By Dr Chloe Farahar | Autistic Researcher, Project Manager for Learning Disability and Autism at Kent and Medway Mental Health NHS Trust, and Founder of Aucademy CIC
The Spectrum Was Never Fit For Purpose – And Uta Frith Still Doesn’t Understand Why…
Frith, in her recent TES interview, claims the spectrum has “collapsed” because it includes too many people. She is “frightened” by rising diagnoses. She questions masking is even a thing preventing many from being recognised as Autistic. She wants autism restricted to a smaller, more easily observable group. She proposes “contraindicators” – including the ability to converse smoothly – that would rule out the majority of Autistic women, people of colour, and late-diagnosed adults.
Simply put: this interview is not just scientifically outdated. It is actively harmful. And I can’t decide if Frith was being lazy, ignorant, or purposely incendiary in her interview, claiming as she did that there is no evidence or science for many of our experiences.
First, I need to say: I actually agree with Frith! She is right that the “autism spectrum” is not a useful concept. I have thought this for years, and I have published on why. But I argue this from a fundamentally different position to Dame Uta Frith, and that difference matters enormously for the lives of Autistic people.
Let’s pick apart her opinions one-by-one, shall we?
The Wrong Reasons to Reject the Spectrum
Frith is right that Wing’s “spectrum” has failed. But she is wrong about why. The spectrum failed not because it became too inclusive, but because it was never a remotely adequate framework to begin with. It was always perceived (and I have tried to find an image in the literature to work out why!) as a flattened, linear continuum – running from “severe” to “mild”, from “low-functioning” to “high-functioning”, even latterly from “male autism” to “female autism” – that told us nothing about how any individual Autistic person actually lived and experienced their life.
My work, published in the Oxford University Press Collection Beyond Autistic Stereotypes (Farahar, in print 2026), proposes an entirely different framework: the Three-Dimensional Autistic Space. Rather than placing Autistic people on a linear line, this framework recognises that Autistic experience exists across three dimensions – internal (what is not visible to outsiders), external (what observers can see), and temporal (how our experience changes across time, context, and environment). This is precisely why a single diagnosis in early childhood cannot – and should not – be treated as the definitive account of a person’s Autisticness across their lifetime.
The spectrum’s failure was never that it included too many of us. It was that it was designed by non-Autistic observers, looking into the Autistic space from the outside, and only seeing what was immediately visible to their bias. This “outsiders-looking-in” phenomenon explains the historical “invisibility” of Autistic women, Autistic people of colour, and those of us whose internality – the richness of our inner Autistic lives – was simply not in the biased telescopes of researchers like Frith.
Frith simply doesn’t seem to like to read the work by Autistic researchers:
“…people still hang on to the idea that there is something that unites all the people who are diagnosed as [A]utistic. I don’t believe that any more.”
Well, Uta, I do. We are Autistic because, as Trauma Geek explains:
“Innate Autistic traits are neural hyper-connection, monotropism, and bottom-up processing.”
| More on Trauma Geek’s definition: Innate Autistic traits are natural characteristics that Autistic people are born with: Neural hyper-connection: Autistic brains often have more connections between different brain regions, which can create deep thinking and notice patterns others might miss. Monotropism: This means focusing intensely on one thing at a time, like shining a powerful spotlight rather than a dimmer light over many areas. This can create deep expertise and passionate interests. Bottom-up processing: Autistic people often process information by starting with details first, then building up to the bigger picture. Most non-Autistic people do the opposite. |
We are Autistic, based on community definitions of our experiences.
We are Autistic because our monotropic, interest-based model of mind (Murray, et al., 2005), impacts our sensory processing, and we have an Autistic pragmatic language, highlighting that we Autistic people have pragmatic language abilities, we just process meaning differently to non-Autistic people (Cullen, 2018), which explains the double empathy problem, demonstrating there is a translation breakdown between Autistic and non-Autistic communication and exchanges (Milton, 2012), and the variation within our community outside of these innate connections are because we exist in the Three-Dimensional Autistic Space, with our Autistic experiences – internal and external – fluctuating across time, the Autistic space placing, as it does, all Autistic people (discovered and undiscovered) in a humanising space away from the binary and obsolete spectrum.
“Frightened” by Our Numbers
Frith says the rate of later diagnoses is “just frightening”. I propose a different interpretation. When more people are discovering they are Autistic, particularly those who were historically excluded from diagnosis – women, people of colour, those of us who mask, those who were written off as “anxious” or “difficult” – this is not a crisis of overdiagnosis. This is a correction of decades of systematic underdiagnosis rooted in racial, gender, and class bias.
My chapter in the Routledge International Handbook of Critical Autism Studies (Farahar, 2022) argues how Autistic identity, culture, community and space are protective factors for wellbeing. The evidence is clear: discovering one’s Autistic identity – particularly through community rather than purely clinical process – is associated with reduced internalised ableism, improved self-worth, and better mental health outcomes (Botha, 2020; Botha & Frost, 2020). Every late-discovered person who finds out who they are is not a problem to be solved. They are a person finally finding the language for their experience, and potentially finding their community.
