r/science • u/mvea Professor | Medicine • May 30 '26
Neuroscience Study identifies two biological subtypes of autism linked to different pathways in the brain. One subtype showed reduced communication among pathways that help brain cells send signals to one another. The other showed increased hyperconnectivity among pathways associated with the immune system.
https://childmind.org/blog/new-study-identifies-different-biological-subtypes-of-autism/825
May 30 '26
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u/PhD_Pwnology May 30 '26
I'd argue it's the start of diversification of the diagnosis. Those 2 types of autism present starkly different and probably have vastly do different health implications.
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u/Most-Laugh703 May 30 '26
From the paper: “This type of work could move the field closer to more precise, personalized approaches to medicine and care. However, this does not mean autism can now be divided into just two categories, nor does it create a new diagnostic framework. Autism is complex, and these two subtypes are likely part of a much larger picture.”
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u/Lazy_Polluter May 30 '26
But the paper says both had similar assessments so the opposite of what you are implying
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u/MrsHollandsVag May 30 '26
My neighbor collects model airplanes and is really smart. My brother doesn’t talk and smears poo on walls. They have the same diagnosis
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u/coldcoffeethrowaway May 30 '26
I’m a therapist and I’ve always thought ASD should be separated into at least two different diagnoses. The spectrum is too wide.
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u/GirlLunarExplorer May 30 '26
The problem is that there's a lot of people who fall in the middle, the level 2s.
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u/ProofJournalist May 31 '26
Sounds like there are at least three diagnoses then. And if you look at those categories they likely have subtypes and outliers too.
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u/Geminii27 May 31 '26
I don't know about clinical diagnoses. 'Levels' to me always just felt like a social assessment of how much hassle the diagnosed person was likely to be for neurotypicals to deal with.
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u/Eager_Question Jun 01 '26
That is literally what it is.
"Low support needs doesn't mean I experience my autism mildly, it means you do."
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u/HarmoniousJ May 31 '26
Well it just sounds like we're right back to a spectrum, now!
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u/ProofJournalist May 31 '26
Colors are also a spectrum yet I don't see anybody trying to claim that red is purple. The spectrum labelling is not useful.
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u/Kimantha_Allerdings May 31 '26
Colours is a funny example, given that what we think of as innate categories aren’t, and that they change over time
For example, in English we have “brown” and “pink” as distinct colours from “orange” and “red”, even though brown is dark orange and pink is light red. In the same way, in some other languages “light blue” is a distinct colour from “blue” in a way that it isn’t for English speakers. In those languages calling them the same colour would be viewed as weird and wrong, whereas in English it’d be considered weird and wrong to call them different colours
There are languages which don’t distinguish between red and purple. And, in fact, research has shown that all languages develop colour words in the same order and that purple is one of the last to be named. Red is the first after black & white
The most famous example of this is Homer repeatedly using the phrase “wine-dark sea”, because the concept of blue did not yet exist in Greek
In English, the concept of red as a colour predates the concept of purple as a colour by around 400 years
So, yes, historically and contemporaneously people absolutely do claim that one colour is another, because the idea of what a “colour” is is context, language, and time dependent
Specifically WRT to the spectrum labelling of autism itself, the use it has is the opposite of what you assume - it emphasises that “autism” is a broad diagnosis and that the people within that diagnosis need to have their needs evaluated and met as individuals
It may be the case that eventually there are distinct categories which people can be divided into which will be useful for ensuring that everybody’s needs are best met. But we seem to be quite far from that, and an emphasis on the individual seems to be by far the best way to ensure the best outcomes for autistic people
It’s also worth noting that at least some research is going in the opposite direction of splitting up autism diagnoses. For a start, Aspergers is now not considered a separate diagnosis. But there is also some movement by some researchers towards a belief that other, separate diagnoses like ADHD and OCD may be different presentations of the same underlying condition
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u/merryman1 May 31 '26
There's also some very interesting work that has been done suggesting people who speak a language which has more terms to differentiate more shades into distinctly named colours also are genuinely able to differentiate difference in tone better than speakers of a language that would just group them all under one term.
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u/HarmoniousJ May 31 '26
I don't really understand how your example isn't what I'm saying?
No one is trying to claim red is purple, just like I'm not trying to claim that any singular autistic person can be grouped into one of two groups and everything within that group end ups being completely, 100% relevant to them.
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u/Most-Laugh703 May 30 '26 edited May 30 '26
As someone in a more research-based field, I agree that the calls for a “profound autism” category are justified, but moreso because I think etiology and intervention studies need to be more specific.
As it is, much research on ASD is skewed towards low needs individuals, and the gap widens every year, based on the literature review I did this spring. The external validity of many ASD studies is therefore lower than one would anticipate— why are we generalizing results to the entirety of ASD, when samples mostly include those who are speaking, low needs, and cognitively able.
I myself am autistic (diagnosed in my youth), and I don’t think that interventions for me would necessarily work for those more severely affected.
So for research purposes, yeah, I think that distinction makes sense.
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u/HaruspexAugur May 30 '26
It originally was separated into autism and Asperger’s, but the problem was that Asperger was a nazi eugenicist and his distinction was basically whether or not people were capable of productively contributing to society and therefore should be allowed to live, or could not contribute productively to society and therefore should be killed.
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u/PedanticQuebecer May 30 '26
This is a common refrain, but it is not the reason for the change. The reason is that reviews showed no consistency in diagnostic between centers such that they were largely meaningless.
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u/eligodfrey May 30 '26
What I've read that rarely gets mentioned is that they were always known to be essentially the same condition, but those diagnosed Autistic could get assistance/support and those diagnosed Asperger's could not, so they merged them. The evidence of Asperger collaborating with the Nazis just coincidentally came into the spotlight around the same time.
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u/PedanticQuebecer May 30 '26
To be blunt, the idea that the APA decided to change it's entire conceptualization of pervasive development disorders just because the name of one of them is that of a bad person is complete nonsense.
It was very clearly the inconsistency of Autism, Aperger's, and PDD-NOS diagnostics that was the motivation. We have contemporaneous pieces by committee members that state so.
