Autistic Intelligence: Interaction, Individuality, and the Challenges of Diagnosis
Executive Summary
Autistic Intelligence: Interaction, Individuality, and the Challenges of Diagnosis by Ginny Russell explores how autism assessment fundamentally misunderstands autistic intelligence by evaluating social performance rather than actual cognitive abilities. The book’s central thesis is that autistic people are routinely judged competent or incompetent based on their ability to conform to neurotypical interaction patterns—quick conversation flow, eye contact, conventional emotional expression—rather than being assessed on their genuine capabilities, knowledge, and problem-solving skills.
Russell introduces a crucial framework distinguishing first-order competence (actual ability to understand, process, and solve problems) from second-order competence (the ability to demonstrate that understanding through normative social channels). Most diagnostic systems, including the DSM-5, assess almost exclusively second-order competence, creating epistemic injustice where autistic intelligence remains unrecognized when it doesn’t present in expected ways. The book critiques the pathology paradigm in autism research, revealing how genetic and neurobiological studies often pathologize differences rather than understanding them as variations in human experience. Ultimately, Russell calls for neurodiversity-affirming assessment that evaluates first-order competence separately from presentation, creates sensory-friendly environments, and builds on autistic strengths rather than perceived deficits.
Overview and Core Thesis
This book examines how the diagnostic process disrupts the social assumption that communication follows standard patterns. Neurotypical clinicians often interpret autistic communication as “not normal,” leading to pathologizing rather than recognizing different ways of being intelligent and competent.
The central challenge is that autistic people are routinely judged competent or incompetent based on their ability to engage in masking and perform neurotypical social interaction patterns, rather than being assessed on their actual capabilities, knowledge, and problem-solving abilities. This creates a fundamental misalignment between what autism diagnosis actually measures (social compliance) versus what it claims to measure (cognitive functioning and adaptive behavior).
The Social Assumption of Common Sense
How Social Interaction Creates Diagnostic Bias
Most humans navigate the world through the fundamental assumption that others share their communication style. This reliance on “common sense” becomes deeply problematic in clinical settings where neurotypical clinicians evaluate autistic individuals. When an autistic person enters a diagnostic situation, they’re immediately evaluated against norms that assume quick back-and-forth conversation flow, maintaining appropriate eye contact, following expected social scripts, and demonstrating emotional expression through conventional means.
Any deviation from these patterns is interpreted as evidence of dysfunction rather than difference. This creates particular challenges for autistic people who may experience sensory overload in clinical environments with fluorescent lighting, strong odors, and background noise—all of which can dramatically affect their ability to perform according to neurotypical expectations.
The Epistemic Injustice of Diagnosis
This system creates a form of epistemic injustice where autistic intelligence is unrecognized when it doesn’t present in expected ways. Communication differences are pathologized as deficits, and the diagnostician’s assessment tools are designed around neurotypical norms. The book argues this represents a fundamental error in how we understand and assess human intelligence across neurological profiles.
The assessment process essentially measures success at performing neurotypical social expectations rather than genuine cognitive ability or problem-solving capacity. Someone may demonstrate sophisticated understanding and competence in areas of interest or expertise, yet be judged incompetent overall because they cannot display that competence through conventional social channels.
The Clinical Diagnostic Process
Structural Barriers in Assessment
The standard clinical diagnostic process presents multiple structural challenges for autistic people that can significantly skew assessment outcomes. Environment-related barriers include overwhelming sensory environments that trigger physiological stress responses, unexpected social norms in medical settings, discomfort with physical touch or personal space invasion, and difficulty navigating unfamiliar buildings.
Communication-related barriers involve questions requiring narrative responses without clear structure, lack of visual supports or written question versions, inconsistent communication styles between practitioners, and questions that assume social understanding not aligned with autistic experience. Physical and processing barriers include hypotonia or low muscle tone affecting sitting positions, apraxia or motor planning difficulties, need for additional processing time, and alternative communication methods or echolalia.
First-Order Vs. Second-Order Competence
The book introduces a crucial distinction that reframes the entire diagnostic challenge. First-order competence is the ability to understand tasks, process information, and solve problems. Second-order competence is the ability to perform those tasks in socially expected ways, communicate processes normatively, and demonstrate understanding through conventional channels.
