We often describe Autism as occurring along a spectrum, but as any clinician, parent, or autistic adult can tell you, that word barely scratches the surface. Why do some children talk early while others are late bloomers? Why do some folks mostly wrestle with social connection, while others face challenges in mood, learning, attention, or all of the above? 

A major new study from Princeton University and the Simons Foundation brings us a little closer to an answer. By following more than 5,000 children and analyzing hundreds of behavioral and developmental traits, researchers found evidence for at least four distinct clusters or subtypes of autism spectrum disorder (ASD). Each has its own unique blend of strengths, struggles, and even distinct underlying biology.

1. Social and Behavioral Challenges (37% of the study's sample)
These are the kids (and adults) whose most noticeable challenges are in social communication and repetitive behaviors. These are the features that people often associate with "classic" autism. Most people in this group reach developmental milestones like walking and talking on time. However, they are more likely to also have other concerns, like attention deficit disorders (ADD or ADHD), anxiety, or obsessive-compulsive disorder (OCD) alongside autism. The research suggests that, for this group, the biggest changes in brain development happen after birth, not before..

2. Mixed ASD with Developmental Delay (19% of the sample)
This group tends to reach milestones (e.g., first words, first steps) a little later than expected, and may again show more classic autistic traits. Kids and adults in this group tend to have fewer additional mental health diagnoses (as compared to the Social-Behavioral group). Also in contrast to the first group, their genetic profile points to differences that begin before birth, which may help explain the early and global impact on development. Finally, evidence suggests that these traits are more likely to be passed down through families.

3. Moderate Challenge (34% of the sample)
Individuals in this group show milder autistic traits, tend to reach milestones on time, and have the lowest rates of co-occurring mental health concerns. Their genetic and developmental profile sits somewhere between the first two groups. People in this category may be less likely to be identified early or may fly under the radar, but their support needs are just as valid.

4. Broadly Affected (10% of the sample)
This group faces more extreme and wide-ranging challenges. They may have significant developmental delays, social and communication difficulties, repetitive behaviors, and co-occuring mental health conditions like anxiety, depression, mood dysregulation, or behavioral difficulties. These traits do not appear to be inherited from parents, but rather may be the result of rare, non-inherited changes or mutations that shape the brain early in development.

Why This Research Changes the Game
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For years, the “spectrum” metaphor has helped us think more flexibly about autism. This new research goes further, showing how and when the brain develops differently for different individuals. This could have some real implications for...

• Personalized Care: If we know which subtype someone best fits, we may be better able to predict and support their unique combination of strengths and needs, not just for autism, but also for related challenges they may face like ADHD or mood issues.
• Early and More Precise Intervention: Understanding a child’s profile could help clinicians and families plan proactively, rather than taking a wait-and-see approach.
• Better Research, Policy, and Advocacy: Future studies (and, ideally, funding priorities) can move beyond “one-size-fits-all” thinking and focus on what works best for each subgroup. This could change how we approach diagnosis, treatment planning, and support across the lifespan.

How This Might Affect You or Your Family

If you or someone you love is on the autism spectrum, this research offers a reminder that your story is uniquely yours. There is no single right way to define autism, and no universal timeline. Support needs may change, and understanding which “road” you’re on can help you be more proactive, prepared, and, honestly, a little more compassionate with yourself (or those you love).
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What's Next?

This study is a big step, but there is so much more we have to learn. As the science gets better at connecting the dots between genetics, brain development, and lived experience, I hope we’ll see more precise diagnoses and more effective, individualized support for those with autism and their families.

If you, like me, are a clinician, keep an eye on this research as it develops. It may re-shape assessment and intervention in the years to come. For parents, educators, and self-advocates: keep asking questions, keep seeking information, and don't be afraid to ask your providers how new science might affect your options. And keep sharing your stories! They are the real foundation for understanding the spectrum in all its forms.

