Over the past few weeks, there has been a sudden surge of interest in the Monotropism Questionnaire (MQ), pre-print released in June 2023 in the research paper 'Development and Validation of a Novel Self-Report Measure of Monotropism in Autistic and Non-Autistic People: The Monotropism Questionnaire.' by Garau, V., Murray, A. L., Woods, R., Chown, N., Hallett, S., Murray, F., Wood, R., Fletcher-Watson, S. This short article will hopefully summarise the questionnaire and open up some conversations regarding the possible impact this may have for monotropic people, and future autism and ADHD research.
What is Monotropism? Monotropism is a non pathologising theory of autism developed by Dr Dinah Murray, Dr Wenn Lawson and Mike Lesser (2005) in their article, Attention, monotropism and the diagnostic criteria for autism. They stated, "At any one moment, the amount of attention available to a conscious individual is limited'. The authors suggest that 'competition between mental processes for scarce attention is an important factor in shaping the cognitive process.”(Murray et al., 2005).
They suggest that autistic minds focus more energy (resources) on a smaller number of things at any one time. This has been likened to having tunnels of attention where monotropic people become so highly engaged in their specific interest that they may not notice what is happening outside of that space but equally could be hyper-vigilant within that attention tunnel. This can make work highly productive and enable people to enter flow states, allowing more profound focused creativity and providing joy. However, if you are monotropic, it may feel quite distressing and take a lot of energy to switch channels of attention to different tasks/activities. Without careful planning and support, this could have a detrimental impact on mental health. In a school setting, this could contribute to autistic young people struggling with school attendance and the increase in CAMHs (Children and Adolescent Mental Health) referrals. Summary of key research to support the theory of monotropism (from MQ Report):
75% to 95% of autistic people report having special interests (Turner-Brown et al., 2011)
Monotropism fits into the theory of autistic and ADHD hyper focus as described by (Ashinoff and Abu-Akel, 2021; Grotewiel et al., 2022).
Monotropism could explain why autistic students find a busy curriculum with lots of change and shifting of attention channels through the day more difficult to manage (Wood, 2021)
Benefits of embracing monotropism My article Monotropism = Happy Flow State has some information about the positive side of monotropism. Being highly monotropic can have many benefits, including:- Attention to detail
Gain deeper knowledge and skills
High levels of focus
Increased attention
Predictable
Reassuring
Reliable
Sensory regulation
Calming
Reduces anxiety
Reduces depression
Joyful experience
Last month, I published the wonderful positive experiences that people shared about being monotropic following a community social media project I led online. The following words were used to describe people's understanding of monotropism and the experience of being monotropic;
"immersion, pull, flow state, flux, switch, force, balance, re-charging, magnet, energy, spin, evaporation, attention tunnel, momentum, fluid, unravelling and rewrapping, state of being, interconnected ideas, tunnel vision, hyper-focus, special interests, singular focus, burrowing". The full article can be found here with a FREE pdf resource, Monotropism and Experiences of Being Monotropic.
What is The Monotropism Questionnaire?
The Monotropism Questionnaire's research paper's full title is 'Development and Validation of a Novel Self-Report Measure of Monotropism in Autistic and Non-Autistic People' (June 2023). The MQ was developed by an autistic-led community group (including academics). The research team consisted of Valeria Garau, Aja Louise Murray, Richard Woods, Nick Chown, Sonny Hallett, Fergus Murray, Rebecca Wood, and Sue Fletcher-Watson.
Eight factors came out of the data analvsis. These elements could be considered to contribute to monotropic thought patterns.
managing social situations
rumination and anxiety
struggle with decision making
anxiety-reducing effect of special interests
need for routines
special interests
losing track of other factors when focusing on special interests
environmental impact on the attention tunnel
Summary of the Report
The MQ consists of 47 items, which a group of autistic adults generated based on their lived experience and academic expertise.
1,110 participants (756 autistic, 354 non-autistic) completed the MQ
As predicted, MQ scores are significantly higher for autistic participants compared to non-autistic participants.
ADHD and autism were both significantly associated with higher mean monotropism scores (see graphs below)
The Monotropism Questionnaire was designed to measure monotropism; it was not intended to be an Autism questionnaire or a replacement for an autism assessment.