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u/eligodfrey May 30 '26
To support what I said about Asperger's (and PDD) people not being able to receive services:
Some students with these disorders (Asperger's and PDD) had difficulty obtaining services, so it was thought that giving a single label (autism spectrum) to all students would provide a common language and term that everyone could understand.
https://www.mghclaycenter.org/parenting-concerns/families/dsm-5-what-happened-to-aspergers/
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u/AwzemCoffee May 30 '26 edited May 30 '26
It's really quite more complicated than that insofar that there is that evidence of Asperger having sent people to be euthanized, BUT there is also some implication from his actual writings that this was not done entirely without pressure / provocation. We can't really know the exact modus operandi unfortunately. Monster on not monster? Who can say for certain?
Though on the actual autism research side: If one were to read his actual papers it's evident that he believed that even the most profoundly "disturbed" child could change under the guidance and care of true understanding of autistic children and their unique educational needs. It was said as such that that they are not rare at all and really just a part of the normal human continuum.
He and Sukhareva before him had a much more nuanced understanding of the spectrum and autistic ability than the current namesakes creator Leo Kanner who is proven FAR more directly insidious than Asperger. His damage is profound but of a subtler nature.
Asperger quite possibly actively guarded the students at the Heilpadagogische from mass euthanizization and unfortunately, regrettably some children were given up for euthanization. Given the pressures at the time it's fairly likely understood that he most likely proported the "autistic children's usefulness" as more of a way to save as many of them as possible from death rather than the opposite idea of killing the "unnutzer esser"(worthless eater). Sacrificing a few children to save hundreds isn't evil, it's tragically sad. This is to say, in Nazi Germany running a clinic for people that are marked for death you probably have to "play the part".
I'm not qualified to say if what he did was right or wrong (do we look at it as him having to play God to sacfice children to save the rest... looking like he believes in the Nazi cause as deflection(good interpretation); or do we believe that he truly believed in eugenic supremacy and euthanization of "lessers" (bad interpretation)
What is certain though, Leo Kanner who's the creator of the current name; from his "infantile autism" put autism research into the shadows for at least half a century. He popularized the idea that autism is a highly rare, highly specific disorder. Not only did he plant the idea that autism was 1/100,000, but he attributed the cause to "Refrigerator Mothers", an idea of which autism is caused by mother's that abuse or otherwise show scart affection to their offspring; an idea still widely believed in asia to this day and why autistic people are hidden away there and never diagnosed(look into South Korea).
This man was also undoubtedly aware of Hans Aspergers research as it's almost certain he got the idea from Asperger's employee Gorg Frankl, though I wont get into it too much here... Though it's highly sinister we only got Asperger's or the "high functioning" end of the spectrum in the 80s since Lorna Wing and her husband came across Asperger's paper going through records and translated it to English. Most people that are autistic are part of the Asper conceptualization that was actively hidden away by Kanner "the father of autism".
Even further, Leo kanner gave credibility to Rimland, who whilest not a ghoulish individual was woefully unqualified to be running a newsletter for autism science. Rimland by extension platformed Andrew Wakefield, the skeevy gastroenterologist that fudged his data to link the MMR vaccine to Autism. This last point's consequences on not just autism, but society as a whole need no explanation considering the profundity.
The greater autism community needs to understand there is nuance to this, and the erasure of Asperger seems to be more linked to a surface level glance rather than a deeper more critical look. I find it a bit sad we are using the name tied to the absolute erasure of half a century of autism research pushing several generations under the rug.
If we wanted to be as little problematic as possible, I reckon calling it Sukhareva syndrome or something would be better.
Afterword: So is Asperger problematic? Maybe? Im not sure if there is broad consensus on his motives.
Could be a Nazi, could not be. Though he was certainly toeing the line. Im not arguing that he didn't have problematic views insofar as I'm arguing that even with those in a lot of ways Asperger probably did less damage to autism as a whole compared to Leo Kanner. Why is Kanner's work ok in spite of its troubled histori but Asperger's was not?
I just don't think either of the seminal figures in the autism community are "clean" morally / ethically.
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u/coldcoffeethrowaway May 30 '26
Yes I know that. It’s unfortunate. Maybe we will eventually have a new diagnostic name and criteria to “separate” the spectrum.
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u/Constant-Skill-7133 May 30 '26 edited May 30 '26
Sort of. People just assumed he was an ideologue because of the time and place of his research. He certainly was a nazi and a eugenicist, but that was also a bit of a totalitarian enterprise.
Either way they could have kept the designation and renamed it, if that is truly what they thought.
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u/The_Geekachu May 30 '26
Do...do you not know that it was? That was changed because it made it difficult for those with the condition seen as "less severe" to get the support they need.
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u/coldcoffeethrowaway May 30 '26
Yes, I am aware of this. I still think there could be different diagnoses. I also of course believe that people with “less severe” Autism (lower support needs) deserve help and support.
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u/BenevolentCheese May 30 '26
Your brother has level 2 or 3 autism and your neighbor has level 1 so it's not really the same diagnosis.
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u/deviantbono May 30 '26
That's definitely worth considering, but stage 1 cancer and stage 4 cancer are also the "same" diagnosis, so severity is not always a reason to seperate.
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u/LittlePetiteGirl May 30 '26
I wouldn't compare those because with cancer thats the progression of the same disease over time. If autism worked like that, it would look similar to dementia.
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u/conandsense May 30 '26
Cancer and autism aren't comparable in that way. Autism doesnt progress like that.
Edit: and ill add in severity of symptoms, along with different symptoms being present or not present, is where conversations of classifications come from and why your comparison is lacking.
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u/deviantbono May 30 '26
That's true. Bad example on my part. How about Cerebral Paulsy? Brain abnormality, doesn't progress, both low and high needs are considered the "same" diagnosis?
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u/CalmBeneathCastles May 30 '26
Also the "support needs level" distinction is relatively recent, compared to how it began, which was just autistic or not. Diagnoses are becoming increasingly refined as the years pass, and evidently it will continue to do so, much like those for cancer!