Most diagnostic systems assess second-order competence almost exclusively. This means someone might be highly competent in their actual abilities but be judged incompetent because they can’t demonstrate that competence through expected social channels. The book provides numerous examples of autistic individuals who can solve complex problems, understand sophisticated concepts, and demonstrate deep expertise in their areas of interest—yet are assessed as having limited intellectual capacity because they cannot perform the social dance of normative assessment interactions.
This framework reveals how intelligence testing in autism settings often becomes an assessment of social compliance rather than cognitive ability. Someone who can explain their knowledge in detail when given time and appropriate communication supports may appear to lack understanding when pressured to respond quickly in face-to-face clinical interviews.
Autistic Intelligence and Communication
Alternative Patterns of Expression
Autistic people often develop sophisticated ways of expressing themselves that differ from neurotypical norms. Alternative narratives may include parallel narratives that seem off-topic but connect through underlying themes, delayed processing requiring time to formulate responses, highly detailed explanations that follow logical connections not immediately obvious to others, and use of scripts, quotes, or special interests to express ideas.
Non-verbal communication differences include alternative movements, gestures, or sounds instead of eye contact, stimming behaviors that serve communication and regulation purposes, written communication or alternative input/output methods, and engagement patterns that prioritize processing speed over social immediacy. These alternative expression patterns represent genuine communication strategies rather than deficits, yet are often misinterpreted in clinical settings as evidence of language impairment or cognitive limitation.
Competence Through Special Interests
The book documents how autistic people often demonstrate exceptional competence through their special interests. They develop deep expertise in complex subjects, create detailed organizational systems for information, maintain consistency and reliability in knowledge areas, and teach others through direct communication styles. However, this competence is often dismissed or pathologized in clinical settings that focus on evaluating deficits rather than strengths.
The intensity and focus autistic people bring to their areas of interest represent genuine cognitive strengths—depth of knowledge, attention to detail, pattern recognition abilities, and systematic thinking that should be recognized as forms of intelligence. Instead, diagnostic frameworks often frame these very capacities as “restricted interests” or “obsessions,” missing the sophisticated knowledge and skill they represent.
Research Limitations and Pathology-Focused Approach
Genetics and Neurobiology Critique
The book offers a strong critique of current autism research approaches. Genetic studies rely heavily on twin studies that oversimplify complex genetic relationships, produce statistical correlational findings that don’t prove causation, focus on identifying “autism genes” without understanding complex gene-environment interactions, and demonstrate poor explanatory power—identified genes account for minimal variation in autistic traits.
Neurobiological research includes brain imaging studies that ignore important information about environmental interactions, reductionist approaches treating brain structures as determinative rather than interactive, small sample sizes and selective reporting creating false confidence in findings, and a tendency to pathologize differences as abnormalities rather than variations. The book argues these approaches operate within a pathology paradigm that prevents genuine understanding of autistic intelligence and alternative ways of being human.
The Pathology Paradigm
Most autism research operates within a pathology paradigm that treats autistic traits as symptoms to be eliminated. This approach uses “normal” development as the standard against which autistic people are judged deficient, frames therapies as normalization rather than accommodation approaches, and focuses on early intervention to make autistic children indistinguishable from peers.
The book reveals how this paradigm shapes research questions, assessment tools, and intervention strategies in ways that prevent recognition of autistic intelligence and strengths. When researchers begin from the assumption that autistic traits represent deficits to be fixed rather than variations to be understood, they design studies that confirm this assumption and miss opportunities to discover the sophisticated capabilities and alternative intelligences that autistic people demonstrate.
Narrative Practices and Self-Understanding
Developing Autistic Narratives
Autistic people develop narratives about themselves through special interests as organizing structures for understanding the world, developing personal philosophies explaining different ways of being, creating connections between experiences through repeated patterns, and building self-understanding through reflection on differences and strengths.
External communication involves learning to translate internal experiences into understandable forms, developing scripts and explanations for autistic differences, finding ways to communicate needs and boundaries effectively, and teaching others about autistic experiences through direct means. These narrative practices represent genuine intelligence and self-awareness, yet are often overlooked in clinical approaches that assume autistic people lack narrative capacity or self-understanding.
