Uta Frith warns that the autism spectrum may be too broad, obscuring true needs

Autism researcher Uta Frith cautions that widening diagnostic criteria may be causing confusion, misdiagnosis, and ineffective support for individuals across the spectrum, calling for more precise classification and tailored interventions.

Dame Uta Frith, a long-standing figure in autism research, is warning that the autism spectrum may have grown so wide that it now obscures as much as it explains. In an editorial in Psychological Medicine, the University College London professor argues that autism spectrum disorder has become a catch-all label for people whose needs, abilities and life experiences can differ dramatically, raising the risk of confusion and misdiagnosis.

Frith’s central concern is that a single diagnosis is now being used for people at very different points on the spectrum of support. Some are profoundly disabled and require lifelong care, while others live independently, do not have language or learning difficulties and are not identified until adulthood. According to SciTechDaily’s report on the paper, she says that this breadth can make it harder for clinicians to work out what help a person actually needs.

She also points to the history of the diagnosis itself. Autism was first described in the 1940s as a condition affecting a relatively small group of children with severe communication and social difficulties. Since then, the definition has expanded steadily to include people with milder traits and far fewer obvious impairments. That wider definition has helped many people obtain recognition and support, but, as Psychology Today noted in its discussion of Frith’s argument, it has also fuelled concern about overdiagnosis among people whose difficulties may stem from something else.

The rise in recorded diagnoses has been striking. SciTechDaily said that in the 1960s, about four in every 10,000 children in the UK were diagnosed with autism, while a later study of more than 7 million schoolchildren estimated that roughly one in 57 children were autistic. Frith does not dismiss the role of better awareness and reduced stigma, but she argues that they do not fully explain the increase. She says social media, self-identification, changing interpretations of diagnostic criteria and a broader cultural readiness to explain everyday struggles through medical labels may all be contributing.

That matters, she argues, because autism is now often diagnosed alongside other conditions, or in place of them. Anxiety, ADHD, depression, trauma and language difficulties can all produce overlapping features. Without a biological test, assessments rely on developmental history, behavioural observation and clinical judgement, and adult evaluations can depend heavily on memory and self-reporting. Frith says that can make it too easy for the wrong label to be applied, with consequences for treatment, identity and access to support.

In the paper, she also raises the possibility that people identified in early childhood may not represent the same pattern as those diagnosed later in life. Children diagnosed young are more likely to show obvious developmental differences, while adults diagnosed later often have average or high intelligence and seek assessment after years of social difficulty, anxiety, sensory overload or exhaustion. Frith argues that these groups may deserve to be understood as more distinct than they are at present, rather than folded into one all-encompassing spectrum.

Her solution is not to abandon diagnosis, but to make it more precise. She calls for clearer subgroups, richer descriptions of individual strengths and difficulties, and support based more directly on need than on a broad label alone. She also wants greater care in distinguishing autism from conditions with similar features. As Frith puts it in the editorial, the field risks misreading people’s needs and sending care in the wrong direction unless the spectrum is defined more carefully.