Autism Subtypes

Continuing on with our suite on disability and accessibility, this episode explores new research exploring autism subtypes and their links to genetic markers. There are implications for people with disabilities and politics. Tell us what you think!

Recommendations

• Abraham: Visit Savannah, GA! https://visitsavannah.com/ 
• Shane: ONTABA (https://ontaba.org/)

Holidays (11/12/2025):

• Chicken Soup for the Soul Day
• GIS Day
• Happy Hour Day
• International Pathology Day
• National French Dip Day
• National Pizza With Everything Day (Except Anchovies)
• World Pneumonia Day
• Dear Santa Letter Week
• Geography Awareness Week
• Home Care Aide Week
• National Book Awards Week
• International Week of Science and Peace

Links: 

1.   https://www.nature.com/articles/s41588-025-02224-z
2.    https://www.princeton.edu/news/2025/07/09/major-autism-study-uncovers-biologically-distinct-subtypes-paving-way-precision
3. https://www.cancer.gov/publications/dictionaries/genetics-dictionary/def/de-novo-mutation

Become a supporter of this podcast: https://www.spreaker.com/podcast/why-we-do-what-we-do--3419521/support.

Support our podcast: www.patreon.com/wwdwwdpodcast

Episode Transcript

Speaker 1 (00:03):
You're listening to Why We Do what we Do. Welcome
to Why We Do what we Do. I am your
typed sub host, Abraham, and I'm.

Speaker 2 (00:23):
You're not a sandwich host, Shane.

Speaker 1 (00:25):
We are a psychology podcast. We talk about the things
that humans and non human animals do, and we if
you're listening to this episode when it comes out and
you are like, stand on top of the feed, and
that's cool, and actually it kind of doesn't matter when
you listen to it. This episode is going to be sandwiched.

(00:48):
I'm sorry, I'm laughing so much. That is an inside
joke from before we were recording. It'll sandwich be sandwiched
in the middle of more episodes that are about disability
and accessibility. We are recording a several episod so it's
about this topic. They're all independent from one another, but
they are all on the same in the same sort
of theme, and we did kind of have an order.

(01:09):
We sort of put the first one first because we
talk in that discussion about the models of disability, and
now we're just going through and the.

Speaker 2 (01:18):
Second, second, we'll do the third, one third exactly.

Speaker 1 (01:22):
We're following the rule of chronological ordering, which is that
one thing comes before another.

Speaker 2 (01:27):
We like lines, guys, we love lines.

Speaker 1 (01:30):
So anyway, if you're joining us in the middle of this,
then do know that this one is fully intended to
stand on its own, and it belongs to multiple topics
on this discussion about disability and accessibility, and that they're
all sort of meant to hang together. And we'll probably
be doing this for the rest of this calendar year
as we're recording this, maybe even into next year a

(01:50):
little bit, who knows. But that's that's where we find
ourselves right now. And if you're listening to this on
the day that it records and you are new here,
then welcome. We are so happy to have you here.
Actually doesn't matter if you're listening to it on the
day that it publishes. I think I said records before.
You're not going to listen to it on the day records,
because you can't. We're barely doing we're not even going
to do that. But anyway, if you're a first time

(02:12):
listener or a turning listener, welcome either way, We're so
happy to have you here. I hope that you enjoy
what you hear in this discussion. If you do, and
you are like I would really like to support these guys.
There's a few ways you can do that. You can
like and subscribe, leave us a rating and a review,
join us on Patreon. I'll talk more about the ways
that you can support us at the end of this discussion,
including ways that include giving us money in ways that

(02:32):
include just giving us attention or time, and they're all different.
But it is November twelfth, and so I'm going to
wish you all a chicken soup for the Soul Day,
and that can be plant based chicken if that's the
way you swing.

Speaker 2 (02:43):
I was just gonna ask if a vegans could have
this day. It is a GIS day, which it means geography.
It's like Geography Information Systems Day.

Speaker 1 (02:52):
Okay, I thought that was GPS day. Just kidding.

Speaker 2 (02:56):
That's uh, who knows anymore, there's too many days.

Speaker 1 (03:00):
Next day. It is is a confusing set of words
in the order that they go. It's Happy hour day,
so a whole day that's an hour long, or a
whole hour that's a day long, and either way it's
happy and it probably has something to do with imbibing substances.
But that's the day.

Speaker 2 (03:14):
That's the day. It is International Pathology day. It's a
weird day.

Speaker 1 (03:19):
It is National French dip Day, although in France they
just call it National dip Day.

Speaker 2 (03:26):
That's true. I don't know what the azu was called
there is it? What does aju mean? Does it just
mean sauce? Anyway, I don't know. I don't know elles
speak French. It's a National Pizza with Everything day except anchovies.

Speaker 1 (03:40):
Both lots of mushrooms. Yes, it is World Pneumonia Day.
Don't get the pneumonia the world. That's bad.

Speaker 2 (03:46):
This is a really wild day. Is It's Dear Santa
Letter Read Week, which is lovely.

Speaker 1 (03:52):
Yeah, I gotta get him in and it's got millions
to read. It is Geography Awareness Week. Geography exists, y'all.
That's an important dude.

Speaker 2 (04:00):
Apparently people do not know that, so we got to
do some more time on that kind of It's a
Home Care Aid Week.

Speaker 1 (04:06):
Good one, man. I think we've talked about doing an
episode about some version of that. We did, yeah somewhere,
but anyway, National Book Awards Week.

Speaker 2 (04:15):
Love that ideal of that. And it's International Week of
Science and Peace, which the United States is best. It's
the best, it's the best. But the United States is
not participating this year.

Speaker 1 (04:26):
No, yeah, we don't participate this year. Maybe probably not
for the next few years. Hopefully one day again that
will be a thing. Hopefully, So if we want to yeah,
if we want to survive as a species at least. Anyway,
let's get to our topic at hand. We don't just
talk about holidays. We do talk about holidays, but we
don't only talk about holidays. As I said, we're sort
of in the middle of this kick of episodes that

(04:47):
are about disability and accessibility, and important to point out
that this episode is not going to unpack the very
complicated history of autism and diagnostic changes that have occurred
over time. We've talked about that in other episodes. We
recommend checking those out. We actually released an episode called
what Happened to Asperger Syndrome and then we re release

(05:10):
that as a nostalgia So you can listen to the
nostalgia one because it'll have the entire original, full length
and updated information. But yeah, you can check that one out.
And we've talked about autism in a number of places
in a number of ways, so feel free to go
back to check out those episodes. But we're adding to
our number of the discussions that we have about this topic.

