In Defence of Autism Spectrum Idea

Autism’s diversity is not the problem; systems built on scarcity are. As India still struggles with late diagnosis and minimal support, narrowing who “counts” as autistic risks deepening exclusion.

Uta Frith is a renowned autism researcher who originally helped popularise the idea of autism as a spectrum, to reflect the wide range of ways autistic traits manifest across people. In her recent interview, she now argues that the spectrum has “widened to the point of collapse”, claiming that people currently diagnosed as autistic no longer share a meaningful common factor.

One of her central concerns is that the rise in diagnoses, especially among people without obvious early developmental differences, is straining limited services and preventing those with more visible support needs from receiving adequate help. Framed this way, the problem appears to be “too many” autistic people and “too little” support. But this logic quickly leads to excluding those whose needs are less visible or more intermittent from formal recognition and services. It shifts the burden onto them to find help elsewhere or to “cope” without accommodations, rather than questioning why systems are built on scarcity in the first place.

In the Indian context, this argument sits very differently. We do not, in any meaningful sense, have a robust, state‑funded support infrastructure for autistic people to begin with. The fear that “mild cases” will drain resources away from “severe cases” assumes a level of systemic provision that simply does not exist here. Our reality is closer to chronic under‑diagnosis, late diagnosis, and almost complete reliance on families and private provision.

Frith also questions whether there is really a “common denominator” across all these different presentations. But another possibility is that we, as clinicians and researchers, have historically only recognised autism when it conforms to a narrow, externalised, largely male and childhood‑centred prototype. As more women, marginalised genders, and late‑diagnosed adults describe their experiences, the commonalities may be less in the surface behaviour and more in underlying patterns of sensory processing, social cognition, and effortful compensation. Late‑identified people have often spent years learning to perform neurotypical behaviour under conditions of non‑acceptance. It is unsurprising if the “common denominators” are harder to see when much of the work is happening internally.

Her dismissal of “masking” and “sensory needs” as insufficiently scientific is particularly troubling. Masking is not a fashionable buzzword; it is a widely reported experience of having to hide or suppress autistic ways of moving, communicating, and regulating in order to be seen as acceptable. Research on camouflaging has documented links to exhaustion, anxiety, depression, and suicidality in autistic people, especially women and gender minorities. To insist that this is not “scientific” enough because it relies on self‑report is to ignore the epistemic status of autistic people’s own accounts of their lives. It also sets up an impossible standard where every accommodation request must be justified by “objective” proof acceptable to non‑autistic experts.

When Frith suggests that smooth conversation, responsiveness to irony, or reading between the lines should count as “contra‑indicators” for autism, she reinforces a very narrow, deficit‑based picture of what autistic communication must look like. Many autistic adults describe learning, often painfully, how to manage eye contact, small talk, and humour as survival skills. The conversation may look smooth on the outside but be experienced as scripted, effortful, and draining. Late diagnosis is often precisely about people who “pass” well enough to be considered “perfectly normal” in brief encounters, while still struggling profoundly in other domains of life.

Globally, we can already see autistic adults “hollering” their needs—through writing, advocacy, and social media—while being misunderstood, dismissed, or pathologised for doing so. This pattern is not unique to autism. It resembles what we see whenever a marginalised group—women, Dalit communities, disabled people more broadly—asserts its own knowledge about its experiences and challenges long‑standing expert narratives. The discomfort often shows up as a call to tighten categories, recentre professional authority, or protect resources, rather than as a willingness to re‑examine our concepts.

Frith is right to raise questions about assessment quality, the pressures on clinicians, and the need to look carefully at how diagnostic tools are used. But these are arguments for improving practice, enhancing assessor training, and making space for both observational data and lived experience—not for declaring that the spectrum has “collapsed” or that masking and sensory needs are not scientifically real. For those of us working in contexts like India, where autism is still under‑recognised and poorly supported, the greater danger is not an over‑inclusive spectrum but the continued erasure of autistic people whose needs do not fit older, narrow templates.

A version of this article was originally published in The Hindu on 14 April 2026.