Frith is frightened by our numbers. I would ask: why? What is the cost to non-Autistic society of more of us knowing ourselves?
As I commented on LinkedIn:
“She claims to be frightened by the number of us. Good. This means people who benefit from the neuronormative society are worried that with so many of us working out we’re Autistic things will have to change.Things will and are changing.
We will keep fighting for better lives for those of us less likely to be employed, and more likely to die by suicide.
We will keep fighting for those in our community who do not currently (maybe ever) share a reciprocal communication, with or without a learning disability, to be humanised and get services and support they deserve.
People like Frith don’t want us Autistic people making the changes.
I refuse to ever view Autistic people the way obsolete “autism” researchers do. We all deserve better.”
Masking: Where Is your Evidence, Exactly, Uta?
Perhaps the most egregious claim in the entire interview is that masking has “no scientific basis”. I would invite Frith to read the House of Lords Autism Act 2009 and New Strategy report (2025), which explicitly references masking and camouflaging as well-evidenced phenomena that contribute to later diagnosis, particularly in women. I would invite her to read NHS England’s own guidance on autism-informed inpatient care, which discusses masking directly. I would invite her to engage with the substantial body of published research on masking (Hull et al., 2017; Pearson & Rose, 2021) – none of which is referenced in her TES interview.
There is more than adequate scientific basis for masking. The evidence is there. To claim otherwise is not rigour – it is a failure to engage with a large body of work simply because much of it was produced by, or in partnership with, Autistic researchers.
And this raises the deepest problem with Frith’s interview. She presents her personal impressions – “I expect we could say we are all masking, all the time” – as though they carry scientific weight, whilst dismissing the lived accounts of thousands of Autistic people as scientifically unfounded. This is, quite simply, a double standard. It also demonstrates she hasn’t picked up our research in the last 10 years – masking is nothing like she seems to think: it’s an unconscious, learnt, trauma response we develop early in Autistic life.
The Dangerous Logic of “Contraindicators”
Frith proposes that smooth conversation is a “contraindicator” for autism diagnosis. If a person converses easily with you, she suggests, they are probably not Autistic. This is one of the most dangerous things in the entire interview.
The entire premise rests on an understanding of communication that was challenged – with rigorous evidence – by Dr Damian Milton in his foundational 2012 paper on the Double Empathy Problem. Milton, an Autistic academic, demonstrated that communication breakdown between Autistic and non-Autistic people is mutual. It is not a deficit located in the Autistic person. A non-Autistic clinician interviewing an Autistic person may find the conversation flows perfectly well – because the Autistic person has spent their life learning to communicate across a neurological divide, because masking is precisely the adaptation to neurotypical social norms that Frith simultaneously dismisses and uses as evidence.
Frith’s “contraindicators” framework would systematically exclude from diagnosis the very people who have historically been most harmed by missing recognition: masked Autistic adults, particularly women, but also many men and non-binary people, who have spent decades unconsciously suppressing their Autistic ways of being at enormous cost to their mental health, their energy, and their sense of self as a means of coping with the trauma of being Autistic in a non-Autistic world. These are the people most likely to present as conversationally fluent in a clinical interview. These are also the people most likely to die by suicide (Cassidy et al., 2014).
I note, too, that Frith’s framework of “contraindicators” reproduces exactly the gendered and racialised assumptions that have driven decades of missed and dismissed diagnoses. When she questions whether there is really a “cultural bias against identifying girls and women as Autistic”, comparing this, bizarrely, to psychopathy rates in men, she reveals a fundamental misunderstanding of the structural and cultural mechanisms through which diagnostic bias operates.
There is extensive evidence – not just anecdote – that the diagnostic tools, the behavioural checklists, the presentation criteria, were developed almost exclusively from research on white boys (Loomes et al., 2017; Russell et al., 2022), and this narrow telescopic view is perpetuated ad infinitum. That is not a coincidence. That is the “culture of autism” – the pathological paradigm – in operation. Frith is far behind us Autistic natural and professional researchers: we’ve already read the Swedish study that shows the binary (agreed, problematic framing, as it does not include non-binary or trans people) male-female ratio of Autistic people is equal – Frith is still quoting old ratios of 4:1 and 3:1!
Where Are the Autistic Theorists?
Read the entire TES interview. Notice what is absent. There is not a single mention of an Autistic researcher. Not Damian Milton and the Double Empathy Problem. Not Dinah Murray and Fergus Murray’s Monotropism theory – developed by Autistic people, for Autistic people, to explain Autistic cognition from the inside. Not Rachel Cullen’s Autistic Language Hypothesis. Not the growing body of Participatory Autism Research. Not the work of the Autistic Self Advocacy Network. Not my own work, or the work of any of the other Autistic academics currently reshaping how we understand Autistic experience.