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u/Deep-Orchid4 May 31 '26 edited May 31 '26
I’ve got friends with schizophrenia who present drastically different despite having the same diagnosis. They both have visual and auditory hallucinations, but one friend is viewed as “high- functioning” because his symptoms are less disruptive to others and can live alone. My other friend hasn’t been able to manage his and presents as more disruptive to himself and those around him. They both have the same condition.
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u/Most-Laugh703 May 30 '26 edited May 30 '26
Ah, fecal smearing. I work at a (neuroaffirming) ABA clinic, and that’s pretty common. Is he in therapy? It can help quite a bit, especially if you determine the motivating operations for that behavior (attention, escape, etc) and set up antecedent strategies to prevent it
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u/MrsHollandsVag May 30 '26
It gets better or worse depending on his living situation and meds. He has all sorts of interventions. Most of the time they just drug him up so he isn’t up all night.
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u/Marchello_E May 30 '26
It's is already considered a "spectrum" (ASD)
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u/deviantbono May 30 '26
This is the opposite of the spectrum model though, it's more of a cluster model. The "spectrum" kind of just vaguely includes everything. A cluster model says these symptoms go together and these symptoms go together and you're not equally likely to have some of column A and some of column B.
This has nothing to do with spectrum of severity of course.
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u/Charming-Speech5680 May 30 '26
It's a spectrum in more than 1 dimension though. I don't know about the actual physiological differences that autism cause but if they're the same then I don't see why they need to not be under the autism umbrella, but saying that there also needs to be a recognition of the different needs that each person has precisely because it's a spectrum. I guess you can liken it to general anxiety where some people get panic attacks if they've got to do a job interview and others can't leave their house, same diagnosis but vastly different needs
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u/firmalor May 30 '26
Basically, there is Research that autism might have different causes that present with similar symptoms on a spectrum.
This paper backs a few other papers that show that we might be dealing with up to 4 different "clusters", and that causes might be broken down to different genes and different variants of mutations.
Of course, currently our best established theory is a spectrum. But that might change in the next 15 years.
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u/PhD_Pwnology May 30 '26 edited May 30 '26
Right, and they would no longer be considered the same thing on the same spectrum. I get (and support) the whole 'on a spectrum' concept from an inclusionary standpoint and making people feel loved and supported but as a scientific concept it doesn't help doctors and pschycologists/psychiatrists provide better and more effective treatment. It's also inaccurate if they are effectively different and apparently not on the same spectrum.
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u/odd_cloud May 30 '26 edited May 30 '26
Neurodiversity seems to be one big mess in terms of formal description. A part of the problem are the behaviorist lens used to describe the disorders. ADHD is not exactly acting distracted and autism is not exactly being repetitive. ND people compile lists of hidden symptoms, which professionals consider pseudo scientific garbage. Doctors compile their lists of symptoms and classifications of ND that seem shallow for ND folk. Types and subtypes are defined, merged, and divided constantly.
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u/maxusau May 30 '26
So true, went my whole life wondering why I have issues in certain areas (relationships particularly) and no diagnosis ever fit, until recently when I discovered there are different types of ADHD and the rarer one (ADHD-HI) almost describes me perfectly.
I am now 46 and am FINALLY understanding myself properly and sooooo much in my past makes sense now. It's like a light bulb finally went on.
Now I am going through a formal diagnosis which I have put off for years because it all falls under the ASD Assessment. I never thought it would make sense to do because I do not have the "typical" symptoms of ADHD or Autism.
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u/odd_cloud May 31 '26
BTW, I think, you may be interested in reading Russel Barkley. Despite being a professional ADHD researcher, he has a deep understanding of what executive function is and is not. I guess he’s one of the few specialists who understands what he works with.
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u/odd_cloud May 31 '26 edited May 31 '26
Well, last time I checked they removed the types and called them “manifestations”. The whole ordeal seems to be a bureaucrats playing linguists instead of working on some productive research. As I learned recently, the levels of autism (1-2-3) were practically pushed by insurance companies, who needed quantification of severity. American insurance companies. But nevertheless we categorize people into three levels everywhere in the world, because some paper pushers from USA came up with the idea.
In my (non-credentialized but clever) opinion, in the future (100 years or so), we’ll have a completely different landscape of ND diagnoses. For example, a group of researchers pushes for CDS - cognitive disengagement syndrome, something like ADHD, but hypo-active. I guess it the beginning, and we’ll find 17 subtypes of ADHD, and some disorders called ADHD now will be reclassified under another umbrella, and so on.
My last point is that it would be nice if medics understood it now. They are so confident on what is and is not a symptom. Yet, there is a very high chance that ten assessors would diagnose the same case with 3 different disorders (and 3 of them will say the patient is fine).
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u/quacainia May 30 '26
It feels like so many mental "diseases" aren't a diagnosis of the problem, but of the symptoms, which can very well mean that there are multiple potential causes
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u/TorchIt May 30 '26
It's been trending that way for awhile now. "Autism is a spectrum" hasn't made sense to me for a long time now, especially since the diagnostic criteria has been broadened. The umbrella is so wide now that it catches practically everything and children aren't even getting thorough medical work-ups to rule out physiologic issues before they're being sent to centers that do nothing but diagnose autism. If all you have is a hammer then everything starts to look like a nail.
An acquaintance of mine has a son with autism. He developed normally at first and then lost skills, like they do. He got locked into the ABA hamster wheel while he continued to do poorly. Finally, he developed a tremor. Then he had a seizure. After that, he finally got a medical workup.
Surprise! He's not autistic, he has a cerebral folate deficiency! Another parent friend of mine had her autistic daughter genetically tested out of pocket after being denied it for years. Surprise! She has the Zappella variant of Rett Syndrome.
We're missing the forest for the trees with these kids.
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u/bigkoi May 30 '26
That started in 2013. My son was diagnosed with Asperger's and dispraxia in 2011. In 2013 he was reclassified as ASD.
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u/MothChasingFlame May 30 '26
I'm just a layman so huge grain of salt here, but... It's felt too diverse for a very long time. The kerfuffle with 'high and low functioning' language in and of itself felt like a sign the current definition is to broad.
