Redefining Autism

Written by Georgie Makary, 2026 - All rights reserved

Autism Spectrum Disorder (ASD), or simply autism, is a highly genetic neurodevelopmental condition with considerable variation in how it presents. Although there are common underlying features, autistic individuals often show unique patterns in cognition, behaviour and day-to-day functioning. In general, these features involve differences in social communication and interaction, sensory integration and behavioural patterns that may be repetitive or more narrowly ranged when compared to neurotypical development (American Psychiatric Association, 2013).

Autism is recognised as a heterogeneous condition, meaning that its presentation can differ significantly between individuals. This diversity has informed the use of the term “spectrum,” reflecting a move away from earlier, more rigid conceptualisations (Wing et al., 2011). The spectrum is not a linear, sliding scale; it is a complex wheel of overlapping characteristics including sensory processing, language, social differences, tics and repetitive behaviours, communication differences, emotional regulation, special interests, executive functioning and learning differences (Pender et al., 2020). 

Earlier understandings framed autism in categorical terms based on observable behaviours like avoiding eye contact and a flat, monotone voice. More recent perspectives adopt a dimensional approach, recognising that while individuals may share core traits, the way these traits manifest vary widely. This variability is evident not only in the expression of core characteristics, but also adaptive functioning and the level of support needed in everyday life (Lord et al., 2020). 

Eye contact is a good example, often experienced as uncomfortable or physically painful for the autistic community. This may lead one individual to avoid making eye contact due to discomfort. However, another individual may force prolonged eye contact for fear of being socially rude. This variability in how a core characteristic can be expressed is reflected in contemporary diagnostic frameworks, where autism is understood both as a clinical diagnosis and a broad range of lived experiences, abilities, personality characteristics and adaptations (American Psychiatric Association, 2013; Lord et al., 2020; Pender et al., 2020).

Autism was first defined as a disorder in the early 20th century by specialists including Kanner and Asperger, however it has long existed as a natural variation of the human brain and widely misunderstood throughout history (Silberman, 2015). The rise in autism diagnoses can be partly attributed to the widening of diagnostic criteria, specifically for the differing presentation in girls and women (the first explicit studies dedicated to the female phenotype of autism began in to 2010s). There are also important advances in diagnostic screening tools to better identifying autism from diagnoses of broader language and behavioural disorders. Other evidence-based hypotheses include sociobiological factors like advanced parental age and genetic mutations or prenatal factors, however these are likely to be factors and no directly causational (Silberman, 2015; Happé & Frith, 2020). Advances in research fields such as genetics, neuroscience, and behavioural science continue to explore the epidemiology of autism (Happé & Frith, 2020). 

Lilly Pilly approaches autism not as a condition to be fixed, but as a valid and meaningful way of experiencing and interacting with the world. The focus is on supporting individuals to better understand their own strengths, needs, and communication styles, rather than attempting to retrain or suppress autistic traits. Therapy is guided by a neuroaffirming framework that prioritises acceptance, self-understanding, and identity. 

References 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Happé, F., & Frith, U. (2020). Annual research review: Looking back to look forward—Changes in the concept of autism and implications for future research. Journal of Child Psychology and Psychiatry, 61(3), 218–232. 

Lord, C., Brugha, T. S., Charman, T., Cusack, J., Dumas, G., Frazier, T., Jones, E. J. H., Jones, R. M., Pickles, A., State, M. W., Taylor, J. L., & Veenstra-VanderWeele, J. (2020). Autism spectrum disorder. Nature Reviews Disease Primers, 6(1), 5. 

Pender, R., Fearon, P., Heron, J., & Mandy, W. (2020). The longitudinal heterogeneity of autistic traits: A systematic review. Research in Autism Spectrum Disorders, 79, 101671. 

Silberman, S. (2015). NeuroTribes: The legacy of autism and the future of neurodiversity. Avery. 

Wing, L., Gould, J., & Gillberg, C. (2011). Autism spectrum disorders in the DSM-V: Better or worse than the DSM-IV? Research in Developmental Disabilities, 32(2), 768–773.