One of the world’s leading experts on autism has questioned the current definition used by clinicians, suggesting it is so broad that it risks “confusion and misdiagnosis”.
Autism is currently diagnosed as Autism Spectrum Disorder (ASD) – a single condition that includes a huge range of people, from those needing round-the-clock care to those who live independently.
Prof Dame Uta Frith, whose research in the 1960s and 1970s lay the foundations for how autism is understood, asked whether the autism “spectrum” has become too broad to be useful.
Writing in the journal Psychological Medicine, the University College London professor said: “Autism wasn’t always defined this way – a sort of catch-all diagnosis for a huge variety of conditions.
“When it was first identified in the 1940s, it referred to a small group of children with severe difficulties in social interaction, communication and behaviour. Over time, the definition has widened to include people with milder traits and no language or learning problems.
“Today, anyone of any age or intelligence level can be diagnosed with autism if they meet certain criteria.”
The number of people diagnosed with autism has increased dramatically, from about four in 10,000 children in the UK in the 1960s, to around one in 57 schoolchildren today.
Seventy-five million people, or approaching one per cent of the world’s population, are thought to have some form of autism.
The UAE has a National Autism Policy, which aims to improve the health and well-being of people with ASD. It sets out to support and empower them across age groups through early detection, accurate diagnosis and clear educational pathways.
In 2022, there were 4,561 registered cases of ASD in the Emirates. According to the Ministry of Community Development, 44 per cent of those were Emirati citizens. The UAE has over the years been working to make it easier for people who live with ASD and their families.
Prof Frith, Emeritus Professor of Cognitive Development at the UCL Institute of Cognitive Neuroscience, said the dramatic rise in global cases was down to greater awareness and less stigma, broader interpretation of diagnostic criteria, more people identifying with autism online, self-diagnosis and social media influence as well as a cultural shift towards explaining everyday life problems via medical labels.
Prof Frith’s 50-year career researching the cognitive underpinnings of autism is longer than nearly anyone else's, and she was among the first people to explore the types of autism using newly available brain scanners in the 1990s.
She developed two landmark theories about how autistic minds might develop differently to neurotypical minds.
They were the theory of mind deficit: the idea that autistic people may find it harder to infer other people’s thoughts, beliefs and intentions; and weak central coherence: proposing that autistic cognition tends to focus on details rather than the bigger picture. Autistic individuals may excel at noticing fine details but find it harder to integrate them into a broader, contextual understanding.
In her new paper, she argues that not all autism diagnoses look the same, highlighting research showing a big difference between people diagnosed in childhood and those diagnosed as teenagers or adults.
Early-diagnosed people often show clear signs from a young age and may have language or learning difficulties, while those diagnosed later are more likely to have average or high intelligence and may also have conditions such as anxiety, depression or ADHD.
Some studies have suggested they are not the same condition.
Prof Frith warns that expanding the definition of autism may lead to people being given an autism label even when another condition might explain their difficulties.
“This matters because diagnoses shape treatment, identity and support. A wrong diagnosis can lead to the wrong help – or no help at all,” she said.
She said: “Autism is no longer just a medical term – it has become part of popular culture. Social media, films and online communities have helped people share experiences, but they have also spread simplified or misleading ideas.
“At the same time, the idea of ‘neurodiversity’ has encouraged people to see autism as a difference rather than a disorder. While this helps reduce stigma, it also creates tension: if autism is not a disorder, why use a medical diagnosis?”
She calls for a rethink of how autism is defined and diagnosed. Instead of one broad “spectrum”, she suggests splitting autism into clearer subgroups, focusing on individuals’ specific needs, prioritising support for those with the greatest difficulties and improving diagnostic precision.
She said: “The time has come to examine whether the autism spectrum has become too broad. Without greater precision, we risk misunderstanding people’s needs and misdirecting care.”
