a significant editorial "discussion" of that. The History section is much longer now than it used to be. I'd like to move the History section to the end of the article (just before Notable individuals). This has the added benefit of following the recommendation of Wikipedia:Manual of Style (Medicine-related articles). I'll move it in the next few days if there are no objections. Ted^Talk/_{Contributions} 02:55, 31 July 2006 (UTC)

I think that history should be placed near the bottom. If you'd like to make a separate linked article for famous people that is also in keeping with the style of medical articles. InvictaHOG 03:35, 31 July 2006 (UTC)

That's fine, but the majority of your history section is regarding the name. How about the history of the treatment of Down syndrome, since that has changed over the last two generations?--Lleshin 15:48, 31 July 2006 (UTC)

I guess I would argue that the history of the name is among the least important and least compelling aspects of the syndrome. Certainly societal response to Down Syndrome has impacted the lives of people with/caring for Down syndrome, but I don't think that it needs to necessarily be at the top. Note that I don't really feel strongly about it, but think it's in keeping with other featured medical articles and flows more logically, IMHO InvictaHOG 16:13, 31 July 2006 (UTC)

Absolutely! Any entry in Wikipedia reflects the interests and backgrounds of the editors. In my eye, the biggest weakness right now in the article is in health and treatment. We have simply not had anyone with the interests/background to flesh out that part. I suggest we start sub-articles for both sections and see where things go from there. Since they will be different articles, the semi-protection would not apply (and, I really don't see much in the way of controversy, anyway). I'll create History of Down syndrome right now as a stub. I'd like a little feedback on a name for the health section. In the past, we have had controversy among editors for the use of the word, "treatment". Some possible titles are (phrases in parenthesis give alternate titles):

1. Down syndrome health (concerns)
2. Health aspects of (individuals with) Down syndrome
3. Health and treatment of (individuals with) Down syndrome

I can help with formatting and gathering references, but I've hit the limit of my knowledge in that area. Ted^Talk/_{Contributions} 17:12, 31 July 2006 (UTC)

I'm partial to "Health issues in Down syndrome" since that's my website's name. But "aspects" is just as good. I'd be glad to help with that. --Lleshin 03:59, 2 August 2006 (UTC)lleshin

All sound good - I think that most people will not be searching for the title and will instead find it through the main article. Whatever you choose will be fine. I'll try to help out (it's pretty much right up my alley as far as specialties go!) InvictaHOG 15:34, 2 August 2006 (UTC)

I have started the page. I simply copied over the material we had, but expect it to change quickly. Once we get that article worked out, we can decide what summary to put over on the Down syndrome page. I'll help where I can. Ted^Talk/_{Contributions} 20:12, 2 August 2006 (UTC)

FA

It should be featured. What are we waiting for? Could I nominate it? NCurse _work 20:32, 10 August 2006 (UTC)

I was waiting for the health article (Health aspects of Down syndrome) to be expanded some. Ted^Talk/_{Contributions} 23:03, 10 August 2006 (UTC)

Sorry, I have been focusing on uploading images and starting a few new articles which I wanted to get underway. I'll work on the health aspects over the weekend InvictaHOG 02:06, 11 August 2006 (UTC)

I didn't mean that as a criticism. I just wanted more in the sub-articles than in the main article. I'm also busy grading papers & some time away from the heat ! There is no need to rush it, we've tried to be very patient with the process. Ted^Talk/_{Contributions} 04:13, 11 August 2006 (UTC)

Please let me know when I can nominate it. NCurse _work 19:07, 11 August 2006 (UTC)

It might be nice if Ted got to nominate it. Either way, I'll let you know when I'm done. I've started arranging my thoughts on paper for the expansion article and when I'm done I will condense it into summary style. InvictaHOG 21:30, 11 August 2006 (UTC)

Well, I replaced the long list with some text from the health aspects article. I'm sure it could be expanded and the health aspects is still only 1/3 of the way done. In any event, if someone wants to copyedit the section (and the whole article) then it's probably ready for FAC InvictaHOG 01:34, 14 August 2006 (UTC)

Yay!

I would just like to congradulate Ted and the contributing writers for a truly excellent article, in my very humble opionion. It is everything wikipedia should be. Good luck on getting featured!

