Definition of autism : The clinical debate

Abstract Autism, which has been defined for more than eight decades, is characterized primarily by difficulties in social communication and specific or restricted interests. However, on the basis of twenty years of clinical practice involving autistic adults, the author proposes that specific interests are the central element of autism and that social difficulties are a consequence thereof. This novel perspective challenges the classical definition of autism. The lack of qualified professionals and multidisciplinary teams hinders responses to the needs of autistic adults, thus highlighting the need for adapted tools and close collaboration with patients. Follow-up in this context is based on weekly interviews and the coconstruction of clinical hypotheses with the autistic person, which is a long and introspective process. Refocusing the definition of autism on specific interests could improve our understanding of this topic, increase the relevance of interventions, promote the recognition of autistic profiles, decrease guilt pertaining to perceived differences, and inspire new research on cognitive functioning in the context of autism.