Like so many of you, my heart has ached in the days since the floods in Central Texas and the tragic losses at Camp Mystic. Even if you and your loved ones were not directly in harm's way, it's natural to feel grief, worry, or a sense of helplessness in the face of so much loss and destruction. 

If you are a parent, teacher, or just someone caring for kids or teens right now, I know that it can be hard to know what to say or do. The Grant Halliburton Foundation has put together a Trauma and Loss Resource Page with tips on how to talk with young people about loss, what to look for if they are having a hard time, and ways you can support their mental health as everyone begins to process what has happened. 

If you or someone you care about could use help finding a counselor or mental health support, you can call the Here For Texas Mental Health Navigation Line at 972-525-8181, Monday through Friday during the day. Their team really listens and can point you to resources close to home. You can also browse HereForTexas.com for local providers or just to get some helpful information.

Please share these resources with anyone who may be having a difficult time right now. Sometimes just knowing what's available can make things a little lighter. None of us are meant to go through times like this this alone.

Ways to Help Others Impacted by the Floods
Many folks have asked how they can help, even from a distance. If you're wanting to do something concrete, here are a few trusted groups who are right there on the ground:

• American Red Cross – South and Central Texas: The Red Cross has opened shelters in affected areas and is accepting donations online. Select "Your Local Red Cross" or Disaster Relief as a donation option. Donations can also be made by phone at 1-800-HELP NOW (1-800-435-7669).
• Kerr County Flood Relief Fund: The Community Foundation of the Texas Hill Country established this fund to support vetted organizations providing rescue, relief, and recovery efforts.
• Kerrville Pets Alive! and Austin Pets Alive!: These animal shelters are caring for displaced pets and working with volunteer search and rescue groups to find lost animals along the riverbank. They are also providing support for families who have lost pets, including help with recovery and cremation costs.
• World Central Kitchen: WCK is providing meals for rescue workers and displaced families. Donations help keep these efforts going.

In moments like these, I'm reminded of how powerful it is when people come together. It is so important to remember the shared humanity that unites neighbors and communities. 

As we show up for our friends and neighbors, remember that small things matter. Give what you can with what you have. And give yourself permission to rest and let others show up for you, too.

I am holding space in my heart for everyone who is carrying sorrow right now, and for all the helpers (seen and unseen) who are quietly supporting others along the way.

This spring a presidential panel of the American Psychological Association (APA) has produced recommendations for the use of social media by adolescents. The advisory panel was formed to provide recommendations grounded in research to ensure that adolescents develop healthy social media practices. The result is the American Psychological Association Health Advisory on Social Media Use in Adolescence. 

The report notes that while these platforms can promote healthy socialization, their use should be preceded by training in social media literacy to ensure that children and teens have skills that will maximize the chances for balanced, safe and meaningful experiences.

This report notes that social media use is not inherently beneficial or harmful to young people. The effects of social media depend on adolescents' personal and psychological characteristics, social circumstances, and the specific content, features, or functions they encounter on social media platforms. 

The report emphasizes that not all findings apply equally to all children and teens. Scientific findings should be used in conjunction with knowledge of specific kids’ strengths, weaknesses, developmental maturity, and contexts to make decisions tailored to each individual. 

​In addition to the new report, the APA's chief science officer, Dr. Mitch Prinstein, provides Q&A and recommendations for parents on how to help teens develop social media literacy skills. Dr. Prinstein specifically advises parents to:

• Monitor and discuss social media use. Take a multipronged approach to social media management by setting time limits, monitoring your child's online activities, and engaging in ongoing discussions about social media. Limit chat functions and exposure to adult content, and consider allowing social media use only when children are at home.
• Model healthy social media use. Be a positive role model by demonstrating healthy social media behavior. Avoid using social media during family time and set limits on your own social media use. Discuss your own social media use with your children and take social media holidays together as a family.
• Watch for problematic social media use. Be vigilant for signs that your child may be using social media in unhealthy ways. Look for interference with daily routines, excessive use over in-person interactions, lack of sleep or physical activity, inability to stop using social media, and deceptive behavior. If necessary, enforce new limits or seek help from a mental health professional.
• Teach social media literacy. Recognize that social media literacy is essential for adolescents. Work with social media platforms, schools, and your teen to promote social media literacy skills. Discuss topics like recognizing false information, understanding the meaning behind likes, preventing conflicts, promoting positive body image, addressing discrimination, and seeking reliable mental health information.

