The Four Biological Subtypes of Autism

The Four Biological Subtypes of Autism

In this episode, I'm taking you inside one of the most important and often overlooked pieces of the autism puzzle: your child's biology. When a child is diagnosed with autism, that diagnosis is based on behavior, and for most families, the story stops there. But underneath the same diagnosis, children can look completely different biologically, and once we begin supporting each child based on their actual biology, things start to shift in ways they couldn't before. I walk you through the four broad biological categories researchers have identified, and the more specific subtypes within each. We start with metabolic, including how the mitochondria (the power plants inside every cell) produce energy, and the nutrient deficiencies like iron, vitamin D, B12, and folate that show up so often. Then we move to immune and inflammatory, where the brain's own immune cells, the microglia, are in constant conversation with the body. Next is cortical patterning, which is really about how the brain was physically built during pregnancy, and what a marker like head circumference can tell us. And finally single gene, where one identifiable gene shapes a recognizable pattern, in conditions like Fragile X, Rett, and tuberous sclerosis complex. This episode is for you if: you've heard that there are "types" of autism but no one has explained what that actually means, your child struggles with sleep, digestion, energy, or sensory overwhelm and you're not sure why, you want to understand the biology behind your child's behavior, or you're looking for a science-backed framework that goes beyond behavior alone.

The Girl Gap: Why Autism Is Missed in Girls

In this episode, I'm taking you inside one of the most important and under-recognized issues in autism: why girls are so consistently missed, often for years, sometimes for decades. I open with a story about a seven-year-old who loves cats, reads chapter books on her own, and holds it together all day at school, until she walks in the front door and falls apart. Her teachers say she's fine. Her parents know something is going on, but they don't have a name for it yet. I walk you through the brain science and the history that explains how this happened (almost all of the foundational autism research, going back to Leo Kanner's work in 1943, was conducted on boys, so the screening tools and diagnostic checklists were built on a mainly male picture), and more importantly, what autism actually looks like in girls once you know what to look for. I break down a landmark 2026 study published in the British Medical Journal that tracked nearly 2.7 million people in Sweden over 35 years and found that by age 20, the male-to-female ratio approaches 1 to 1, nearly equal. If autism occurs at roughly the same rate in girls and boys, why are girls being missed during the exact window when recognition and support would make the biggest difference? We cover the four key differences that make autism harder to see in girls: social motivation and why an autistic girl often wants connection deeply yet works extraordinarily hard to navigate it, special interests and why a passion for animals or fiction draws praise instead of recognition, masking and the cost of performing neurotypical behavior for years (three out of four autistic women in one study said camouflaging directly affected their ability to get a diagnosis, compared to one in four men), and the misdiagnosis maze of anxiety, depression, OCD, and more that so often comes first. I close with the part I find most heartbreaking and most hopeful: what happens when a girl is finally seen, and how the single question "what kind of environment and support would have helped me thrive?" can change everything. I also give you a concrete list of things worth paying attention to if you have a daughter, a student, a niece, or a patient, so you can see what you couldn't see before. If today's episode made you think of someone in your life, I hope you'll follow that instinct. The earlier we recognize autistic qualities in girls, the less of that road they have to walk alone.

How Much ABA Is Too Much? How Much Is Too Little? The Truth About Dosing ABA for Your Child

In this episode, I'm taking you inside a question that keeps so many parents up at night: how many hours of ABA does my child actually need, and who really decides? I open with a scene from a recent New York Times investigation, a little girl woken from her nap after exactly seven minutes because the clinic couldn't bill insurance while she slept, and I explain why stories like that reveal a system that has, in some places, started making financial decisions in place of clinical ones. I walk you through what the research actually shows about ABA dosage (the studies that found intensive 25 to 40 hour programs help some young children were real and important, but that finding got distorted into the idea that every autistic child needs as many hours as possible, which the science simply doesn't support), and more importantly, how the right number of hours should be determined for your child: their specific developmental needs, the behaviors affecting their safety and learning, and their age. I also share brand new research, an April 2026 study in the Journal of Personalized Medicine from Cortica and NYU, showing that the greatest growth across every developmental domain came from a more integrated, whole child model of care rather than from simply adding hours. And I tell you about Max, a little boy who came to me at three and a half on a required 40 hour per week program: not sleeping, melting down, and losing weight. Once we addressed his sleep, his nutrition, and his sensory needs and rebuilt his schedule around what his nervous system could actually handle, he became a different child, and on fewer hours than before. If you're weighing an ABA prescription right now, I'll give you the exact questions to ask, where the hours happen, the balance of center, home, and community, the ratio of individual to group, and whether there's still room in the week for your child to just be a child.

A Caregivers Guide to Sensory Processing and Autism: Understanding How your Child Sees the World with Christine Adintori

In this episode, I'm taking you inside something that shapes every single moment of your child's experience but is so often overlooked: sensory processing. If your child melts down at toothbrushing, covers their ears at certain sounds, seeks out spinning objects, or seems not to notice when they're hungry or hurt, this episode will give you a whole new way to understand what's actually happening. I'm joined by Christine Adintori, occupational therapist and Senior Manager of Clinical Excellence at Cortica, to walk through what the science says about how autistic children take in and make sense of the world. I walk you through the brain science behind the senses you've heard of and the ones you probably haven't (beyond the familiar five, there are three more, proprioception, vestibular, and interoception, that tell us where our body is in space, whether we're balanced, and what's happening inside us), and more importantly, what that means for how you can support your child every day. We get into why up to 97% of autistic individuals experience sensory differences, how those differences show up at every stage from infancy through adolescence, why sensory processing is now part of the diagnostic criteria for autism, and the single idea I want every parent to hold onto: all behavior is a response to sensory processing. When you ask what your child is experiencing, you get much closer to answering why they're doing what they're doing. Christine also shares real stories from her work, including a child who couldn't tolerate toothbrushing until they found the right kind of input, and a little girl who went from avoiding the whiteboard entirely to writing with confidence, and what those breakthroughs teach us about seeing the whole child.

Autism and Language: What Every Parent Needs to Know with Laura Bierck, SLP-BCBA

In this episode, I'm taking you inside one of the most misunderstood topics in autism: how speech and language actually develop. If your child isn't talking the way you expected, or speaks in scripts and echoes, or can read words but struggles to have a conversation, this episode will give you the framework you've been searching for. I'm joined by Laura Bierck, speech language pathologist, board certified behavior analyst, and our Senior Manager of Clinical Excellence at Cortica, to walk through what the science actually says about autistic communication. I walk you through the brain science that explains why so many autistic children process language differently (many have stronger visual brain networks than auditory ones, which is why some children can read words before they ever speak them), and more importantly, what that means for how you support your child every single day. We break down Gestalt language processing and the 2025 research showing up to 90% of autistic individuals use echolalia at some point, hyperlexia and the surprising power of written words, the simple 9-to-1 language shift that changes everything, and why AAC is never a last resort. This episode is for you if: your child communicates in ways that don't match the typical milestones chart, you've been told to "wait and see" but something in you wants to do more, or you simply want to understand how your child's brain is approaching language so you can meet them there. Throughout, I want you to remember this: communication is something we build with our children. When you shift from trying to pull language out of your child to creating opportunities for connection, everything changes.