The Multidimensional Profile

The linear misunderstanding

The most widespread image of autism and context blindness is linear: whoever has more characteristics is "further along the spectrum." The more disturbances, the more severe the diagnosis. This is also the logic of the DSM: a list of criteria with threshold values.

This model has a practical advantage — it gives clinicians a shared language. But it is not accurate as a description of reality. Someone can be severely impacted by sensory stimuli and at the same time be flexible in language use. Someone else may miss social signals entirely, but is organizationally very strong. A single number on a line does not capture this.

The CASS — a circle, not a line

Colette de Bruin and dr. Fabiënne Naber proposed the CASS (Circle of Autism Spectrum Symptoms) as an alternative to the linear spectrum model. Instead of a line, the CASS shows a concentric circle with a color gradient from green (outside) to red (center).

The circle has four zones and two sides:

• Top (green): everyone has some characteristics. No diagnostic threshold.
• Right side (blue) — ♂ > ♀: classic ASD presentation. Rigid behavior, fixed rituals, meticulous and rule-oriented. This is the side described in the diagnostic literature and on which the DSM criteria are based. More men tend to fall here.
• Left side (yellow) — ♀ > ♂: less visible presentation. Socially interested, copying behavior, creative. Women on this side camouflage their autism characteristics — which at a later age leads to burnout and depression. They are systematically less diagnosed because their presentation does not match the DSM criteria, which are based on the right side.
• Bottom (red): core autism — reachable from both left and right.

The key point: these are not two spectra, it is one circle with two routes to the same center. The same level of information processing problems can look completely different in behavior on the left and right sides.

View the CASS poster on geefmede5.nl (Colette de Bruin & dr. Fabiënne Naber, Erasmus University Rotterdam).

The eight disturbances — the brain level

De Bruin describes eight information processing disturbances that accompany autism. These are brain mechanisms — the why behind the behavior:

• Processing information in fragments (central coherence) — information arrives in loose pieces without automatic coherence. The trees are seen, not the forest.
• Not recognizing social information (superior temporal sulcus) — emotional and social signals are missed or misread. Literal and factual information takes priority.
• Making incorrect connections (insula) — cause-and-effect relationships are stored incorrectly, leading to unexpected reactions and difficult-to-predict behavior.
• Over- or under-reacting (thalamus) — the filtering function of the thalamus works too little or too much, both for sensory stimuli and internal signals.
• Difficulty with meaning-making — frames of reference are incomplete or incorrectly built. Language is interpreted literally, prediction takes more time.
• Storing information chaotically — neural pathways are less structurally organized. Retrieving information costs disproportionately much energy.
• Missing frames of reference — insufficiently developed social and factual frames of reference for correctly interpreting and generalizing new situations.
• Not discarding information — irrelevant information is not automatically filtered out. Working memory fills up, leading to a "full head."

The six behavioral categories — the profile level

The disturbances at brain level are not directly visible. What you see in behavior falls into six categories — the what. De Bruin calls the unique combination of a person across these six categories the barcode:

• Fragmented information processing (central coherence) — difficulty seeing coherence
• Over- and under-reacting — sensory stimulus processing
• Social and communication (Theory of Mind 2 & 3) — implicit signals, social reciprocity
• Repetitive behaviors, rigidity, and fixated interests — fixed routines, resistance to change
• Thinking and doing (executive functioning) — planning, initiation, flexibility
• Emotional / the 'self' (Theory of Mind 1) — self-experience, emotion regulation, self-knowledge

Two people with the same diagnosis can have a completely different barcode. That is precisely the point: the label describes the threshold, not the profile.

De Bruin and context blindness — complementary models

The eight disturbances and context blindness are not competing explanations — they are complementary. The information processing problems that De Bruin describes are the cause; context blindness is the cognitive consequence. Because the brain processes information in fragments, lacks frames of reference, and does not automatically recognize social signals, context blindness arises — the reduced automatic integration of implicit environmental information in meaning-making.

The connection is directly visible in the disturbances:

• Processing information in fragments — context that holds loose fragments together is absent → context blindness.
• Not recognizing social information — implicit social context is not automatically integrated → context blindness.
• Difficulty with meaning-making — meaning arises from context; without context, only the literal interpretation remains → context blindness.
• Missing frames of reference — frames of reference are built from context-rich experiences; those who integrate context less build them more slowly → context blindness.

Context Thinking and De Bruin thus describe the same phenomenon from a different angle: De Bruin from the brain and behavior, Context Thinking from the cognitive processing style. Together they offer a more complete description than either model alone.

There is also a difference in scope. De Bruin describes this multidimensional profile specifically for autism. Context Thinking applies the same information processing framework more broadly: the same disturbances — fragmented processing, reduced context integration, difficulty with meaning-making — also appear in ADHD, personality disorders, overstimulation, and burnout. Context blindness in that sense is not an autism-specific concept, but a processing style that is recognizable across multiple diagnostic presentations.

See Autism and context blindness for the further elaboration of this connection.

What this means in practice

• Profile thinking, not label thinking. Two people with the same label have a different barcode — different strengths, different vulnerabilities, different needs.
• Strengths and weaknesses coexist. Someone who is highly vulnerable to sensory stimuli can at the same time be exceptionally strong in rigidity as structure — which in the right environment is an advantage.
• Presentation depends on the route. Left in the CASS or right — the behavior looks different, but the underlying information processing problems are comparable.
• Support requires tailoring. What helps for one profile works against another with the same label. See Guidance and treatment.

Further

• The spectrum of context sensitivity — the tree as a metaphor: context sensitivity differs per domain
• Autism and context blindness — context blindness as an explanatory mechanism
• Context and DSM — the linear classification model and its limits
• Personality disorders — profile variation across clusters
• CASS poster on geefmede5.nl — Colette de Bruin & dr. Fabiënne Naber
• Lexicon — multidimensional profile