Even decades into large shifts in how culture understands neurodiversity, we’ve still — in our research, in our textbooks, in our own predictive minds — defined autism first as a disorder. A social communication disorder, a neurodevelopmental disorder, a disorder of restricted and repetitive interests. It’s not that the challenges those describe aren’t real — many autistic people do face significant disability — but as a definition they are drastically incomplete.
It goes back to the old parable of the elephant: one hand on the trunk, another on the ear, another on a leg, each certain it has the whole animal. Defining autism through a deficit-based lens is like feeling the trunk, noticing it’s like a snake, and running off to prove how snake-like it is. And more than that, to reduce what is human in that way isolates and harms autistic people. For many of us, our simple error was that somewhere along the way, we forgot we were using a lens in the first place.
It’s time for a new lens.
Autism is a neurotype. A different way of noticing, processing and responding to the world that, from the very beginning, shapes how the senses integrate and how development unfolds. It carries certain strengths and certain challenges, and for some, significant disability.
I bring years of deep scientific research, lived experience and a mind that can turn a web of chaos into something that resembles a line.
Or at least I try to.
Autism and ADHD as neurotypes
Hey Dr. B! What’s a neurotype?
A neurotype is a kind of mind: a stable pattern in how a nervous system notices, processes and responds. We all have one. Autism and ADHD are two of them. A neurotype isn’t a diagnosis and isn’t a deficit, though it can come with both. It’s the shape of the mind that everything else happens inside of.
Hey Dr. B! Wait, are you talking about ADHD too?
Yes, because the science already does. The diagnostic manual doesn’t define autism or ADHD by what’s happening in the brain. Each is a cluster of observed behaviors that tend to travel together, drawn up by committee and revised every edition. The boundaries between clusters are decisions, not discoveries. Until 2013, the manual didn’t allow a person to be diagnosed with both; the overlap was so obvious that the rule was dropped. Today, somewhere between a third and two-thirds of autistic people also meet criteria for ADHD, depending on the study, and ADHD is the most common co-occurring diagnosis in autism. Twin and family studies show the two share a large part of their genetic risk, and they share many of the same features: differences in attention regulation, executive function, sensory processing and emotional regulation. Clinicians increasingly describe them as overlapping presentations rather than separate conditions, and the people who first described monotropism noted from the start that ADHD attention looks monotropic too.
Imagine we each explore the world with a beam — a flashlight. Whatever falls inside the beam gets noticed, processed, and responded to. Whatever falls outside it goes unnoticed.
That beam is attention. We can focus it narrow and bright, or spread it dim and wide, but the lumens — the energy available — stay the same. And the quality of the light — steady or flickering, calm or driven by fear — shapes how we feel about what we see.
And for all of us, where attention goes, and how long it stays, is first an instinct: shaped by the pull toward what matters to us, and the push away from what we don’t yet have the capacity to face.
Change how you pay attention and you change everything that follows.
How layers of memory, context and meaning are added.
How emotion, empathy and awareness are constructed.
How we understand ourselves, our world and those around us.
How learning and development unfold.
“Monotropism is a way of thinking about autism not as a set of deficits, but as a different, more focused strategy for using attention.”
Monotropism is often reduced to “autistic people can’t multitask.” That misses the idea. It’s more like one web, one experience, one channel at a time. The foundation of monotropic theory is the relationship: the gravitational pull between what the nervous system flags as important or interesting and the processing resources that follow.
In autism, that pull is stronger.
Inside the pull, details are noticed, and the connections between them, and the layers of meaning they carry. Attention stays there until processing is complete and resources are freed up, ready to shift elsewhere. Monotropic attention can only spread as wide as the processing demands inside it allow.
The difference is a trade-off between breadth and depth. Monotropic processing brings certain strengths, like deep focus, pattern-finding and noticing what others miss. And certain challenges, like overwhelm, burnout and inflammation, especially when autistic thinkers exist in environments and systems that weren’t built for their processing style.
Monotropic attention is pulled into a narrow, bright beam
Details and connections inside the beam are fully processed. Outside the beam, the world goes quiet.
