Harry Motro, PsyD, Clinical Director, LMFT

Listen to the Summary below: Listen to a podcast-style audio summary of this research. It’s an excellent way to digest these new findings quickly.

ism Trait Wheel

For decades, we’ve used the word "spectrum" to describe autism. We visualize a linear line stretching from "mild" to "severe," trying to find where we or our loved ones fit. But in my years working with neurodiverse couples, that model has often felt incomplete. It doesn’t quite capture the brilliant engineer who struggles to read his wife’s facial expressions, or the deeply empathetic partner who shuts down when overwhelmed by sensory noise.

Now, groundbreaking research is finally catching up to what we see in the therapy room every day.

A new study from Princeton University and the Flatiron Institute suggests that autism isn't just one thing—it’s actually four distinct biological types, each with its own genetic timeline.

How This Research Was Done 

This discovery wasn't based on simple behavioral observations. It utilized sophisticated genetic analysis and advanced computational science (AI) that wasn't possible even a few years ago. By applying machine learning to analyze massive genetic datasets from the Simons Foundation, scientists were able to decompose complex data into clear patterns. This allowed them to see distinct biological "signatures" that the human eye—and traditional diagnostic tools—had previously missed.

Our Client Base: The "Invisible" Majority

What is most fascinating about this research is that the first two groups identified—comprising about 70% of the population—are the exact individuals we work with most frequently at the Neurodiverse Couples Counseling Center. These are the partners who often mask well, hold down successful careers, but struggle deeply with the relational and social demands of marriage.

Here is the breakdown of the four (4) distinct phenotypes (types):

1. The "Social and/or Behavioral" Type

• Prevalence: ~37% (The largest group).

• Typical Diagnosis Age: Late (Age 6+ to Adulthood).

• Clinical Presentation: Individuals are often high-functioning and cognitively brilliant but struggle significantly with social demands. There is a high comorbidity with ADHD, anxiety, and depression.

• Biological Markers: Late-Activation Genes. Mutations are present at birth but often do not "activate" until later in childhood or adolescence.

• Suggested Clinical Focus: Mental health integration (treating anxiety/ADHD), executive function coaching, and support with relationship dynamics rather than basic developmental skills.

2. The "Moderate Challenges" Type

• Prevalence: ~33%.

• Typical Diagnosis Age: Variable (often missed in early screenings).

• Clinical Presentation: Displays the hallmark traits of neurodivergence—such as social communication differences and repetitive habits—but without the cognitive delays seen in other groups.

• Biological Markers: Subtle Genetic Architecture. Driven by "common variants" scattered throughout the DNA rather than single, high-impact mutations.

• Suggested Clinical Focus: Strength-based support focusing on self-advocacy, sensory regulation, and "translating" social nuances.

3. The "Mixed" Type

• Prevalence: ~19%.

• Typical Diagnosis Age: Early (Toddlerhood).

• Clinical Presentation: A complex presentation involving early developmental delays (speech or motor skills), yet often showing fewer emotional struggles like anxiety or aggression compared to the first group.

• Biological Markers: Variable Expression. Linked to a high rate of inherited rare variants, where genes are often active prenatally.

• Suggested Clinical Focus: Developmental support, with speech, occupational, and physical therapy often being the primary interventions.

4. The "Broadly Affected" Type

• Prevalence: ~10% (The smallest group).

• Typical Diagnosis Age: Very Early (Infancy/Toddler).

• Clinical Presentation: Severe challenges across all domains, including communication, social interaction, and daily living skills.

• Biological Markers: High-Impact Mutations. Often linked to "de novo" (spontaneous) mutations that occur for the first time in the child.

• Suggested Clinical Focus: Comprehensive care requiring high-level support needs, often involving complex medical and behavioral care planning.

Visualizing the Complexity: The Autism Trait Wheel

Because these "types" are not rigid boxes, we need better tools to visualize how they show up in real life. This is why we utilize the Autism Trait Wheel in our assessments.

Rather than a straight line from "less autistic" to "more autistic," the Trait Wheel allows us to map a person's unique strengths and struggles across specific categories—like sensory processing, executive function, and social perception. It helps us see exactly where you fit within these new biological categories.

Why This Matters for Your Relationship

This research is profoundly validating because it offers a biological answer to the question many of our clients ask: "Why now?"

Many partners we see are confused because they navigated childhood successfully—hitting milestones, performing well in school—only to hit a wall in adulthood when the complexities of marriage, parenting, or career dynamics increased.

This study reveals that for the largest group of autistic individuals, the genes involved may not even activate until later in development. This means your current struggles aren't a sign of regression or failure; they are simply the result of a distinct biological timeline. Understanding this helps us move away from blame and toward our core goal: acting as a "Translator" to bridge the gap between neurological languages.

You don't need to bridge this gap alone. Let’s work together to translate your neurological differences into a shared language that works for your marriage.

[Click here to schedule a session today]

Harry Motro

Clinical Director, Neurodiverse Couples Counseling Center 

© 2025 New Path Family of Therapy Centers Inc. All rights reserved. No portion of these statements may be reproduced, redistributed, or used in any form without explicit written permission from the New Path Family of Therapy Centers.

Want to learn more about yourself?

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• Autism Screeners 

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References

• Cha, A. E. (2024). New science points to 4 distinct types of autism. The Washington Post. https://apple.news/AbM0W3IXWQc2fzc39hfMLzA

• Litman, A., Sauerwald, N., Snyder, L. G., Foss-Feig, J., Park, C. Y., Hao, Y., Dinstein, I., Theesfeld, C. L., & Troyanskaya, O. G. (2025). Decomposition of phenotypic heterogeneity in autism reveals underlying genetic programs. Nature Genetics. https://doi.org/10.1038/s41588-025-02224-z

• Matuskey, D., Yang, Y., Naganawa, M., ... & McPartland, J. C. (2024). 11C-UCB-J PET imaging is consistent with lower synaptic density in autistic adults. Molecular Psychiatry, 30, 1610–1616. https://doi.org/10.1038/s41380-024-02776-2

• Zhang, X., et al. (2025). Polygenic and developmental profiles of autism differ by age at diagnosis. Nature. https://doi.org/10.1038/s41586-025-09542-6