The popularity of the MQ on social media over the past two weeks, with some TikTok accounts getting over 1.9 million views and 186k likes (28th July 202,3), such as Dr Joey (nd_psych), highlights how deeply people are resonating with this theory. Responses to social media posts reflect that many people value the MQ as representing their inner autistic experience better than some current assessment models; it has been called 'the new autism assessment'. This reflects how many people feel validated by gaining a deeper understanding of themselves despite it clearly being named a monotropism questionnaire (not an autism assessment); it shows the potential is huge for further research and development of ideas to support monotropic autistic ADHD people further.
The shift towards autistic researchers being an integral part of autistic research is beginning to grow. There is a definite surge in more neurodiversity-affirming discussions and work being put into practice. The paper, 'Centering the Inner Experience of Autism: Development of the Self-Assessment of Autistic Traits' (Ratto et al., 2023), explores the inner lived experience of being autistic at a deeper level. The research results were the development of a new strength-based Autism assessment called the Self Assessment of Autistic Traits (SAAT). The 'SAAT moves beyond a deficit-based model to include autistic strengths and joy, such as noticing details and patterns, strong empathy and honesty, and creative problem-solving...In framing items about challenges, the SAAT emphasises how autistic people are most successful (e.g., by practising language in advance, finding unique ways to understand nonverbal communication, or demonstrating knowledge in specific ways) rather than the challenges themselves.'. This is similar to the MQ, and it would be fascinating to see how the scores compare and what it would look like to combine these assessments.
Monotropism, Autism, and ADHD
I feel there is considerable overlap between autism and ADHD; the more I read, the more I have begun to question where the difference lies. A better understanding of monotropism could help develop a greater understanding of both autism and ADHD. It could help to explain the increased likelihood of Autistic / ADHD people experiencing burnout and mental health issues. The MQ research paper brings together other research that supports the overlap between autism and ADHD and states:
As indicated by the MQ research, "there are indications that ADHD and autism share some attentional features such as hyperfocus (e.g., Grotewiel et al., 2022), which is Conceptually very similar to the monotropic “attention tunnel” – namely the absorbing experience of focused attention, often to the exclusion of all else. It may be that monotropic attention is not only captured endogenously by individuals’ special interests but also exogenously by highly salient environmental stimuli - as has been observed in autistic children (Amso et al., 2014)". A research paper by Hanna Bertilsdotter Rosqvist and others entitled, Intensity and Variable Attention: Counter Narrating ADHD, from ADHD Deficits to ADHD Difference, The British Journal of Social Work, (2023) highlights both the positives (as shared in my online project Monotropism and Experiences of being Monotropic) and also some of the more challenging aspects of what they describe as 'intense and variable attention' for ADHDers. They report, "Our findings reveal the intensity and variable attention as sources of happiness, playfulness, creativity and recreation, as well as exhausting, limiting and subjected to feelings of shame and guilt, and even fear.".
I have personally taken the MQ several times now, each time with a slightly different score, but all within an average difference of around 0.1- 0.2. This indicates that a person's monotropic state is fluid, just like their sensory profile. This fluidity of autistic-being is described in my article Autism is fluid. We are all in a constant state of flux, and this needs to be considered when analysing questionnaires and managing your own life or supporting others. What works one time may not work the next. What you can successfully achieve with ease one day may feel near impossible another time. This means that if people are taking the MQ and are stressed, feeling they are in burnout or experiencing other mental health issues, it could impact the scores of the MQ. Monotropism and Burnout
Being monotropic can make daily life feel demanding and impact mental health. If you are using so much energy on a single task, it can feel like you need to constantly weigh up and balance your energy resources throughout the day to manage other tasks /channels of attention. If you are highly monotropic, life may feel even more intense as you become fully immersed in your attention tunnels/various tasks/sensory experiences and your entire bodymind energy flow is engaged. Moving in and out of channels of attention can feel challenging, each time costing more energy. It is a privilege being able to work in the field of your particular special interest and to have a safe space and time at home to engage in monotropic flow when needed to rest and recharge. Having such privilege along with gaining a deeper knowledge of your own monotropic/ autistic /adhd identity could really help support better mentalhealh. The effects of juggling other demands from work and family, the effects of masking and the impact of other factors of intersectionality (disability/race/gender/class and other co-occurring physical and mental health issues a person may