Stop Looking for What’s Missing. Start Recognizing What’s There.
For decades, autism diagnosis has revolved around one central axis: social difference.
The DSM-5 defines autism by deficits in social interaction and communication. Assessment tools are designed to flag what’s missing — eye contact, shared attention, conversational rhythm. Therapies aim to adjust these behaviors. And the public narrative is clear: autistic people struggle to connect.
But what if this entire structure relies on a misreading?
Dr. Pierre Defresne’s 2025 paper in Neuroscience & Biobehavioral Reviews is titled "Considering autism diagnosis through the lens of social cognition can lead to mistakes." It doesn’t reject the role of social difference in autism. But it challenges something deeper — the assumption that autism is, at its core, a disorder of social cognition. And that assumption, he argues, is why we’re misdiagnosing some people — and misdefining others.
This paper isn’t splashy. It doesn’t chase novelty. But for those of us who live with the consequences of diagnostic frameworks, it marks something more important: a subtle but sharp shift toward a different epistemology. One that sees autism not as a social failure, but as a different way of interfacing with the world.
Let’s take that seriously.
The Myth of the Social Brain
Defresne starts by acknowledging what most clinicians take for granted: that social challenges are common in autism. But then he does something more unusual — he questions whether those challenges are specific enough to define autism in the first place.
“In prototypical autism, social signs are highly sensitive but not necessarily specific.”
In other words: yes, autistic people often experience social friction. But so do many people with ADHD, intellectual disability or schizophrenia. And that overlap, Defresne warns, dilutes the meaning of the autism label when diagnosis relies too heavily on generic social indicators.
He doesn’t deny the usefulness of social cognition tools. But he calls them “context-dependent,” “heterogeneous,” and vulnerable to bias. Autistic adults who’ve learned to mask — or young children who’ve adapted quickly — may not “fail” these tests. Others may be misdiagnosed entirely.
These assessments don’t measure autistic reality. They measure how far someone is from neurotypical expectation.
Autism as Perceptual Priority
So what does define autism?
Here, Defresne turns to Laurent Mottron’s work and affirms a model where autism is understood as a specific cognitive profile — one marked by a heightened attention to perceptual and mechanistic information, and a reduced prioritization of social cues.
“Autism is not merely a social issue — at least not exclusively — nor is it a variable assemblage of independent social and non-social traits.”
This framing doesn’t deny the social challenges autistic people face. It explains them without pathologizing them. Social friction, in this view, is not the result of empathy failure or defective cognition — but of a brain tuned to different signal sources. It’s a difference in priority, not a deficit in ability.
This reframing has profound implications, both practical and ethical. It invites us to see autistic cognition not through what it lacks, but through what it organizes. The goal is not to minimize support needs, but to anchor the diagnosis in something specific, observable and coherent.
The Risk of Diagnostic Drift
Defresne expresses concern that the overuse of vague social traits as diagnostic criteria has led to both over- and underdiagnosis.
- People with non-specific social struggles — unrelated to autistic cognitive patterns — may be brought under the autism label.
- Others whose social presentation improves (through age, environment or masking) may be dismissed prematurely.
This has real consequences. It can delay accurate support. It can inflate diagnostic categories without clarity. And it can flatten meaningful differences into one undifferentiated spectrum.
Defresne also critiques certain self-diagnosis tools — especially online quizzes and screening checklists — for emphasizing generic “autistic traits” without anchoring them in a coherent cognitive profile.
“This concern is particularly evident in self-diagnoses based on questionnaires emphasizing so-called ‘autistic traits’…”
He’s not condemning self-recognition. He’s calling for specificity. If everyone with social difficulty is told they “might be autistic,” the term itself loses clarity — and those with autistic neurology lose visibility.
Prototypes, Not Personality Tests
Defresne calls for a return to what Mottron described as a “prototypical” model of autism — a stable, recognizable profile grounded in shared cognitive patterns, not a diffuse cluster of behavioral traits.
This isn’t gatekeeping. It’s epistemic repair. If autism is to remain a meaningful category — one that protects the rights, needs and dignity of autistic people — then it must be defined by what is distinct, not just what is difficult.
That doesn’t mean social difference doesn’t matter. It means social difference is not the root — it is the outcome of a brain that engages the world differently.
And once we understand that, the framing shifts. We stop asking how to correct the social behavior, and start asking how to recognize the cognition beneath it.
Why It Matters
This paper won’t make headlines. It’s quiet, careful and written in the cautious dialect of clinical academia. But its implications are significant.
Because if autism is not a social disorder, but a cognitive configuration that deprioritizes the social, then our entire diagnostic logic needs rethinking.
It means assessment tools must evolve.
It means support plans must be personalized.
It means clinicians must stop assuming that social performance equals mental health.
And it means that many of us — long dismissed for “not looking autistic” — deserve to be seen in full.
This study doesn’t do the work of narrative reframing. That’s our job. But it gives us firmer ground to stand on — and a signal to those in the clinical world who are ready to question what they've been trained to see.
Let’s meet that moment with precision. And with celebration — not of the system, but of a study that quietly reorients it.
Defresne’s paper offers a paradigm shift. And with it, the kind of autistic clarity deficit-framed researchers keep trying to test for — without ever recognizing when they’re in its presence.