Autism research has made enormous progress in recent decades with significant advancements in the diagnosis, treatment, and understanding of the disorder. Yet, it continues to struggle with the profound heterogeneity of the autism ‘spectrum’, in other words the fact that autistic people are incredibly diverse.
“It is important to recognize variation in how autism presents. For example, autistic people may be hypersensitive, hyposensitive, or experience a mix of both. The outdated idea that all autistic people lack emotional awareness or communication misses this complexity; in reality, there are many dimensions—sensory processing, emotion, cognition, communication—and autistic individuals can differ widely across each of these,” explains Dr. Yona Lunsky, Scientific Director of the Azrieli Adult Neurodevelopmental Centre.
To manage this complexity, researchers often try to “subtype” individuals based on shared traits, brain patterns, or behaviours. While this approach is intuitive—it is human nature to try and categorize things—the subtypes often don’t tend to be replicable across studies and even using the same baseline data can lead to differing subtypes. In addition, individuals that do not “fit” into the subtypes are often disregarded as outliers, meaning the very people research aims to understand can be excluded.
“Over the years, autism labels kept changing. The more subsets people create, the more confusing it can become for autistic people. You’re given a label, then it’s taken away, then replaced with something else. While we share some commonalities, autistic people are incredibly diverse, and constantly trying to categorize us misses the reality that we’re complex individuals,” says Mirella B., Self-Advocate Advisor with over two decades of experience working in hospital and community-based organizations across Ontario and Quebec.
A new perspective: Embracing individuality rather than disregarding it as noise
A new perspective, published in Nature Mental Health and chosen as the cover topic of the March issue, by Dr. Hsiang-Yuan Lin, Scientist at the Azrieli Adult Neurodevelopmental Centre, in collaboration with Dr. Michael Breakspear, Professor of Neuroscience and Psychiatry at the University of Newcastle, Australia, and Dr. Laurent Mottron, Professor at Université de Montréal, fundamentally challenges this approach. The authors argue that rather than trying to continue to search for distinct subtypes we should respect and embrace idiosyncrasy—meaning stable, person-specific neural, cognitive, and behavioural patterns.
Data consistently show that there is greater interindividual variability among autistic individuals compared to neurotypical individuals. Instead of treating this variability as noise to be controlled or eliminated, the proposed approach suggests that this idiosyncrasy may be central to understanding autism.
“From a neuroscience perspective, I hope this work encourages people to rethink autism beyond fixed categories towards individualized education, support, and treatment—recognizing that idiosyncrasy is not an exception in autism, but essential to understanding it,” says Dr. Hsiang-Yuan Lin.
Bridging the gap between biomedical science and the neurodiversity movement
This perspective aligns closely with neurodiversity-affirming ideas, recognizing that there is no single, “right” way to be autistic and that meaningful support begins with listening to autistic people themselves, rather than assuming needs on their behalf.
“I think the implications of the article further what has already begun in mainstream society. While there is still a long way to go, autism acceptance is much more the norm than it was twenty years ago. The article brings to light the importance of individualized services to optimize quality of life for autistic individuals, and reminds us to see people holistically—not just their brains, but their whole selves,” says Courtney Weaver, Self-Advocate Advisory Group Member.
Why the shift matters
Recognizing individuality has real world implications — especially in clinical settings.
Too often, services and supports assume that all autistic people will want or need the same accommodations, therapies, or environments. But what works well for one person may be unhelpful, or even harmful, for another.
“In research and clinical care, it’s important to acknowledge that autistic individuals have different needs and preferences for how they participate or receive support,” says Dr. Yona Lunsky. “A one-size-fits-all approach risks overlooking individual strengths, challenges, and needs. What works one person may not work for another. Rather than being prescriptive, we should focus on person-centred approaches that seek to understand each individual and support them in ways that allow them to thrive.”
Idiosyncrasy can also influence how autistic people respond to treatments. For example, some autistic individuals experience medication side effects that are uncommon or rarely seen in neurotypical populations. If idiosyncrasy is dismissed rather than examined, these differences may be missed.
By seeing autistic people as individuals first—listening to diverse autistic voices, reflecting lived experience in research and care, and designing supports that respond to individual needs—we come closer to understanding autism as it truly is: diverse, complex, and deeply human.