Prof Uta Frith on autism: "why I no longer think autism is a spectrum" and a whole lot more

Uta Frith: why I no longer think autism is a spectrum https://www.tes.com/magazine/teaching-learning/general/uta-frith-interview-autism-not-spectrum

I often find that as people age/mature and maybe start to take their foot off often powerful careers, they tend to say more of what they actually think rather than what the 'trends' say they should think.

I think the same applies to this interview with the very famous Uta Frith and some of her views on autism now, particularly in the context of the singular description of autism now moving to something a little more 'plural' (sounds very familiar).

A few choice phrases: "... people still hang on to the idea that there is something that unites all the people who are diagnosed as autistic. I don’t believe that any more." Can't argue with that as the old 'autism community' which was often used by some very vocal people to give the impression that 'everyone agrees with me' gives way to the plural autisms communities. The diagnostic criteria for autism still unite all, but the expression of those core symptoms and their meaning and effects do not.

Further: "I think at least we have two big subgroups: the people who are diagnosed in early childhood - usually before age three or age five, depending on things like their intellectual abilities and language - and another group, diagnosed much later." Yes, one of many 'partitions' that subdivide the very heterogeneous autism label. There's lots more across symptoms intensities, developmental trajectories and also importantly, different aetiologies. The plural autisms.

"Now, I think the people in the second group really do have problems. I would definitely not say they are “making it up”. But I would say that these are problems that can perhaps be treated much better than under the label of “autism”. I would fight for that label to be limited to the first group." That is a big statement unlikely to make too many friends among certain people/groups. But I think she's right, as per the seemingly now redundant label of 'social (pragmatic) communication disorder' remaining underused and how autistic traits don't necessarily mean autism (see the ICD-11 autism criteria for what else it might mean).

And finally: "The masking idea has no scientific basis, yet everybody, including the researchers and the clinicians, has been enamoured with this idea." Not me. And certainly not Prof Fombonne and his 'poor fit' description. Indeed, even the 'science' on autism and masking isn't too sure: e.g. Camouflaging and autism: Conceptualisation and methodological issues (and that's putting it mildly).

Indeed her 'shredding' of masking / camouflaging in the context of autism is particularly welcome and a bit of wake-up call to various academics, some of whom have seemingly forgotten what (a) autism is, and (b) what scientific evidence is. It might also be worth their while looking up Hacking's 'Looping Effects' too. Mind you, they also tend be the same people who would happily study autism and include those who 'self-diagnose' as all part of a homogenous group. Even many people with autism are getting a bit sick of that (see here) as per the words: "Self-diagnosis “muddies the water”". If you'd care to see the ICD-11 autism diagnosis boundary conditions, you'll also see what other conditions may well be included in such 'self-diagnosing' studies including personality disorders and schizophrenia spectrum disorders. Nobody seems to be running to self-diagnose with them.

There'll be blood boiling about this piece from someone who knows more than most about autism but on many points, she's probably right.