Assessment & Research

Is it still autism? The increasing broadening of the autism spectrum.

Bertelli et al. (2025) · Autism research : official journal of the International Society for Autism Research 2025
★ The Verdict

Trait-level checklists can over-label autism; insist on full clinical picture before signing the form.

✓ Read this if BCBAs who screen or intake new clients
✗ Skip if Clinicians only treating long-confirmed cases

01Research in Context

01

What this study did

Bertelli et al. (2025) wrote a position paper. They asked: are we stretching the autism label too far?

The authors looked at checklists that flag 'autistic traits.' They warned these traits can look like normal personality quirks.

02

What they found

The team found that mild traits alone do not equal autism. Without full syndrome, the label loses meaning.

They say loose labeling wastes therapy hours and hides real needs.

03

How this fits with other research

Gillberg et al. (2014) made a similar point. They showed that calling every mix of autism plus ADHD 'autism' buries the ADHD.

Watt et al. (2026) give hard numbers. A 331 % jump in autism cases almost matches a 64 % drop in ID labels. This swap supports the drift worry.

Woods et al. (2023) seem to disagree. They fight the new 'profound autism' tag because it can hide medical issues. Both papers fear diagnostic overshadowing; one wants a tighter filter, the other warns against a new box.

04

Why it matters

Before you write 'ASD' on a plan, pause. Ask: do the data show full syndrome or just a few traits? If another condition drives the problem, target that first. This keeps caseloads true and goals sharp.

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Add one line to intake: 'Rule out primary ADHD, ID, language disorder before ASD Dx.'

02At a glance

Intervention
not applicable
Design
theoretical
Finding
not reported

03Original abstract

Clinical significance of a broad autism phenotype (BAP) seems to be increasingly supported by growing reports of high prevalence of subthreshold autism spectrum disorder (sASD) or autistic traits (AT) in various demographic samples, particularly in individuals with psychiatric conditions. We question this increasing extension of the autism spectrum and its potential negative consequences for clinical services, research, cultural attitudes, and resource allocation, as well as alternative explanations of what is currently attributed to sASD and AT. In modern psychiatry the diagnostic threshold is paramount and associated with a significant impairment of functioning, implying that symptom specificity is more relevant than sensitivity. Within a syndrome, symptoms have to be present together, with the parts related to and interconnected with the whole. Single autism symptomatic dimensions have low syndromic specificity and can be observed in many different mental disorders. For instance, communication problems may present in communication disorders, social-cognitive difficulties can be found in schizophrenia, and rigid and/or repetitive behaviors can be found in obsessive compulsive disorder. One alternative interpretation of AT and/or sASD relates to personality traits. For example, within the Big 5 Model, low openness is associated with a dislike of change and a narrow range of interests, low extraversion with social withdrawal and coldness, and low agreeableness with disinterest in others and disregard for their feelings. These risks of overreliance on non-specific aspects of autism are particularly likely to occur with screening checklists, self-assessment, or assessment by a lay interviewer with only limited expertise in clinical assessment.

Autism research : official journal of the International Society for Autism Research, 2025 · doi:10.1002/aur.3282