Posted by amichail 12/28/2025
Shows how shockingly unaware even researchers are on how broad and nonspecific the diagnosis of autism is...
Were these 16 people hypo or hyper sensitive? Which of their five senses were involved? All? Some? Were some senses hyper and others hypo?
Need to start with categorization and specificity before we can make meaningful progress in research
The part I take issue with: "lower brain-wide mGlu5 availability may represent a molecular mechanism underlying altered excitatory neurotransmission that has the potential to stratify the heterogeneous autism phenotype."
Seems like the very premise is flawed, though. Searching for a single global identifier for autism would be like if we spent research time trying to find a single global identifier for cancer. Noble effort... Way harder than spending effort on subcategorization into "lung" and "heart" cancers and working on research for detection of those subtypes.
The only good categorization we have in autism now is severity.
The anecdote I always like to share is Temple Grandin.
She was hyper-sensitive to auditory and tactile senses. The cause for this hypersensitivity was cerebellar abnormalities in her brain. Right now, someone who is hypo-sensitive to sound and touch because of different cerebellar development will also be put in the same bucket diagnostically speaking. There's not gonna be any universal way to detect that though...
To quote her directly:
"It would be my number one research priority, but one of the problems we’ve got on studying this, is that one person may have visual sensitivity, another one touch sensitivities, another one, auditory sensitivities. And when you study these, you got to separate them out. You can’t just mix them all together." https://www.sensoryfriendly.net/podcast/understanding-my-aut...
I'm a dad of two autistic boys who I think would be very different categories. I have friends whose child isn't really autistic, they have a much more rare and specific diagnosis but it's so rare it's hard to get supports so they got him diagnosed as autistic because that criteria is so broad almost anyone can qualify.
Thank you for your work!
As an example: I'm autistic and I learn inside-out, building larger new concepts out of smaller existing ones; those with Asperger's on the other paw, learn outside-in instead, breaking down larger existing concepts into smaller new ones; both are part of the "autism spectrum", but differ very fundamentally.
Given that the origin of "autism" is simply "thinking that differs from usual", there's no evidence that there is a single underlying cause to find, nor that generalizations across the entire spectrum will reveal much of anything other than coincidence.
I believe we need to individualize new research to the variants that we now know exist, because otherwise we will continue to all-but erase anything that isn't common to the entire spectrum.
[0]: https://www.medrxiv.org/content/10.1101/2024.08.15.24312078v...
This is a really interesting observation - can you expand on this a bit more, please? How did you first notice this distinction?
When, for example, learning a new concept in math or physics, what would outside-in look like vs inside out? Would you characterise neurotypical learning in one way or the other?
A year or two ago I interacted with someone with Asperger's, and since that very rarely happens I hit a sort of uncanny valley with the way they wrote to me, because their writing gave me a lot of neurotypical vibes, but at the same time seemed a lot more logical and structured than actual neurotypical writing. They seemed to be building their writing and ideas out of logical tokens and constructs in an evidently autistic way, but so much of their writing looked neurotypical.
It was sort of like Scratch blocks, where they learned general templates for sentences and paragraphs from neurotypicals, and then substituted entire phrases at a time within them to achieve the desired communication. So while their templates and phrases were learned mostly from neurotypicals, the structure of their communication and usage of it still had a sort of logical system to it.
They remembered concepts by the phrases that had been used to explain it to them in the past, and reused those phrases verbatim, slotting them into the templates wholesale. They didn't fully parse everything like I do, they only broke things down as needed to create new logical tokens for new concepts. It's very interesting and fascinating. I mostly only know the one experience I've had, since I didn't get to speak to them again, but I've started to see it absolutely everywhere since.
Plenty of engineering blogs, for example, share that sort of tokenized writing style, like for instance this one I recently noticed: https://www.righto.com/2024/12/this-die-photo-of-pentium-sho...
> When, for example, learning a new concept in math or physics, what would outside-in look like vs inside out?
I can only guess, because I haven't interviewed someone with Asperger's about this, but I know what it looks like for me and I can guess what it could look like for them (at least for the purposes of the outside-in analogy).
For me, when I learn a new concept in math or physics, I want to build an intuition about that concept so I can come up with strategies about it and involving it. This actually mostly does not consist of algorithms related to the concept, but rather more of a fundamental intuition about the nature of the concept itself; what shape it is, what holes it fills, what types and classes of things it can do or model, etc. With this I can come up with my own algorithms on the fly, and also know when the concept might be relevant.