 
You can read the APA's recommendations in full here, and Dr. Prinstein's Q&A here.

​As the number of cases of COVID-19 increase, so does our collective anxiety. It can be difficult to know what tomorrow, next week, or next month will bring. This lack of expectations and being unable to plan can heighten anxiety. Routines we may have worked hard to build and which support our work-life balance and mental health are thrown off. And many of us find ourselves isolated from our usual social supports. 

In the video below, clinical psychologist Dr. Alli Mattu addresses important coping skills for working from home, social distancing without feeling isolated, and managing information related to the COVID-19 public health crisis without feeling overwhelmed.

The following additional resources can help individuals and communities navigate this stressful time. Remember, we're all in this together.
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CDC: COVID-19 Resources
Latest updates, tips and resources by the US Centers for Disease Control.

Living With Mental Illness During COVID-19 Outbreak– Preparing For Your Wellness
This webpage provides information and wellness tips for individuals living with mental health conditions during the COVID-19 outbreak.

Mental health and wellness during a public health crisis
Dr. LaGenia Bailey, a former DBSA board member, discusses tips on how to stay well during this public health crisis. In this podcast, she addresses the benefits of mindfulness practice, lifestyle habits, and ways to stay connected with others to avoid isolation.

COVID-19 Mental Health Support Line: 833-986-1919
Texas Health and Human Services has launched a 24/7 statewide mental health support line to help Texans experiencing anxiety, stress or emotional challenges due to the COVID-19 pandemic. People can call the Statewide COVID-19 Mental Health Support Line 24 hours a day, 7 days a week toll-free at 833-986-1919. Operated by the Harris Center for Mental Health and IDD, the support line offers trauma-informed support and psychological first aid to those experiencing stress and anxiety related to COVID-19.

Seven Crucial Research Findings that can Help People Deal with COVID-19
Psychological research on past crises can help people cope with the daily — sometimes hourly — news flashes about the coronavirus.

How to Transition to Seeing Your Therapist Online
Continue the work of therapy even from a distance. (And yes, Dr. Novinski offers sessions via Telehealth.)

Psychologists’ Advice for Newly Remote Workers
As employers close offices to slow the spread of COVID-19, here’s advice from I/O psychologists on how both managers and employees can work more effectively during this time.

Dial 2-1-1
If you need assistance finding food, paying for housing bills, accessing free childcare, or other essential services, visit 211.org or dial 211 to speak to someone who can help. Run by the United Way.

COVID-19 Ancillary Costs
The HealthWell Foundation announced a COVID-19 Fund that provides up to $250 in assistance with ancillary costs associated with COVID-19. Grants awarded through the fund will provide reimbursement assistance to at risk or quarantined individuals for delivered food, medication, telehealth copays and transportation costs associated with COVID-19.

Care for your Coronavirus Anxiety

Staying Grounded

Meditations and Calming Exercises

National Domestic Violence Hotline
For any victims and survivors who need support, call 1-800-799-7233 or 1-800-799-7233 for TTY, or if you’re unable to speak safely, you can log onto thehotline.org or text LOVEIS to 22522.

Talking to Kids about the Coronavirus

The Parent Guide to Resilience

Yale University's The Science of Well-Being
Yale's most popular class is now free online via Coursera. The course focuses on how to increase happiness and productivity in your everyday life. 

University of Pennsylvania:  Positive Psychology Resilience Skills

The Heads Together campaign has partnered with this weekend's London Marathon to help raise awareness and encourage people to speak up about and prioritize their mental health (all the runners will be given Heads Together headbands, modeled by the Royal Family above). ​