have) could all really impact on the outcome of the monotropism questionnaire and how much being monotropic affects a person at any given time. If you are in burnout, you are in survival mode; you will likely need to use more energy to meet your basic authentic needs to get through the day; you may not have enough energy left to mask consciously or even subconsciously. When taking the questionnaire, the current state of a person's mental health will impact the results. If you need to hyperfocus and preserve energy, it may feel like you only have your 'core' autistic/ADHD self left, what I would call the survival self. It would be interesting to have research to see if the survival self i.e.. a person in autistic /ADHD burnout would have higher monotopic scores than when not in burnout, a way of measuring an individual's personal 'baseline'. Using the 8-Factor MQ Model, it would be interesting to know how scores differ for a person experiencing burnout or a mental health crisis. Scores could be higher when experiencing a mental health crisis. They may be trying to 'hang on' and clutching onto routines, consistency and hyperfocus. Equally, some people may not have enough energy left to engage in their monotropic interests and flow state, and their score could be even lower, such as when experiencing severe autistic burnout and catatonia as described by Dr A Shah (2019). It would be interesting to have a study to explore the following:-
managing social situations - to help reduce anxiety
rumination and anxiety - likely to be increased in burnout
struggle with decision making - likely be increased in burnout
anxiety-reducing effect of special interests - likely increased time spent engaging in special interests
need for routines - likely be increased in burnout to reduce anxiety
special interests - time and space to engage in special interests could help mental health
losing track of other factors when focusing on special interests - could be a respite from mental health issues and could help improve mood and well being
environmental impact on the attention tunnel - heightened sensory perception is often discussed in relation to burnout. An awareness of the impact of the environment could benefit mental health outcomes
Further research in this area would enable those struggling with burnout to understand their needs. It would also support friends/ families and professionals to have a deeper understanding of managing the day in flow states as described by Jamie Knight on '1800 seconds of Autism' BBC Podcast with Wenn Lawson ( March 2023). This is also explained in their blog "Applying Monotropism" where they talk about the importance of planning your day around "tunnels not tasks" (Jamie & Lion @spacedoutsmiles 2022). The results from the Monotropism Questionnaire could help validate people's feelings. Knowing they have a monotropic mind could help people give themselves permission to recharge by engaging in their monotropic interests. This would enable them to enter a restorative 'flow' state to reduce and help prevent burnout and mental health crises.
Monotropism and Education For children and younger people (and those with learning disabilities), the monotropism questionnaire may need to be revised. However, this could have a great positive impact on educational outcomes. A deeper understanding of autism, ADHD and monotropism (alongside other neurodivergences) would enable educators to tailor planning to meet monotropic needs in various settings. It could help improve education outcomes, too, for monotropic learners. There is an emerging wave of writing and research about the benefits of teaching through a. It could lens and planning a curriculum around individuals ' neurodiversity-affirming needs (including monotropic learners) rather than trying to fit the child into the curriculum. Rebecca Wood has excellent research and a valuable book for educators that explore this more in-depth, available here: Inclusive Education for Autistic Children: Helping Children and Young People to Learn and Flourish in the Classroom (2019). Summary
The Monotropism Questionnaire is an excellent non-pathologising next step towards a greater understanding of monotropism, autism and ADHD. The potential outcomes from this initial research are tremendous in education, health, social care and mental health.
However, most importantly, I feel the overwhelmingly positive response from the Autistic and ADHD community speaks volumes. Tens of thousands have responded to say how validated they think now, having a word and a concept to describe many aspects of the inner experiences of being autistic / ADHD. The benefits of further research into monotropism are immeasurable to enable those that resonate with this theory to feel understood, connected to others and have a feeling of things finally 'making sense'.
A fantastic source of information about monotropism is available on the website run by Fergus Murray: Monotropism Stimpunks also has a great collection of writing about monotropism available here: Monotropism - Stimpunks Foundation *This article reflects my own personal thoughts and opinions. I am writing as a late-diagnosed autistic person, a resigned primary teacher, a parent and an active member of the online neurodivergent community.* *** Please seek professional advice if you need support or have mental health concerns.***
I am honoured to now be an affiliate for The Autistic Advocate, Kieran Rose. You may be interested in the courses below which will explore autism, masking, autistic identity, burnout and monotropism in more detail.