An outside-in learner, however, would be different. I have very little experience with the learning process or even with the execution process, but it's likely that they would not bother to break the concept all the way down and try to fully fundamentally understand it. Rather they might look to learn examples of it, algorithms and procedures relating to it, and ways to prove that their approach is correct. It would be less of "understand all the intricacies of this thing and every property it could possibly have and integrate that with everything else" and more of "fill a mental knowledge base with examples, applications, procedures relating to this thing".
> Would you characterise neurotypical learning in one way or the other?
I would not. I don't mean to imply that neurotypical logic is inherently more simplistic or inferior to autistic logic, but to me it seems far more like rote learning. They don't necessarily seem to break things down to understand the smaller details, but they don't really commit full logical tokens to memory either. They seem somewhere in the squishy middle, where they can be good at doing something that they don't understand at all, just because they practiced a lot, and they can be terrible at doing something that they understand far better, just because they're not practiced.
I've found that given I understand something well enough, I can perform better on the first try than some others who practice. That's not really a reliable indicator of much, but for me a lot comes from similar sources of truth, whereas it seems for a neurotypical they don't always necessarily organize or canonicalize their learnings, so their knowledge can be completely disjoint in areas that could totally be combined.
This is all just my personal experience/opinion though, fwiw.
I generally do the same thing when I'm learning something, and I have to fully understand a concept and then attack the concrete applications of the concept. But I've also learned how to go the other way when I need to because much of the technical writing I encounter is written for people who need a lot of examples but don't follow abstract concepts. So I've internalized building up the abstract concept from the concrete examples.
I believe it is both. You can go against your brain's coding with some extra work; somewhat like an adapter, I suppose. Your brain just still is coded a certain way natively.
> or example, what you're describing is basically typical of how Keirsey describes concrete versus abstract reasoning in Please Understand Me. And it could be kind of alienating to be the one abstract reasoner in a group of concrete reasoners and if you believe his statistics it's kind of likely that you'll find yourself in that situation a lot because you gravitate toward the abstract rather than the concrete/operational aspects of a concept.
This is very interesting. I've never heard of concrete/abstract reasoners before, but that does sound similar to what I've described. Thank you for the book.
> much of the technical writing I encounter is written for people who need a lot of examples but don't follow abstract concepts.
Yes! I love using examples to illustrate applications of an abstract concept, but I always explain the concept first. When the concept isn't explained first, I am sad. :(
> So I've internalized building up the abstract concept from the concrete examples.
I believe you may be better at it than I :)
Hi, I'm the author of that blog. Can you tell me more about what you mean by a "tokenized writing style"? One confounding factor is that I have a PhD, so I was trained for many years to write in a formalized, academic style. Also, I deliberately put a lot of "signpost" phrases in my posts, since I'm writing about complex subjects and want to avoid readers getting lost.
Reading from what you have written - that is part of my experience, though I don't think that it has anything to do with being Aspergers or even being on a spectrum, but being alone a lot and educating myself a lot - that basically is what "smart people" in general are doing - including NT. Yes, there are a lot of people that do not actively learn, but that can apply to Aspergers as well as NT. That is not the reason for differences.
Just to save space and not to create another comment - "four phenotypes" are not new attempt to classify. To me it looks like rewording - before there was already quite clear distinction between Aspergers and Aspergers&ADHD combination - both of them are part of "high functioning autism", and they behave wildly differently(people with Aspergers&ADHD part might not be recognized as "weird" but even as NT - by other people). They were all part of spectrum anyway. And from reading the paper it seems, that they have made 2 other types for what was "low functioning" autism. Apparently putting them all in ASD was not helping for bureaucracy - especially when it comes down to finances - it is quite important in Trumps USA and might be also for other countries.
People do often use the terms interchangeably, but that's not how I use it. I use Asperger's to refer to a specific place on the autism spectrum; I don't think there's a better term I can use right now. That place is as opposed to the three other phenotypes. I don't claim to know for absolute certain that the four phenotypes are correct, but I do believe strongly in the idea, because my lived experience appears to match with it closely. It has helped me understand others better, for sure. (Or at least to believe that I do)
I say I don't have Asperger's because I seem to function differently than others who do have it. When I encounter it, I find it interesting, because it's clearly different than how I function and that makes me curious. That makes me think I don't have it, because if I did, then surely I would be able to study myself to learn more about it, yet so far I can only speculate about how my experience must be different.
