Washington Post on identification of distinct autism subtypes

[Anonymous]

Anonymous wrote:WaPo published a piece today on a Princeton study published in Nature this summer around identifying 4 distinct phenotype and geneotype based groups of autism:

WaPo piece: https://www.washingtonpost.com/health/2025/12/26/autism-research-diagnosis-subtypes/

Article: https://www.nature.com/articles/s41588-025-02224-z

What do you all think?

Personally I think their classifications makes lot of sense and may settle some of the strife in the community between those who right now are classified as level 1 vs levels 2/3. Thoughts?

I can’t give you an opinion because there’s a paywall and I don’t have time to read the Nature report.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:The only people that seem to care are the parents of kids who have more difficult symptoms/experiences.

I’m not sure that’s quite true. I got diagnosed recently as an adult… I’m very high functioning (have a doctorate, high paying career, etc) but have struggled socially forever and sought a diagnosis after pretty much realizing it for myself a few years back. My mother refuse to accept I have autism because her vision of autism is the very high needs, low functioning type…

What symptoms did/do you have?

I’m asking because I believe my 18yo DD might be on the spectrum. She’s never really completely fit in with other girls her age. She’d try and like the same things but it wouldn’t come natural to her, at 13/14 when other girls were experimenting with makeup/fashion, she felt too young and wasn’t as interested, and now regularly says she still feels 12 and can’t imagine having the independence to do adult things like drive, work, etc.

I’m fiercely independent so not like your daughter in that way. I have always, always been perceived as weird by the people around me and was severely bullied pretty much my whole life. In high school I had a girl pretty much tell me to my face that she didn’t want me to come to a social gathering because I was weird. I never understood social cues and would end up trying to mimic things I saw on tv shows to try to fit in which just made me weirder. In my adult life I don’t have many friends. I am married (my husband is also neurodivergent and accepts my weirdness). I also get really easily frustrated at things. Oh and I never realize how loud I am especially when I get excited about what I’m talking about… my husband always has to shush me, lol.

But as I said besides socially I’m prettt successful… I’ve always been smart and excelled academically and in my career. Professionally I’m able to mask and fake my way through being collegial and I supervise a ton of folks who have all raved about me as a manager, so it doesn’t manifest there…

If how you described yourself is autism, then that tent is pretty big.

That sounds exactly like what Level 1 ASD is.

It really does not. even level 1 is supposed to be apparent across multiple domains (so you wouldn’t expect to just not be evident at work) and cause clinically significant impairment.

Please tell me what makes you qualified to be the arbiter of who is impaired enough to be deemed autistic or not… why are you so concerned?

It’s in the DSM.

Then you missed the pount. The DSM is ever evolving and will very likely change again with all this new research

[Anonymous]

Anonymous wrote:The only people that seem to care are the parents of kids who have more difficult symptoms/experiences.

I'm the parent of a girl who is generally considered 'higher functioning'-but these levels seem like a box. As I sometimes say 'she's high functioning unless she isn't'. She doesn't seem to fit into any one box 100% of the time. I really do think autism is a spectrum. It seems to be for my child.

[Anonymous]

Anonymous wrote:

Anonymous wrote:One thing I found really helpful here is the idea that in the last “category”, individual’s ASD can activate later.

I have always wondered if I failed our DD by not identifying her ASD early, which seems to be consistent communicated as so critical that you start intervention. But the reality is that when I look back on her early years there were things that were never issues (eg sustained eye contact) that became issues as she got older.

Agreed — I found it interesting that that group by and large hit their early developmental milestones without delay… definitely speaks to this being a much more complicated disorder than people realize, particularly for girls

Agree with this. I have been thinking about getting my 8 yr old DD tested but wavering because in many ways she's on track and I don't want to pathologize her "quirkiness." But I worry I could be depriving her of important self knowledge. Having this kind of categorization makes it feel more approachable to me, a way for her to better understand how her brain works instead of a binary choice between autistic and neurotypical. I know the old system also has levels, but they are so vague as to essentially be meaningless. I could see this being more helpful to those diagnosed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:One thing I found really helpful here is the idea that in the last “category”, individual’s ASD can activate later.