Speaker 2 (05:30):
Yes, so we are going to talk about a major
development in the autism studies that have occurred more recently
and specifically how it intersects with genetics, because this is
a there was a really interesting study that came out
that was kind of an interesting advancement. I would say
maybe as we unpack kind of the science and the
structure and the new information that we have with autism

(05:51):
studies and genetics.

Speaker 1 (05:53):
Very good. We always begin with the necessary information that
you need to sort of proceed with the discussion that
we're going to have here, and the argument about causes
of autism have been complex, to say the least. However,
the most currently accepted viewpoint outside of the ultra maga
anti vax conspiracy theorists people who cannot tell their ass

(06:16):
from a hole in the ground, is that autism is
genetic and the causal factors of it are not understood. Really,
we don't know what's going on here, but the research
is ongoing. We're trying to learn more about what's going
on with this diagnosis, how it comes about, what does
it mean, et cetera.

Speaker 2 (06:34):
Right, So, in pursuit of understanding autism and autism spectrum
disorder researchers continue to explore various aspects of autistic people
and their related biology.

Speaker 1 (06:43):
So we're gonna this gets to be a fairly research
heavy discussion and today because this is really based on
like the sort of latest stuff that's coming out, So
jump right into that. Actually, yeah, Littman and colleagues in
an article published this year, this year being twenty twenty five.
You might be listening to this years down the road. So,
published in twenty twenty five is an article called Decomposition

(07:07):
of Phenotypic Heterogeneity and Autism reveals underlying genetic programs.

Speaker 2 (07:12):
That's the title of the article. Just it's like it's
like a spicy read. It's like how people like to read,
like sexy romantic novels. That's what we're That's what we're
talking about here. Like it's like, oh, just rolls off
the tongue, doesn't that it does?

Speaker 1 (07:25):
Yeah, it's very catchy, very catchy title.

Speaker 2 (07:27):
Mmmmmm okay, So we're gonna do our best to explain
what this means. So bear with us here. First, what
this article did. It identified four specific, clinically and biologically
distinct subtypes. I want you to remember this from now.
Clinically and biologically, we're gonna unpack what that means. But
those are two specific I'm sorry, two specific terms for

(07:49):
four specific subtypes that they have identified in this study.

Speaker 1 (07:52):
And by subtypes, I think what we can broadly say
that that means. If you hear that and you're like,
what are you talking about subtypes, is that if you
have the broad classification of autism spectrum disorders, the notion
being put forward here is that you could actually lump
them into four categories under that umbrella how autism shows up? Right?

(08:16):
Does that that feel like that's a cogent way to
describe them?

Speaker 2 (08:18):
I think that makes sense.

Speaker 1 (08:19):
Okay, cool. So the researchers collected and analyzed data from
over five thousand autistic individuals, and of course there's way
more than that out in the world, but you got
to go somewhere. So that was their pool of people.
Five thousand's a pretty decent sample when you're doing some research,
so they got a good end size there. Specifically, what
they were looking for is they were trying to look

(08:39):
at genetic markers and combinations of other traits so that
they could find some pattern in how to then classify
sort of how this shows up in these different silos
of characteristic features.

Speaker 2 (08:54):
Right, and so the team describes using what they what
they called as a person centered approach that included identify
over two hundred and thirty separate traits in each individual.
These traits included behaviors and characteristic That's a lot, I mean,
that's that's like, that sounds like, you know, when we're
talking about five thousand people, that's at least two hundred
and thirty separate traits from at least five thousand people.

(09:15):
This is a heavy duty study.

Speaker 1 (09:16):
Yeah, that's a lot. I'm trying to imagine, like if
someone said tell me two hundred and thirty things about yourself,
I'm like, would I would I be able to get
to two hundred and thirty? Yeah, that seems like a lot.

Speaker 2 (09:27):
It feels a lot. So these traits included behaviors, characteristics
related to social engagement, stereotopy, developmental milestones, lots of different things.
And this original identification of traits did not include identifying
genetic markers or links to single traits. This is actually
important for the study because they were able to link
traits back to those specific genetic markers independently and across subjects.

(09:47):
They weren't looking for the genetic markers at the same
time they were looking at the traits. They gathered all
trades first and then they went back and looked at
genetic markers. Is in relation to those traits, right.

Speaker 1 (09:58):
So I guess the way you could sort summarize that
as they're like, we find these categories of behavioral traits,
and we did the typing of the genetics of these individuals,
and we're going to see can we link those categories
to the genetics and see like it's common enough among
this genetic marker that we're going to link those the trait,

(10:19):
the behavioral trait and the genetic marker together to say
this forms a subtype, and this is like a classification
if you will, right.

Speaker 2 (10:26):
Yes, exactly.

Speaker 1 (10:27):
So this resulted in the findings that there were clinically
relevant autism subtypes which were linked to those distinct genetic
profiles because they could make an association between the prevalence
of a genetic marker and the behaviors that were associated
with that category that could then be linked to that
genetic marker. So they say, quote, understanding the genetics of

(10:49):
autism is essential for revealing the biological mechanisms that contribute
to the condition, enabling earlier and more accurate diagnosis and
guiding personalized care.

Speaker 2 (11:00):
Quote. And I think that there's a lot to say
about that. There's some questions, some comments and things, but
I do think it's really important they're leaning on this
idea of personalized care in individualized care. I mean, when
we go work with folks, we spend so much time
doing individualized treatment that like this is this is I
think a really great look at like or at least

(11:20):
a great idea to be going. We're going to look
at personalized care like important specific care for this individual
and this individual alone. And that's that's a really big deal.

Speaker 1 (11:28):
For sure. We'll get more into sort of our thoughts
around this as we're wrapping up this discussion, because you
might be like wondering, like I don't know, for people
who listen to this, we tend to insert our own
thoughts about this as we go. Sometimes we save it
for the end, and that's kind of the plan today,
I think, is let's just talk through it and then
we can give a little bit more in terms of

(11:51):
how we are thinking about this as a couple of
people who have worked in this field. Yeah, and also
understand that like those are going to be our opinion,
but we do want to just make sure we can
through the science part first.