> Reading from what you have written - that is part of my experience, though I don't think that it has anything to do with being Aspergers or even being on a spectrum, but being alone a lot and educating myself a lot - that basically is what "smart people" in general are doing - including NT. Yes, there are a lot of people that do not actively learn, but that can apply to Aspergers as well as NT. That is not the reason for differences.
Of course neurotypical and neurodivergent people alike can educate themselves and learn. The difference is in how they learn, and what type of learning is most effective for them. Even among autistics, the most effective or natural style of learning can greatly differ. This is also why many schools have entirely different classes for autistic people, because the style of learning that works best for neurotypicals may not be as effective for an autistic person.
What I think has to do with Asperger's is in the type of knowledge that is most useful to you, and the style of learning that is most useful to you. I don't actually know this for sure, but I believe that for any given concept, you would probably use different aspects than I would to understand it. That means if I told you everything that I believe is most essential to my own understanding of something you don't understand yet, you still might not get it, because you might have different requirements to understand that thing, and you might find different things most essential to that understanding.
Of course, in some ways this is true for everyone, for example if my most essential pieces of knowledge relate to or build upon other of my knowledge that you also do not have. But in other ways this is only true across different neurotypes, such as Asperger's and neurotypical, or Asperger's and another type of autism, because generally each phenotype appears to share a largely similar type of logical structure. For Asperger's it appears to be those nested tokens, for myself it seems to be a linear stream of thought or reasoning, for some of my friends it appears to be based on context and metadata, and for others of my friends it appears to be based on emotions and lore (sort of hard to explain). That makes four, and every single autistic person I know or encounter seems to fit into one of those boxes. Sometimes it takes longer to tell for sure, but I believe that I eventually always can.
> Just to save space and not to create another comment - "four phenotypes" are not new attempt to classify. To me it looks like rewording - before there was already quite clear distinction between Aspergers and Aspergers&ADHD combination - both of them are part of "high functioning autism", and they behave wildly differently(people with Aspergers&ADHD part might not be recognized as "weird" but even as NT - by other people). They were all part of spectrum anyway. And from reading the paper it seems, that they have made 2 other types for what was "low functioning" autism. Apparently putting them all in ASD was not helping for bureaucracy - especially when it comes down to finances - it is quite important in Trumps USA and might be also for other countries.
It's entirely possible that Asperger's without ADHD is, well, Asperger's, while Asperger's with ADHD is actually not Asperger's, and is rather another autism phenotype instead. To be honest, I've never heard of Asperger's + ADHD, while I've heard of ADHD for all three of the other types, so maybe that's the difference you are observing. I can't know for sure though.
I believe low-functioning autistics may happen to have brain defects or severe trauma or something else that disables them. I don't believe they are fundamentally different from other autistics in terms of the phenotype. I believe that a lot of the time, whether someone is called low-functioning is based primarily on how well they are able to function and how much support they need, and not really specific indicators that would indicate phenotype. Similar to how the criteria for ASD can diagnose autism, but not specifically Asperger's or specifically my type. I know that all four of the phenotypes certainly can be high-functioning, so that leads me to believe that low-functioning may be on top of that, and not a separate category altogether.
I don't think Trump has anything to do with this -- in fact he has been trying to shut down government benefits for autism (and for other things he views as a disability), so it's hard for me to believe that he cares about better classifying them when he seems to want them dead.
To me this just sounds like the interaction of autism with other variances in neurotype. You can also reasonably categorise non-autistic people into people who learn outside-in and those who learn inside-out.
Inside-out versus outside-in also doesn't really have to do with the order of learning. I could very easily learn the basic metadata of an overall system before I start diving into the details. Black boxes are very common for me to avoid going too deep into research or reverse-engineering rabbitholes (or to paper over an inability for me to learn more about inner workings). It has to do with the structure of learning. For me to model something as a black box, I'll accept that, though there may be parts inside it, I don't need to care how they're implemented. For someone with Asperger's to model something as a black box ... I imagine they already do that by default. How much of that is cognitive strategy or not, I can't really tell, but outside-in learning seems to prefer to pick up entire pieces that have a desired value rather than digging into every detail contributing to that value. While I could mimic that or show behavior that resembles something like that, it's just not really how my brain works on a fundamental level like that? I don't really know how to draw the line. You do raise a decent point.