Prototypical autism: New diagnostic criteria and asymmetrical bifurcation model, (2023), Mottron L., Gagnon D.

Open access article: https://www.sciencedirect.com/science/article/pii/S0001691823001142

Abstract
The current “autism spectrum” DSM 5 diagnostic criteria and autism standardized diagnostic
instruments promote considerable heterogeneity or clinical indecision and may be detrimental
to the advancement of fundamental research on autism mechanisms. To increase clinical
specificity and reorient research towards core autistic presentations, we propose new
diagnostic criteria for prototypical autism during the age of 2- to 5-years. We include autism
within other non-dominant, familiarly aggregated phenomena sharing asymmetrical
developmental bifurcations, such as twin pregnancy, left handedness, and breech
presentation/delivery. Following this model, nature, trajectory, and positive/negative signs
structure of autism would result from the polarized problem of whether or not language and
information is processed in a socially biased manner. Prototypical autism would follow a
canonical developmental trajectory by which a gradual decline in social bias in the processing
of incoming information, overtly beginning at the end of the first year, bifurcates into a
prototypical autistic presentation in the second half of the second year of life. This bifurcation
event is followed by a plateau, in which these atypicalities show maximal stringency and
distinctiveness, and then ultimately, in most cases, by partial normalization. During the
plateau period, the orientation towards, and processing of, information is considerably
modified, with an absence of bias for social information, contrasting with a high level of
interest in complex, unbiased information, independently of its social or non-social nature.
Integrating autism into asymmetrical developmental bifurcations would explain the absence
of deleterious neurological and genetic markers and the presence of familial transmission in
canonical autistic presentations.

Citation: Laurent Mottron, David Gagnon, Prototypical autism: New diagnostic criteria and
asymmetrical bifurcation model, Acta Psychologica, Volume 237, 2023, 103938, ISSN 0001-
6918, https://doi.org/10.1016/j.actpsy.2023.103938.