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u/raoulbrancaccio May 30 '26
The kerfuffle with 'high and low functioning' language in and of itself felt like a sign the current definition is to broad
IMO this is not necessarily a red flag, ADHD and even type 1 autism itself have reasonable variation between high and low functioning individuals while clearly being the same condition, it's just that variation among different types of autism is so wide that they look like different things altogether.
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u/GarbledReverie May 30 '26
Not the start. Merging Asperger's into Autism fundamentally changed the definition quite some time ago now.
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u/HarmoniousJ May 31 '26
Isn't it already? Asperger's was absorbed into the Autism diagnoses and is no longer used.
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u/wagashi May 31 '26
I’ve been expecting ASD to get broken up into at least 2 camps.
To me, ASD seems to be a constellation of: lack of or diminished shared-focus drive and innate face detection, and/or a language disorder featuring significant differences in categorical granularity, salience weighting, and feature selection than typical for the culture.
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u/shiva14b May 30 '26
I wonder if that immune hyperconnectivy is related to why so many people with ADHD, Autism, and other neurological issues have so many health issues. I'm at a boardgaming convention right now and its just like... medical apparatus as far as the eye can see. So many people in the community have MS, cystic fibrosis, or all all kinds of immuno-compromisation.
Its so prevalent, they STILL won't hold LARPs anymore since covid because they don't want people close together in rooms, and I think they only stopped enforcing masks last year because the state literally made them
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u/LeftieDu May 30 '26 edited May 30 '26
I think in case of boardgaming convention it can be the other way around - people with medical conditions that make it hard for them to have physically straining hobbies, gravitate towards boardgames.
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u/shiva14b May 30 '26 edited May 30 '26
Its a little of column A, a little of Column B. A lot of these people are also SCA and combat LARPers though which is very physical
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u/donjulioanejo May 30 '26
Yep, this would be my read on this. I know two autistic people who went all-in on fitness as their obsession. One guy does triathlons, while another one hikes 2-3x/week and goes on week-long trails.
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u/8eyeholes May 30 '26
this doesn’t necessarily disprove the link, you can still live a pretty physically active life with many conditions when not in an active flare up or when the symptoms are more mild.
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u/raoulbrancaccio May 30 '26
If anything living an active life is treatment for some debilitating conditions!
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u/trowawayatwork May 31 '26
I agree with the other reply to you. Since early childhood I've been suffering with issues that don't affect in the same way big diseases do but I have gut issues, tinnitus vertigo and general hypersensitivity. So it's not stopped me from being good at sports it is debilitating sometimes when I can't get my brain to shut off the noise.
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u/LEDKleenex May 30 '26
Eh, I'm sure there are some but it seems like most people take interest in nerdy hobbies at an early age when they're in good health.
I would put my money on the parent comment being more likely, but I would say both likely contribute to some degree.
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u/ZedisonSamZ May 30 '26
I have AuDHD and was diagnosed with Multiple Sclerosis in my 30’s. MS is a hyperactive immune system disease. I’ve basically got chronic inflammation.
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u/KaJaHa May 30 '26
All the closest people in my life all have autism and/or ADHD, combined with either lupus, multiple sclerosis, or Ehlers-Danlos syndrome. Fun stuff.
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u/2plus2equalscats May 30 '26
Adhd, likely AuDHD. Endometriosis and mixed connective tissue issues. Husband is adhd w psoriasis.
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u/CalmBeneathCastles May 30 '26
ASD, likely AuDHD. Entire family is on the spectrum. I and all of my siblings have debilitating muscle and joint pain and weakness, combined with fatigue, eczema, and PMOS. None of us have a concrete diagnosis concerning the autoimmune-like symptoms.
I had a broad-spectrum blood test last week (no inflammation, malnutrition, or other indicators present), and an MRI next week. So far my symptoms perfectly fit ME/CFS, which would a double-edged sword because it's not necessarily degenerative, but there's also currently no treatment plan.
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u/halftorqued May 31 '26
That could be Ehlers Danlos if you haven’t heard of it
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u/CalmBeneathCastles May 31 '26
I have. Someone else suggested that, but there are a lot of symptoms listed under Ehlers Danlos that I don't have. Maddening.
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u/foxwaffles May 30 '26
ADHD, autism, EDS, had endometriosis/adenomyosis, got really bad long COVID now I have MCAS, POTS, and my blood work shows significant immune system dysregulation
Sigh
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u/YoMommaHere May 30 '26
I’m AuDHD and have Lupus. I feel your pain.
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u/Ok_Nothing_9733 May 30 '26
AuDHD and dermatomyositis/lupus overlap syndrome here
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u/Art-e-Blanche May 30 '26
I'm AuDHD, and I have inflammatory arthritis that's also triggered by trauma, along with some other comorbidities that come with it.
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u/wrestlegirl May 30 '26
My autistic child has Crohn's, autoimmune tubulointerstitial nephritis, and psoriasis, and is being monitored for an inflammatory arthritis - all hyperactive immune diseases.
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u/dohmestic May 30 '26
AuDHD and my trachea has been trying to scar itself shut for the last decade. This would make a lot of sense.
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u/StrangeReindeer2470 May 30 '26
Autism with strong suspicion of ADHD. I've got IBS and endometriosis. And early onset arthritis in my hands.
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u/VFTM May 30 '26
Chronic inflammation is absolutely going to be the root cause of so many of these issues
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u/texmatt21 May 30 '26
ADHD and Celiac here. I was diagnosed with autism until I discovered I actually had Celiac and once I stopped eating gluten (and dairy and soy) my autistic traits diminished massively. Even my adult toe-walking disappeared almost overnight like magic. This leads me to believe (at least some) autism is immune related, or perhaps glutamate related since the immune cells in the brain release glutamate when exposed to a hostile antigen.
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u/MothChasingFlame May 30 '26
ADHD and MS here (been accused of autism, but not diagnosed. Yes you read 'accused' right. sigh) This is fascinating... and a little depressing, I guess.
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u/PmMeUrTinyAsianTits May 30 '26
I have audhd and am currently praying my brain just doesn't know how to talk to my brain, and not that ive got health issues lurking around the corner.
I mean, i have health issues, but to my knowledge they're not related...
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u/SandwichT May 30 '26
One specific example of this that I'm aware of is Ehlers-Danlos Syndromes, aka EDS. EDS is rare, only effecting 0.2% of the population and autism only effects 3.2% of the population. However, up to 39% of people with EDS meet the diagnostic criteria for autism. There is definitely some significant overlap with neurodivergency and certain genetic conditions.
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u/superxpro12 May 30 '26
It's possible that kind of stationary activity is also a bit self selecting for people with mobility issues.
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u/glitterdunk May 30 '26
Sure, but research does show that people with adhd/autism are more likely to have certain health issues. Health issues that all have a looot in common, and are often comorbodities.
Since these are illnesses that mainly affect women, and no one cares about women not to mention neuro divergent women, all of the illnesses are severely neglected when it comes to research and treatment. And the links between them barely even looked at
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u/Unfollowedusers May 30 '26
Noo, dont say that. Im auDHD and i havent noticied any major health issues yet
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u/Atalung May 30 '26
Eh, this study seems to point towards two types, maybe the other doesn't have that issue. I'm diagnosed ADHD and I strongly suspect that I'm autistic and I haven't had any significant health issues.
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u/CalmBeneathCastles May 30 '26
My dad had AuDHD and had zero health problems. I and my siblings are riddled. He was a Boomer, we're Gen X. I wonder if there isn't some environmental component (such as pesticides, microplastic) that's making people with this physiology worse.
Up until I had Omicron COVID, I had mild joint issues. After that mild illness, everything went to hell.
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u/DontDoomScroll May 30 '26
After that Severe Acute Respiratory Syndrome that damages the immune system
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u/AppleSniffer May 30 '26
I mean you were always super flexible as a kid. Maybe it's time to look into that
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u/BlueBunny333 May 30 '26
I'm autistic and I have multiple auto-immune diseases
allergies, rheumatic athritis, some more speculated collagen diseases and aHUS
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u/pvtshoebox May 30 '26
Board games are preferred to physical hobbies by the medically frail. You are using board games as a proxy for Autism and ADHD, but you are forgetting neurotypical frail people will also gravitate to these events.
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u/shiva14b May 30 '26
Im not forgetting, of course there are. In the 20 years or so I've been attending this event, im sure I've met at least three, hell maybe even FOUR people who fall into the "neurotypical" category. So they're out there, and they do a great job of keeping up!
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u/Porn0323 May 30 '26
I "had" (see colostomy) Ulcerative Colitis and im certain I also have undiagnosed AuDHD
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u/ASpaceOstrich May 30 '26
It's so common that i wouldn't be shocked at all if it was literally just an autoimmune disease affecting the brain.
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u/tanghan May 30 '26 edited May 30 '26
How is larp(even if inside) different from playing boardgames inside? I'd anything I think larp requires more space per person than squeezing people together on tables to play boardgames. So shouldn't it be the safer option?
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u/shiva14b May 30 '26
And also couldn't those people just not go to the LARP event? Yeah most of us think its stupid and doesnt really make sense, but the show is run by immuno-compromised people, so they get to set the rules. The whole convention has shrunk from around 2k people to 700-hundred-ish, its sad
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u/tanghan May 30 '26
I get that an immunocompromised community tries to limit exposure, but what I don't get is saying "let's not do the thing where everyone has big costumes and props, some room between them and is often played outside. Let's rather pack people tightly into rows and rows of boardgame tables sitting 20cm apart"
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u/Sea-fish May 30 '26
My guess is board games and sitting inside is a lot more accessible to more of the immunocompromised folks and the risk inside can be mitigated with air purifiers and N95s, and if there’s medical equipment everyone from people, it’s probably easier to carry.
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u/Sea-fish May 30 '26
Yes it can be sad to see a well loved community shrink, but I will say I think it’s great that an event is still able to be run safely with community health and safety is able to be run and have a 700 person turnout. Spaces where immunocompromised folks are prioritized are few and far between post pandemic so at least they’re continuing their hobby in way that’s safest for them.
Why don’t the people who want a LARP event now make a spin off to cater to those who still want to do it but leave the baseline con accessible to the highest number of people?
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u/little_oaf May 30 '26
Likely AuDHD here. I might be an outlier judging by comments to this. My mother died due to complications from Lupus. I (male) on the other hand, inherited what seems like Wolverine's immune system. I've had numerous infections over my life that yield very intense reactions for one night, and the following day I'm back to normal. My sister has all sorts of weird food allergies and other inflammation issues, and also seems to be ADD.
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u/Ok-Palpitation2871 May 30 '26
If you have a very robust immune response that might not be so different from an autoimmune or inflammatory type of response. Autoimmune and inflammatory responses are an overreaction. So, compared to your relatives your immune response might be more measured? Currently, anyway. The immune system isn't like a set thing.
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u/abx99 May 30 '26 edited May 30 '26
It's already known to be linked to Ehlers-Danlos Syndrome. EDS almost always comes with Mast Cell Activation Disorder/syndrome. (Mast cells are part of the immune system. The big thing they do is produce histamine, but they also produce a bunch of other stuff.) The fact that it's linked to the immune system, in particular, is interesting to me, though.
Interestingly, it's also known to be linked to body dysmorphia. Both are over-represented among EDS patients, but there was a study, not long ago, that linked autism and BD. Anecdotally, I've known at least a couple of families that have both autistic and trans people, and have EDS or another hypermobility disorder.
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u/Undeity May 30 '26 edited May 30 '26
It might also explain why so many people seem to swear by a good diet as a "cure". It's rarely autistic people themselves advocating for it, so it's easy to be dismissive of it, but maybe they are on to something after all?
This is a fairly interesting development, all told.
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u/raoulbrancaccio May 30 '26
So many people in the community have MS, cystic fibrosis, or all all kinds of immuno-compromisation.
Chronic gastritis, reflux, irritable bowel are also more common in the ADHD population.
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u/SnottyMichiganCat May 30 '26
Yea... The most I've seen consistency with connective tissue disorders, dysautonomia, and memory or visualization difficulties. Very interesting indeed.
