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Creating truly radical change in autism research: A response to Frith and Mottron
Running Title: Response to Frith and Mottron
Amy Pearson¹, Richard Woods², Hayley Morgan³ and Monique Botha
¹School of Psychology, Faculty of Health and Wellbeing, University of Sunderland, Sunderland, UK.
²School of Law and Social Sciences. London South Bank University. 103 Borough Road. London.
SE1 0AA, UK. ORCID: 0000-0002-8292-632X
³Faculty of Medicine, Health and Life Science, Swansea University
⁴Division of Psychology, University of Stirling, Stirling, FK9 4LA, Scotland. ORCID: 000-0002-5935-
9654
Correspondence:
Amy Pearson
amy.pearson@sunderland.ac.uk
School of Psychology
Faculty of Health Sciences and Wellbeing
University of Sunderland
City Campus
Sunderland
SR1 3SD
Tel: 0191 515 2279
ORCID ID: 0000-0001-7089-6103
Keywords: Subtypes (of ASD), Developmental Psychology, Social Cognition and
Theory of Mind
Frith (2021) and Mottron (2021) recently called for a backwards shift in autism research towards
identifying cognitive deficit and ‘prototypes’, to remedy a more heterogeneous diagnostic criteria. Frith
argues that our current conceptualisations of autism have shifted too far away from the idea of
‘disorder’. Likewise Mottron argues that autism has been ‘trivialised’, diluted by the inclusion of the
merely quirky. Whilst there is much to critique in the suggestion that research into the mechanisms of
autism should be prioritised over the identification (and associated support) of autistic people, here we
focus on two key points: autism as a discrete variable, and cognitive deficits as a core feature of
autism.
The initial introduction of autism as a diagnostic category in the 1940s was grounded in early 20th
century conceptualisations of normality and productivity (Evans 2014). These conceptualisations were
reified in the stratification of autism into ‘classic’ (or ‘Kanner’s’) autism, and Asperger Syndrome,
which were later collapsed with acknowledgement that it provided little insight into the support needs
of autistic people, and was stigmatising (Woods, Waldock, Keates and Morgan, 2019). Mottron
acknowledges that attempts to identify a singular genetic marker for autism has failed, as have
attempts to divide autism with biomarkers, and it is now recognised these endeavours are unlikely to
succeed. Frith acknowledges that theories of cognitive deficit are foiled by heterogeneity. The most
parsimonious explanation here does not require a narrowing to prototype, but an acknowledgement of
human error.
Multiple co-occurring diagnoses are common in both autistic adults and children, and attempts to
distill ‘pure’ autism have proved futile so far. ‘Autism’ may currently represent a particular clustering of
characteristics within the wider umbrella of developmental differences (Astle et al. 2021), or may
reflect more broadly the psychiatric othering endemic in the 20th century. As we debate the nature of
autism, autistic people continue to experience poorer mental and physical health outcomes,
victimisation, and stigma which is often grounded in cognitive deficit views of autistic people as
mindblind and lacking empathy. Differences at the cognitive level fail to translate to real world social
skill (Morrison, Pinkham, Kelsven, Ludwig, Penn and Sasson, 2019) whereas advances in theory
about autistic social style (Milton, 2012) have been confirmed in robust and ecologically valid social
research (Crompton, Ropar, Evans-Williams, Flynn, and Fletcher-Watson, 2020). These findings
suggest that it is indeed better theory we need, and not simply smaller, more stratified groups of
autistic people.
From birth our cognition is shaped by our interaction with the outside world, just like our behaviour.
Perhaps it is time to acknowledge that separating humans into smaller categories based upon their
perceived difference from normative expectations is unhelpful. Whilst a desire to understand the link
between brain, mind, and behaviour is a basic impetus in Psychology, this cannot be separated from
the social context (or ‘extraneous variables’) that has underpinned our knowledge. A truly radical
approach would be research that aims to understand autistic people, instead of the entity we call
autism.
References
Astle, D.E., Holmes, J., Kievit, R. and Gathercole, S.E. (2021), Annual Research Review: The
transdiagnostic revolution in neurodevelopmental disorders. J Child Psychol Psychiatr.
https://doi.org/10.1111/jcpp.13481
Crompton, C. J., Ropar, D., Evans-Williams, C. V., Flynn, E. G., & Fletcher-Watson, S. (2020).
Autistic peer-to-peer information transfer is highly effective. Autism, 24(7), 17041712.
https://doi.org/10.1177/1362361320919286
Evans B. (2014). The foundations of autism: the law concerning psychotic, schizophrenic, and autistic
children in 1950s and 1960s britain. Bulletin of the history of medicine, 88(2), 253285.
https://doi.org/10.1353/bhm.2014.0033
Frith, U. (2021), When diagnosis hampers research. Autism Research.
https://doi.org/10.1002/aur.2578 Online ahead of print.
Milton, D.E.M. (2012) On the ontological status of autism: the ‘double empathy problem’, Disability &
Society, 27:6, 883-887, DOI: 10.1080/09687599.2012.710008
Mottron, L. (2021). A radical change in our autism research strategy is needed: Back to prototypes.
Autism Research. https://doi.org/10.1002/aur.2494. Online ahead of print.
Sasson, N. J., Morrison, K. E., Kelsven, S., & Pinkham, A. E. (2020). Social cognition as a predictor of
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04287-4
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