One tiny criticism/ questio: why that first picture? I find the idea of ANY child at that age hammering a nail- seemingly alone- somewhat disturbing. In an article on a mental disability, it's even more jarring, especially since it's the first thing the reader sees. Perhaps it could be replaced with a more generic photo of a child playing or reading. Singlewordedpoem 05:50, 11 August 2006 (UTC)

How about this picture on the right? It shows most of the physical characteristics of down syndrome. --WS 20:02, 11 August 2006 (UTC)

Some comments. The first is this is a drill, not a hammer. Second, how old do you think the child is? While not using a drill, a common Montessori work for 3-6 year olds is to hammer nails into a stump. The child in the picture seems to be older than that. It helps to develop fine motor skills -- something that many children with Down syndrome need to work on. I've seen a few children with Down syndrome use that activity and eventually master it. I believe the child in the picture is using the drill as an electric screwdriver to assemble a bookcase. Overkill on the drill, but it is certainly age-appropriate. Personally, I prefer real pictures, unless it is to help point out some physical features. The picture is the son of an early contributor, so has a Wiki-connection. Ted^Talk/_{Contributions} 20:29, 11 August 2006 (UTC)

Mia Peterson - Down syndrome advocate testifying before U.S. Senate

I personally couldn't care less about the picture - seems fine to me and I'm a pediatrician with a stake in child safety. However, the issue has been brought up several times so it is worth addressing. I have found an image of Mia Peterson, an individual with DS who is an advocate and success story. It's a little small and I could probably make it look a little nicer if I were home with photoshop. I personally don't care, but it's just another image to offer InvictaHOG 21:18, 11 August 2006 (UTC)

Good point about it coming up more than once. Other eponymous diseases use a picture of the named person (see, for example, Huntington's disease). I've not found a public domain picture yet. I prefer a more personal touch, but I'm not set against any good picture. Ted^Talk/_{Contributions} 23:15, 11 August 2006 (UTC)

You're welcome to use one of the photos of my son from my webpage.Lleshin 14:30, 18 August 2006 (UTC)lleshin

Thanks, but Wikipedia is very cautious about using pictures from websites. I cannot add the picture, since I don't have the right. It is actually very easy to add pictures -- I've done several of various diagrams and such.

1. Go to the page Special:Upload
2. Browse for the file on your computer
3. Give it a Wiki-name (lower case except for first letter and proper names)
4. Give a short description, including the source. Mine say something like "picture taken by me"
5. Licensing. This is the hard one. A separate picture from the website is much better, since it has no copyright attached to it. For those I choose GFDL (self made) or you created this yourself and release it to the public domain. Once the image is uploaded, it can be referenced in any article or talk page. Ted^Talk/_{Contributions} 15:04, 24 August 2006 (UTC)

References for the individuals and fiction sections

I think that the article needs to provide references for the individuals and fiction sections. Currently it is not possible to verify any of the information in those sections. For instance, my memory of Sound and the Fury does not include a discussion of Benjamin Compson's Down syndrome. Yes, he was portrayed as having a lower than average IQ. However, is he truly identifiable as Down syndrome? I did a search through the full text for the common synonyms for DS and for some of the physical characteristics and did not come up with any hits. If there are not sources which can cite passages which support a diagnosis of DS, we should remove them! InvictaHOG 17:31, 28 August 2006 (UTC)

I agree, to a large extent. For real individuals, the only ones we have listed have Wikipedia entries that specifically mention Down syndrome. For characteristics such as Tourette syndrome or CAIS, it is easy to sling around suspected names. I'm comfortable that we haven't done that with Down syndrome (which is more physically obvious).

For works of fiction, I think we should only include those that specifically mention Down syndrome. I spent about an hour looking around the internet concerning Compson. Many people mention Down syndrome, but I am no literary critic. I'd be willing to pare it down considerably -- including only those works that are in Wikipedia and specifically mention Down syndrome, or where we can find verifiable sources outside Wikipedia. If there is no objections, I'll do that in a day or so. Ted^Talk/_{Contributions} 03:28, 30 August 2006 (UTC)

It sounds great. Compson may well have Down syndrome - my google search only revealed one person who didn't seem to support from the primary text and just sorta assumed. The text itself doesn't say, to my memory. I will ask my wife - she's re-reading it now! InvictaHOG 09:05, 30 August 2006 (UTC)