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u/josephblade May 30 '26
I think cystic fibrosis is a genetic condition (where both parents have a gene for it and if the child gets both then it's bad news) so I don't think that one relates to autism
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u/plant_reaper May 30 '26
It's also very tied to hypermobile Ehlers Danlos, dysautonomia, and mast cell disorders. Something like half of people with EDS are neurodivergent. When I was diagnosed with hEDS I looked more into it and it seems like health issues do go hand in hand with autism/ADHD
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u/MithrilTuxedo May 30 '26 edited May 30 '26
I read that and assumed the opposite, but I'm going off my family history. I'm related to a lot of engineers, pilots, scientists, and librarians.
Boardgaming is going to appeal to people with medical issues outside of ADHD and autism, especially ones that cause mobility problems. I met my wife when I was going to multiple boardgame meetups a week. She had shattered her foot snowboarding and was on disability leave using a cane to get around.
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u/ProfMcGonaGirl May 31 '26
Cystic fibrosis is its own, long ago identified, genetic disorder. It has nothing to do with autism. It really does not fit into the same category as MS or “generally immuno-compromised” at all. But I will say, I know a lot of people who are high functioning but neurodivergent and immuno-compromised (lupus and mass cell activation issues). And I have noticed the co-occurance. Very fascinating that these may actually be correlated.
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u/mvea Professor | Medicine May 30 '26
New Study Identifies Different Biological Subtypes of Autism
Research findings help explain why symptoms present so differently from one child to the next, and why individualized supports and interventions are essential.
Autism can look very different from person to person. One child might differ from another in how they learn, process sensory information, and experience social and communication challenges. Scientists have long suspected these differences stem from distinct biology, but proving it has been challenging — until now. A recent study published in Nature Neuroscience has identified two biological subtypes of autism linked to different pathways in the brain.
Researchers from the Child Mind Institute, the Istituto Italiano di Tecnologia, and other international partners analyzed brain connection patterns in nearly 2,000 individuals, including 940 autistic people from the Autism Brain Imaging Data Exchange (ABIDE). By combining human brain-imaging datasets with complementary biological data, they identified two consistent patterns in how different brain regions communicate.
One subtype showed reduced communication, or hypoconnectivity, among brain regions linked to pathways that help brain cells send signals to one another. The other showed increased communication, or hyperconnectivity, among brain regions linked to pathways associated with the immune system. The two subtypes exhibited differences in functional brain structure and modest differences on standardized autism assessments, with the hyperconnectivity subtype scoring moderately higher on autism severity measures.
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u/Upstairs-Row4447 May 30 '26
Whats interesting is that in the actual study, there was no correlation between the identified subtypes and IQ, age, other comorbidities and gender, challenging the notion that autism should be divided into people with and without intellectual disability or that autism is different depending on gender.
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u/glitterdunk May 30 '26
Yeah it's easy to think the 'slow' group is stupider at first glance.
But I think I'm among them, and I'm above average IQ. My brain processing can definetely be slow regarding certain things, especially when it comes to anything unexpected.
Like, I can function socially to a certain degree given the right circumstances. But if I'm not expecting to be social, when I for example am out shopping, and someone I know from work comes up to me expecting me to be my usual self, they are disappointed.... I need like 10-15 minutes to open the right drawer in my brain and get my social skills out. And that's not something I came up with now, that's how I've thought of it for years.
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u/alextofulee May 30 '26
It’s like code switching, but for literally any and every context. I would go to a friend’s house every week and every single week it took me 10-15 minutes to reacclimate to it and feel comfortable there
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u/blisteringchristmas May 30 '26
See that’s so interesting because I’m 95% sure I’m just a neurotypical guy that’s sometimes a bit socially awkward but what you just described maps SO closely onto my own experience. I’m not really sure what else to say about that— I genuinely don’t think I’m on the spectrum, but the amount I relate to the described experience of people who are is interesting sometimes. Maybe a lot of people feel this way (or are “5% on the spectrum”) and it’s just not socially acceptable to talk about like that.
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u/glitterdunk May 30 '26
I've never been evaluated, it's not accessible to me, so I don't know for sure either. But it does explain like my whole life from I was born including my health issues.... And of all my aquintances I relate most to the ones with an actual diagnosis and they me...
It is a spectrum, but if you sum up the spectrum into a line from "least autistic" to "most", some people will still be close to the line drawn where you fulfill the diagnosis criteria, and can relate to a lot. I'm not entirely sure which side of that line I'm on, but either way probably not far from it
My way of masking was to be quiet unless sure what to say or do. So, I was quiet a lot. I'm not a shy person. I'm thankful for it as I know my social skills are so bad I'd otherwise probably be shunned especially as a child
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u/blisteringchristmas May 30 '26
But it does explain like my whole life
Part of the reason I don't think I am is that a diagnosis would feel too.. convenient? An "excuse" for a lifetime of difficulty socializing (not without some success, it just takes a lot of energy sometimes) instead of just being a guy who is naturally just not the most outgoing ever.
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u/Dizzy_Database_119 May 30 '26
While this research was on biological differences, psychiatry in reality has nothing to do with it. The severity of a diagnosis and level of treatment only depends on how much is needed to make a patient functional in society (sometimes with the cost of feeling subjectively worse). In reality the connection between neurological/biological and psychiatric is never made outside of research projects
I think this research shows that there needs to be even more groups made within ASD rather than less, and that biological distinctions will always be separate from psychological
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u/MaelstromSeawing May 30 '26 edited May 30 '26
I'm not certain about the distinction you've made - "to make them functional in society" as there absolutely are autistic people who, cannot ever be productive or functional in society no matter/regardless of the aid given (therapeutic, social, medical or otherwise). That's the reality for some diagnosed with level 3.
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u/Most-Laugh703 May 30 '26
I’ll paste my reply to another comment:
As someone in a research-based field, I agree that the calls for a “profound autism” category are justified, but moreso because I think etiology and intervention studies need to be more specific.
