Autism Is Not a Single Condition and Has No Single Cause, Scientists Conclude
Autism Is Not a Single Condition and Has No Single Cause, Scientists Conclude
If autism isn't a single condition, why do we lump everyone who's autistic into the same bucket? You've got the people that like trains and struggle with social cues and are sensitive to sound, and the people who broke their carer's arm because their DVD boxset of Dexter's Lab had a disc in the wrong place, and yes both are autistic, but it's unhelpful because when someone says they're autistic, you have no idea what that means.
I know there's levels depending on how much care you need, but nobody's going "I'm level 1 autistic" in daily conversation. It's not like cancer where you can say "I have cancer" or "My dad died of cancer" and you can then say "It was prostate cancer", because everyone knows what that means.
the people that like trains and struggle with social cues and are sensitive to sound
Well there goes the last shred of doubt I had that I'm high masking AuDHD.
It's not new information, and it's simple stereotypical stuff, but something about the way you phrased it made it hit different.
My kid is exactly like me, so learning how to deal with my issues is doubly valuable.
If autism isn't a single condition, why do we lump everyone who's autistic into the same bucket?
Why do we talk about the autism spectrum like it's a disease (or a bunch of diseases)? The only problem with autistic people is that they live in a society that is made for non-autistic people and it actively punishes them for being different. Kind of like with LGBT people, though I'd say a lot worse in this case. There's nothing stopping people in the spectrum from functioning similarly or better than 'regular' people, other than the aforementioned society.
I'm with you... it won't kill them and it's not progressive. It's not caused by a pathogen. It's not a disease like polio or measles.
If a parent would rather have their child die, or no child at all, rather than an autistic child, they shouldn't have children at all.
The only reason is that more is known about cancers than about the physiological basis of different psychological conditions. Psychology often has to work at the level of grouping symptoms because it's difficult and takes a long time to discover any neurological and/or genetic causes behind them.
What about the different STAGES of cancer?
It used to be a binary "you have cancer or you don't"
We've learned more and adjusted the spectrum of cancer severity. Why not the severity of autism (I know it's not progressive, but it is a spectrum!)
Cancer also has "stages" that people generally are aware of.
Scientists concluded this in the 1990s, and then had to produce yet another study to unequivocally state it again after every time someone claimed to have found the “cause”.
This is part of the reason it was re-named ASD in the first place; it describes a set of atypical neurological development symptoms, not an identifiable state of being. Kind of like “cancer” describes an atypical cellular reproductive state, not a pathogen attacking your cells. Both can be caused by many different factors or combination of factors.
Of course, with ASD, it doesn’t even mean there’s anything particularly wrong most of the time; just atypical, resulting in a person whose thoughts are weighted differently than historically typical, with less interpretation of social cues and a greater ability to focus.
with less interpretation of social cues and a greater ability to focus.
"ability to focus" is more accurately described as "tendency to focus". "ability to focus" connotes control over focus, which... from lived experience and what I've read, just isn't generally true. Autistic inertia – the inability to defocus and then focus on a new context – is very real. Autism is a neurodevelopmental disorder not just because of an ignorance of social cues but because of how rigid, inflexible patterns of behavior often interfere with daily life.
Autist here:
Yeah, describing it as simply 'greater' or 'lesser' ability to control or maintain focus is... well, too simplistic.
I can, when it comes to task, hyperfocus on something like writing a piece of complex code / software, try to solve a real world engineering problem, do a comprehensive data analysis of some topic, write a chapter of a novel... I can hyperfocus on that for a solid day or week or month, and I have to actively remind myself to do things like eat and sleep regularly, because I know I tend to get obsessively focused on 'the task'.
Shifting to another task, another very different ... realm of thinking, or way of thinking, is often very jarring and exhausting.
But on the flip side, when socializing, people tend to say I am scatter brained, overwhelming, because I just flow all the way through my entire chain of concept associations to end up with a resulting... thing I am trying to say.
Sort of like how modern agentic AI has an 'explain its thinking process' mode.
Thats just the default for me, its all an explicit, conscious train of thought.
For me, summarizing that chain of thought into just a resultant 'thing to say' is the difficult part, that I get worse at the more mentally exhausted I am.
Also, I would say most, not all, but most autists... its not that we are inattentive to or ignorant of social cues.
Its that neurotypicals tend to process social cues mostly subconsciously, whereas autists tend to process social cues mostly consciously...
... and that most neurotypicals actually all have widely variable, inconsistent and imprecise standards by which they judge and perform social cues, but most of them are unaware of this, to the point that they are overly confident that everyone has the same rubric and understanding of social cues as they do, when this very obviously is not the case.
So, this confuses/overwhelms many/most autists, because they are presented with an inconsistent and variable ruleset, and then also told that this ruleset is consistent and invariable.
Neurotypicals will often get angry/rude/frustrated/overwhelmed when you try to break this down and explain this to them, presumably because they largely are not aware of / do not have this explicit, conscious thought process, and tend to interperet being asked to formulate it in consistent, precise detail just as a rude, unreasonable thing to ask for.