I have always wondered if I failed our DD by not identifying her ASD early, which seems to be consistent communicated as so critical that you start intervention. But the reality is that when I look back on her early years there were things that were never issues (eg sustained eye contact) that became issues as she got older.

Agreed — I found it interesting that that group by and large hit their early developmental milestones without delay… definitely speaks to this being a much more complicated disorder than people realize, particularly for girls

Agree with this. I have been thinking about getting my 8 yr old DD tested but wavering because in many ways she's on track and I don't want to pathologize her "quirkiness." But I worry I could be depriving her of important self knowledge. Having this kind of categorization makes it feel more approachable to me, a way for her to better understand how her brain works instead of a binary choice between autistic and neurotypical. I know the old system also has levels, but they are so vague as to essentially be meaningless. I could see this being more helpful to those diagnosed.

I am just getting my 13 yo tested. She has had an anxiety dx but I wouldn’t be surprised if adhd or asd were added to that. I realize my big fear about the eval is that she might have asd - and that’s a terrible reason not to get her tested.

[Anonymous]

Anonymous wrote:

Anonymous wrote:WaPo published a piece today on a Princeton study published in Nature this summer around identifying 4 distinct phenotype and geneotype based groups of autism:

WaPo piece: https://www.washingtonpost.com/health/2025/12/26/autism-research-diagnosis-subtypes/

Article: https://www.nature.com/articles/s41588-025-02224-z

What do you all think?

Personally I think their classifications makes lot of sense and may settle some of the strife in the community between those who right now are classified as level 1 vs levels 2/3. Thoughts?

I can’t give you an opinion because there’s a paywall and I don’t have time to read the Nature report.

WaPo is 6 months late reporting on this.

It was also discussed on DCUM previously.

https://www.psychiatrist.com/news/new-autism-study-uncovers-four-biological-subtypes/

https://www.autismspeaks.org/science-news/study-identifies-autism-subtypes

[Anonymous]

11 pages of previous discussion in July 2025

https://www.dcurbanmom.com/jforum/posts/list/105/1282436.page#30403121

[Anonymous]

Anonymous wrote:

Anonymous wrote:My DH is believed to have autism but he is really high functioning and independent. He tells me that some people may see him weird and geeky but he did well in academic and sports growing up. He lived in dorm room and shared apartment with roommates with no issues during college years. He has friends and he can hold conversation if he wants. He does well at career, and he can talk confidently and does presentation for hours on stage in front of thousands of people or in front of management. He only shows all of his autism traits at home which is some stubborn and childish behaviors because I have been married with him for 10 plus years. He lived by himself in a studio for many years, so I know that he can be independent. He talks mature and acts responsibly/professionally in front of other people. He is not worried at all on our children who also have asd and adhd.

Level one autism has nothing to do with not being independent or not having empathy. In fact, many level one ASD people are wildly independent and empathetic. I think there’s a lot of misconceptions about what autism is. Also many men are able to mask their traits when they’re young adult/teens with drinking. They seem to be able to keep up in the social scene until at least mid 20s and many cases. But the parts of them that are more childish or immature seem to Persist through the adult years while people who are not neurodivergent Mature through the years.

Incredibly stupid comment.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The only people that seem to care are the parents of kids who have more difficult symptoms/experiences.

I’m not sure that’s quite true. I got diagnosed recently as an adult… I’m very high functioning (have a doctorate, high paying career, etc) but have struggled socially forever and sought a diagnosis after pretty much realizing it for myself a few years back. My mother refuse to accept I have autism because her vision of autism is the very high needs, low functioning type…

What symptoms did/do you have?

I’m asking because I believe my 18yo DD might be on the spectrum. She’s never really completely fit in with other girls her age. She’d try and like the same things but it wouldn’t come natural to her, at 13/14 when other girls were experimenting with makeup/fashion, she felt too young and wasn’t as interested, and now regularly says she still feels 12 and can’t imagine having the independence to do adult things like drive, work, etc.