Speaker 2 (12:01):
Yeah. Absolutely, So we're gonna take a quick ad break.
And this is something I learned while I was in
Canada is that our Canadian friends don't hear ads. So
what they hear is they hear us lead up to
the AD and then go right back into the episode
without a single AD showing up. Wow, at least I
had somebody tell me that. And they also told me
that I have an AD prep voice that has become

(12:22):
a cmo R for them, So they start cringing when
they hear me prepare for an AD, and then they
and then they and then no ad ever comes, which
is like this whole thing. So it's a really kind
of funny thing. So our Canadian friends, if anybody up
there is listening, please let us know if you hear
an AD after this.

Speaker 1 (12:44):
All right, we're back, And if you are in Canada,
then we're really back very quickly. But I guess surprise
too many of the other people. You probably heard an
AD for some kind of medication or something. Who knows. Yeah,
but let's let's get into the four sub tie or
phenotype classes that were identified in this recent research.

Speaker 2 (13:04):
Yeah. So for this section, it's important note specifically a
term that comes up a few times Denovo mutations. So
Denovo mutations refer to a quote genetic alteration that is
present for the first time in one family member as
a result of a variation or mutation in a germ cell,
which is Spermer egg of one of the parents, or
a variant that arises in a fertilized egg itself during

(13:27):
early embryogenesis, and that comes from the National Cancer Institute.

Speaker 1 (13:31):
So to put this in simple terms, the mutation is
expressed for the first time due to variation in one
of the parents, but the parents do not have the
expressed mutation themselves, but in the gammytes in the Spermer
egg that they produce.

Speaker 2 (13:45):
Yep, you nailed it. So the first phenotype is labeled
social and behavioral challenges. What this means is individuals with
this marker may be more prone to social challenges and
or stereotopy. They may reach general developmental milestones at a
pace similar to the majority of children. They may also
experience higher rates of comorbidities related to anxiety, depression, ADHD
or OCD.

Speaker 1 (14:06):
That sounds about right. Co morbidity autism and between autism
and ADHD and things like depression is so high. So
it'd be interesting to see the extent to which the
co morbidity exists more among this subtype as they've identify
it than others. Yeah, but anyway, this was the largest
group in the study. This accounted for about thirty seven
percent of participants that were linked to this marker, and

(14:29):
so out of four subtypes, over a third of them
were in this group, meaning that this is not equally
distributed among subtypes.

Speaker 2 (14:37):
Yeah, exactly. Now. The second subtype was called mixed ASD
with developmental delay, and about nineteen percent of participants were
found to have this phenotype. And again these were folks
that were likely to reach certain developmental milestones. It may
not show anxiety depression, but they may have some stereotopy
and social challenges and some other type of developmental delay
they may have, you know, maybe they have some challenges walking,

(14:59):
or they may not communicate as early they do it
some milestones, not all the milestones, and that developmental delay
exists with them.

Speaker 1 (15:06):
The next subtype number three if you will, if you're
trying to keep track, this is moderate challenges. So these
folks are more likely to show common well you might
think of as common. I guess you could sort of
like lump it into broad interpretations of what might be
considered common or core autism related behaviors, but less strongly

(15:26):
than other groups. They're likely to achieve developmental milestones, and
these folks do not experience co occurring psychiatric conditions. And
this paper indicates that this group actually makes up one
of the second largest chunks here. This is it is
the second largest chunk. It's about thirty four percent of
the total sample. So between moderate challenges and social and

(15:47):
behavioral challenges, that is over sixty percent. Mater of fact,
that's over seventy percent of the entire population. And so
the remaining thirty percent is split among the other two subtypes.

Speaker 2 (15:59):
I also think that as an important statistic that we'll
talk about later. Yeah, And then the final group is
labeled broadly affected, and this is the group that appears
to be the most severely impacted with a wider range
of concerns related to challenging behavior, developmentalays, social and communication difficulties, stereotopy,
and comorbidities. This is the smallest group, the smallest group

(16:19):
of all the subtypes of about ten percent of the participants.
But this group actually showed the highest proportion of Dnovo mutations.
So this is the first group that those mutations that
we showed that talked about earlier, this was had the
highest impact, the most what they described is the most
severely impacted and had the highest proportion of those Denovo mutations.

Speaker 1 (16:38):
It's going to be important to remember these as we
start to talk through the implications of this as well,
which because of how this is showing up in politics
as right in like sort of contemporary discussions and what
we'll get back to that. But an important thing here
is that the first author, Ivia Littmann, says about this quote,

(17:01):
these findings are powerful because the classes represent different clinical
presentations and outcomes, and critically, we were able to connect
them to distinct underlying biology end quote. So they're specifically
pointing out that what is different about this approach relative
to how we have talked about, researched and understood autism

(17:23):
in the past is we're now saying that they can
look at the genetics that are specifically related to the
way that the autism shows up for the people that
have that diagnosis, where you look for it and you
see how the variety of ways that people experience the
symptoms of an autism diagnosis, how it presents in those individuals.

(17:46):
There is now an underlying genetic marker that they can
turn to and say that we've seen a correlation between
this and how it presents, which is very different than
we've ever known or talked about or had access to
the information before.

Speaker 2 (18:01):
Yeah, there's like a I feel like what might be
assumed as a level of precision that we haven't had before. Yeah,
precision and predictability. I would say, it's like and that's
really kind of what maybe is like. One of the
big implications of this is that I can identify this
particular genetic marker, which means I can assume with high
predictability that you're going to see it presented this way,
which is which means that you can get this level

(18:22):
of care. And the authors actually go on and they
say they actually note that other biological processes may influence
these subtypes. They say, specifically, what we're seeing is not
just one biological story of autism. But multiple distinct narratives,
and I think that's important too, Like they're not going
if you have this, you're gonna be this. They're saying, yes,
this is one thing, but like we've seen pretty consistently

(18:42):
that this particular marker is an indicator that you might
see these types of behaviors, these types of presentations of
the disorder, and these folks with this with this marker.

