Photo: Faith Ninivaggi
Autism spectrum disorder is a complex neurodevelopmental condition that affects how individuals communicate, behave and interact with others. Despite increasing awareness, misconceptions about autism persist—from when it can be detected to whether it can be “cured.”
Sarabeth Broder-Fingert, MD, MPH, professor of pediatrics, vice chair of clinical research in the Department of Pediatrics and the executive director of the Eunice Kennedy Shriver Center at UMass Chan Medical School spoke about the evolving understanding of autism, early detection and the importance of language. The Shriver Center is dedicated to understanding and improving the challenges faced by individuals with intellectual and developmental disabilities and behavioral health disorders. From neuroimaging to intervention development, research at the Shriver Center includes multiple clinical trials to support the health and well-being of people with autism.
Detecting autism early: What signs are there?
Official diagnoses of autism typically occur between 14 and 20 months of age, but researchers hope biomarkers will allow detection much earlier—possibly within the first six months of life.
“There are early signs—some visible, some not. For example, certain EEG patterns might be very predictive, but we just don’t know or see them yet,” said Dr. Broder-Fingert of medical tests that record the electrical activity of the brain.
Visible signs often include delays in development, differences in how children engage with adults and sensory sensitivities. “Infants as young as six months who really can’t tolerate bright lights, loud noises or certain textures can sometimes show early indicators,” she said.
However, she emphasized the current limitations: “Right now, there aren’t any official tools to formally diagnose autism that young. The signs are there, but we can’t formally assess them yet.”
What causes autism?
While many are eager to understand what causes autism, Broder-Fingert urged sensitivity.
“Trying to find a cause can feel invalidating to autistic people, who are often proud of their identity. There are lots of autistic people who live amazing lives—and I wouldn’t want their autism taken away from them,” she said.
Still, experts generally point to three primary contributors to autism and to an increase in diagnoses in recent years:
Improved diagnosis and access to care
“This is probably the biggest contributor,” Broder-Fingert said. “More people are looking for autism, so more people are finding it and that’s a good thing.”
Genetic predisposition
Autism often runs in families, though no single “autism gene” has been identified. “Some call it associative mating—people with similar traits having children, which can increase the likelihood,” said Broder-Fingert. “There’s a ten-times increased risk if you have an older sibling with autism.”
Environmental factors
Though still speculative, some researchers believe environmental influences play a minor role. “Most of us think they contribute, but much less than genetics or better diagnosis,” Broder-Fingert said.
Can labels harm more than help?
Terms like “high functioning” and “low functioning” are common but misleading and can oversimplify a complex reality.
“I don’t like those words,” Broder-Fingert said. “Autism affects so many parts of life. A person might be verbal but have severe sensory issues or vice versa. Labels don’t capture that and can misrepresent their experience.”
She prefers more specific descriptions, such as “needs support with communication” or “sensory processing challenges.” One label she finds useful is “profound autism,” typically referring to individuals who are nonverbal and require intensive support.
“Kids change over time,” Broder-Fingert said. “Labels can minimize what they’re capable of. It’s better to address each child’s individual needs rather than putting them in a box.”
Is autism a lifelong identity or a condition to ‘cure’?
Despite some public perception, autism is not something to “cure.”
“There’s no cure for autism, and if someone claims they have one, I’d be very skeptical,” she said. “Our focus should be on helping people live their best lives.”
Support may include therapy, family education and sometimes medication.
“Many autistic people are proud of their identity,” said Broder-Fingert. “Autism is a spectrum— some traits are valuable to both individuals and society. We want to provide supports that help people thrive, not eradicate their traits.”
She offered an analogy: “No one wants to be cured of all anxiety—a little keeps us safe. We manage anxiety that interferes with life. That’s how we should think about autism.”
Why are more women being diagnosed later in life?
In recent years, more women are receiving autism diagnoses in adulthood.
“Forty years ago, autism was thought to be almost exclusively male,” Broder-Fingert said. “Girls were often missed.”
One key reason is the phenomenon of masking—the tendency to hide or suppress traits to fit in socially. “It’s more acceptable for girls to be quiet or shy,” she said. “Many only feel safe being themselves later in life.”
Some women discover they’re autistic only after their child is diagnosed. “They go through the process with their kid and suddenly recognize the same traits in themselves.”
What is the path forward?
Understanding autism requires looking beyond simplified labels and misconceptions. Early detection is improving, but more tools are needed. The focus must remain on personalized support.
“We’re not trying to ‘fix’ autism,” said Broder-Fingert. “We’re trying to create a world where autistic people have the support they need to thrive.”