I’m fiercely independent so not like your daughter in that way. I have always, always been perceived as weird by the people around me and was severely bullied pretty much my whole life. In high school I had a girl pretty much tell me to my face that she didn’t want me to come to a social gathering because I was weird. I never understood social cues and would end up trying to mimic things I saw on tv shows to try to fit in which just made me weirder. In my adult life I don’t have many friends. I am married (my husband is also neurodivergent and accepts my weirdness). I also get really easily frustrated at things. Oh and I never realize how loud I am especially when I get excited about what I’m talking about… my husband always has to shush me, lol.

But as I said besides socially I’m prettt successful… I’ve always been smart and excelled academically and in my career. Professionally I’m able to mask and fake my way through being collegial and I supervise a ton of folks who have all raved about me as a manager, so it doesn’t manifest there…

If how you described yourself is autism, then that tent is pretty big.

That sounds exactly like what Level 1 ASD is.

It really does not. even level 1 is supposed to be apparent across multiple domains (so you wouldn’t expect to just not be evident at work) and cause clinically significant impairment.

Please tell me what makes you qualified to be the arbiter of who is impaired enough to be deemed autistic or not… why are you so concerned?

It’s in the DSM.

Then you missed the pount. The DSM is ever evolving and will very likely change again with all this new research

If the DSM changes it will be to tighten the criteria.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The only people that seem to care are the parents of kids who have more difficult symptoms/experiences.

I’m not sure that’s quite true. I got diagnosed recently as an adult… I’m very high functioning (have a doctorate, high paying career, etc) but have struggled socially forever and sought a diagnosis after pretty much realizing it for myself a few years back. My mother refuse to accept I have autism because her vision of autism is the very high needs, low functioning type…

What symptoms did/do you have?

I’m asking because I believe my 18yo DD might be on the spectrum. She’s never really completely fit in with other girls her age. She’d try and like the same things but it wouldn’t come natural to her, at 13/14 when other girls were experimenting with makeup/fashion, she felt too young and wasn’t as interested, and now regularly says she still feels 12 and can’t imagine having the independence to do adult things like drive, work, etc.

I’m fiercely independent so not like your daughter in that way. I have always, always been perceived as weird by the people around me and was severely bullied pretty much my whole life. In high school I had a girl pretty much tell me to my face that she didn’t want me to come to a social gathering because I was weird. I never understood social cues and would end up trying to mimic things I saw on tv shows to try to fit in which just made me weirder. In my adult life I don’t have many friends. I am married (my husband is also neurodivergent and accepts my weirdness). I also get really easily frustrated at things. Oh and I never realize how loud I am especially when I get excited about what I’m talking about… my husband always has to shush me, lol.

But as I said besides socially I’m prettt successful… I’ve always been smart and excelled academically and in my career. Professionally I’m able to mask and fake my way through being collegial and I supervise a ton of folks who have all raved about me as a manager, so it doesn’t manifest there…

If how you described yourself is autism, then that tent is pretty big.

That sounds exactly like what Level 1 ASD is.

It really does not. even level 1 is supposed to be apparent across multiple domains (so you wouldn’t expect to just not be evident at work) and cause clinically significant impairment.

She’s masking at work.

Yeah that’s not a thing.

DP- it’s quite literally one of the common attributes of level one ASD.

It’s quite literally not. It’s not a disability if you can so completely compensate. That’s why the DSM says the deficits have to show up in multiple settings.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The only people that seem to care are the parents of kids who have more difficult symptoms/experiences.

I’m not sure that’s quite true. I got diagnosed recently as an adult… I’m very high functioning (have a doctorate, high paying career, etc) but have struggled socially forever and sought a diagnosis after pretty much realizing it for myself a few years back. My mother refuse to accept I have autism because her vision of autism is the very high needs, low functioning type…

What symptoms did/do you have?