Speaker 1 (18:52):
I want to go back to to what you were
saying about this level of precision, because it strikes me
that I think that a lot of peop people think
that this was the level of precision that people have
been operating at for a long time when diagnosing autism. Yes,
Like I think that they hear there's a diagnosis of
autism and they're like, well, that it's settled. This is

(19:13):
concrete now, Like they must know because the level of
science is such that if they can make this diagnosis,
then there is not a shadow of a doubt that
it's wrong. And that's not how it's been operating. Like
many many mental health diagnoses are like, well, you answered
this questionnaire in this way, so that is good enough

(19:34):
to say you meet the criteria for this diagnosis and
there's some that are like, we observed this set of
behaviors this time and within this time framework that meets
the qualifications of this diagnosis. So this is a new
level of precision that I think a lot of people
believed was being brought to diagnostic criteria before that it

(19:58):
simply wasn't and so on. Fortunately, I think the experience
that people have now is like, now there's a greater
level of precision, and they're almost going to be like, well,
didn't we always have that? Why is this new? I
don't know. I'm interested in sort of the perception that
people have had about what it meant to getting diagnosis

(20:18):
in the past, because I gotta tell you, there is
a shockingly large number of diagnoses where to achieve that
diagnosis you fill out a questionnaire. Yeah that's a thing.
That is a thing, Yeah, exactly.

Speaker 2 (20:30):
And I think the other thing that stands out to
me in this particular section of the article when they
talk about this is the level of folks that are
likely to have an autism diagnosis but do not present
in what is often the stereotypical way that autism shows up,
Like you're going to have over seventy percent of autistic
folks that like are somewhat I mean, according to this article,

(20:53):
reported to be less impacted than ten percent, which is
often what I mean. I don't. I think we've worked
in this space for a long time. I generally work
with the folks who could be described as either moderately
no I'm sorry, mixed ASD with development delay, or broadly affected.
So I work with that thirty percent that operates at
that on those subtypes. Yeah, But like the broadly effective

(21:15):
folks are the folks that I often get called in
to work with, Like I get I work with autistic
people that barely communicate or don't communicate at all, that
have missed multiple developmental milestones, like I work with the
folks that are often supported by the profound autism society,
Like I don't work with the folks that are like
portrayed on television as like the quirky doctor that knows

(21:36):
how to answer every single question and has like an
unlimited knowledge of the of all the medical books. Like
that's not usually it. I was actually pretty surprised to
find that they were such a low the broadly affective
folks were such a low percentage comparatively. But I think
that's I think it's important. I think it's important because
I think that that shows you the one we've already
kind of already known that autism was a spectrum, but

(21:57):
like that, I think that really shows to a degree
like that there is more of a spectrum. But the
other side is that it's a hidden disability. Like you've
got folks that are diagnosed autistic and have very mild symptoms,
but are still impacted because of the comorbidities, because of
their own symptoms with autism. Like you've got all these
different things that are I think maybe this opens up

(22:20):
that perspective a little bit.

Speaker 1 (22:22):
Absolutely, Yeah, And I think that that again, it's going
to be very relevant as we get to some of
the implications about this later, is that that ten percent,
and I completely agree the majority of the work that
I did was with that ten percent group, the smallest
group there of the people who would be classified as
broadly affected. And I do I'm going to go back
to one more step again, I apologize, but in this

(22:44):
discussion about the precision of the diagnosis that even though
they're bringing a level of precision that I think is
closer to what people thought that already existed this still
is not that precise, right, Like it's more precise, but
it's not the end all be all. It's not like
the job is done now, you know, wipe your hands
off and call it a day. Like, there's just now

(23:06):
a different level that's being brought to this, and so
I think it's important still to understand that there's a
lot more work to do to understand more of what's
going on. Absolutely, we're going to keep it simple. There's
going to be an ad for our American friends and
dead air for like one second for Canadian friends. We

(23:30):
are back. Let's start getting into some of the implications here.
I think it's important to start asking the question the
questions that might arise from even being able to present
the idea and then some evidence to support that idea
that there's such a thing as US autistic subtypes. What
does that do for us as clinicians? What does it

(23:51):
do for the autistic population? Like? What are the implications here?

Speaker 2 (23:55):
Yeah, so genetic testing is already part of the standard
care for autistic people in the US. I think that's
something that is often missed that's already there, But current
testing only provides explanations for about twenty percent of those tested.
With possible advances like this, we may get that level
of precision where we can get far more people tested,
we can get far more information about what might be

(24:16):
impacting them. And like I said, we're really only seeing
a very small portion of those folks that are even
being tested, and there's any sort of like usable results
with our current testing.

Speaker 1 (24:26):
Yeah, the greatest implication here is that there is an
argument for biological markers as predictors for clinically relevant concerns
as they might arise. By identifying the genetic markers, we
can I guess to an extent predict you might predict
with greater accuracy than before the types of clinical concerns

(24:49):
that might arise throughout the development depending on the subtype
that that person belongs to or could potentially belong to
based on those genetic markers. So this could potentially lead
to more targeted clinical and social supports earlier in the
process of providing supports for this person and individualize to
that person's unique needs, assuming that it is correct and

(25:13):
precise enough to put you on that path.

Speaker 2 (25:17):
Yeah, and I think the timing of these emerging traits
may also be dependent on these subtypes too. Because genes
kind of quote switch on and off like and of
course I'm not a geneticist, so and I'm not a biologist.
I actually like flunked out of biology early on. I
was like, I hate this, this is terrible. That's actually
the reason I'm not a marine biologist, because that was like,
I hate biology. But genes kind of switch on and off.

Speaker 1 (25:38):
I just like fish, I just like totles.

Speaker 2 (25:41):
So genes will switch off and on at various stages
of development. We may find that these subtypes may also
express at different stages. So for some types without developmental delays,
these markers may express later in development, whereas those who
have who are broadly affected, may see more immediate presentations.
So there are other factors here that just saying the
markers exist, it also is important to understand when those

(26:04):
genes switch on and off and how that's impacted. That
might explain why somebody who has pervasive developmental disorder or
NOS like or what it's called now that that's kind
of pulled into the autum specrum disorder, but like that
disorder where like the genes might switch on at a
certain age and then all of a sudden you lose
a little bit of communication. We don't know that, and
I think that's something that we can now start kind

(26:24):
of asking questions about now that we understand that these
genetic markers exist.

