Published April 2026 · 9 min read
For decades the dominant clinical frameworks treated ADHD and autism as two separate — and for a long time, mutually exclusive — diagnoses. The DSM only permitted their co-occurrence in 2013, and the field is still catching up with what that rewrite actually means for the people who were living the dual reality all along. In 2025, the most interesting theoretical development is not coming out of pharmacology or neuroimaging. It is coming from a twenty-year-old cognitive model called monotropism — and the researchers using it most fluently are autistic and AuDHD themselves.
What monotropism actually says
Monotropism, first proposed by Dinah Murray, Wenn Lawson and Mike Lesser in 2005, argues that human attention is a finite resource that can either be spread broadly across many channels (polytropism) or concentrated into a small number of highly-engaged “attention tunnels” (monotropism). On this account, autism is not a deficit of social cognition or a surplus of rigidity; it is what happens when a brain allocates almost all of its processing power into whichever tunnel it is currently inside. Shifts between tunnels are effortful, costly, and sometimes physically painful.
What is new, and what matters for AuDHD, is the recent proposal that ADHD might represent a kinetic form of monotropism. The tunnels exist — but they shift rapidly and often involuntarily. Where the autistic brain is a single laser, the ADHD brain is a strobe. Where the AuDHD brain lives is the place where both are true at once: deep tunnels that also refuse to stay put.
Monotropism appears to be a fundamental cognitive style, not a behaviour to be modified. Effective therapy does not try to make monotropic people polytropic — it helps them understand their attention system, reduce harmful splitting, and build a life compatible with how their brain works.
Therapist Neurodiversity Collective, 2025
Why the reframe matters clinically
It explains the lived contradiction the old framework could not. The constant internal conflict between ADHD traits — stimulation, novelty, movement-seeking — and autistic traits — structure, routine, sameness — is now one of the most reliable signatures in AuDHD self-report. Monotropism explains why: it is not two disorders colliding. It is a single attention architecture oscillating between hyperfocus and involuntary tunnel-switching.
It changes what “good therapy” looks like. Traditional CBT asks clients to distribute attention evenly across thoughts, feelings, behaviours and contexts — a polytropic task. Third-wave approaches such as Acceptance and Commitment Therapy, Dialectical Behaviour Therapy, and Internal Family Systems work with whatever attentional architecture the client actually has, rather than against it. Neurodiversity-affirming clinicians in 2025 are explicitly framing their work around monotropic interest systems rather than pathologising them.
It gives the AuDHD community a model of itself that is not written in the grammar of deficit. For late-diagnosed adults — and especially late-diagnosed women — this is not a cosmetic distinction. It is the difference between “what is wrong with me?” and “how does my brain actually work, and how do I build a life that fits it?”
What to do with this, today
If you are AuDHD, the practical implication is that your attention system is not broken — it is differently organised, and the organisation is coherent once you know what you are looking at. Respect the tunnels. Build your week around them rather than against them. Notice what a forced tunnel-switch costs you, and budget for the recovery it will demand.
If you are a clinician, the implication is that the question “are you ADHD or autistic?” may be the wrong opening. The better question is: how does your attention move, and what does it cost you to move it?
The work of the next decade will be turning monotropism from a theory into a measurable, testable, clinically actionable framework. In the meantime, the model is already doing what every good theory does: it is explaining the data the old models could not, and it is being built, deliberately, by the people who live inside it.
Further reading
Murray, D., Lesser, M., & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism, 9(2).
Therapist Neurodiversity Collective (2025). Neurodiversity-Affirming Therapy: Positions, Therapy Goals, and Best Practices.
Graf-Kurtulus, K. et al. (2025). Rethinking psychological interventions in autism: Toward a neurodiversity-affirming approach. Counselling and Psychotherapy Research.
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