DAME Uta Frith is emeritus professor in cognitive development at the Institute of Cognitive Neuroscience at University College in London (UCL). She is the grand dame of autism research in the UK and has been active in the field for 60 years. Since completing her PhD in 1969 she has published hundreds of papers that aim to illuminate the condition, its impact and related disabilities (such as dyslexia). What’s more, she has supervised and supported many of the leading names in the field including Professor Sir Simon Baron-Cohen and Professor Francesca Happé CBE who now continue her work.
Despite previously supporting the incorporation of classical autism with much higher functioning cases, she has now thrown the notion of the spectrum under the bus.
Frith is understandably upset about the way that autism has become a celebrity-endorsed label that is liberally applied to all sorts of people and activities with little if any grounding in clinical practice. She is cross that the diagnostic clarity about autism has been overshadowed by the inclusive notion of ‘neurodiversity’ which necessarily includes everyone and makes ‘medical diagnosis completely meaningless’. She wants to rescue our children – who have very serious disabilities that will likely be with them for the rest of their lives – from celebrity attention seekers who use the label to cover their sins.*
So far, so good, you might think. She is way ahead of some of her students who have willingly undermined their own profession and professionalism by labelling everyone as ‘neurodiverse’.
However, there is something much bigger at stake in the comments she makes. She opens the door to a paradigm shift.
Since its inception, autism has been diagnosed on the basis of behaviour. It is associated with deficits in social interaction and communication, restricted interests and a desire for sameness.
There has never been any adequate explanation for these behaviours.
In the past, the problem was laid at the door of ‘refrigerator mothers’. Today, we are told it is ‘genes and environment’. But the clinicians are telling stories. None of them knows.
And it is here that Frith gets most interesting. She acknowledges that ‘there is a lot more work to be done’. She calls for ‘biomarkers’ that alert us to the biological pathology that explains the problematic behaviour.
As she puts it: ‘We do not have a biomarker and I suspect that when we get a biomarker we will need more than one. There will be different kinds of autism – many different kinds.’
Frith is making the case for psychologists to start working with biologists. She is opening the door to a paradigm shift that should have happened decades ago.
In fact, there is already a wealth of rigorous research that points to the biological pathologies that explain autistic behaviour.
I’ve had a go at listing these and associated biomarkers in the table below.
The well-established causal impact of particular (rare) genetic variants (included in the final row of the table) highlights the biological pathways that are already implicated in the condition. In addition, it is obvious that these biological pathways overlap such that having deficits in an area like immunity will impact on both bowel and brain. If screening was routine, it would be possible to identify clusters of cases that are amenable to treatment. There are also important overlaps with other neuropsychiatric, neurodegenerative and metabolic conditions that provide pointers to diagnostic tools and potential treatments.For more than 100 years, the psychology profession has had a stranglehold on research and clinical practice in autism. One of their most established and successful academics has now admitted that they made a mistake.The time has come for an alternative paradigm. We need full spectrum science to understand the full spectrum of symptoms that we currently call ‘autism’. It is likely that different and/or overlapping pathologies underpin different manifestations of the condition (early onset, regressive, anxiety-related etc) with important connections to the patterns of comorbidities that accompany these (such as bowel problems, allergies, insomnia and OCD). If we can understand what has gone wrong, we can identify how to treat it and how to stop it happening in the first place.It is more than annoying that we have had to wait for Dame Uta to come to the end of her career for a flash of insight like this. For decades, we parents have been hitting our heads against the wall of the psychological paradigm, trying to get our children some medical help. There is still no routine screening for the genetic, energetic, immune and metabolic disorders that are clearly plaguing our kids. Indeed, clinicians are advised – by psychologists – not to look at such things.We have to hope that Dame Uta’s intervention provokes the paradigm shift that we all badly need.*Although I haven’t made anything of it, Dame Uta seems to think that the number of children with classical autism at the severe end of the spectrum has remained largely stable over time. This is sadly not true. The rising demand for EHCPs, places in special schools and disability payments has been driven by diagnoses of severe autism. These comments reflect the paucity of any decent data on autism rates and severity in the UK. Given the social and economic costs of autism, and the need to plan services into the future, this is truly remarkable and I’ve commented on it before.
This article appeared in the Autism Tribune on March 12, 2026, and is republished by kind permission.