I’m asking because I believe my 18yo DD might be on the spectrum. She’s never really completely fit in with other girls her age. She’d try and like the same things but it wouldn’t come natural to her, at 13/14 when other girls were experimenting with makeup/fashion, she felt too young and wasn’t as interested, and now regularly says she still feels 12 and can’t imagine having the independence to do adult things like drive, work, etc.

I’m fiercely independent so not like your daughter in that way. I have always, always been perceived as weird by the people around me and was severely bullied pretty much my whole life. In high school I had a girl pretty much tell me to my face that she didn’t want me to come to a social gathering because I was weird. I never understood social cues and would end up trying to mimic things I saw on tv shows to try to fit in which just made me weirder. In my adult life I don’t have many friends. I am married (my husband is also neurodivergent and accepts my weirdness). I also get really easily frustrated at things. Oh and I never realize how loud I am especially when I get excited about what I’m talking about… my husband always has to shush me, lol.

But as I said besides socially I’m prettt successful… I’ve always been smart and excelled academically and in my career. Professionally I’m able to mask and fake my way through being collegial and I supervise a ton of folks who have all raved about me as a manager, so it doesn’t manifest there…

If how you described yourself is autism, then that tent is pretty big.

That sounds exactly like what Level 1 ASD is.

It really does not. even level 1 is supposed to be apparent across multiple domains (so you wouldn’t expect to just not be evident at work) and cause clinically significant impairment.

She’s masking at work.

Yeah that’s not a thing.

DP- it’s quite literally one of the common attributes of level one ASD.

It’s quite literally not. It’s not a disability if you can so completely compensate. That’s why the DSM says the deficits have to show up in multiple settings.

Are you a licensed psychologist? If you’re not, please stop talking like you are the truthsayer of the DSM.

Masking is in fact a deficit behavior that has real long term issues. Just because someone can play the part doesn’t mean they don’t have an underlying disorder.

What’s ironic here is so many parents swear by ABA which is literally teaching kids how to mask… and leads to burnout down the line. But they’re no less autistic.

In any case PP, if someone has a diagnosis from a licensed practitioner, why do you feel like you can just say “nah, I know better”

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The only people that seem to care are the parents of kids who have more difficult symptoms/experiences.

I’m not sure that’s quite true. I got diagnosed recently as an adult… I’m very high functioning (have a doctorate, high paying career, etc) but have struggled socially forever and sought a diagnosis after pretty much realizing it for myself a few years back. My mother refuse to accept I have autism because her vision of autism is the very high needs, low functioning type…

What symptoms did/do you have?

I’m asking because I believe my 18yo DD might be on the spectrum. She’s never really completely fit in with other girls her age. She’d try and like the same things but it wouldn’t come natural to her, at 13/14 when other girls were experimenting with makeup/fashion, she felt too young and wasn’t as interested, and now regularly says she still feels 12 and can’t imagine having the independence to do adult things like drive, work, etc.

I’m fiercely independent so not like your daughter in that way. I have always, always been perceived as weird by the people around me and was severely bullied pretty much my whole life. In high school I had a girl pretty much tell me to my face that she didn’t want me to come to a social gathering because I was weird. I never understood social cues and would end up trying to mimic things I saw on tv shows to try to fit in which just made me weirder. In my adult life I don’t have many friends. I am married (my husband is also neurodivergent and accepts my weirdness). I also get really easily frustrated at things. Oh and I never realize how loud I am especially when I get excited about what I’m talking about… my husband always has to shush me, lol.

But as I said besides socially I’m prettt successful… I’ve always been smart and excelled academically and in my career. Professionally I’m able to mask and fake my way through being collegial and I supervise a ton of folks who have all raved about me as a manager, so it doesn’t manifest there…

If how you described yourself is autism, then that tent is pretty big.

That sounds exactly like what Level 1 ASD is.

It really does not. even level 1 is supposed to be apparent across multiple domains (so you wouldn’t expect to just not be evident at work) and cause clinically significant impairment.

She’s masking at work.