This absence is not incidental. It reflects a research paradigm – the one Frith helped build – that has consistently treated Autistic people as objects of study rather than producers of knowledge. In my presentation Theories of “Autism” and Autistic Theories of Autistic Experience (Farahar, 2022), I set out the contrast directly: on one side, neurotypical deficit theories – behavioural, biological, cognitive – that look at Autistic people from the outside; on the other, Autistic theories developed by Autistic people from lived expertise, which offer entirely richer and more accurate accounts of how we actually experience the world.
The field has moved. Frith has not.
The Culture of “Autism” and the Harm It Causes
In my 2022 chapter in the Routledge International Handbook of Critical Autism Studies, I argue that there are two fundamentally different “cultures” of autism. The first – what I call the “culture of autism” – is the pathological paradigm: Autistic people as disordered, deficient, requiring intervention and cure. This is the culture Frith’s career has perpetuated, contributed to, and embedded themselves in. The second is Autistic culture: a neurodiversity paradigm, a cultural minority framework, in which Autistic identity, community, language, and space are recognised as the foundations of wellbeing.
The harm of the first culture is well-documented. It produces internalised self-stigma and negative self-worth (Botha & Frost, 2020). It leaves people in what I have described as “purgatory” – unable to belong to non-Autistic spaces (even when they mask), and simultaneously unable to find belonging in Autistic community, because they have been taught that being Autistic means being deficient. This is not a minor academic distinction. This is the difference between life and death for a significant number of Autistic people. Autistic people are disproportionately likely to experience suicidal ideation and to die by suicide (Hirvikoski et al., 2016; Cassidy et al., 2014). The pathological narrative – the one Frith continues to promote – contributes to this.
What We Actually Need
We do not need a narrowed, dehumanising diagnostic category. We do not need a scientist “frightened” by how many of us there are. We do not need the spectrum replaced with two crude groups and a set of “contraindicators” designed by a non-Autistic researcher based on her personal, unscientific impressions.
What we need is precisely what my work in the NHS Learning Disability and Autism Programme, and through Aucademy, is working towards: systems, services, and clinical frameworks that are built with Autistic people as decision-makers, not consultees. Frameworks that recognise the fluidity, dimensionality, and lived richness of Autistic experience. Discovery processes that account for masking, for late identification, for the systemic biases that have meant that for decades certain Autistic people – women, people of colour, those without accompanying learning disability – were not counted.
Uta Frith does not speak for this Autistic researcher, or for the Autistic community and their loved ones. Things are changing. We will keep fighting for better lives for those of us who are most marginalised – those of us less likely to be employed, more likely to die by suicide, more likely to be missed, dismissed, or misdiagnosed. We will keep fighting for those in our community who do not currently share reciprocal spoken communication, with or without a learning disability, to be humanised and to access the services and support they – we – deserve.
People like Frith don’t want Autistic people making the changes. But we are. And we will continue to do so.
References
Botha, M. (2020). Autistic community connectedness as a buffer against the minority stress of stigma. University of Surrey doctoral thesis.
Botha, M. & Frost, D. M. (2020). Extending the Minority Stress Model to understand mental health problems experienced by the Autistic population. Society and Mental Health, 10(1), 20–34.
Cassidy, S., Bradley, P., Robinson, J., Allison, C., McHugh, M. & Baron-Cohen, S. (2014). Suicidal ideation and suicide plans or attempts in adults with Asperger’s syndrome attending a specialist diagnostic clinic. Lancet Psychiatry, 1(2), 142–147.
Farahar, C. (2022). Autistic identity, culture, community, and space for wellbeing. In D. Milton & S. Ryan (Eds.), The Routledge International Handbook of Critical Autism Studies (1st ed.). Routledge.
Farahar, C. (2026, in print). The Farahar and Foster Three-Dimensional Autistic Space: Dismantling the ‘autism spectrum’ and centring observer bias in the missing, dismissing, and misdiagnosis of Autistic people. In Herbert, R., Shaughnessy, N. & Williams, E. (Eds.), Beyond Autistic Stereotypes: New Perspectives on Identities, Gender, and Experience. Oxford University Press.
Fyfe, C., Winell, H., Dougherty, J., Gutmann, D. H., Kolevzon, A., Marrus, N., … & Sandin, S. (2026). Time trends in the male to female ratio for autism incidence: Population based, prospectively collected, birth cohort study. BMJ, 392. https://doi.org/10.1136/bmj-2025-084164
Hirvikoski, T., Mittendorfer-Rutz, E., Boman, M., Larsson, H., Lichtenstein, P. & Bolte, S. (2016). Premature mortality in autism spectrum disorder. British Journal of Psychiatry, 208(3), 232–238.
House of Lords (2025). Time to Deliver: The Autism Act 2009 and the New Autism Strategy.
Milton, D. (2012). On the ontological status of autism: The ‘double empathy problem’. Disability & Society, 27(6), 883–887.
Murray, D., Lesser, M. & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism, 9(2), 139–156.
NHS England (2025). Autism-Informed Inpatient Care.