There are FOUR distinct subtypes of autism, say scientists – and discovery could ‘transform treatments'

The Sun

3 days ago

THERE could be as many as four different types of autism, Princeton scientists have discovered.
Each type has its own genetic signature and unique brain activity, helping explain why symptoms vary so widely between people.
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'Understanding the genetics of autism is essential for enabling earlier and more accurate diagnosis, and guiding personalised care,' senior study author, Olga Troyanskaya, said.
Researchers at the US University and the Simons Foundation analysed data from more than 5,000 children with autism.
Using advanced computer modelling, they grouped the children based on over 230 traits.
These traits ranged from social skills and repetitive behaviours to key developmental milestones like walking and talking.
This approach revealed four distinct autism subtypes, all with different characteristics.
The team linked each autism subtype to specific genetic factors by analysing the children's DNA.
They looked at inherited mutations, random ones not found in the parents, and when key genes switch on during brain development.
They found each subtype is shaped by different genetic glitches that affect the brain at different stages, sometimes even after birth.
It's a major shift in how we understand autism.
Experts used to think its genetic roots formed only before birth, but the study shows they can also appear in early childhood.
Simple 10-question test that can help determine if you have autism
The four autism subtypes are:
1. Social and behavioral challenges
This group has classic autism traits such as social difficulties and repetitive behaviours, with developmental milestones generally reached on time.
Many also experience anxiety disorders, attention deficit hyperactivity disorder (ADHD), or obsessive-compulsive disorder (OCD).
2. Mixed autism spectrum disorder developmental delay
Children with this form of autism often reach milestones like walking and talking later than usual, but rarely have mental health issues.
They're also more likely to carry rare genetic mutations passed down from their parents.
3. Moderate challenges
This group shows milder autism traits, hits developmental milestones on time, and has fewer additional conditions, meaning they may need less ongoing support or treatment.
4. Broadly affected
This is the smallest but most severely affected group, showing major developmental delays, communication and social challenges, repetitive behaviours, and mood disorders.
They're also more likely to carry new, non-inherited gene mutations.
The key characteristics of autism - and why they go unnoticed
By Alice Fuller, Health Features Editor
MODEL Christine McGuinness was a 'recluse' for eight years and only left the house at 3am.
Springwatch presenter Chris Packham says it makes him a 'task-centric workaholic who sees problems in everything he does'.
And recently, Bella Ramsey revealed they were diagnosed after struggling to wear thermals on the set of The Last of Us.
But what exactly is autism and why does it seem so different in everyone?
Leanne Cooper-Brown, neurodevelopmental lead at Clinical Partners, tells Sun Health: 'Autism is considered a spectrum, so not all people share the same traits.
'Whereas we used to think of autism as a linear line, we have come to realise that terms such as 'high' and 'low' functioning or definitions of 'mild', 'moderate' or 'severe' aren't helpful and can be misleading.
'Nowadays, we think of autism in terms of the strengths and needs of the individual, which can change over time depending on their environment and support network.'
About 700,000 people in the UK are thought to have autism - that's one in 100.
But research by University College London suggests that number could be twice as high, as many people remain undiagnosed.
Cases are on the rise though. Figures released last year showed a 175 per cent increase from 2011 to 2022.
Dr Selina Warlow, clinical psychologist and owner of The Nook Neurodevelopmental Clinic, says: 'Conversation around neurodiversity is becoming normalised, and that's so positive to see. But more awareness is needed.
'Receiving a diagnosis can open access to expert resources that support autistic people to thrive in society.'
Autism has long been associated with social difficulties, like problems maintaining conversations and forming relationships.
But research published in the journal Cell Press suggested that repetitive behaviours - like rocking or finger-flicking - and special interests - whether it's TV shows or specific animals - are more indicative of an autism diagnosis.
Generally though, experts say the core characteristics include…
Sensitivity - autistic people can be much more or less sensitive to sights, sounds, textures, tastes and smells. For example, they find bright lights or crowded spaces overwhelming, Leanne says. They may also stand too close to others or need to move their whole body to look at something.
Stimming - to manage this sensory overload, some people use repetitive movements or sounds. 'This is called stimming, and includes rocking, tapping and hand-flapping,' Dr Warlow says. 'Though it's something everyone does to some extent, those with autism are likely to engage with it as a form of self-regulation.'
Masking - this is a strategy used by some autistic people, consciously or not, to match neurotypical people, Dr Warlow says. 'It's a way of hiding your true characteristics, and could involve copying facial expressions, planning conversations in advance, or holding in 'stimming' - swapping hand clapping with playing with a pen, for example,' she adds.
Burnout - this is a state of physical, mental and emotional exhaustion and is a common feature in autism. 'Being extremely tired, both mentally and physically, can be associated with the act of masking for a long period of time, or sensory or social overload,' Dr Warlow says. 'Symptoms of autistic burnout include social withdrawal, reduced performance and increased sensitivity.'
Social struggles - socialising can be confusing or tiring for autistic people. They often find it hard to understand what others are thinking or feeling, making it challenging to make friends. Leanne says: 'In adults, autism may present as difficulties with interpreting social cues such as understanding body language or sarcasm, struggling to express emotions or preferring to be alone. This can impact relationships and work.'
Routine - many of us have a fairly regular daily schedule. But for autistic people, this becomes a 'very strong preference for routine', Leanne says. This could be needing a daily timetable to know what is going to happen and when, or having rigid preferences about foods or clothing.
Literal thinking - some autistic people have a literal view of language - like believing it's actually 'raining cats and dogs' or that someone really wants you to 'break a leg'. Dr Warlow says: 'This can result in confusion with figures of speech, irony or indirect requests. 'For instance, being told to 'pull your socks up' might be understood literally, not as a motivational phrase.'
Hyperfocus - often associated with ADHD, hyperfocusing is also common in autistic people. 'It's where you're able to focus intensely on an activity and become absorbed to the point of forgetting about time,' Dr Warlow says. 'This is useful in work or hobbies but can result in neglect of other aspects of life, such as food or rest.'
Special interests - we all have hobbies and interests, but for autistic people, these are so compelling they often want to spend all their time learning about, thinking about or doing them. 'Special interests could include anything from dinosaurs to superheroes, and gardening to music,' Dr Warlow says. 'These usually begin in childhood, but can also form as an adult. 'Chris Packham is an example of an autistic person who turned his childhood special interest in animals into a successful career, becoming one of the UK's best-loved natural world TV presenters.
'These findings are powerful because the classes represent different clinical presentations and outcomes," PhD student and co-lead author Aviya Litman said:
"And critically, we were able to connect them to distinct underlying biology," they added.
Co-lead author Natalie Sauerwald said: 'What we're seeing is not just one biological story of autism, but multiple distinct narratives.
"This helps explain why past genetic studies often fell short.
"It was like trying to solve a jigsaw puzzle without realising we were actually looking at multiple different puzzles mixed together.'
About 700,000 people in the UK are thought to have autism - a lifelong condition that affects how people experience and interact with the world.
Diagnoses are becoming more common each year, partly due to increased awareness from sites like TikTok and better screening.
The latest NHS England figures, covering the period ending March 2025, show the number of patients waiting at least three months for an initial specialist appointment has jumped by more than a quarter since last year. That figure has also tripled since 2021.
In total, nearly 124,000 under-18s are on the waiting list for over three months - almost 30,000 more than the year before.
NHS guidelines say patients should be seen within 13 weeks. But nine in 10 wait much longer.