Challenges in Narrative Development
The clinical environment often makes narrative development more difficult by assuming that autistic people lack narrative ability, interrupting or redirecting explanations that don’t follow expected patterns, treating systematic explanations as evidence of dysfunction, and missing the underlying connections and logic in autistic expression. This creates particular challenges for late-diagnosed autistic people who may have spent decades developing sophisticated coping strategies and self-understanding that clinical approaches fail to recognize or appreciate.
The book provides numerous examples of autistic people who have developed detailed explanatory frameworks for their experiences, only to have these dismissed by clinicians trained to recognize deficit patterns rather than alternative intelligence and self-knowledge.
Sensory Processing and Physical Challenges
Sensory Integration Difficulties
Many autistic people experience significant sensory processing challenges that affect their ability to participate in clinical assessments. Sensory overload involves difficulty processing multiple simultaneous sensory inputs, heightened sensitivity to light, sound, touch, taste, or smell, need for reduced sensory input to maintain focus and comfort, and specific sensory triggers that may not be obvious to neurotypical observers.
Self-regulation strategies include stimming behaviors that help manage sensory input and anxiety, use of objects, sounds, or movements to create predictability, need for sensory breaks or alternative environments, and preference for controlled sensory environments. These strategies represent sophisticated self-regulation and environmental management skills, yet are often misinterpreted in clinical settings as evidence of behavioral dysregulation or lack of self-control.
Motor and Physical Challenges
The book documents how physical challenges are often misinterpreted as cognitive or behavioral issues. Hypotonia affecting posture and movement may be interpreted as lack of cooperation or attention. Motor planning difficulties making responses appear delayed may be read as cognitive processing limitations. Oral-motor differences affecting speech clarity may be misinterpreted as language impairment. Alternative ways of writing or typing may seem unusual and raise questions about competence.
These misinterpretations reveal how diagnostic processes often read physical and sensory differences through a pathological lens, missing the sophisticated adaptation and coping strategies they represent. An autistic person who types to communicate because of motor planning differences may be assessed as having limited verbal ability, when in fact they may have sophisticated language skills that simply require an alternative output method.
Towards Better Assessment and Support
Neurodiversity-Affirming Assessment
The book suggests several approaches for more effective and ethical assessment. Environmental accommodations include sensory-friendly environments with reduced lighting and noise, clear expectations and visual supports for assessment procedures, extended time for processing and responding, and alternative communication methods and supports.
Competence-focused assessment involves evaluating first-order competence separate from second-order presentation, using assessment tools that don’t require normative social performance, including specialists who understand autistic communication styles, and respecting alternative ways of demonstrating knowledge and ability.
A collaborative approach includes including autistic voices in assessment tool development, training clinicians in neurodiversity-affirming approaches, recognizing expertise from lived experience alongside professional knowledge, and creating assessment partnerships rather than hierarchical evaluations. This approach recognizes that autistic people are experts on their own experiences and that clinical assessment should be a collaborative process of understanding rather than a hierarchical evaluation.
Alternative Support Frameworks
Beyond changing assessment, the book envisions support approaches that build on existing strengths rather than fixing perceived deficits, create environmental accommodations rather than individual normalization, support autistic people in developing self-understanding and self-advocacy, and recognize the value of autistic perspectives and intelligence.
This represents a fundamental shift from the pathology paradigm toward a neurodiversity paradigm that recognizes multiple ways of being intelligent and competent. Instead of asking how to make autistic people appear more neurotypical, this approach asks how to create environments and supports that allow autistic intelligence and capabilities to emerge fully.
Critical Insights and Counterintuitive Understanding
What Autism Diagnosis Actually Measures
Perhaps the most important insight from the book is that autism diagnosis often measures not intelligence or cognitive ability, problem-solving skills, knowledge acquisition, or adaptive functioning. Instead, diagnosis typically measures ability to perform social expectations, compliance with neurotypical interaction patterns, willingness to suppress autistic behaviors for social acceptance, and success in demonstrating competence through conventional channels.