Basically, imo, NTs use a fuzzy, fast, less accurate, mostly unconscious heuristic to evaluate and perform social cues, and they tend to be very confident they are doing this correctly...
... whereas Autists tend to logically and consciously go through an entire evaluation system, which is more robust and thorough in that its basically a discrete series of probabilistic associations, but this is all much slower, much more 'computationally costly' to perform.
So, when an Autist is oversocialized, under too much pressure to perform socially, they can get overwhelmed and then either basically shutdown or freak out.
This also works, imo, to explain why Autists tend to take longer to initially learn socialization cues and concepts... because they are having to build a much more conscious, step by step evaluation model of all possible micro/macro expressions, tonal shifts, inflexions, vocab choices, all possibly relevant context, etc, and this can often be much more difficult to establish when Neurotypicals are nearly entirely unaware of or dismissive of their own inconsistencies and variability when it comes to those things.
This also works to explain why Autists are often seen as overly straightforward or blunt: They're just telling you the result of their attempt to evaluate a social interaction.
And this also explains why almost no NT person I've ever met can accurately assess my emotional state / social interaction disposition, yet they almost all are very confident they can do so correctly and precisely.
EDIT
And I will here comment on the meta-irony of all of this, that ... any scientist could just ask a 'high-functioning' autist to explain how this works, and they could... you know, trust what a person says about how their own thought processes work?
But nope, nope, still we are pathologized as if we are strange, alien, confused and confusing others, not valid sources of information as to how our own minds work, when our whole 'problem' is that we are way too aware of how our minds work.
Why do you think PTSD coincides with the later Autism diagnosis group more strongly than the early diagnosis group?
Because we have been saying shit like this our whole lives, and broadly, nobody cares and just makes up whatever explanation or understanding they prefer, which is almost always significantly innacurate/incomplete, so we tend to live lives of constantly being slandered and mocked, rarely being respected as human beings with full agency.
This seems similar to the phenomenon where antidepressants are only effective for about 15% of patients. The benefit is large for those who benefit. For the rest, they're no better than placebo, suggesting the drugs treat one of several causes for the syndrome known as depression.
Yeah but we're not allowed to talk about how that 85% has been prescribed stuff that doesn't help them, very often has negative, deleterious, harmful mental and physical sideeffects, oh and also often cause dependency/addiction.
Because then when you look at it that way, that would mean basically all currently active, prescribing pscyhiatrists would be open to malpractice lawsuits, and/or drugmakers would be open to gigantic class action lawsuits.
You know, like with opioid pain killers?
But uh nope, nope, that can't be allowed to be considered, so .... just don't talk about it.
In other words, "Scientists Conclude Both Trump & RFK Jr. Are Utter A**holes For Believing Autism Is Caused By Tylenol, And You Should Be Voting For Democrats Instead"
Welcome to 2015. This is not new.
Sometimes it's worth having new studies that add confirmation and detail to conclusions people have already reached. This article does seem to be reporting on new research.
But that's not what politicians with absolutely no scientific or medical credentials are telling me.
Been saying this for years, feels vindicating. I'm ADD and I've been wondering about the possibility of autism, every time I try to look into the symptoms it seems wildly varied, poorly defined and vastly misunderstood. At least with ADHD/ADD you can blame the blood ghosts and do a cocaine about it.
Technically, we do a meth about it! Cocaine does almost nothing for me since I've received a doctor-ordered double dose of meth daily since my diagnosis at 17. Damn the blood ghosts for cockblocking all the potential cocaine connections I've missed out on!
The only thing “technically meth” about Ritalin is that it has the word “methyl” in it. I know you are making a lighthearted joke but it’s still really harmful because a majority of the population still literally believe that the doctor wants to give their kid meth and then withhold critical treatment that people need.
But chief US stientists have discovered that it's all caused by Tylenol!
Here's the source instead of a paywalled news article https://www.cam.ac.uk/research/news/study-reveals-genetic-and-developmental-differences-in-people-with-earlier-versus-later-autism
And here is just the full open access paper:
I thought we already knew, it's a spectrum
The 'spectrum' terminology comes about from the field of peychology only being able to attempt to analyze ... basically, 'symptoms', behavioral profiles, phenotypes, and also the field of psychology constantly changing how it does those analyses as well as categorize observable behaviors into conditions/disorders.
What this new understsnding is pointing toward is that there is an actual, identifiable, genomic variance of mutation clusters that actually explains how differences in that spectrum of 'symptoms' actually work, what actually causes which ones.
It’s multiple conditions we group together naively based on surface level symptoms. Same for many disorders.
The type that comes with gender and sexual fluidity, bendyness, ADHD = rccx caused ASD.
Then that will have multiple subtypes based on mutation combination within the rccx module.
(The RCCX module would’ve been excluded from the genetic analysis the report this article is based on - due to its complexity).
Severe/non-verbal ASD is more likely completely unrelated and caused by dendritic abnormalities (reduced or excessive branching, immature spines, disrupted morphology, etc)
You seem to have a more in depth grasp of the precise genetics involved here than I do, what would your opinion be of Dr. Frye's concept of "Cerebral Folate Disorder" that I mention in another comment?