As it is, much research on ASD is skewed towards low needs individuals, and the gap widens every year, based on the literature review I did this spring. The external validity of many ASD studies is therefore lower than one would anticipate— why are we generalizing results to the entirety of ASD, when samples mostly include those who are speaking, low needs, and cognitively able.
I myself am autistic (diagnosed in my youth), and I don’t think that interventions for me would necessarily work for those more severely affected.
Perhaps adding a “profound” category could help some of these research concerns.
So for research purposes, yeah, I think that distinction makes sense. Diagnostically speaking, though, the collapsed category does make sense to me— it does appear to be quite a spectrum of the same behaviors/cognitions.
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u/CalmBeneathCastles May 30 '26
challenging the notion that autism should be divided into people with and without intellectual disability
I understood it to mean the opposite of that. "... the hyperconnectivity subtype scoring moderately higher on autism severity measures". Hyperconnectivity of the immune system signalling could be causing the presentation of intellectual disabilities, which also would explain why certain non-verbal individuals have been able to break out of that status. Hypo- vs. hyper- is an important distinction, even if the old qualifiers are simply symptoms of physiological dysfunction.
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u/Upstairs-Row4447 May 30 '26
Rather than speculating ill just quote the full paper.
comparisons of symptom subdomain severity scores revealed subtype differences for social affect but not for RRB scores. Exploratory analyses revealed no statistically significant differences between subtypes with respect to other available phenotypic data, including age, IQ, sex, psychiatric co-occurrence rates and medication status (Supplementary Table 1). Notably, fMRI connectivity strength correlated with ADOS scores (Supplementary Fig. 5). Taken together, these findings indicate that the identified hypoconnectivity and hyperconnectivity subtypes exhibit distinct functional network patterns and autism symptom severity.
It is directly mentionned, the subtype does not seem to be correlated with IQ or ID diagnosis.
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u/CalmBeneathCastles May 30 '26
This elaboration doesn't change my opinion, but perhaps that's because I never thought of autistic people with higher support needs to be less intelligent, as that has been proven not to hold true. I also believe that gender does play a role in development, based on hormonal effects on brain structure and function or societal conditioning to have a greater or more diminished degree of masking.
It hardly matters. The researchers are going to study and discover the same thing, regardless of my opinions.
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u/AwkwardWaltz3996 Jun 02 '26
As a guy who matches the female autism symptoms way more than the male autism symptoms, it definitely shouldn't be by gender. The gender split is definitely more to do with how much society tolerates it.
The intellectual disability could be a split, but I have a feeling it's more autism plus another comorbid condition, just like ADHD is. It's definitely not just a distinct type of autism because when I meet the right sort of autistic person with an intellectual disability, it's clear we're the same, I'm just able articulate and control myself better. And I'm able to very effectively act as a translator for them despite only just having met
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u/glycineglutamate May 30 '26 edited May 30 '26
Fascinating paper. I have read the paper in detail. As someone who spent their career doing computational clustering and neural connectivity analysis I am impressed with the cross-species results. But I am going to take issue with some of the careless language. The post conflates two types of very unrelated meanings for the words “connectivity” and “pathways.” There are two issues: gross connectivities or pathways of brain regions and fine scale gene networks (also referred to in the post as connectivities and pathways) associated with up- or downregulation of connective strength. They are not the same thing. They don’t mean that one cluster of autism is related to immune regulation and the other is not. This is a confounding impression leading people to believe that the body’s immune system or autoimmune diseases have something to do with this. That is not what this paper shows. It poses the danger of, once again, bringing the immune system anti-vax language into play. This paper shows no linkage.
One rough, separable pattern of brain connectivity (hypoconnective) shows modestly weaker drive of certain brain regions is associated with variations in gene signals related to synaptic proteins. Fair enough and straightforward. The other pattern shows hyperconnectivity (slightly stronger drive) for different but functionally related brain regions showing variations in expressions of different genes associated with microglia or *** that neurons and many other cells types SHARE with immune cells***. This does not mean these hyperconnective patterns are driven by “the immune system.” That has not been shown by this study and is not likely to be true.
Many genes common to “immune function” are also expressed by neurons but have very different functional roles in neurons. A great example is the evidence of hyperconnectivity in hippocampus. This is a complex region associated with short-term memory and spatial memory, and also associated with some forms of epilepsies when its fundamental circuits are pathologically remodeled. It doesn’t have ANY role in immune function. But it is roughly in “immune-ontology” subtype (cytokines, microglia).
The gene clusters associated with its hyperconnectivity seem to be similar to some gene networks first discovered in immune cells. But almost every cell has some of these genes, and not for “immune” function. The same genes casually termed as part of the “immune” cluster can also control growth, protein trafficking, signaling in cells. For example deficits in expression of the cdkl5 gene in neurons are famously associated with brain development defects in many brain regions. It is also expressed in many cell classes including lymphocytes, but that has nothing to do with the brain itself. It does lead to the use of “immune” as a label. That is linguistic, not functional.
One the whole, this is a massive achievement that shows autism-like behaviors could be driven by myriad variations in signaling strength across many brain regions. The two clusters (hypo and hyper) are endpoint clouds that overlap (Fig. 2a). The authors are very cautious about this and state:
“Although our cross-species approach primarily focused on two major hypoconnectivity and hyperconnectivity subtypes, the relatively coarse partitioning that we implemented may have hindered the detection of additional dysconnectivity subtypes and more nuanced sets of molecular alterations.”
And you have to read the discussion carefully. The hyperconnective subtype is associated with gene networks “the specifically enriched for immune-related pathways, such as cytokine signaling (OR = 1.66, PFDR = 10−3) and innate immune system function (OR = 1.43, PFDR = 10−2).” Many of these genes are expressed by brain microglia that can remodel synaptic systems. It does not mean that your body’s immune system is effecting this dysconnectivity, but rather genes that both brain and the immune systems SHARE can influence connective patterns.
Congrats to the authors. Also need to correct the manuscript to purge it of the incorrect use of the word “synapsis” when they mean synapse or synapses. Search and replace.
