ADHD and Monotropism

Fergus Murray with Sonny Hallett (2023)

Monotropism was formulated as a theory of autism. It seeks to explain the experiences and traits of autistic people in terms of a tendency for resources like attention to be concentrated on a small number of things at a time, with little left over for everything else. Through this lens we can make sense of autistic social, sensory and executive functioning differences, as laid out in Monotropism – Explanations.

As time has gone on, it has become clear that many diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) also identify strongly with many aspects of monotropism. I want to explore this by looking at the diverse ways that autism and ADHD present; where the traits associated with ADHD fit in with monotropism in an obvious way, and where they might seem to be in tension; and what this might mean for how we think about diagnoses and neurodiversity. Much of what I have to say here is necessarily speculative, all of it calls for further research, and parts of it may be in tension with some of the ways that many people are used to talking about neurodivergence.

The way that ADHD and autism are characterised in diagnostic manuals is completely different. ADHD is treated as primarily an attentional difference; autism as chiefly social in nature. Where descriptions do overlap, they can seem contradictory: autism is apparently characterised by rigid, restricted interests, while ADHD is said to cause impulsive behaviour and an inability to concentrate.

So the facts that anywhere from 30% to 80% of autistic people seemingly fit the diagnostic criteria for ADHD, and the two clearly run in the same families, might initially seem surprising. It cries out for an explanation. One possibility is that autism and ADHD – or a Kinetic Cognitive Style (KCS), as I prefer to call it – share an underlying cause. Monotropism has been put forward as one candidate for this, for example in Patrick Dwyer’s Revisiting Monotropism.

It is well established that autism can manifest very differently in different people, in ways that can seem contradictory. We know that autism can come with hyperlexia, or serious language difficulties. We know that it’s associated with sensory seeking and sensory avoidance. We understand that it might come with with crystal-clear memories, or forgetfulness. All of these things can coexist in one person, or just a selection.

With this in mind, it is perhaps not such a stretch to suggest that impulsivity, inattention and hyperactivity might share cognitive or neurological roots with their apparent opposites, like inflexibility, hyperfocus and inertia. When and how such traits manifest might depend on a person’s interests and experiences, or it might have to do with innate neurocognitive differences. Understanding this kind of variation fully would take far more research on the life experiences and psychological development of people with a variety of cognitive styles, without assuming that current diagnostic categories reflect objectively real categories of human being.

Impulsivity could come from the monotropic tendency to lose awareness of things as soon as our attention shifts away from them. Inattention is a very familiar thing among autistic people – not an attention deficit, which was never the right term, but profound difficulty steering attention in directions which don’t align with our current interests. Hyperfocusing is common with KCS, as it is with autism.

Hyperactivity can refer to a need to keep moving, which bears a striking resemblance to the autistic need to stim. It can also refer to a cognitive tendency which is a little harder to reconcile with how monotropism has been characterised: a habit of hopping mentally from one thing to another. In contrast, difficulty shifting from one attention tunnel to another has been a central feature of the ways monotropism has been described. This tension is worth digging into.

It might be that a Kinetic Cognitive Style arises out of a combination of a relatively monotropic processing style combined with other factors – difficulty accessing flow states, for example, as suggested by some recent research (Grotewiel et al 2022). There are all kinds of reasons why people might not be able to enter ‘flowy focus tunnels‘, as Jamie Knight calls them. They might have too many distractions, or too much nervous energy; they might not feel safe enough to lose themselves in the flow; they might have had bad experiences being told off for doing so, or been wrenched out of them too many times. They might just be too depleted to be able to connect deeply with their passions, something which also occurs during autistic burnout.

We know that novelty-seeking is a trait that varies greatly between people. It’s also possible that some people just have naturally very mobile attention, which might compensate for the monotropic tendency for attention to get sucked into one thing at a time. And maybe some of that apparent attention-hopping happens within an attention tunnel anyway, and other people just aren’t seeing the connections! KCS might look like polytropism sometimes, but I think that can be misleading. I delayed getting my own autism assessment for years because I mistook my serial monotropism for polytropism: I told myself I was multi-tasking, when it would probably be more accurate to say I repeatedly forgot what I was supposed to be doing.

Meanwhile, it is likely that monotropism doesn’t necessarily give rise to autism in the sense required by diagnostic manuals – but that above a certain level of intensity, or in combination with other factors, it causes the familiar social differences, fixity and so on. An early intense interest in other people, and how they behave, might equip someone with tools that will allow them to avoid being seen as too socially weird. The ability to present a ‘normal-looking’ face to the world is likely a major factor in the under-identification of autistic girls, who face far more social pressure to blend in than boys do. None of this changes a person’s cognitive style; but then, autism, like ADHD, has always been assessed based on outward presentation. One hope for Monotropism as a theory is that it helps us to make sense of these things from an internal perspective, rather than looking only at the surface level.

It is, I think, too early to say with any confidence that autism and ADHD (or KCS) share a common root in monotropism, but the overlapping traits of the people receiving each label clearly demand some kind of explanation, and preliminary results do suggest that each is strongly correlated with monotropism – especially in combination. With any luck, we will see a good deal more research on this in coming years.

A possibly-illustrative photo: Two cats have been fighting. Fur lies scattered way across the path. The ginger cat is lying down, looking at the black cat, who looks the other way, still bristling.

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