Here's a paper from him and his team, he has many though:
https://pmc.ncbi.nlm.nih.gov/articles/PMC5794882/
As best I can tell, he is focused on the non-syndromic, non-verbal, uh, what this recent paper OP is about seems to categorize as 'early diagnosis autism'.
He's got a cluster of specific mutations that produce an evidenced, differing neurochemistry in the brain, and apparently a potential treatment for that 'subypr/component' as well?
I... don't agree with his general description of autism as basically only the kind that makes you developmentally delayed, but, if you can get past that... do you think he may be onto something as far as that being an distinct 'type' of autism?
Also, apologies if I am using some terms incorrectly or innacurately, I am not a neuroscientist.
Oh me either don't worry - CS with a personal interest in genetics/RCCX.
At a (quick) skim, RCCX can set the terrain for Frye’s “cerebral folate disorder” pattern. The block on 6p21 carries C4A/C4B for complement, CYP21A2 for steroid 21-hydroxylase, and TNXB for tenascin-X, with tight linkage and lots of copy-number shuffling.
How this maps to the folate-receptor autoantibody story and folinic response:
Likely RCCX culprits to look at: C4 copy number and long vs short C4 with HERV-K(C4), TNXB loss or TNXB–CYP21A2 hybrid alleles, and common CYP21A2 deficiency variants or pseudogene conversions. (And hope you get lucky - much of RCCX still escapes us) These do not prove causation for CFD, yet they explain why this subtype clusters and why folinic acid helps the FRAA-positive group.
So I'd probably say this (might) be a non-verbal type of ASD caused by RCCX, unlike the type caused by dendritic abnormalities.
The analysis, published last week in the journal Nature, showed that children diagnosed before the age of 6 were more likely to have behavioral difficulties—such as problems with social interaction—from an early age. In contrast, those diagnosed after the age of 10 were more likely to experience social and behavioral difficulties during adolescence.
So if you have behavioral problems early, you're more likely to get diagnosed early, when you have behavioral difficulties later, you're more likely to get diagnosed later.
The phrasing here seems to want to imply a reverse causal relationship, but I'm pretty sure the conclusion here is that kids don't get tested for autism before they display autism-like behaviour.
As for the actual causes of autism, I recently read that the genetic and family is about 60-90% of the causes, making it by far the biggest cause, and not environmental factors like RFK likes to suggest. But it's not a single gene, it might be other stuff, and it's not an on/off thing but a big pile of factors that add up.
But there are also environmental factors that do have an impact. Not vaccines or Tylenol, but some kinds of pesticides, for example. Maybe that's something RFK could focus on.
Its more than a tautology, you are oversimplifying.
Or, well, as always with writings on or about science aimed at a general audience... the writers are oversimplifying, always read the paper.
https://www.nature.com/articles/s41586-025-09542-6
What they are describing is that those diagnosed early have a different behavioral psychological profile, different set of observed behaviors, than those diagnosed later.
They are saying that ASD has roughly two different sets of distinguishable behavioral profiles, and one of those sets is so obvious it tends to get diagnosed early, and another set is less obvious such that it tends to get diagnosed later.
While they seem hesitant to use the terminology of saying 'there may be two fairly distinct subtypes of autism', likely because they want to emphasize that more research needs to be done, they do not want to lead to people making rash and non nuanced conclusions... that basically is what they are saying, that there appear to be distinct genetic profiles that produce observably different 'kinds' of autism.
They ran a battery of statstical meta analysis on different genomes and behavioral profiles of Autists, and this chart I think summarizes it best:
(Those bars are 95% confidence intervals)
Two, fairly distinct behavioral/neurodevelopmental/phenotypical profiles, that also go along with two, fairly distinct underlying genomic profiles.
So if autism is a broader term that includes multiple conditions shouldn't we stop using it and start using the names of the actual conditions? Isn't it basically like hysteria which was split into epilepsy, dissociative disorders, personality disorders and so on?
The DSM hasn't even been updated with the differences in how women present ASD.
Having been born female, it’s amazing how I was diagnosed with everything from paranoid fucking schizophrenia to bipolar rather than acknowledge ASD/ADHD.
I remember cleaning out my locker once at the end of school and having a ton of crap just fall out on me. Absolutely no recognition of my lack of organizational/executive function skills because girls couldn’t possibly be ADHD/ASD.
IMO, as a 'high-functioning autist':
Yes.
The field of psychology is constantly redefining things based on ever shifting subjective analysis of behavioral patterns, and uh, being someone who very much prefers concrete, consistent, definable rules and categories, logically followable mechanistic processes...
Fucking yes, please, be more accurate and precise in a more objective way, based on far superior methodology, fucking please.
I feel like at minimum we should have it broken up by different favors, kinda like how Asperger's was a sub diagnosis under the umbrella of autism for awhile.
When they're understood well enough to have individual names, yes.
No. It's Tylenol... Did these people miss the memo, or...?
Early circumcision, too. See? Multiple causes!
It's tyrenol AND vaccines. Gottem
Lol