Yeah that’s not a thing.

DP- it’s quite literally one of the common attributes of level one ASD.

It’s quite literally not. It’s not a disability if you can so completely compensate. That’s why the DSM says the deficits have to show up in multiple settings.

Are you a licensed psychologist? If you’re not, please stop talking like you are the truthsayer of the DSM.

Masking is in fact a deficit behavior that has real long term issues. Just because someone can play the part doesn’t mean they don’t have an underlying disorder.

What’s ironic here is so many parents swear by ABA which is literally teaching kids how to mask… and leads to burnout down the line. But they’re no less autistic.

In any case PP, if someone has a diagnosis from a licensed practitioner, why do you feel like you can just say “nah, I know better”

ABA doesn’t teach kids to mask these days. It teaches them skills.

[Anonymous]

I am seeing the Facebook memes about girls with autism, and I ticked all the boxes when I was younger.

But I am not autistic. It's ludicrous to say I am.

If you are a functional adult, you aren’t either. The DSM specifically says that the condition must impact daily living.

The categories are a mess and written in a way that people are DXed with ASD when they actually have a genetic condition like Downs or Cornelia de Lange syndrome.

Maybe these categories will prove fruitful down the road but there is still a lot of work to do.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The only people that seem to care are the parents of kids who have more difficult symptoms/experiences.

I’m not sure that’s quite true. I got diagnosed recently as an adult… I’m very high functioning (have a doctorate, high paying career, etc) but have struggled socially forever and sought a diagnosis after pretty much realizing it for myself a few years back. My mother refuse to accept I have autism because her vision of autism is the very high needs, low functioning type…

What symptoms did/do you have?

I’m asking because I believe my 18yo DD might be on the spectrum. She’s never really completely fit in with other girls her age. She’d try and like the same things but it wouldn’t come natural to her, at 13/14 when other girls were experimenting with makeup/fashion, she felt too young and wasn’t as interested, and now regularly says she still feels 12 and can’t imagine having the independence to do adult things like drive, work, etc.

I’m fiercely independent so not like your daughter in that way. I have always, always been perceived as weird by the people around me and was severely bullied pretty much my whole life. In high school I had a girl pretty much tell me to my face that she didn’t want me to come to a social gathering because I was weird. I never understood social cues and would end up trying to mimic things I saw on tv shows to try to fit in which just made me weirder. In my adult life I don’t have many friends. I am married (my husband is also neurodivergent and accepts my weirdness). I also get really easily frustrated at things. Oh and I never realize how loud I am especially when I get excited about what I’m talking about… my husband always has to shush me, lol.

But as I said besides socially I’m prettt successful… I’ve always been smart and excelled academically and in my career. Professionally I’m able to mask and fake my way through being collegial and I supervise a ton of folks who have all raved about me as a manager, so it doesn’t manifest there…

If how you described yourself is autism, then that tent is pretty big.

Exactly. The reason why scientists have basically have had to create new autism categories is to fix the overly broad diagnostic criteria of the DSM 5 and clinical practice. If you don’t filter out the adults who are normal in all ways except some social quirks then you cannot do any sort of meaningful research.

It isn’t just “social quirks”.

[Anonymous]

Anonymous wrote:I am seeing the Facebook memes about girls with autism, and I ticked all the boxes when I was younger.

But I am not autistic. It's ludicrous to say I am.

If you are a functional adult, you aren’t either. The DSM specifically says that the condition must impact daily living.

The categories are a mess and written in a way that people are DXed with ASD when they actually have a genetic condition like Downs or Cornelia de Lange syndrome.

Maybe these categories will prove fruitful down the road but there is still a lot of work to do.

“Functional adult” isn’t the test. Significantly impaired in a basic function is. You can be a functional adult with no friends, for instance. Or a functional adult who regularly changes jobs. Or a functional adult who is unable to go on vacation due to restricted eating patterns. That’s all significant impairment.

But I continue to think that the diagnostic criteria are a mess and this study doesn’t shed that much light on it.