Polytropic attention is spread into a wide, soft light
Many things are held in view at once, each a little lit. Small details blend into the whole.
If monotropism describes a neurotype, then are autism and ADHD two of its shapes?
The brain networks responsible for deciding what in this moment is most interesting and important — how should our limited processing resources be distributed? — are built in infancy, or before. Emerging evidence shows that differences in these networks are already visible on brain scans of six-week-old infants with a family history of autism. Hey Dr. B! Really? Show me the studies.
Two to start with. The first scanned 53 sleeping six-week-olds and found that infants with an autistic older sibling already showed a different pattern of salience-network connectivity (the network that flags what matters and directs resources toward it) than infants with no family history. The second scanned six-month-olds and used their connectivity patterns to predict, with high accuracy, which of them would be diagnosed autistic at age two.
Tsang, T., Green, S. A., Liu, J. et al. (2024). Salience network connectivity is altered in 6-week-old infants at heightened likelihood for developing autism. Communications Biology, 7, 485. doi:10.1038/s42003-024-06016-9
Emerson, R. W., Adams, C., Nishino, T. et al. (2017). Functional neuroimaging of high-risk 6-month-old infants predicts a diagnosis of autism at 24 months of age. Science Translational Medicine, 9(393), eaag2882. doi:10.1126/scitranslmed.aag2882
Our neurobiology doesn’t just shape how we pay attention. Attention shapes our neurobiology. That’s neuroplasticity. Hey Dr. B! What’s neuroplasticity?
Neuroplasticity is the brain’s ability to change its own structure in response to what it does. Connections that are used repeatedly get stronger and faster; connections that go unused are pruned away. The pattern is often summed up as “neurons that fire together, wire together.” It happens throughout life, but it is fastest in early childhood, when the brain is forming and trimming connections at an enormous rate. So what a young mind attends to, over and over, is quite literally what it builds.
Starting from the very beginning, this processing difference changes how sensory channels integrate and how the dance of development unfolds. And it might explain why monotropic minds may need to rely more on bottom-up sensory processing, and why that might predispose them to neuroinflammation and other inflammatory hits.
Our minds use a combination of top-down (predictive) processing and bottom-up (sensory) processing to construct experience.
(Autistic thinkers tend to rely more on bottom-up sensory processing than non-autistic thinkers.)
Your brain lives inside the skull. It doesn’t see images like a camera or hear sounds like a microphone; it constructs them from sensory input that arrives from the body as electrical or chemical signals. Exteroception delivers information about the outside world (light, smell, sound) and interoception delivers information about the inside world (glucose, pH, the stretch of the arteries, pain).
Experience is constructed in layers. First into the image you see, the sound you hear or the sensation you feel, and then, as context and meaning are added, into emotions, understanding and entire experiences.
That is bottom-up (sensory) processing.
Try this. Look at this picture and, just at a glance, try to make meaning of it:
Once your mind knows what the image is (because you did the work to build it, or because you peeked at the reveal), you can’t unsee it.
That’s top-down processing: your mind’s best guess at what’s happening right now. Not only what you see. The mind predicts how you’ll feel about it, and whether you have what it takes to meet it. Whenever that guess is good enough, the mind skips the deep processing and relies on the prediction.
Why? Because top-down (predictive) processing is cheap. If you already know what to expect, the work has already been done. There is nothing more to learn. Bottom-up processing — constructing from the sensory system up — requires far more processing energy. And because maintaining allostasis is how the mind protects us from threat. Hey Dr. B! What in the world is allostasis?
Allostasis is stability through change. Instead of waiting for the body to drift out of balance and then correcting it, the brain predicts what the body will need next (more glucose, a faster heart, less digestion) and arranges it in advance. Peter Sterling coined the word in 1988; Lisa Feldman Barrett calls the same process body budgeting. It is the reason the brain predicts at all: a body that only reacts is always a step behind what it needs.
So what does any of that have to do with autism or monotropic processing?
These threads are some of my favorite to pull: