In recent years, important research has begun to reshape how we understand care and support for Autistic people in healthcare, education, and workplace settings. At the same time, Autistic people are re-storying our lives in neuroaffirming ways that centre our authentic identities and lived experiences.

Autistic ways of sensing, focusing, and connecting are shaped by monotropism a cognitive style where attention flows deeply into a few things at a time (Murray, Lesser, & Lawson, 2005). This can create rich experiences of flow and meaning, but it also makes Autistic people more vulnerable to stress and mental health difficulties when environments are not meeting needs and overwhelming (Heasman et al., 2024). I believe a deeper understanding of monotropism is essential for Autistic wellbeing.

Recent research has built strong neuroaffirming frameworks to guide more humanising care. The Autistic SPACE framework sets out five key areas — Sensory, Predictability, Acceptance, Communication, and Empathy — as foundations for safe, inclusive practice in healthcare and education (Doherty et al., 2023; McGoldrick et al., 2025). Alongside this, the eight dimensions of care (based on the work from Todres et al., 2009) from An Experience Sensitive Approach to Care With and for Autistic Children and Young People in Clinical Services highlight the importance of Togetherness, Insiderness, Sense-Making, Uniqueness, Sense of Place, Embodiment, Agency and validating our Personal Journey’s so Autistic people can thrive with dignity and a sense of belonging (McGreevy et al., 2024).

I’ve developed a neuro-affirming SPACE-TIME framework to invite community conversation. SPACE-TIME is more than an acronymn, it opens up conversation to also reflect how Autistic people move through the world and how important space and time is for us. It is flexible enough to benefit everyone and is very relevant for those with profound and multiple learning disabilities too. What benefits an Autistic person is generally good practice and will support everyone.

I have tried to bring various academic concepts and theories together and root them in the theory of monotropism. I hope it offers both a practical tool for people to build on and an invitation to re-imagine education, healthcare, and workplace cultures so that Autistic people are not only safe, but able to thrive.

Inspired by Autistic SPACE Framework

The Autistic SPACE framework (Doherty et al., 2023; McGoldrick et al., 2025) highlights five core areas of Autistic differences and things to consider to support people in a neuroaffirming way. They suggest that these are the foundations for inclusive environments:

Sensory,
Predictability,
Acceptance,
Communication,
Empathy

Autistic Sensory, Predictability, Acceptance, Communication and Empathy (SPACE) Framework (Doherty et al., 2023). Credit: Doherty M, McCowan S, Shaw SC. Autistic SPACE: a novel framework for meeting the needs of autistic people in healthcare settings. Br J Hosp Med (Lond). 2023 Apr 2;84(4):1-9. doi: 10.12968/hmed.2023.0006. Epub 2023 Apr 17. PMID: 37127416.

Inspired by 8 Dimensions of Care from An Experience Sensitive Approach to Care

The eight dimensions of care from An Experience Sensitive Approach to Care With and for Autistic Children and Young People in Clinical Services (McGreevy et al., 2024) brings further attention to lived experience, focusing on dignity, belonging, and whole-person care.

The 8 dimensions of care from Todres et al., (2009), as adapted and applied in Autistic contexts (e.g., McGreevy et al., 2024):

1. Embodiment ↔ Reductionist view of the body
   – Acknowledging the whole, lived body–mind experience vs. fragmenting or medicalising the bodymind.

2. Insiderness ↔ Objectification
– Valuing lived experience and inner perspective vs. reducing a person to data or labels.

3. Agency ↔ Passivity
– Supporting autonomy and choice vs. enforcing compliance.

4. Uniqueness ↔ Homogenisation
– Recognising individuality vs. treating people as stereotypes.

5. Togetherness ↔ Isolation
– Fostering connection and belonging vs. leaving people alone in their experience.

6. Sense-making ↔ Loss of meaning
– Supporting understanding and coherence vs. stripping away meaning.

7. Personal journey ↔ Loss of personal journey
– Honouring someone’s story and trajectory vs. overriding it with institutional priorities.

8. Sense of place ↔ Dislocation
– Enabling comfort, belonging, and orientation in the world vs. feeling disconnected.

The 8 dimensions of the experience sensitive approach to care, adapted from Galvin, K., & Todres, L. (2013). Caring and well-being: A lifeworld approach. Routledge. Credit: McGreevy, E., Quinn, A., Law, R., Botha, M., Evans, M., Rose, K., Moyse, R., Boyens, T., Matejko, M., & Pavlopoulou, G. (2024). An Experience Sensitive Approach to Care With and for Autistic Children and Young People in Clinical Services. Journal of Humanistic Psychology, 0(0). https://doi.org/10.1177/00221678241232442

SPACE-TIME

This acronym reflects Autistic experiences as unfolding in relation to attention, embodiment, and environment. It combines the Autistic SPACE domains with the 8 lived dimensions of affirming care to ensure that support is not only practical, but also strengths based, relational and rooted in the theory of monotropism. Bringing these approaches together, I hope that my suggestion of a SPACE-TIME framework offers a possible unified, neuroaffirming model for people to build on or discuss, it connects structural and systemic support with lived Autistic experience through the lens of monotropism. I am very open to community conversation to develop these ideas further.

Safe spaces that honour sensory needs, communication differences, and Autistic agency provide the foundation for belonging and togetherness. Alongside this, recognising different Autistic experiences of time deepens the commitment to everyone’s personal journey and meaning-making. Safe spaces, flexible time and supportive environments help meet Autistic people’s needs across the lifespan.

SPACE-TIME & Monotropism

SPACE-TIME Element	From (Doherty et al., 2023; McGoldrick et al., 2025)	From (McGreevy et al., 2024; Todres et al., 2009)	Monotropism & Autistic Flow Connection (Murray et al., 2005 & Heasman et al., 2024)
S Sensory attunement	Sensory	Embodiment, Insiderness	Monotropic focus impacts our sensory experiences; attunement validates embodied inner worlds and helps regulation and wellbeing.
P Predictability and place	Predictability	Sense of place, Personal journey	Predictability and flexible time reduces attentional fragmentation, allowing grounding, deep focus and continuity and flow in safe environments.
A Acceptance and agency	Acceptance	Agency, Uniqueness	Embracing monotropism enables agency; people can follow interests without constant redirection which causes dysregulation.
C Communication and connection	Communication	Togetherness, Sense-making	Monotropic attention shapes communication through detail, flow, and passion, creating authentic connections and different ways of communicating.
E Empathy	Empathy	Embodiment, Insiderness	Monotropic flow is expressed through our bodies and minds by stimming and engagement in interests; empathy requires honouring and helps build trust.
T Togetherness	(implicit in SPACE)	Togetherness, Sense of Place, Sense Making	Shared monotropic focus and joint flow (e.g., special interests) builds deep relational bonds and helps foster relationships and community.
I Insiderness & Personal Journey	(implicit in SPACE)	Insiderness, Embodiment, Uniqueness, Personal Journey	Monotropism centres our unique internal perspectives; validating our inner experiences and stories validates Autistic knowledge and ways of being.
M Meaning-Making & Sense of Place	(implicit in SPACE)	Sense Making, Sense of Place, Personal Journey	Monotropic attention drives coherence and narrative, making meaning and having a shared understanding with others is central to our wellbeing.
E Embodiment & Uniqueness	(implicit in SPACE)	Embodiment Insiderness Uniqueness	Flow and attention are lived through our bodyminds — being monotropic is an embodied way of being which impacts every aspect of life.

SPACE-TIME & Monotropism

Monotropism shapes Autistic experiences through deep,
embodied attention tunnels.

Being monotropic shapes how Autistic people sense, focus, and connect.

With Sensory attunement, Predictability, Acceptance, Communication, and Empathy, Autistic people find grounding and flow.

Through Togetherness, Insiderness, Meaning-Making, and Embodiment, we can thrive, belong, and share our unique ways of being.

SPACE–TIME helps us reimagine care and create environments where Autistic people can thrive.

My offering of the SPACE-TIME framework highlights how monotropism, safe environments, and an attunement to Autistic inner experience can bring systemic change into relation with the eight dimensions of care. When we recognise that attention flows differently for Autistic people, we open possibilities for creating environments where Autistic people not only feel safe but can truly belong and thrive.

I imagine SPACE-TIME to be more than a framework for inclusion; it is an invitation to reimagine and re-world care and support, centering Autistic ways of being as vital, valuable, and full of possibility.

References

Doherty M, McCowan S, Shaw SC. Autistic SPACE: a novel framework for meeting the needs of autistic people in healthcare settings. Br J Hosp Med (Lond). 2023 Apr 2;84(4):1-9. doi: 10.12968/hmed.2023.0006. Epub 2023 Apr 17. PMID: 37127416. https://pubmed.ncbi.nlm.nih.gov/37127416/

Heasman, B., Williams, G., Charura, D., Hamilton, L. G., Milton, D., & Murray, F. (2024). Towards autistic flow theory: A non-pathologising conceptual approach. Journal for the Theory of Social Behaviour. Advance online publication. https://onlinelibrary.wiley.com/doi/10.1111/jtsb.12427

McGoldrick, E., Munroe, A., Ferguson, R., Byrne, C., & Doherty, M. (2025). Autistic SPACE for Inclusive Education. Neurodiversity, 3. https://doi.org/10.1177/27546330251370655 (Original work published 2025)

McGreevy, E., Quinn, A., Law, R., Botha, M., Evans, M., Rose, K., Moyse, R., Boyens, T., Matejko, M., & Pavlopoulou, G. (2024). An Experience Sensitive Approach to Care With and for Autistic Children and Young People in Clinical Services. Journal of Humanistic Psychology, 0(0). https://doi.org/10.1177/00221678241232442

Murray, D., Lesser, M., & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism, 9(2), 139-156. https://doi.org/10.1177/1362361305051398 (Original work published 2005)

Todres, L., Galvin, K. T., & Holloway, I. (2009). The humanization of healthcare: A value framework for qualitative research. International Journal of Qualitative Studies on Health and Well-Being, 4(2), 68–77. https://doi.org/10.1080/17482620802646204