Speaker 1 (26:28):
Genetics are definitely very complicated in something about which we're
still learning a tremendous amount. But you may have heard
in our voice already in some of the discussion we've
had we are trying to present this essentially with like
the kind of narrative that the author's brought to it.
There is definitely a note of caution here that we

(26:50):
should we should take on and understanding this, I think
it's worth worth having a brief conversation here about eugenics,
as is probably going to come up. I think again
speaking to some of the discussion that's been happening politically,
is the idea of autism has been treated as if
it's basically a death sentence. The worst thing that could

(27:11):
happen to a human autism is the way that people
are talking about this, that is not we do not
subscribe to this by the way that autism is the
worst thing in the world, or even really something that
needs to be treated as if it's always a pathological
thing to be concerned about, but autism and disability at
large has a long history of genetics research and related concerns,

(27:34):
mostly dickheads that think eliminating these genetic anomalies is the
best thing for humanity. They look at something that has
a diagnosis, and because we have labeled it as having
a diagnosis, it is therefore something broken. This goes back
to the medical model of disability, and that the person

(27:54):
who is therefore considered broken by that idea should be cold,
or at least vented from contributing any more to humanity
because they represent a deviation from the ideal, which is
I'm going to use a term here to because I
was just in the South, that is hogwash, soph In

(28:20):
this space, in a discussion about genetics, you're going to
hear people talk about curing genetic variations, fixing them, curing them, whatever.
These kind of got discussions will prompt larger discussions that
sort of lead down the gross path to eugenics. I
would caution folks that as this research emerges and develops,
we are cautious to understand the dark history related to

(28:43):
this idea of fixing genetic variations and ensure that like
we when we notice that that conversation is happening. We
catch it and prevent it as much as possible. So
I don't think it's a hard stance to say that
eugenics is awful. I think we can as a podcast
espouse that. I think we can as a species espouse that. Yeah,

(29:04):
and we should never be considering this. It's a low bar,
but there there are too many people who are not
meeting that standard. But yes, eugenics is bad.

Speaker 2 (29:12):
Yes, in case that wasn't clear now, I think, on
the other side, more information isn't bad, but I do
think that it can mask more nuance concerns related to
the individual. So, for instance, it's great to know that
someone has one of these subtypes or a genetic marker,
but there are other factors that can contribute to a
person's development. For instance, someone with social behavioral challenges, which
is the largest group, could also have a limb difference,

(29:34):
family history of other diagnoses, an acquired brain injury, et cetera,
et cetera, et cetera. Right, we have to remember that
biology is not the only predictor of behavior, and it
is really only a small portion of it in the
large the grand scheme of things biology will maybe maybe
lead to or like may set the cajun for certain things,

(29:54):
but it's really all about the mechanism by which we engage,
Like it's it's how we engage in behavior, it's how
we interact, like how our body interacts with each other,
and like all those things. It's not the cause of
behavior in these situations. And I think it's really important
to kind of like reorient to that that it is
nature and nurture together that creates behavioral circumstances. Yes, we

(30:14):
can't just go, oh, they got this, that's it, Like
we have to be really cautious to make sure that
we have that balance.

Speaker 1 (30:20):
Yeah, never one without the other. And man, it is
so tempting that people see there is a behavior they
find challenging, and the knee jerk solution is always just
like call it.

Speaker 2 (30:32):
I'm just like, yeah, but the behavior do we have?

Speaker 1 (30:35):
I mean, do we have to start there? Could we
maybe like not start there and start somewhere else instead,
because I'm like, if we start at some other place
that's more compassionate and thoughtful and not stupid, we'll probably
much never get to kill it as the solution, right, So, like,
I don't it feels like people start there a lot
of the time.

Speaker 2 (30:52):
Yeah.

Speaker 1 (30:53):
Anyway, last point on this part here I think is
this is only one study that we're talking there are
more research is definitely needed. Sometimes we find studies like
this and we want to run with it because it's
so it's so much of a new revelation in the
sort of discussion, the space of discussions around topics like this.

(31:13):
But we we caution that this is just a single study,
which means that the findings need to be replicated before
and ideally by independent research groups before we start assuming
that we have enough information to say we've got it,
let's go. This is very early stage research. The findings
are promising, they'll likely lead to other research lines that

(31:35):
will continue to inform our thoughts and an understanding of this.
But again we're just we're at there are limitations to
behold and understand that we're still in early stages.

Speaker 2 (31:44):
Yes, essentially, what we're saying is, please do not run
with this as accepted fact. Like this is the part
where you get to be skeptical. You get to go
this sounds really nice. I really like where this is going.
We need more research to bolster it up, to lift
it up to give it more credence. And that's not
to say that these researchers are bad researchers. That's not
at all what we're saying. We're simply saying that one

(32:06):
study does not equal consensus. So we just need a
little bit more to kind of like push it forward
and to give it more evidence and more backing.

Speaker 1 (32:14):
Absolutely, all right, let's go ahead and get into then.
You know, we're behaviorists. We should get into a behavioral
interpretation and understanding of what to take away from this research.
But first we are going to get into some more ads.
For some of you, we'll be r hey back, Okay,

(32:42):
we are back. We're talking about the sort of behavioral
interpretation here, and to dive into this, I think we
need to make sure we're clear on a few points. Okay. First,
behaviorists have this reputation as thinking that biology sometimes that
biology is irrelevant. That is not the ethos that is

(33:02):
actually foundational to an understanding. As we've described before many
times in our discussions and even in this very episode,
biology is one of the determinants of behavior. Said another way,
maybe we are born with it. It is to say
that we are biological organisms. To pretend that biology is
not relevant is to suggest that we are not biological organisms,

(33:24):
but in fact we are, and that we interact with
the world as biological organisms. I think the problem is
that most people look at behavior and they're like, well,
that's all the biology. That's the only reason they're doing
all the things that they're doing. And we keep pushing
back on that because there's so much more to say
about what's going on with the behavior. We have shown

(33:46):
empirically so many times it's not even worth attempting to
list the number. Let's just say a trillion because it's
going to be close enough to that anyway, A trillion
times we have demonstrated that environmental factors influence behavior, and
people just keeping that so to keep harping on that.
But that is not to say that we don't understand
that biology as relevant is completely relevant, right, you can't

(34:07):
have behavior without biology, so like, of course it's relevant.
But also just people I think misunderstand that point, right.

Speaker 2 (34:15):
I think the second thing that we have to also
point out to is that specific genetic markers can help
predict possible behavioral traits that may emerge. But said another way,
the more information that we have can tell us what
might happen, not what will happen, but what might happen.
Genetic markers do not dictate fate. It is not a

(34:36):
preordained set of behaviors or problems they're going to come up.
It's just telling us that the likelihood might be higher
but not certain. I think that's really really important to
pin down here.

Speaker 1 (34:47):
Yes, very good point. Okay, this kind of is I mean,
the definition of this. We aren't born with learned behavior
because it's learned.

Speaker 2 (34:58):
Right so much I sometimes you just got to say it,
you know, is I mean one hundred percent?

Speaker 1 (35:04):
Like, you're absolutely right. I think that people think there's
these learns They will talk about like a reaction to
something like text, and they're like, well, I guess you're
just born that way. I'm like to text, our genetics
know what kind of text we're going to be encountering
in life.

Speaker 2 (35:20):
Oh my god, to understand that language specifically.

Speaker 1 (35:25):
Right, Yeah, what a revelation? No, God, come on, Like
we're born with the capacity to interpret text, sure, and
that's a very interesting thing. But the reaction we have
to a specific kind of text, how could biology possibly
plan for that? Our biology doesn't know what English is.

(35:46):
It doesn't know what Spanish is, It doesn't know what
Mandarin is. We don't have genes that code for what
language we are going to speak. It is the environment
we are raised in, the languages that we are exposed to.
We know that one hundred percent. Like that, like the
fact that we can speak language biology the language we
speak learned, right, But okay, got to say it. I

(36:08):
guess yeah, we don't have genetic flagpoles that tell us
will have social issues or that tell us that will
have aggression. Boy, that one comes up a lot too.

Speaker 2 (36:16):
Yep.

Speaker 1 (36:17):
We may have an increased likelihood for those kind of
behaviors based on the markers, but it's not a guarantee,
Like we might never encounter a situation where that behavior arises.
Even if we had those markers. We might not have
those markers and still be aggressive. So like it tells
us that there is it seems like it's correlated with

(36:38):
an increased potential, It does not mean it's going to happen.

Speaker 2 (36:42):
Right, And I think that's important to point this out
here because this is a larger discussion about labels and correlation.
It doesn't account for actual experience. Actual experience does alter
or change the course of somebody's entire life. I always
think about the difference between like I have a family
member and myself that are the samege and we have
lived two very different lives. Yeah, similar biology, because we

(37:06):
come from the same family tree. You're related, Yeah, because
we're related, similar circumstances, low socio economic status, parents were
together those types of things and have vastly different outcomes.
So you could probably look at our genetic markers and
find similar markers, but have very very very different sets
of behaviors and different outcomes for lots of different reasons. Yeah,

(37:26):
so actual experience does make it different. I mean, we
grew up in the same town, almost on the same street,
so like it's one of those things where our circumstances
were as close as they could be without living in
the same house. I think it's really important to remember
that when we talk about these labels and we talk
about this, it doesn't automatically dictate that this person is
going to have this outcome, because actual experience does make
a difference.

Speaker 1 (37:47):
Yeah. Yeah, you could clone a seed of some plant
plant the original in one planter, the clone in another,
and like give one of lots of like fertilizer and
sunlight and water and take really good care of it,
and the other one you just give it nothing whatsoever.
And you will get very different plants even though they
are clones, right, And there are lots of factors you
can manipulate that are going to change the kind of

(38:10):
plants that you get, even though they are genetically identical.
You will get different kinds of plants because you've done
different things to their environments. And behavior is vastly, vastly
more complicated than that. So let's take, for instance, someone
who is labeled as broadly affected. This is that ten
percent category where it's like they have some of the

(38:30):
most salient impacts related to that diagnosis. Someone who's severely
impacted under this category, we should expect behavioral challenges or
severe deficits. However, this does not account for things like
personal circumstances, access to care, cultural perspectives, the myriad of
factors that could shift behavior in many different directions. Someone

(38:55):
who is raised with a huge amount of structure and
support and like people who are experts at guiding the
development of an acquisition of new skills, versus someone who's
the parents who are neglectful and don't care or don't
know how to participate, and maybe only rely on things
like punishment, and they don't really communicate with their child.
Those two children, even if they were genetically identical, would

(39:17):
turn out very different in those circumstances. And when we're
most of these are not genetically identical anyway, but those
circumstances are going to play a huge role.

Speaker 2 (39:26):
Right, So I think we can illustrate this with using
two other examples. I think you can use Down syndrome
and generalized anxiety disorder as two specific labels for different
conditions that people have. Right, one is a disability related
to genetic variations, and the other one is a mental
health diagnosis that's an anxiety disorder specifically in both situations.
In both cases, the label establishes a set of expected outcomes.

(39:47):
You expect certain traits, certain behaviors, certain experiences out of
those folks, including those behaviors that we expect to see generally,
Like when we've talked about somebody with Down syndrome, we
expect some level of developmental disability. We expect something like
maybe some some porous skill acquisition. In some ways, we
generalize anxiety disorder, we expect to see panics, panic attacks.
We expect to see these different things. But we know

(40:09):
here the beauty is in the variation. We also know
that people the beauty is in the experience that people
will change and alter, they'll gain skills. You'll have folks that,
regardless of those labels, they will have unique skill sets.
I was going to use the example of juggling, right,
There are some people who can juggle and some people
who can't. I cannot juggle. And that's the beauty of

(40:29):
behavioral variation in general, right, Like, that's the beauty of
that is Like, we're gonna see variations across labels, across people,
across circumstances. It's a really wonderful thing.

Speaker 1 (40:40):
Is there a genetic marker that tells you whether or
not you'd be good at juggling? No, because you just
though't something you practice, Like right, I think there are
going to be people who struggle with motor coordination that
might be related to some kind of medical diagnosis, and
it might be tougher for them to learn how to juggle.
Maybe you could say something about that, but it certainly
won't tell you anything about particularly think about things like

(41:02):
mental health conditions. The extent to which that would be
that predictive of something like talent or skill, right like
where you spend your time and imagine growing up in
a time where juggling was not a thing that was
known to the culture that you were raised in time
or a culture. I guess, would you ever be good
at juggling even if you had that genetic marker they've identified, No,
because you would have never ever tried so like right',

(41:24):
It's just not as black and white as I think
a lot of people seem to think that it is.