This reveals how autism assessment has less to do with autistic traits themselves and more to do with social performance and assimilation. An autistic person who has learned effective camouflaging strategies may be assessed as less autistic or more “high-functioning” regardless of their actual support needs or internal experience. Conversely, someone who cannot or chooses not to mask may be assessed as more impaired even if they have significant cognitive strengths and capabilities.
The Interaction Order As Cultural Assumption
The book reveals how what we consider “natural” social behavior is actually a culturally specific interaction order that varies dramatically across cultures and historical periods, assumes shared communication styles and norms, prioritizes certain types of intelligence and expression, and masks political choices as biological necessities. Recognizing this helps us understand that autistic differences aren’t necessarily deficits but may represent alternative interaction orders.
This insight reframes autistic social differences from individual deficits to variations in communication styles that reflect different cultural assumptions about interaction, attention, and expression. When clinical assessment assumes neurotypical interaction patterns are natural and universal, it fails to recognize these as culturally specific ways of being that autistic people may not share or value.
The Politics of Intelligence Assessment
The book connects autism diagnosis to broader questions about how societies determine who counts as intelligent. Intelligence testing has historically been used to justify social hierarchies. Different types of intelligence are valued differently based on social utility. Alternative ways of knowing and expressing are often dismissed as less sophisticated. The determination of “competence” serves social and political purposes.
This historical context reveals how current autism assessment practices continue patterns of using intelligence testing to determine who deserves access to resources, opportunities, and social status. When autism assessment measures social compliance more than actual ability, it serves to maintain existing social hierarchies rather than genuinely identify support needs or capabilities.
Practical Applications and Moving Forward
For Autistic Individuals
Self-advocacy development involves understanding personal strengths and communication styles, learning to explain autistic needs and preferences clearly, finding environments that value different ways of thinking and being, and building confidence in alternative intelligence and competence.
Environmental navigation includes identifying sensory-friendly spaces and supports, developing personal regulation strategies, creating alternative communication methods when needed, and building networks of understanding friends, family, and professionals. The book emphasizes that autistic people shouldn’t be expected to do all the work of adaptation—neurotypical people and institutions also have responsibility to create accessible environments and communication approaches.
For Professionals and Caregivers
Assessment improvements include learning to recognize competence beyond conventional presentation, creating sensory-friendly assessment environments, extending time limits and processing expectations, and including autistic perspectives in interpretation of results.
Support approach changes involve focusing on accommodation rather than normalization, recognizing the value of autistic strengths and perspectives, supporting self-advocacy and self-understanding, and creating environments that allow different ways of being. The book emphasizes that professionals should approach assessment with humility about the limitations of their tools and frameworks, and with respect for the expertise that autistic people have about their own experiences.
For Research and Policy
Research direction changes include moving beyond pathology-focused approaches, including autistic researchers in study design and interpretation, studying autistic intelligence and strengths rather than just deficits, and developing assessment tools that recognize different ways of demonstrating ability.
Policy considerations include supporting autistic self-advocacy organizations, requiring neurodiversity training for professionals, funding accommodation-focused rather than normalization-focused interventions, and creating educational and workplace environments that value diverse cognitive styles. The book argues that research funding priorities should shift away from finding causes and cures toward understanding how to create a world that works for autistic people as they are.
Conclusion: Towards Recognizing Multiple Intelligences
Autistic Intelligence ultimately argues for a fundamental rethinking of how we understand and assess human intelligence across neurological differences. The book challenges us to recognize that communication differences don’t indicate intellectual deficits, value alternative ways of processing information and expressing ideas, create environments that allow different types of intelligence to emerge, and move from normalization to accommodation as our primary support approach.
By understanding the social and political nature of intelligence assessment, we can create more inclusive and accurate ways of recognizing the diverse ways that humans think, communicate, and solve problems. This benefits not just autistic people but society as a whole, as we learn to value multiple ways of being intelligent and competent.
The book represents a crucial contribution to neurodiversity understanding and provides a framework for reimagining how we might support and value autistic people as they are, rather than trying to make them conform to neurotypical expectations. Its central insight—that we need to distinguish between genuine ability and the social performance of ability—offers a powerful tool for transforming assessment, research, and support approaches in ways that recognize rather than erase autistic intelligence.