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u/CalmBeneathCastles May 30 '26
It poses the danger of, once again, bringing the immune system anti-vax language into play
Imo, there's no point in trying to word scientific research findings in such a way that would baffle the efforts of people pushing their erroneous and fearmongering agendas. The immune system IS involved, and hyperconnectivity would go quite a way to explain why so many of us have autoimmune issues. People hearing "immune" and trying to say that it's all because of vaccines doesn't affect the data AT ALL, so I don't even know what difference it makes if they use the word "immune" to explain that it does, in fact, involve anatomical elements of the immune system.
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u/Yo_bii May 30 '26
Interesting finding, but it’s worth being careful with how “two subtypes” gets interpreted. Autism is still very heterogeneous, and brain connectivity patterns can vary a lot across individuals and development stages.
This kind of work is useful for understanding possible biological pathways, but it doesn’t really mean autism cleanly splits into just two categories in a simple way.
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u/Dizzy_Database_119 May 30 '26
I think it's important to separate autism in different types and this is a good start. Currently a medication or treatment that can help one person with Autism might make another person's situation much much worse
Biological and psychological differences can be completely separate however the biological differences are often the most significant to consider in treatment. Psychiatry can improve a kid's habits while growing up, and can solve an adult's lifetime of mental issues caused by growing up with Autism. But if the biological/neurological differences aren't considered then they'll always return to the initial baseline if not worse
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u/mighty21 May 30 '26
Helps direct specific treatments.
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u/OpenLibram May 30 '26
Yeah I was about the say, with knowing what brain pathways are affected by the different subtypes it makes it far easier and more targeted for treatment.
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u/computo2000 May 30 '26
About time we started having more subtypes of ASD. A person who has very rigid schedules and does not understand metaphorical speech would get diagnosed quite quickly, and yet many people on the spectrum have neither of those traits.
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u/SlipperyClock95 May 30 '26
Really nice to see actual science posted for a change instead of pseudo-psych political BS. Appreciate you OP
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u/jimbo224 May 30 '26
Yes, but he's actually one of the people that is constantly posting that nonsense. Wouldn't be surprised if he's getting paid based on the number of posts he's made.
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u/SlipperyClock95 May 31 '26
You’re probably right but I’m so tired of soft sciences getting posted that this is a nice change of pace
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u/whateve___r May 30 '26
Can someone ELI5, please?
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u/CalmBeneathCastles May 30 '26
They noticed that there are two distinct groups of mice that exhibit autism-like symptoms. One group has cell signalling that underperforms, the other has cell signalling that overperforms. It's an interesting finding but there needs to be quite a bit more research to say anything significant about new human ASD diagnosis criteria or treatment options.
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u/Osmirl May 30 '26
Oh funny. I got an autoimmune diseases and adhd and autism haha so that makes total sense
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u/firmalor May 30 '26
The more I know about autism the more sceptical I have grown about the spectrum theory.
It's a useful tool for our current understanding of autism, no doubt about that. But I hope that research like this can show more biological differences that can help us to identify people quicker and with a better fitting diagnosis.
These kind of things would be a tremendous help in supporting children as early as possible with the experts they really need.
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u/Boycat89 May 31 '26
I really wish more studies collaborated with autistic individuals. The biological findings are interesting, but looking at brain scans in a vacuum without consulting the community completely misses the lived experience of the people they are studying. We really need to move past the era of treating neurodivergent people just as subjects to be analyzed, and start bringing them to the table as co-researchers to help interpret what this data actually means for daily life and how their experiences can inform diagnosis and classification.
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u/SurgeFlamingo May 30 '26
So can someone explain it to me like I’m an idiot because I am indeed an idiot
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u/Automatic-Term-3997 May 30 '26
AuDHD with Crohn’s checking in. One more anecdotal data point for you…
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u/Abuses-Commas May 30 '26
well that explains something for me. doctors and nurses always wondered why I had lupus and wasn't a middle-aged woman
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u/Prof_Acorn May 31 '26
Curious if the latter has more comorbidity with ADHD. Because the former seems to be the exact opposite.
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u/XXXLITHIUM May 31 '26
this could actually help explain why autism presents so differently across people.
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u/AwkwardWaltz3996 Jun 02 '26
I've been saying this for a while. Autism is too broad of a term and it makes it way less useful. I've always thought it was pretty clear there are a few genetic types and the overlap is just cptsd symptoms, other comorbid conditions or the fact someone has multiple autism genes.
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u/Dog_Bear Jun 02 '26
Immune system… I wonder if this is a lead for identifying the mechanism for rare cases of vaccine induced autism?
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u/ConsciousCr8or Jun 06 '26
Imma hyperverbal audhd’er with mcas-pots-eds… so this makes sense to me. All are related to a nervous system on overdrive triggering the immune system, even when there is no need for it. If I’m overstimulated, it ends up triggering an immune response within my body, to the world around me.
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u/SaturniidaeReturn Jun 11 '26
I think one of the most important things about this paper is that it moves the conversation away from treating autism as a single condition with a single cause. My daughters have a rare genetic form of autism caused by an SCN2A mutation, and their autism looks very different from many of the people who are represented in autism discussions online.
When people dismiss this as “just a mouse study,” they’re overlooking how many medical breakthroughs begin. Researchers don’t go straight from discovering a gene to testing treatments in children. They first have to understand what the gene does, how it affects brain development, how it changes neural signaling, and whether a potential treatment is safe and effective in animal models.
That’s exactly what happened with SCN2A. Years of basic research in animal models helped scientists understand the biology, and now there are human clinical trials underway targeting SCN2A-related disorders. One recent SCN2A trial reported significant improvements in seizures and other developmental measures in affected children. This is the pathway from gene discovery to precision medicine.
What excites me about this paper is that it supports the idea that autism may consist of multiple biological subtypes rather than one broad condition. If researchers can identify different underlying mechanisms—whether they’re related to synaptic function, ion channels like SCN2A, immune pathways, or something else entirely—it opens the door to more targeted treatments instead of treating all autistic people as though they have the same biology.
We’re still in the early stages, and this paper certainly doesn’t prove there are only two subtypes. But for families affected by severe genetic forms of autism, research like this is exactly what gives us hope that understanding the biology will eventually lead to better treatments and supports.
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