Speaker 2 (41:29):
So going back to the example of DOWNS in German
generalizing xiety disorder, someone with DOWNS in GERUM may have
significant challenging behavior or they may never need behavioral interventions
throughout their life. There you might see the two of
those in those situations. Similarly, the spectrum of behaviors we
may find across individuals with generalized anxiety disorder can include
more severe clinical concerns such as substance use to mother

(41:49):
experiences like minor avoidance behavior somewhere in between where you
have major panic attacks. You can see lots of different
things in there. The variation, again is part of the
beauty of this and really understanding that those diagnoses do
not automatically dictate how somebody is going to act in
every circumstance.

Speaker 1 (42:06):
Yeah, exactly, even the ones that are based on the behavior,
that that behavior may not occur again given the circumstances
under which it arose in the first place. Because, as
we've talked about in a couple of different places in
past episodes, like that, a whole saying the past behavior
is the best predictor of future behavior is just wrong.

(42:27):
It's just wrong. It's right, the past circumstances and what
you learn from that situation is the best predictor of
future behavior, right, because you will have had an opportunity
to do something in a similar situation, and then there
was some outcome that told you, do you do that
thing more in the way that you did it, or
do you do it in a different way than maybe
how you did it? Do you maybe just escape the
situation altogether. Point being that, like, just even classifying things

(42:50):
based on their behavior you would think would be predictive,
except that it needs to factor in context and the
learning that happened inside of that context. So no, right,
Like anyway, the point here is that behavioral classification occurring
before learning history is developed is very misleading, and I
think people are going to be tempted to do this

(43:11):
and jump the gun. It's not necessarily unhelpful, but it
can be very misleading, and I think it can people
can shoot too early at what they think is going
to be the best course of action before they've had
an opportunity to observe how things are actually unfolding. Right,
And if we know what kinds of potential problems can occur,
then we can try to attempt that the right resources

(43:32):
are in place to prevent the development of those And
if they never develop, we won't know whether or not
it was providing those supports or if they weren't going
to develop. But honestly, who cares? Like the fact is
it didn't develop, Like we at least did something, and
now we have some reason like things are turning out. Okay.
We should not expect that someone who has said characteristic

(43:52):
will have said characteristics simply because of the label. So
broader discussion here, I guess just about how we interpret
things diagnoses and genetics, but I think is relevant here.

Speaker 2 (44:03):
Yeah, yeah, I really don't have much more to say
beyond this right now, in this moment, but I do
think it's important to remember this as a single study.
And I think what's happened is this this study caught fire,
and it's and for a good reason. It's an interesting study,
it's a fascinating study. It's a powerful study. However, it's
a it started conversations. I mean, here we are doing

(44:23):
a whole podcast on it. Yeah, you know. But I
do think that there is like this level of just
understanding that it's one study. We need your applications. It's
not sufficient for adoption, it's not sufficient for consensus because
we do not have consensus. We need more research. So promising,
but let's be cautious and let's dip our toes in
the water a little bit and just understand that there

(44:45):
are lots of big conversations that are going to come
out of this.

Speaker 1 (44:48):
I actually do have two quick things I was thinking
about that we should discuss. The first one is an
ad I knew it all right, we're back, So thing
one is downing two. There's an implication about this politically

(45:11):
as well, and because as we've described, there's in the
United States, RFK Junior is doing his best to kill
all of us, and he's got a target on the
heads of all the people who are autistic, and he's
gone on to say things about people who are autistic,
like they don't pay taxes, they don't create works of art,
they don't write poems, they can't do anything. Basically is

(45:32):
his sort of his sort of take on it. And
you may have noticed as we're describing these subtypes that
he's describing what would probably be fall into that broadly
affected subtype, that ten percent. And he keeps a lot
of people in the anti vax space who are really
concerned about people having autism has been the worst thing ever.

(45:53):
They frequently point to the increase in the prevalence of autism,
which actually, to be fair, has tapered off the last
decade and a half or so. And the reason that
we saw autism was on the rise to begin with
had to do with a lot of factors. And we
talked about this in some past episode. I don't even
remember which, although I do think that we mentioned it
in the Asperger syndrome discussion. But part of it was

(46:16):
recognition of the symptoms, Like it just wasn't very common
for a long time because people weren't diagnosing it, and
then they started diagnosing it. And they started recognizing the
symptoms more. That was one. Another one is that like
criteria for or like mandating support from insurance became a thing,
which meant that like people were more likely to look

(46:36):
for that as what the diagnosis could be because that
would provide funding than for intervention and support for that disability.
And then the third one, there's more than three, but
the third one I'm gonna mention is that they collapsed
all versions of the spectrum of autism into one label.
So now you what people who are being called like

(46:57):
pervasive developmental disorders. Yeah, yeah, that was its own thing.
Now it's called autism. So the numbers that were over
there are now subsumed over another one. So anyway, like,
those are many of the features that led to the
increase in here. But as awareness has spread about autism
and a lot of communication, I think ultimately that's mostly

(47:17):
been a good thing for the autistic community. They do
see these numbers swelling in terms of the rates of
people who are communicating autism and who again, that's as
largely plateaued in the last decade and a half. But
RFK Junior points to this and says, like, look at
this huge problem that we have. The vast majority of
those diagnoses are the other ones that we described. It's

(47:40):
the mixed ASD with developmental delay, the social and behavioral
challenges people, the people who are not how he described
right as like the ten percent ten percent, and like
the ten percent that made up pretty much everyone who
is being diagnosed before. But the spectrum nature of this
that is includes those other types. Those have way outpaced

(48:02):
the sort of broadly affected group, and so there's actually
some kind of utility and building these subclasses to help
show like the people that RFK Junior is so afraid
of that might fall into the nonverbal camp, that might
fall into the like requiring support for a lot of
physical things, even like learning how to wash your hands
and brush your teeth and put on clothes, Like the

(48:23):
people who fall into that camp. That's only ten percent, right.
The growing number is coming from recognizing the spectrum as
being applied to things like the people in the social
and behavioral challenges category and the mixed ASD with developmental
delay category. It's like those are the spots where there's
the most recognition is now occurring. And he's like pointing to, like,

(48:44):
look at all these cases of autism like those aren't anyway,
I think you know what I'm saying, right, Like, Yeah,
the whole point is I think there is some political expediency,
and I don't think that was the goal of the authors,
but I could be wrong, but I think there's some
political expediency and helping to specifically isolate here, Like where
is it you think that there's such a massive problem.
And again, even if we have these people who are

(49:07):
in the category of the like broadly affected, it doesn't
mean there's like they're not bad people. We're not trying
to rid the world of them. They're just people who
need extra support. Like let's let's provide the extra support.
So I don't know, it's I think those an important
feature to just sort of get into here.

Speaker 2 (49:21):
Yeah, and I think you nailed it. I think one
percent perfect.

Speaker 1 (49:25):
I think we've said what we need to say about
the autism subtype. So let's go ahead and wrap this
one up here. Is there anything you'd like to add
before we get to our sort of closing comments. Uh no,
If any of you are new here, I wanted to
let you know that we are going to give some recommendations.
That's the thing that we do and it's really fun.
So stick around through the credit so we can get
to that part. If you would like to support us,

(49:46):
you can head over to Patreon. There's a cool group
of people over there, and we really like them and
they get extra content, bonus content, add free content, all
kinds of stuff. They're really good and possibly the favorite thing,
the reason that they're actually here is at the end
of each discussion. At the end of each discussion, I
can say words, I will read the list of names
of people who have been so generous as to support us.
So thank you to Mike, m Megan, Mike T, Justin,

(50:07):
Kim Brad, Stephanie, Brian, Ashley, Kiara, and Charlie. Thank you
all so much, so much.

Speaker 2 (50:13):
You're the best. You're the best, You're the best of
your best.

Speaker 1 (50:15):
Writing and fact checking from Shane and myself. Thank you
so much for putting together the notes on this one today. Shane, Hey,
thank you.

Speaker 2 (50:21):
This one was fun.

Speaker 1 (50:22):
It's fun. Our social media coordinator is Emma Wilson, and
our editor in chief who makes all the episodes sound
good is Justin and believe me, he does a lot
of work. So thank you so much, Justin.

Speaker 2 (50:31):
You guys don't even know the amount of work he does.

Speaker 1 (50:34):
You don't even know. And of course thank you all
for listening. Otherwise, you can support us. You can pick
up some merch, leave us a rating and a review, like,
and subscribe and tell a friend. Just go out and
tell of friends, you know, go tell people about all
the cool stuff that you hear in podcasts. It's really
good helps us. Yeah, but yeah, but I think that
that's what we have to say about those things are
ready to transition to our recommendations, I think, so all right,

(50:54):
let's do it. Recommendations I'm recommending. So. I just got
back from a conference. It was in a city I
have never been to. It was lovely Savannah, Georgia, And
man is it beautiful there. Holy cow. Pretty much everyone

(51:16):
I interacted with was just unbelievably nice. The city itself
is gorgeous. It is it is old. It is like,
got all these really cool buildings. There's a bunch of
modern stuff. There's amazing parks, like it feels like a
huge metropolis condensed down into a small city. That's like
the proper city of Savannah's got like one hundred and
twenty thousand people. The Savannah area is like four hundred thousand. Like,

(51:39):
this is not a super large place, but it's got
everything that you would want from a city and it
is gorgeous. So I'm recommending to visit Savannah when you
get a chance. And I even I'm putting a website
visit Savannah dot com in the notes here. I mean,
I just told you what it is. It's not that
you remember, but you can click on that link and
go check it out.

Speaker 2 (51:56):
I love Savannah. The first time I ever got to
visit Savannah, I was on tour and we played a
pizza place called Sweet Melissa's and we had to carry
all of our gear downstairs and play in a brick
basement and we got paid in pizza. So uh, that
was my first memory of Savannah and it was lovely.

Speaker 1 (52:14):
So that's awesome.

Speaker 2 (52:15):
Yeah, it was great. It was it was I mean,
we needed gas money, but like the pizza was helpful. Yeah, yeah,
go visit Savannah. So I also just got back from
a conference and actually this this one pains me a
little bit, only because you were so close to me,
Like if you if I, if I had not gone
to the conference I was going I went to, I
could have gone to Savannah because it's only a three
hour drive from me, Like you were right down the road, man,

(52:39):
but lo and behold, I was in another country. Yes,
I went to on Taba And on Taba is the
Ontario Apply Behavior Analysis Association. If you ever get a
chance to go to this conference, they are truly the
loveliest people I have ever spent time with. There are
very few conferences that I'm like, just go to this
conference and spend time with these people, because like sometimes
I'm just like, yeah, it's Comsida, I like I enjoy it.

(53:01):
But I would say on Taba, Faba and Asyaba, so Arizona,
Florida and Ontaba are all three really truly wonderful conferences,
and on Taba always makes me feel like home away
from home. Like the community there is very rich. They
are leading an advocacy. They've done some really killer work
to make sure that the profession stays a profession in

(53:22):
the in the province. The people that are working on
the board are very forward thinking, progressive, incredible people. Some
of my favorite folks and just some of the behavior
analysts there, Like I've had the lovely opportunity of meeting
some really truly amazing behavior analysts and wonderful people. So like,
just a huge shout out to to Jamie, jess Ali,
Naomi Sarah. I got to meet Ben from Behavior Speaks

(53:45):
at this conference too, and he's a really lovely dude.
So and if I forget anybody's names, by all means
you can yell at me and scream at me. Albert
like just really cool people. So but either way, lovely people,
super scientist, practitioner forward, just really really great conference. So
you should go. And if you can't go, you should
go onto their website and you should purchase some of

(54:06):
the talks to watch what they do, because they do cool,
so go support them.

Speaker 1 (54:12):
Fantastic. All right, very good, Well we will wrap this
one up here. I think I did not say this earlier,
but you can tell us your thoughts on the autism
subtypes and anything we discussed in this episode. We also
accept heaping amounts of praise. Of course, you can email
us directly at info at wwdwwdpodcast dot com or reach

(54:36):
us on the social media platforms. But I think that's
what we have to say about this for now, So
thank you all for listening. Anything else you'd like, d
ed not today, all right, then this is Abraham.

Speaker 2 (54:45):
And this is Shane. We're out sea. You've been listening
to Why We Do What We Do. You can learn
more about this and other episodes by going to wwdwwdpodcast
dot com. Thanks for listening, and we hope you haven't
allo okay,